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Psych > Depression, Bipolar, Suicide, & Electroconvulsive Therapy > Flashcards

Depression, Bipolar, Suicide, & Electroconvulsive Therapy Flashcards

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1
Q

What neuroT’s is more associated with depression

A

decreased norepi and serotonin, dopamine

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2
Q

What hormone or hormone probs are related to depression

A

low thy hormone (hypothyroidism)
Addison and Cushing syndrome - bec of steroid use decreasing dopamine lev
High level of glucocorticoid - too much cortisol, depleting dopamine
Beta blockers and antibiotics causing Estrogen and progestrone unbalanced

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3
Q

Symptoms of depression

A 
anhedonia (lack of pleasure)
self harm 
feelings of guilt 
grief 
psychomotor retardation - so unmotivated that they dont move

vegitative symps
insomnia
loss of appetite
over activation of stress hormone

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4
Q

With a pat that has depression with signs of anger turned inward, what is a intervention

A

providing an outlet to be able to express that anger

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5
Q

Depression care

A 
exercise 
nutrition 
sleep 
scheduling
help them find a purpose 
taking showers/saunas
vitamin D
Folic Acid - ese with mutation that interferes with absoption  
Assertiveness training
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6
Q

What are the types of depression

A 
Major depressive 
persistent depressive (dysthymia)
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7
Q

Manis of major depressive

A

needs at least 5 of the symps for 2 weeks

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8
Q

manis of persistent

A

down in the dumps

symps are not as severe as major depressive and have been happening for at least 1 yr for children and 2 yrs for adults

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9
Q

Assessment for depression

A

Analyze risk factors and cardinal signs

PHQ-9 helps to understand the depression but not used to diagnose

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10
Q

Psychotherapies for depression

A 
Cognitive behavior therapy
Dialectical Behavior Therapy
Group Therapy
Family Therapy
Interpersonal Therapy
Light Therapy

Electroconvulsive therapy (ECT)

Transcranial Magnetic stimulation (TMS)
Vagus Nerve Stimulation (VNS)

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11
Q

Why is bupropion used over SSRI’s sometimes

A

bec it doesnt have sexual disfunction side effects like SSRI’s do

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12
Q

What type of pat is cymbalta good for

A

depression with lots of mus aches

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13
Q

What are the phases of bipolar DO

A

predromal
acute
continuation
maintenance

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14
Q

What happens in predromal phase of bipolar

A

manic symptoms

depressive symptoms

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15
Q

What is the treatment for the predromal phase of bipolar

A 
protect against self harm
calming music 
relaxation techniques 
rest 
regular meals
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16
Q

What happens in the acute phase of bipolar

A

depressive symptoms
manic symptoms
hypomanic episodes
lasts for 3-8 wks

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17
Q

What is the treatment for acute phase of bipolar

A

hospitalization
one on one supervision
reduction of manic symptoms
protect against self harm

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18
Q

What is the number one med for bipolar

A

lithium

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19
Q

Considerations with lithium

A

lab draw after the first 12 hrs to check level, hold med until lab results are in

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20
Q

What is a key difference between OCD and OCPD

A

OCPD dont think they have a problem while OCD pats know they do

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21
Q

How long for an OCD diagnosis

A

6 mo

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22
Q

Would the ID ego or super ego likely be implicated in OCD disorders

A

super ego

23
Q

What is an example of a super ego imbalance

A

perfectionism

24
Q

What is an example of ID imbalances

A

not letting go of anger towards something

25
Q

What is a consideration with electro-convulsive therapy

A

given when meds dont work

may cause short term memory loss

26
Q

Discharge teaching for depression

A

dont take OTC drugs that increase risk of serotonin syn

exercise 30 mins 3-5 times weekly

27
Q

What are common signs of mania and hypomania

A

increased activity
euphoria
racing thoughts

28
Q

What are some manis that are unique to mania

A

reduced sleep
irritability
sudden extreme money spending or promiscuous behavior

29
Q

What are some unique mani’s of hypomania

A

carefree
very witty and joking attitude
oblivious to others feelings
cant follow through a project

30
Q

What are mixed episodes

A

manic and MDD symps at the same time

31
Q

What is rapid cycling

A

four or more acute mania episodes within 1 year

32
Q

What is the continuation phase of bipolar DO

A

remissions of acute phase symptoms for 2 to 6 mo

33
Q

What is the treatment during continuation for bipolar

A

maintenance medications

promoting treatment adherence

34
Q

What are the types of bipolar

A

type 1
type 2
cyclothymic

35
Q

What is type 1 bipolar

A

one major depressive period of at least 2 weeks followed by a manic period of around 4 days

36
Q

What is type 2

A

same as type 1 except they have hypomania instead of mania

37
Q

What is cyclothymic

A

tons of mood swings lasting at least 1-2 years where they never reach major depression or mania just fluctuating somewhere in between

38
Q

Because lithium takes a little bit to be therapeutic what med is used for short term symptom relief

A

clonazepam

39
Q

What are some other anti manics

A

lithium
clonazepam
carbamazepine
valporic acid

40
Q

What is the normal lithium level

A

.6 to 1.2

.5 to 1.5 for acute phase

41
Q

What is a consideration with lithium levels above 1.2

A

levels need to be reduces as soon as possible after therapeutic effects have been reached bec that level is toxic

42
Q

Care for bipolar

A

psycho education - ese the symps that are unique to them during mania, hypomania or depression
get the pat to acknowledge that they have a DO
avoid or limit caffeine
avoid stimulants
get enough sleep

43
Q

What are examples of primary secondary and tertiary interventions for suicide

A

primary- instituting and prevention strategies
secondary- management of suicide actions, one on one monitoring
tertiary- interventions for the fam and friends

44
Q

Care for suicide

A

self assessment about how you feel about it
15 minute checks
one on one
making sure they are swallowing their meds

45
Q

Discharge teaching for suicide

A

create a verbal or written no self harm contract
create a list of social support system with names and numbers
Give them a call when they get home

46
Q

What happens in electroconvulsive therapy

A

induced seizures lasting at least 15-25 seconds

47
Q

What is the typical treatment regimen for electroconvulsant therapy

A

every other day for a total of 6-12 treatments

48
Q

What pats can receive electrocon therapy

A

MDD mostly
Acute manic episodes
OCD
personality DO

49
Q

What are contraindication for electrocon therapy

A

increased ICP
recent MI
CVA’s
brain tumors

50
Q

Side effects of ECT

A

short term memory loss

RARE
permanent mem loss
brain damage
death

51
Q

Is consent required for ECT

A

yes

52
Q

What are some requirements before ECT starts

A

removing all jewlery assistive devices like dentures and glasses
voiding
admining atropine 30 mins before starting
vital signs (and after)

53
Q

What meds are given during ECT

A

muscle relaxants usu succinylcholine
short acting anesthetics like methohexital
O2

Psych (14 decks)

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