Depression Flashcards
1
Q
What is one of the oldest and most frequently diagnosed psychiatric illness is
A
Depression
2
Q
What is a healthy response to every day disappointments in life
A
The blues
3
Q
Pathological depression occurs when
A
Adaptation is ineffective
Symptoms impair functioning
4
Q
What is mood?
A
Persuasive in sustain emotion that may have a major influence on a persons perception of the world
5
Q
What are some examples of mood?
A
Depression, joy, anger, anxiety
6
Q
What is affect
A
Described as an external observable emotion reaction associated with an experience
7
Q
What is depression?
A
An alteration in the mood expressed by sadness despair and pessimism
There is a loss of interest in usual activities, and somatic symptoms may be evident
8
Q
What are some common changes when a person has depression?
A
Appetite, sleep patterns in cognitive
9
Q
What is a flat affect?
A
Someone who likes emotional expression often seen in severely depressed, patience
10
Q
What is one of the leading causes of disability in the United States?
A
Major depressive disorder
11
Q
Depressive disorder is twice as high in in women or men
A
Depressive disorder is twice as high in women
12
Q
What are some biological factors that can cause depression
A
Monoamine oxide
Thyroid dysfunction
Hormonal changes
13
Q
What are some psychosocial factors that can affect depression?
A
Stress sensitivity
Multiple social roles
Poor coping mechanisms
14
Q
What are some socioeconomic factors that can influence depression?
A
Social class
Poverty
Education level 
15
Q
What do clinicians tender under diagnose?
A
Mood disorders
16
Q
What do clinicians often over diagnose
A
Schizophrenia and clients, who have racial or cultural backgrounds different from their own
17
Q
Can marital status affect depression in a patient
A
It seem to have a positive affect on the well-being of an individual what is not a valid indicator for risk of depression
Lack of social connectedness, rather than marital status, may be associated with higher levels of depression
18
Q
Is depression and seasonal affective disorder, the same
A
They are separate conditions a load the DSM-V does not listed as a separate diagnostic
19
Q
What is severe depression marked by?
A
Distress that interferes with social, occupational cognitive and emotional functions
20
Q
What are the four spheres of human functioning?
A
Affective
Behavioral
Cognitive
Psychological
21
Q
Symptoms of depression can be described as alterations in
A
Four spheres of human functioning
Affective
Behavioral
Cognitive
Psychological
22
Q
When someone is depressed, what occurs in the affective sphere of human functioning?
A
Feeling of total despair, hopelessness in worthlessness, flat, unchanging affect, appearing devotion of emotional tone, prevalent feeling of nothingness and emptiness, apathy, loneliness, sadness, inability to feel pleasure
23
Q
When someone is depressed, what occurs in the behavioral sphere of human functioning?
A
Psycho motor retardation so severe that physical movement make completely stop or psycho motor behavior manifested by rapid, agitated, purposeless movements,
slumped pasture,
sitting up in a curled position walking slowly and rigidly,
virtually nonexistent communication verbalization do occur they may reflect delusional, thinking,
no personal hygiene and grooming, social isolation with virtually no inclination toward interaction with others
24
Q
When someone is depressed, what occurs in the cognitive sphere of human functioning?
A
Prevalent delusional, thinking, with delusions of persecution, in somatic delusions being most common
Confusion
Indecisiveness
Inability to concentrate
Hallucinate, reflecting, misinterpretations of the environment
Excessive self deprecation
Self blame
Thoughts of suicide
25
When someone is depressed, what occurs in the psychological sphere of human functioning?
General slow down of the entire body
Sluggish digestion
Constipation
Urinary retention
Amenorrhea
Diminished libido
Anorexia
We gain or weight loss associated with appetite changes
Changes in sleep pattern
Feeling worse in the morning, and so much better as the day progresses
26
What are symptoms at the transient depression?
Symptoms are not necessarily dysfunctional
Subsides quickly in the individuals able to refocus on their goals and achievements
27
What is an affective symptom of transient depression
The blues
28
What is an behavioral symptom of transient depression
Some crying
29
What is an cognitive symptom of transient depression
Some difficulty getting mine off of one’s disappointment
30
What is an physiological symptom of transient depression
Feeling tired and listless
31
What are symptoms at the mild depression?
