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NU 350 Therap Interv: Care Ind Fam (Exam 1) > Depression > Flashcards

Depression Flashcards

1
Q

What is dysthymic disorder?

A

Occurs when feelings of depression persist consistently for at least two years. Children, adolescents, and adults may have this problem. Usually not severe enough to require hospitalization.

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2
Q

What is premenstrual dysphoric disorder?

A

Refers to a cluster of symptoms that occur in the last week prior to the onset of a woman’s period.

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3
Q

What is substance-induced depressive disorder?

A

Applies when symptoms of a major depressive episode arise as a result of prolonged drug or alcohol intoxication or as the result of withdrawal from drugs and alcohol.

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4
Q

What is Depressive disorder associated with another medical condition?

A

Can be the result of changes that are directly related to certain illness such as kidney failure, Parkinson’s disease, and Alzheimer’s disease however, the symptoms that result from medical diagnosis or that result from the use of certain medications are not considered major depressive disorder.

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5
Q

What is subsyndromal depression?

A

Results in mainly elderly. In which they experience many, but not all, of the symptoms of a major depressive episode; these individuals have an increased resin of developing major depression.

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6
Q

What is one of the most common combined psychiatric presentations?

A

The combination of anxiety and depression.

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7
Q

What are some biological factors that cause depression?

A 
Family Hx
Genes
Biochemical: Stressful event
Neurotransmitters 
Alterations in hormonal regulation
Inflammatory process
Diathesis-stress model
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8
Q

What neurotransmitters play a role in stress regulation?

A

Norepinephrine
Serotonin
Acetylcholine

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9
Q

What is stress associated with?

A

Stress is associated with a reduction in neurogenesis, which is the ability of the brain to produce new brain cells.

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10
Q

What is the diathesis-stress model?

A

Takes into account the interplay between genetic and biological predisposition toward depression and life events. The physiological vulnerabilities such as genetic predisposition, biochemical makeup, and personality structure are referred to as a diathesis.

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11
Q

What are the two Psychological factors of depression?

A

Cognitive theory

Learned helplessness

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12
Q

What is cognitive theory?

A

The underlying assumption is that a person’s thoughts will result in emotions. If a person looks at life in a positive way, the person will experience positive emotions, but negative interpretation can result in sorrow, anger, and hopelessness.

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13
Q

What is Beck’s cognitive triad?

A

1) A negative, self-deprecating view of self
2) A pessimistic view of the world
3) The belief that negative reinforcement (or no validation for the self) will continue in the future

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14
Q

What is learned helplessness?

A

Although anxiety is the initial response to a stressful situation, it is replaced by depression if the person feels no control over the outcome of a situation. A person who believes that an undesired event is his or her fault and that nothing can be done to change it is prone to depression.

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15
Q

What is the benefit of using assessment tools?

A

use of these tools during multiple encounters with a pt also allows the nurse to follow changes in the pt’s symptoms and depression severity over time.

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16
Q

What are some assessment tools for depression?

A

1) Beck Depression Inventory
2) Hamilton Depression
3) Zung Depression
4) Geriatric Depression
5) Patient Health Questionnaire -9 (PHQ-9)

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17
Q

What is anergia?

A

Lack of energy or physical passivity

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18
Q

What is psychomotor agitation?

A

Client constantly pace, bite their nails, smoke, tap their fingers, or engage in some other tension-relieving activity, may also be observed.

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19
Q

What is psychomotor retardation?

A

May range from slowed and difficult movements to complete inactivity and incontinence.

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20
Q

What are some somatic complaints?

A

Headaches, malaise, backaches

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21
Q

What are the vegetative signs of depression?

A

Change in bowel movements
Eating habits
sleep disturbances
disinterest in sex (loss of libido)

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22
Q

In primary care, people with major depression experience ….

A

Chronic pain and disabling pain

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23
Q

What is affect?

A

Is the outward representation of a person’s internal state of being and is an objective finding based on the nurse’s assessment.

