Depression Flashcards
1
Q
Assessment
A
- Affect
- Thought Process
- Mood / Feelings
- Physical Behaviour
- Communication
- Religious beliefs and spirituality
2
Q
Nursing Diagnosis
A
- Risk for suicide - safety is always the highest priority
- Hopelessness
- Disturbed thought process
- Chronic low self-esteem
- Ineffective coping
- Social isolation
- Spiritual distress
- Self-care deficit
- Imbalanced nutrition: less than body requirements
- Disturbed sleep pattern
3
Q
Nursing Interventions: Suicide precautions
A
- Close observation, may require a sitter
- Check q15-30 minutes as per protocol
- Place patient near the nurses’ station or in a room with another patient
- Search patient’s belongings (with patient present) and remove harmful objects i.e. razors, metal nail files, glass, cords, belts, matches, etc.
- Ensure visitors do not bring or leave harmful objects
- Provide plastic utensils for eating
- Obtain a “no self-harm” contract from the patient
4
Q
Nursing Interventions: Communication
A
- Short visits (10-15 minutes) at a time throughout the shift
- Always introduce yourself first and explain your role
- Ask how the patient would like to be addressed
- Ask the patient what their plan is for the day
- Spend time listening, listen for covert messages
- Use simple concrete words
- Allow patient time to respond
- Assist the patient in evaluating a positive aspect of his/her life and encourage expression of feelings
- If patient doesn’t acknowledge your presence or doesn’t speak, sitting in silence can communicate caring
5
Q
Nursing Interventions: Anorexia
A
- Offer small high-caloric, high protein snacks throughout the day & evening - easier to tolerate than a large plate of food when patient is anorexic
- Encourage family/friend to remain with patient during meal
- Offer choices
- Observe eating patterns
- Weigh weekly
6
Q
Nursing Interventions: Sleep
A
- Provide rest periods - fatigue can intensify feelings of depression
- Encourage patient to get up, dressed and stay out of bed during the day - increases likelihood of sleep at night
- Encourage relaxation measures i.e. soft lights, soft music
- Reduce stimulation i.e. provide decaffeinated drinks
7
Q
Nursing Interventions: Self care deficits
A
- Encourage the use of toothbrush, washcloth, soap, make-up, shaving equipment, etc.
- When appropriate, give step by step instructions/reminders i.e. “Wash the right side of your face, now the left”
8
Q
Nursing Interventions: constipation
A
- Monitor intake and output
- Monitor bowel movements
- Encourage increase in fluid and fibre
- Provide periods of exercise
- Evaluate need for laxatives and enemas
9
Q
Health Promotion
A
- The elephant in the room
- An obvious truth that is being ignored or goes unaddressed
- Once people understand that depression has a physical cause and is out of one’s control then stigmatizing behaviours may decrease and seeking help is more accepted.
- Encourage activities that raise self-esteem
- Identify need for problem solving skills, coping skills, assertiveness skills
- Discuss the role of medication and possible adverse effects
- Important to increase family’s understanding of the illness (biological, psychological, and cognitive changes) - include clarification of interpersonal stresses and discussion of measures to reduce tension for the family system
- Encourage support groups & peer support
- Provide information on resources in the community
10
Q
Outcomes
A
- Patient able to state alternative to suicidal impulse by expressing that he would inform his nurse should he have such an impulse.
- Patient verbalized positive concept of self by reviewing his personal strengths and accomplishments.
- Patient showed interest in socializing with others and participated in a group activity for one hour.
- Patient’s appetite returning ate full breakfast i.e. cereal, two toasts and one cup of milk.
- Patient took a shower and got dressed with minimal prompting.