Are identified by clinicians is those associated with normal uncomplicated grieving
32
What is an affective symptom of mild depression
Anger
Anxiety
33
What is an behavioral symptom of mild depression
Tearful
regression
34
What is an cognitive symptom of mild depression
Preoccupied with loss
35
What is an physiological symptom of mild depression
Anorexia
Insomnia
36
What are symptoms of moderate depression
Symptoms associated with a Dysthymic disorder
37
What is dysthymia
Also called persistent depressive disorder is an example of moderate depression and represents a more problematic disturbance which
Chronically depressed mood for most of the day more days than that not for at least two years
38
According to the DSM5 moderate depression is characterized by symptoms that
Are enduring for at least two years
39
What is an affective symptom of moderate depression
Hopeless
Powerless
40
What is an behavioral symptom of moderate depression
Slowed physical movements
Slumped pasture
Limited verbalization
41
What is an cognitive symptom of moderate depression
Retarded thinking processes
Difficulty with concentration
42
What is an physiological symptom of moderate depression
Anorexia or overeating
Sleep disturbances
Headaches
43
What are symptoms of severe depression
Symptoms of major depressive disorder, and bipolar depression
Characterized by intensification of symptoms, describe for moderate depression
44
What is an physiological symptom of severe depression
A general slow down of the entire body
45
What is an affective symptom of severe depression
Feeling of total despair worthlessness flat affect
46
What is an behavioral symptom of severe depression
Psycho motor retardation
Curled up position
, absence of communication
47
What is an cognitive l symptom of severe depression
Prevalent delusional, thinking, with delusions of persecution in somatic delusions
Confusion
Suicidal thoughts
48
What is major depressive disorder categorized by?
Depressed mood or loss of interest or pleasure and usual activities
49
What evidence will show someone has a major depressive disorder
Impaired social, and occupational functioning that is existed for at least two weeks
No history of manic behavior
Symptoms that cannot be attributed to the use of substances or general medical conditions
50
What is the diagnostic criteria for major depressive episodes?
The DSM five
51
What is PMDD
Premenstrual dysphoric disorder
52
What is premenstrual dysphoric disorder characterized by?
Markedly depressed mood, excessive anxiety mood swings, decrease interest in activities
During the week prior to menses
Improving shortly after the onset of menstruation
Becoming minimal or absent, the week post menses
53
What is the difference between PMDD and typical premenstrual mood changes in a matter of intensity and frequency of symptoms
PMDD symptoms interfere with the ability to function, socially at work or school
Recurrent for majority of menstrual cycles 
54
What is substance/medication induced depression
Consider the direct result of physiological effects of substances
55
Depressed mood in substance/ medication induced depressive disorder is associated
with intoxication or withdrawal or adverse effect from different meds
56
What are some examples of medical conditions that influence depression?
Stroke
Traumatic brain injury
Thyroid disorders
Huntington’s disease
Parkinson’s disease
MS
57
Is the cause for depression clear
No, it’s unclear and no single theory or hypothesis offers a clear cut explanation for the disease
58
What are predisposing factors to depression?
Genetics
Biochemical influences
Neuro endocrine disturbances
Physiological influences
59
Family studies have shown that major depression is what
More common among first-degree, biological relatives with the disorder
60
Depressive illness is may be related to a deficiency of what
Neuro transmitters no Eppinette friend, serotonin and dopamine
Acetylcholine
61
What has a profound effect on mood and an imbalance between excessive this might be a factor to depression
Cholinergic transmission 
62
Inpatient or depressed the normal system of hormonal, intubation fails resulting in
Hypersecretion of cortisol
63
Individuals with hypothyroidism manifest
Signs of depression
64
What is done to determine the difference between depressive and thyroid disorders
Lab results since depression symptoms due to thyroid disorders are treated with hormones rather than anti-depressants
65
What are the most common drugs that have a direct effect on the central nervous system producing depressive syndrome
Anxiolytics
Antipsychotics
Sedative hypnotics (barbiturates, and opioid:)
Anticonvulsant mood stabilizers
66
Childhood depression, symptoms less than age 3
Feeding problems, tantrum’s, lack of playfulness and emotional expressiveness
Failure to thrive delays in speech and gross motor development
67
Childhood depression, symptoms in children, ages 3 to 5
Accident phroness
phobias
aggressiveness
excessive self reproach for minor in fractions.
68
Childhood depression, symptoms in children, ages 6 to 8
Vague, physical complaints and aggressive behavior. They may cling to parents in avoid new people in challenges. They may leg behind their classmates in social skills in academic competence.
69
Childhood depression, symptoms in ages, 9 to 12
Morbid thoughts and excessive worrying
They may reason that they are depressed because they have disappointment their parents in someway
Lack of interest in playing with friends
70
Other symptoms of childhood depression
Hyper activity
Delinquency
School problems
Psycho, somatic complaints
Sleeping and eating disturbances
Social, isolation
Delusional thinking
Suicidal thoughts or actions
71
What is the focus of therapy with a depressed child
To alleviate the child symptoms and strengthen the child’s coping an adaptive skills
With the help of possibly preventing future psychological problems
72
Youth with depression are often what
More irritable, rather than dysphoric, and consequently, less likely to identify themselves as depressed
73
Childhood depression can be precipitated by
Precipitated by a loss
Divorce
Parent dying
Pet dying
Grandparent dying
74
Common symptoms of depression in an adolescent
Inappropriate expressed anger
Aggressiveness
Running away
Delinquency
Social withdrawal
Sexually acting out
Substance abuse
Restlessness and apathy
Loss of self-esteem
Sleeping and eating disturbances
75
What is the best clue that differentiates depression from normal stormy adolescence behavior?
A visible manifestation of behavioral change that last for several weeks
Ex. Normally, outgoing and extroverted who has become withdrawn and isolating.
Ex. Normally gets consistently high marks, but there’s no feeling in skipping classes.
76
What is the most common precipitant of adolescent suicide?
Perception of abandonment by parents, or close peer relationship
77
What is treatment of a depressed adolescent often include
Support of psychosocial intervention
Antidepressant medication -fluoxetine
78
All anti-depressants carry what
A food and drug administration, black box, warning, for increase risk of suicidal and children and adolescents
79
What percentage of women feel the blues after delivery
Of women who give birth approximately 50 to 85% experienced the blues falling delivery
80
What are symptoms of Moderat postpartum depression been described as
Depressed mood, varying from day today with some more bad days thing good tending to worsen toward the evening in associate with fatigue, irritability, loss of appetite, sleep disturbances, loss of libido
81
How long will postpartum depression last
May last for a few weeks to several months
82
What is postpartum depression associated with?
Hormonal changes or sale alterations
83
An individual experience the death of a parent two years ago. This individual has not been able to work since the death cannot look at any of their parents, belonging and cries daily for hours at a time which nursing diagnosis most accurately describes the individuals problem.
Post traumatic syndrome related to parents death
Anxiety, severe related to parents death
Coping ineffective related to parents death
Grieving complicated related to parents death
Grieving complicated, relieved to parents death
84
What does interpersonal psychotherapy focus on?
The patient’s current interpersonal relationships
Is designed to encourage the patient to continue working in participating in regular activities, helping the patient resolve, complicated grief reactions and help the patient recover enhance social functioning
85
What is Group Therapy?
Forms an important dimension of multi module treatment for a depressed patient
Peer support provide the feeling of security is troublesome or embarrassing issues are disgusting, resolved,
Gain a sons of perspective on their condition, encourage them to link up with others, who have common problems, 
86
What is family and how does it work with family in patients with mood disorders?
Resolves the symptoms initiate or restores adoptive family functioning
87
What is cognitive therapy?
The individual is talk to control, thought distortions that are considered to be factors in the development and maintenance of mood disorders
88
What is the general goal and cognitive therapy?
Obtain symptom relief as quickly as possible to assist a patient in identifying dysfunctional patterns of thinking you’re behaving. Indigo the patient to evidence in logic that effectively test validity of the dysfunctional thinking.
89
What types of groups are included in group therapy?
Therapy, education, and self-help
90
When is family therapy most effective
When used in combination with psychotherapeutic in pharmacotherapeutic treatments
91
What does cognitive therapy focus on?
Changing, automatic thoughts that contribute to distorted affect
92
What is ECT?
Electro convulsive therapy
Electrical currents are apply to the brain causing a grand mal generalized seizure
93
How is ECT effective?
With patients who are acutely, suicidal, and in the treatment of severe depression
94
When should ECT be considered?
