Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mental Health > Depression, Bipolar > Flashcards

Depression, Bipolar Flashcards

1
Q

Some facts about depression?

A

Universal experience. 5-25% of the population. May be masked by alcohol or substance abuse. Acting out in children and teens. Incidence is higher in women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

People with what are at a higher risk for depression?

A

Co-occuring chronic medical problems. Eg hypertension, backache, diabetes, heart problems, arthritis.
Depression is often secondary to a medical condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some examples of symptoms of depression?

A
  1. Depressed mood or irritable most of the day, nearly every day
  2. Decreased interest or pleasure in most activities, most of each day
  3. Significant weight change (5%) or change in appetite
  4. Change in sleep: Insomnia or hypersomnia
  5. Change in activity: Psychomotor agitation or retardation
  6. Fatigue or loss of energy
  7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
  8. Concentration: diminished ability to think or concentrate, or more indecisiveness
  9. Suicidality: Thoughts of death or suicide, or has suicide plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Assessment guidelines for depression?

A

Risk of self harm to harm to others? Medical issues? History of depression? Support systems? Precipitating events? Psychosocial assessment?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Health teaching for depression?

A

No fault diagnosis. Their target symptoms and symptoms of suicide risk (e.g. medications). Follow-up therapy. Healthy living skills. Community resources.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does follow-up therapy as far as depression goes include?

A

Clarify stressors and measures to reduce impact of stressor through problem solving. aftercare facilities, relapse prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain ECT for depression?

A

Electroconvulsive therapy
NPO 8 hours prior. General anesthetic. Muscle paralyzing agent. Oxygen. After care, including reassessing, reorienting, and short term memory loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other types of medical management for depression?

A

Stimulation therapies, photo therapy, vagus nerve stimulation, rapid transcranial magnetic stimulation, deep brain stimulation, medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do all antidepressant medications have in common?

A

All have discontinuation syndrome, gradually wean off of them. About hazardous activities due to the sedation effect. “Wash out” period between trying different antidepressants. Adverse effects. “Start low, go slow”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are examples of three s/s that one must have to have serotonin syndrome, after having been taking a drug that changes the body’s serotonin level?

A

Mental status changes, diarrhea or ab pain, heaving sweating, fever, altered muscle tone, overactive reflexes, shivering, tremors, uncoordinated movements (ataxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of serotonin syndrome?

A

Control hyperthermia, stop serotenergic drugs, treat muscle rigidity and agitation with clonazepam, benzotropine, lorazepam. Anticonvulsants for seizures, cyproheptadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain alcohol and antidepressants>

A

Adds to the CNS depression of antidepressant meds, impairment occurs after fewer drinks than in person not taking these meds, may render antidepressant ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do tricyclics do?

A

Block reuptake of NE and 5-HT, thus increasing availability in the synapse. Side effects include anticholinergic, histamine blockade, and cardiovascular.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tricyclic contraindications and effect onset?

A

Narrow angle glaucoma and history of seizures are contraindicated. Narrow therapeutic window
Lethal in OD. 10-14 days for initial effect and 4-8 weeks for full effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do SSRIs do?

A

Selectively blocks the reuptake of 5-HT in synapse, thus increasing available serotonin with less side effects. First-line therapy for depression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Side effects of SSRIs?

Adverse effects?

A

Fatigue, nausea, diarrhea, dry mouth, dizziness, tremor, sexual dysfunction, lack of libido
Risk for cerebral microbleeds, strokes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do MAOIs do?

A

Block an enzyme needed to metabolism norepinephrine, 5-HT, and D, thus increasing the neurotransmitters in the synapse.

18
Q

Side and adverse effects of MAOIs?

A

Orthostatic hypotension, weight gain, anticholinergic, sexual dysfunction, insomnia.

19
Q

What can happen when one takes MAOIs and eats tyramine? How? What else should be avoided?

A

Hypertensive crises. Caused by the MAOIs decreasing the amount of monoamine oxidase used to break down tyramine and tryptophan in the liver.
Avoid OTC meds.

20
Q

First signs of a hypertensive crises?