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24
Q

What is an illustration of an individual with negative affect?

A

The patient may not make eye contact, may speak in a monotone, may show little or no facial expression (flat affect), and may make only yes or no responses. Frequent sighing is common.

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25
Q

What are some areas to assess for depression?

A 
Affect
Thought processes
Mood
Feelings
Physical behavior
Communication
Religious beliefs and spirituality
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26
Q

What is an example of altered thought process?

A

The individual may claim that the mind is slowing down. Not thinking clearly. Thinking negatively. Memory and concentration are poor. Evidence of delusional thinking may also be seen in person with major depression.

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27
Q

What is an example of delusional thinking?

A

“I’m responsible for Elvis Presley’s death because I work in a pill factory. I deserve to die.”

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28
Q

What is an example of depressed mood?

A 
Reports of anxiety
worthlessness 
guilt 
helplessness
hopelessness 
anger
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29
Q

What are the 5 main feelings of depression?

A 
Guilt
Helplessness
Hopelessness
Anger
Irritability
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30
Q

Guilt

A

A person may ruminate over present or past failings

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31
Q

Helplessness

A

Demonstrated by a person’s inability to solve problems in response to common concerns. ever situations: grooming, dong housework, caring for children)

32
Q

Hopelessness

A

1) negative expectations for the future
2) Loss of control over future outcomes
3) Passive acceptance of the futility of planning to achieve goals
4) Emotional negativism, as expressed in despair, despondency, or depression

33
Q

Change in sleep patterns…

A

is a cardinal sign of depression. Often people experience insomnia. For some hypersomina

34
Q

Assessment in children and adolescents.

A

Young children: Cry
School age: might withdrawal
teenager: may become irritable in repose to feeling sad or hopeless.
In general: increased irritability, negativity, isolation, and withdrawal alone with a loss of energy.

35
Q

What is self assessment?

A

1) Recognizing any unrealistic expectations for yourself or pt
2) Identifying feelings that they pt may be experiencing
3) Understanding the roles biology and genetics play in the perception and maintenance of a depressed mood.

36
Q

Which question would be a priority when assessing for symptoms of major depression?

A

“You look really sad. Have you ever thought of harming yourself?”

37
Q

What are some nursing diagnosis?

A 
Risk for suicide—safety is always the highest priority
Hopelessness
Ineffective coping
Social isolation
Spiritual distress
Self-care deficit
38
Q

What are the 3 criteria of the recovery model?

A

Focus on patient’s strengths
Treatment goals mutually developed
Based on patient’s personal needs and values

39
Q

What is planning geared towards?

A

Patient’s phase of depression
Particular symptoms
Patient’s personal goals

40
Q

What are the 3 phases of implementation?

A 
Acute phase (6 to 12 weeks)
Continuation phase (4 to 9 months)
Maintenance phase (1 year or more)
41
Q

What is acute phase?

A

(6 to 12 weeks)

Directed at reduction of depressive symptoms and restoration of psychosocial and work function

42
Q

What is Continuation phase?

A

(4 to 9 months)

is directed at prevention of relapse through pharmacotherapy, education, and depression-specific psychotherapy.

43
Q

What is Maintenance phase?

A

(1 year or more)
Treatment is directed at prevention of further episodes of depression. Depending on the risk factors for relapse, medication may be phased out or continued.

44
Q

What type of communication should a nurse avoid?

A

Platitudes: “Things will look up”

45
Q

What is anhedonia?

A

Loss of ability to experience joy or pleasure in living.

46
Q

What is the main drawback to antidepressant drugs?

A

Improvement in mood may take 1 to 3 weeks or longer.

47
Q

What are some main consideration when choosing antidepressants?

A 
Symptom profile of the pt
Side-effect profile (Sexual dysfunction, weight gain)
Ease of administration 
Hx of past response
Safety and medical considerations
48
Q

What is marasmus?

A

severe undernourishment causing an infant’s or child’s weight to be significantly low for their age

49
Q

What are the 4 types of medications used for depression?