Only after a trial of therapy with antidepressant medication has proved ineffective
95
What is rTMS
Repetitive transcranial, magnetic stimulation
Uses short, pulses of magnetic energy to stimulate nerve cells in the brain
96
How are ECT in TMS different?
TMS does not result in a generalized seizure activity. It is non-invasive and consider generally safe
97
What is VNS and DBS
Vagal nerve stimulation in deep brain stimulation
Involves implanting an electronic device into the skin to stimulate the vagus nerve
98
How is VNS different from DBS
Devious is a deep implant that requires a craniotomy
Currently, DVS is reserved for patient with severe incapacitating depression, or OCD
99
What is light therapy?
Exposure to light
100
How does light therapy work
Fluorescent light tubes covered with plastic screen that blocks UV rays mechanism of action is believed to relate, did retinal simulation that triggers, a reduction of melatonin and increases serotonin in the brain
101
What is generally considered first line treatment for severe clinical depression
Anti-depressants
102
Can antidepressants be lethal
Yes, in overdose, so depressed, suicidal patient may be observed closely and suicide risk assessed frequently
103
What are some common antidepressants?
Tricyclic
SSRIs
SNRI
MAOI
104
What is the most commonly prescribed antidepressant?
SSRIs
105
Why are SSRIs the most commonly prescribed antidepressant?
They have fewer side effects when compared to other anti-depressants
106
What is the most common SSRI?
Fluoxetine
Others include Sertraline, paroxetine, escitalopram, andcitalopram
107
What are commonly used SNRI
Duloxetine
Venlafaxine
108
Why are tricyclic antidepressants no longer recommended
They are second generation, and I depressants they can be more dangerous in an overdose and cause more undesirable side effects
109
What are some common tricyclic antidepressant?
Nortiptyline
Amitriptyline
110
Why are the use of MAOI no longer recommended
They can cause potentially severe side effects
Everything interacts with them
111
What are some common MAOI prescribe for depression?
Phenelzine
Tranylcypromine
IsocarboXazid
112
When teaching about the tricyclic group of anti-depressant medication’s which information should the nurse include
Strong or aged cheese, should not be eaten while taking this group of medication
The full therapeutic potential of tricyclics may not be reached for four weeks
Long-term use may result in physical dependence
Tricyclic should not be given with antianxiety agent
The full therapeutic potential of tricyclics may not be reached for four weeks
113
A patient has been diagnosed with major depression, the psychiatrist prescribe paroxetine, which of the following medication information should the nurse include in discharge teaching
Do not eat chocolate while taking this medication
The medication may cause priapism
The medication should not be discontinued abruptly
The medication can cause photosensitivity
The medication should not be discontinued abruptly they should be tapered
114
What happens if you have an abrupt withdraw from an SSRI
Such as paroxetine
Dizziness, lethargic headache, nausea
115
Why should a patient continue to take medication, even if the symptoms have not subsided
Therapeutic affect may not be seen for as long is four weeks
116
What should a patient you use caution and if they taking an antidepressant
Driving or operating dangerous machinery
Rice slowly from sitting or lying position
117
What does a patient taking antidepressants need to maintain
Good oral care by brushing teeth frequently
Take frequent sips of water
To sugarless gum
Suck on hard candy if dry mouth is problem
118
Why should you not discontinue a drug abruptly?
May produce withdrawal symptoms, such as nausea, vertigo, insomnia, headache, malaise, nightmares, return of symptoms
119
Which of the following symptoms should you report immediately to a physician after taking an antidepressant?
Sore throat, fever, malaise, yellowish skin, unusual, bleeding, easy, bruising, persistent, nausea, vomiting, severe headache, rapid, heart rate, difficulty urinating, anorexia, weight loss, seizure activity, stiff neck, sore neck, and chest pain
120
What are some side effects of SSRIS + SNRIS
Insomnia
Erectile dysfunction
Lots of libido
Stomach aches, or feeling sick
Constipation or diarrhea
Loss of appetite
Headaches and dizziness
121
What are some side effects of a tricyclic
Blurred vision
Dried mouth
Difficulty passing urine
Night sweats
Drowsiness, dizziness, constipation,
Heart problems, 
122
What are some potential health risks of taking an antidepressant?
Serotonin syndrome
Type two diabetes
Hyponatremia C
123
What food should you avoid when taking an MAO I
Foods high in tyramine
Aged cheese
Wine, beer
Chocolate colas
Smoked and processed meat
Sour cream and yogurt
Beef
East products
124
Why should you avoid drinking alcohol while taking antidepressants?
These drugs affect each other
125
What happens when an SSRI or SNRI is combined with another medicine that increases serotonin
Leads to high serotonin levels in the brain which causes serotonin syndrome
126
What are patients who take SSRIs and tricyclics more prolonged periods at higher risk for
Developing type two diabetes
127
Old patient to take SSRIs may experience what
Severe drop in sodium levels
128
What is the highest potential health risk when taking an antidepressant?
Desire to self harm or commit suicide
129
What are severe symptoms of serotonin syndrome?
Arrhythmia fits in unconsciousness
130
Why do patients often stop taking medication?
Because of side effects particularly sexual dysfunction or dry mouth
131
What are the criteria used for measurement of outcomes in the care of a depressed patients
Has experience no physical harm to self
Discuss his feelings with Steff and family members
Expresses hopefulness
Set a realistic goals for self
Attempts new activities
Identify self control over life situation
132
What are some short term goals for risk of suicide?
Patient will seek out, saffron, feeling urge to harm self
Patient will not harm themselves
133
What are some long-term goal interventions with suicide risk prevention
Patient will not hold them selves
134
What are some interventions for suicide prevention?
Create safe environment, move all potentially harmful objects
Assessed frequently for presence of lethal risk of suicidal ideations
make rounds at irregular intervals
Have concrete plan for seeking assistance to prevent self-destructive behavior
Spend time with patient
135
What is the most important suicide prevention intervention?
Spend time with patient to provide a feeling of safety and security will conveying the message. I want to spend time with you because you are a worthwhile person.
136
What is self care deficit?
Impaired ability to perform her complete activities of daily living for self
137
What are some interventions for self-care deficit
Where things like it’s time to eat lunch rather than would you like to eat lunch
Severe depressed patients may have difficult time making decisions
138
What is powerlessness?
Defined as the lived experience of lack of control over situation, including a perception that one’s actions do not significantly affect an outcome
139
The client age 68 is a widow of six months over the last month. She has become socially withdrawn with loss of weight and told her sister today that she doesn’t have anything more to live for. She’s been hospitalized with major depressive disorder priority nursing diagnosis for this client would be.
Imbalanced nutrition, less than body requirements
Complicated grieving
Risk for suicide
Social, isolation
Risk for suicide
140
The goal of cognitive behavior therapy with the press clients is two
Identifying change, dysfunctional patterns of thinking
Resolve the symptoms in initiate or restore, adaptive family functioning
Alter, the Neuro transmitters that are creating the depressed mood
Provide feedback from peers who are having similar experiences
Identify and change dysfunctional patterns of thinking
141
The client expresses interest in alternative treatments for depression with seasonal variations and asks the nurse about like therapy which of the following are evidence-based teaching points of the nurse may share with a client select all
Right there if he has demonstrated effectiveness that is comparable to anti-depressant
Play therapy should be used regularly until the season changes
Play therapy should be used only when electroconvulsive therapy has proven to be in effective
Side effect, such as headache, nausea or agitation, when they occur, are usually mild and transient
Light therapy uses sedation so the best time to use it before bedtime
Light therapy has demonstrated effectiveness that is comparable to anti-depressants
light therapy should be used regularly until the season changes
side effect, such as headache, nausea or agitation when they occur are usually mild and transient
142
A client has been admitted to the psychiatric unit with a diagnosis of major depressive disorder, which of the following behavioral manifestations, make the nurse expect, assess select
Slumped posture
Hallucinations
Feeling of despair
Appears to have boundless energy
Anorexia
Slumped posture
Feeling of despair
Anorexia
143
A client with depression asks the nurse why would they be checking my thyroid function when I clearly have depression and I’m not overweight which of these is an accurate response
An underactive thyroid gland can manifest as depression
Depression has been proven to be a hormonal illness
Thyroid hormone replacement is a first line treatment for most clients with depression
All of the above
An under active thyroid gland can manifest as depression
144
Anna cutely depressed client isolates herself in a room and just sits and stares into space which of these is the best example of an active communication approach with the client
Do you like exercise?
