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Final - Mgmt - Neuro/Psych > Depression > Flashcards

Depression Flashcards

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1
Q

what is major depression

A

symptoms that last longer than 2 weeks w/a chg. in fxn

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2
Q

how do we classify major depression (MDD)

A

anhedonia and a depressed mood

5 of 9 symptoms

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3
Q

mood symptoms of MDD

A

guilt, worthlessness, helplessness

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4
Q

cognitive symptoms of MDD

A

can’t make decisions, diminished problem solving

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5
Q

physical symptoms of MDD

A

vegetative (not sleeping/eating enough, eating too much decreased libido)

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6
Q

decreased levels of NE are responsible for

A

anergia and anhedonia

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7
Q

decreased levels of serotonin are responsible for

A

changes in mood

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8
Q

2 neurotransmitters involved in MDD

A

decreased serotonin and norepinephrine

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9
Q

**key priority for assessing someone with depression

A

identify suicide risk - anyone w/MDD is risk for suicide

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10
Q

how do you determine risk for suicide on an assessment

A

ask directly - do you have thoughts of suicide

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11
Q

if pt. states they are having thoughts of suicide what is the follow-up question

A

have you thought about how you would do that

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12
Q

2 most lethal ways of suicide

A

gun and hanging

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13
Q

common screening tools to assess depression

A

PHQ9, Beck inventory, and Hamilton screening tool

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14
Q

assessment guidelines for depression

A 
are they suicidal
do they have s/s (can vary from norm)
is there a hx of depression
determine presence of medical conditions (increase risk for depression)
co-morbidities (substance use, anxiety)
is there a triggering event (grief)
determine cultural/spiritual beliefs
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15
Q

pneumonic for assessing depression

A

SIGECAPS

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16
Q

***what does SIGECAPS represent

A 
sleep (increase/decrease)
interest (diminished)
guilt
energy (low)
concentration (poor)
appetite (increase/decrease)
psychomotor (agitation/retardation)
suicidal ideation
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17
Q

communication guidelines for depression

A

establish rapport
establish clear times for interaction-set limits-follow through
pt. may need more time to reply - SILENCE IS OKAY
do not be EXCESSIVELY happy and cheery
observe environment (is pt. groomed? encourage a shower - don’t ignore)
never provide trite reassurance’s (this will pass)

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18
Q

red flag for suicide

A

give away possessions

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19
Q

what is the model of care when incorporating client specific goals

A

recovery - we want to empower people to lead best possible life

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20
Q

why not give a TCA to someone who is suicidal

A

due to cardio-toxicity

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21
Q

what can happen if someone suddenly stops taking their SSRI abruptly

A

withdrawal - become very sick - teach s/s

22
Q

what is the intervention for safety

A

observation level

23
Q

is someone is actively suicidal what observation level will they be on

A

level 1 - 1:1 within arms length (accompany to shower, bathroom)

24
Q

what do we want to teach families about depression

A

s/s
trt. options
medications (alternative therapies)

25
Q

what do we want to focus on for discharge planning

A

relapse prevention - identify signs of relapse

26
Q

an important aspect of intervention for depression

A

structure - attend groups (milieu therapy)

27
Q

by engaging in the environment (milieu) they engage in

A

recovery

28
Q

those with social supports are less likely to relapse, t or f

A

true

29
Q

what is cognitive theory

A

thoughts influence feelings which influence behaviors

help pt. identify thoughts

30
Q

one of the last key interventions to work on

A

social skills therapy - socializing

31
Q

your active therapeutic agent

A

milieu (hospital environment) structured - locked units

32
Q

if pt. is suicidal what it a good tool to Implement

A

contract for safety (come to staff member)

33
Q

a contract for safety is a verbal or written contract

A

it can be either

34
Q

what will you not see in an inpatient setting

A

Freud - psychoanalytic therapy; too expensive too much time

35
Q

what is IPT

A

interpersonal therapy - focuses on interpersonal relationships (those around you feel better when you are treated for depression)

36
Q

principles of group therapy

A

every group has its own culture/values
interaction in the group is for self need
opportunity to learn about yourself

37
Q

group norms can be

A

overt - what time the group meets

covert - sit in same chair

38
Q

nurses role in leading groups

A

provide boundaries - set limits
make everyone safe
engage people who aren’t motivated
be direct - may need to ask someone to leave

39
Q

biological trt. for depression

A

ECT

40
Q

how often do pt. receive ECT

A

2-3 trts/week; for 6-12 treatments

41
Q

ECT is used for this type of dx

A

eating disorders
those who haven’t responded to meds
major depression with psychosis
bipolar disorders

42
Q

adverse reaction w/ECT

A

long-term memory deficits

difficulty remembering the day of treatment

43
Q

If pt experiences long-term memory deficits w/ECT what should be done

A

discontinue ECT

44
Q

1st line of trt for seasonal affective disorder

A

light therapy - sunlight for 30-60 min/day

45
Q

how does light therapy work

A

suppresses melatonin

46
Q

exercise is a good therapy for depression, t or f

A

true - increases mood and decreases depression

47
Q

**short-term evaluation of outcome for depression

A

reduction in suicidal thoughts
state alternatives to suicide
decrease in severity of symptoms (emotional, cognitive, physical) - sleeping, hydrated…

48
Q

A patient became depressed after the last of six children moved out of the home 4 months ago. The patient has been self-neglectful, slept poorly, lost weight, and repeatedly says, “No one cares about me anymore. I’m not worth anything.” Select an appropriate initial outcome for the nursing diagnosis Situational low self-esteem, related to feelings of abandonment. The patient will:

A

A.verbalize realistic positive characteristics about self by (date)

49
Q

long term goal for care of depression

A 
taking meds (after yr can go off meds and try different strategies)
functioning in the community
re-establishing relationships
50
Q

A priority intervention for a patient with major depression is:

A

B.carefully and unobtrusively observing the patient around the clock.

Final - Mgmt - Neuro/Psych (11 decks)

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