A

1) SSRI’s
2) TCA’s
3) MAOI’s
4) Saint John’s Wort

50
Q

Name 3 SSRI medications

A

1) Prozac
2) Lexapro
3) Zoloft

51
Q

What do SSRI’s do?

A

Work on serotonins.

52
Q

What are the major SE of SSRI?

A
  • Sexual,
  • GI (nausea & vomiting)
  • Sleep (insomnia)
53
Q

What are the therapeutic ranges of SSRI’s?

A
  • Non
  • 1st line because they are safest
  • Give these to suicidal pts (safest)
54
Q

What are the two main TCA drugs?

A

1) Elavil (which can be used for Migraines)

2) Tofrainil

55
Q

What are the main SE of TCA’s?

A
  • Anticholinergic
  • Cardiac (hypo, arrhythmias, etc)
  • Sedation
  • Sexual dysfunctions
56
Q

What do TCA’s do?

A

Work on serotonin and neurofornphron

57
Q

What are two main MAOI’s?

A

1) Nardil

2) Adinate

58
Q

What are the major signs and symptoms of MARI’s

A
  • Hypotension

* Red flag: foods low in tyromine (cause hypersensitive crises)

59
Q

What is some important info regarding Saint Johns Wort?

A 
o	Not FDA approved. 
o	Can interact with a lot of things 
o	Has MARI’s properties 
•	Tyamine foods 
o	Mild to moderate depression
60
Q

What is serotonin Syndrome?

A

This syndrome is thought to be related to over-activation of the central serotonin receptors.

61
Q

What are SE of serotonin syndrome?

A 
abdominal pain
diarrhea
sweating
fever
tachycardia 
elevated blood pressure
altered mental state
myoclonus
increased motor activity 
irritability
hostility 
mood change
62
Q

electroconvulsive therapy (ETC) indications from the book?

A

When a pt is suicidal or homicidal and there is a need for a rapid, definitive response.
Previous medication trials have failed
When there is marked agitation, marked vegetative symptoms, or catatonia
For major depression with psychotic feature or for pervasive hallucinations

63
Q

ETC indications from lecture?

A
  • Have agitated depression
  • Pregnant
  • Manic phase
  • Respond well to past
  • Very suicidal
  • Severe vegetated signs
64
Q

What is a rapid cycler?

A

Is a person with bipolar disorder who has many episodes of mood swings close together (four or more in 1 year)

65
Q

What is the duration of ETC treatment?

A

The usual corse of ECT for a pt with depression is two or three treatments per week to a total of 6 to 12 treatments.

66
Q

ETC requirements?

A
  • Need permission
  • EKG
  • EEG monitors brain waves
  • Spinal X-Ray
  • 2 meds
  • anesthetics
  • Muscle paralyzer
67
Q

What are the two meds given before ETC?

A

Anesthetic to induce sleep

Muscle-paralyzing agent to prevent muscle distress and fractures.

68
Q

What are some adverse effects of ETC?

A

Confusion
Disoriented
Long-term memory problems

69
Q

What is light therapy used for?

A

o S.A.D Sessional affective disorder

70
Q

What causes S.A.D?

A

o Due to lack of exposure to light

• Melatonin is stimulate in light

71
Q

During assessment for suicide a nurse should obtain what 4 answers from the pt?

A

thoughts
plan
how available
lethality

72
Q

what is Milieu therapy?

A

Utilize environment for therapeutic treatment.

73
Q

Nurse should always rule out what before diagnosis pt with depression?

A

Physiological cause such as hypothyroidism.

74
Q

What is Rumination?

A

Thinking deeply about something. SE of depression/suicide

75
Q

What would you want to explore with hopelessness?

A

Want to know what has prevented them from committing suicide

76
Q

What is a requirement for diagnosis?

A

Needs to have 3 major symptoms over a period of 2 weeks

77
Q

What type of communication is crucial for depressed clients?

A

Making observations

NU 350 Therap Interv: Care Ind Fam (Exam 1) (8 decks)

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