Come with me I will go with you to group therapy
Would you like to go to group therapy stay in bed or come out to the day lounge for some activities
Why do you stay in your room all the time
Come with me I will go with you to group therapy
145
A client who has been taking sertraline (Zoloft) 50 mg PO be ID for depression tells the nurse I’ve been on this medication for almost a week and I don’t feel better. What is the most appropriate response by the nurse
Cheer up you have so much to be happy about
Sometimes it takes a few weeks for the medicine to bring about improvement in symptoms
I’ll report that to the physician maybe he will order something different
Try not to dwell on your symptoms. Why don’t you join the others down in the day room?
Sometimes it takes a few weeks for the medicine to bring about an improvement in the symptoms
146
A client reports to the mental health clinic with complaints of feeling more depressed over the last few weeks. The patient score on the Hamilton depression. Rating scale is the 41 priority, nursing action at the finding.
Assess the clients history of treatment for depression
Encourage the client to keep weekly follow up appointment at the clinic
Educate the client about treatment options for mild, moderate and severe depression
Assess the clients current risk for suicide
Assess the clients current risk for suicide
147
Client whose husband died six months ago I was given a diagnosis of major depressive disorder. She says to the nurse I start to feel angry that Harold died and left me all alone. He should’ve stopped smoking years ago, but then I start to feel guilty for feeling that way what is the most appropriate response by the nurse
Yes, he should have stopped smoking then he probably wouldn’t have gotten lung cancer
I can understand how much you must feel
Those feelings are normal part of the grieving response
Just think about the good times you had while he was alive
Those feelings are normal part of the grieving process
148
A client is admitted to the hospital with major depressive disorder and repeatedly makes negative statements about herself, which of the following interventions are identified as those that will promote positive self-esteem to the client select
Teach assertive communication skills
Make a observations to the client when she completes a girl or a task
Instruct the client that you will not talk with her, unless she stops talking negatively about herself
Offered to spend time with a client using nonjudgmental excepting approach
Teach assertive communication skills
Make observations to the client when she completed goal or task
Offered to spend time with a client using nonjudgmental accepting approach
149
A client reports to the nurse that she has been on her antidepressant medication fluoxetine for almost 2 weeks, and does not feel much better which of these actions by the nurse demonstrates the best clinical judgment
Educate the client that this medication may not be fully effective for up to four weeks
Hold the next dose in contact the position to recommend an alternative anti-depressant
Check the clients, vital signs and check the labs are therapeutic blood levels
Assess whether the client is aware of mood, swings, or history of bipolar disorder, and her family
Educate the client of the medication may not be fully effective for up to four weeks
150
The client who is recently prescribed an MAOI tells the nurse that he drinks 3 to 4 cups of coffee with each meal which of these actions by the nurse demonstrates the best clinical judgment
Instruct the client that he only needs to avoid foods high in tyramine coffee consumption is not an issue with this medication
Inform the client that food or beverages, with high caffeine content, increase the risk for serious hypertension in arrhythmias
Inform the client that caffeine interferes with the effectiveness of this medication
Instruct the client that red ones are better beverage choice, because they do not contain tyramine
 Inform the client that foods or beverages, with high caffeine content, increase the risk for serious, hypertension and arrhythmias
151
A young adult has been prescribed with an SSRI antidepressant from what she has been taking for one week. She reports that she feels like she’s getting worse and feels like nothing is going to help which of these actions by the nurse is a priority.
Educate the client that SSRIs have a leg. Before fully therapeutic affective Ness as a parent.
Ask the client to describe why she think she is depressed
Contact the physician to recommend a different medication
Conduct a suicide risk assessment
Conduct a suicide risk assessment
152
A licensed practical nurse who is administering medication reports to the RN in charge that he forgot to get the last scheduled dose of bupropion into a client. He asks CRN if he should give the client two doses in the next schedule time which of these responses, for the nurse demonstrates the best clinical judgment.
Yes, that would be fine. Just make sure the client stays in bed since he is sedating medication.
No doses of this medication should not be doubled since that poses at increased risk for seizures
Yes, as long as the client has not changed his sodium intake recently
No doses should not be doubled because there’s an increase with a tolerance in addiction
No doses of this medication should not be doubled since that poses an increased risk for seizures