A

Severe headache, followed by neck stiffness, N/V, sweating, tachycardia. Death can result from circulatory collapse or intracranial bleeding.

21
Q

What foods contain tyramine?

A

Aged cheeses, pickled or smoked fish, yeast breads, lunchmeat, soy products.
Draft beer, wine, and yogurt in moderation.

22
Q

What does one look for when evaluating the effectiveness of anti-depressant meds

A

Appetite/weight. Ability to get self up, attend and participate in groups and complete tasks. Sleep quality and amount. Suicide assessment.

23
Q

Bipolar with mania diagnosis requires three or more of the following?

A

Inflated self-esteem, grandiosity, hyperverbal and pressured speech, flight of ideas, racing thoughts, distractibility, decreased need for sleep, increased goal activity, psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences.

24
Q

What is mania, especially as relates to bipolar disorder?

A

Abnormally and persistently elevated, expansive, or irritable mood lasting at least 1wk.

25
Q

What is the difference between bipolar 1 and bipolar 2?

A

1 requires that pt had a full blown mania either currently or in the clients history.
2 is the client has had a hypomania but no full-blown mania.

26
Q

What should be included in a nursing assessment for bipolar disorder?

A

Physiological safety, hydration, cardiac status, sleep exhaustion, danger to self/others, inappropriate sexual activity, uncontrolled spending/giving. Knowledge of disorder, meds, support groups, and organizations.

27
Q

What is involved in the different phases of mania?

A

Acute: medical stabilization, maintaining safety, self-care needs.
Continuation: maintaining med adherence, psychoeducational teaching, referrals, learning about signs of relapse.
Maintenance: preventing relapse, support groups, med adherence, psychotherapy

28
Q

The ability to contain or diminish unacceptable or inappropriate heavier in a positive, professional manner.

A

Limit-setting. An interpersonal skill that maintains the self-esteem of all parties and establishes personal boundaries.

29
Q

What skills are used in limit setting? What is avoided?

A

Assertive communication techniques, detached concern, consistency with behavioral expectations and consequences.
Avoid setting limits out of proportion to the situation and colluding with the patient splitting up the staff.

30
Q

Interventions for a structures and safe milieu?

A

Decrease environmental stimuli by limiting joking and noise. Avoid competition, provide structured solitary activities with the staff. Protect the patient from the consequences of poor judgement.

31
Q

Priorities and interventions during acute mania?

A

Structure in a safe milieu, nutrition, sleep, hygiene, elimination

32
Q

Mechanism for lithium carbonate mood stabilizer?

A

First-line agent for bipolar disorder. Alters sodium transport in nerve and muscle cells, and inhibits the release of norepinephrine and dopamine.

33
Q

Therapeutic windows for lithium?

A 
Very narrow therapeutic window.
Therapeutic: 0.8-1.4 mEq/L
Maintenance: 0.4-1.3 mEq/L
Toxic: 1.5-2.0 mEq/L
Higher doses during acute mania, lower maintenance dose
34
Q

Contraindications for lithium?

A

Renal, thyroid, or neurological disorders. Cardiovascular disease. Pregnancy and breast feeding.

35
Q

Long term risks for lithium?

A

Hypothyroidism. Impairment of the kidney’s ability to concentrate urine, AKA nephrogenic diabetes insidious.

36
Q

Lithium drug interactions?

A

Any drug that affects sodium levels. Diuretics, low-salt diet, NSAIDs, halloo, aminophylline

37
Q

What should be taught to be a patient who is taking lithium?

A

Adequate fluid intake. Awareness of heavy sweating and the need to replace fluids and electrolytes. Don’t change salt intake. Take with food or milk. Symptoms of toxicity.

38
Q

Why are anxiolytics used with mania?

A

Treatment-resistant mania and psychomotor agitation.
clonazepam
lorazepam

39
Q

Why are atypical antipsychotics used with mania?

A 
Sedative properties. 
olanzapine
risperidone
aripiprazole
ziprasidone
quetiapine
40
Q

How long do mood stabilizers take to work?

A

Mania is 1-3 weeks

Depression is 4-6 weeks

Mental Health (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions