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Mental Health- Exam 2 > Depression & meds > Flashcards

Depression & meds Flashcards

1
Q

What is the typical depressive disorder that is characterized by a depressed mood w/ or w/o psychosis, has no history of manic behavior & individual loses interest or pleasure in usual activities?

A

Major Depressive Disorder (MDD)

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2
Q

What neurotransmitters are involved in Depression?

A

Norepinephrine, Serotonin & Dopamine

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3
Q

What is the term used to describe an increase of a cellular component or (more receptors)?

A

Up-Regulation

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4
Q

What is important for executive functions of memory, reasoning, problem solving & planning?

A

Norepinephrine

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5
Q

How many weeks might it take for an antidepressant med to take effect?

A

6 weeks

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6
Q

What disorder is consistently chronically depressed w/ no bad days then good days impairs social & occupational function & cannot be attributed to substance use of another medical condition?

A

Major Depressive Disorder

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7
Q

What is the term used to describe going back to a normal amount of receptors?

A

Down-regulation

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9
Q

What neurotransmitter is involved in mood, appetite, libido & cognition?

A

Serotonin (SSRI’s)

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10
Q

What action do SSRI’s have in the brain?

A

Block reuptake of serotonin

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11
Q

Why might it take up to 6 weeks for an antidepressant to take effect?

A

bc of down-regulation, it needs to get back to physiological normalcy

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12
Q

How many weeks must symptoms be present in a pt. diagnosed w/ MDD?

A

At least 2 weeks

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13
Q

What disorder is referred to as sad or “down in the dumps”, is a more milder form of MDD bc individual is function-able & will still have thing to make them laugh, but has no evidence of psychotic symptoms?

A

Dysthymic Disorder

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14
Q

What is the mechanism by which antidepressant meds achieve their desired effect?

A

increase levels of serotonin & norepinephrine

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15
Q

What must the nurse be on alert for w/ a pt receiving antidepressants?

A

Negative symptoms-thoughts of suicide

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16
Q

How long is a pt w/ Dysthymic Disorder chronically depressed for?

A

most of the day, more days than not for at least 2 years

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17
Q

What disorder is considered more than PMSing, have a depressed mood, excessive anxiety, mood swings, & a decrease in interests in activities?

A

Premenstrual Dysphoric Disorder

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18
Q

What is the most potentially life-threatening adverse effect of MAOI’s?

A

Hypertensive crisis

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19
Q

What classification of a med is Evexor?

A

SNRI

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20
Q

How long do symptoms of premenstrual dysphoric disorder last for?

A

2 weeks of cycle

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21
Q

What classification is the medication marplan parnate?

A

MAOI

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22
Q

What classification is the medication welbutrin?

A

NDRI

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23
Q

When do symptoms of premenstrual dysphoric disorder begin, start to improve, & become minimal or absent?

A

begin- week prior to menses, improve- w/in few days after onset of menses, minimal/absent- week post-menses

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24
Q

What disorder is associated w/ intoxication/withdrawal of substances like beta blockers, opioids, or benzodiazepines & can cause significant distress/impairment in social/occupational or other areas of functioning?

A

Substance-induced Depressive Disorder

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25
Q

What disorder is a direct physiological effect of a general medical condition?

A

Depressive Disorder associated w/ another medical condition

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26
Q

Is depression life long?

A

NO!

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27
Q

What disorder may be caused by a deficiency in norepinephrine, serotonin & dopamine & excessive cholinergic transmission?

A

Depression

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28
Q

What classification are the medications Prozac & Zoloft?

A

SSRI’s

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29
Q

What classification are the meds Imipramine, Clomipramine & doxepin?

A

Tricyclic

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30
Q

What disorder may be caused by a possible failure w/in hypothalamic-pituitary-adrenocortical axis such as thyroid problems & pituitary problems from stress?

A

Depression-neuroendocrine disturbances

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31
Q

What is the triad of negative distortions in depression?

A

Negative expectations of the environment, self, & future

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32
Q

What is the predisposing factors that includes: med side effects, neurological disorders (CVA, brain tumors-temporal lobes), electrolyte disturbances, hormonal disturbances (thyroid, adrenal cortex, estrogen, progestogen), & nutritional deficiencies?

A

Physiological influences of depression

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33
Q

In the cognitive theory Beck views primary disturbances in depression as ______ rather than ______. & that depression is the product of negative thinking.

A

cognitive; affective

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34
Q

Stress can equal a?

A

cholinergic attack

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35
Q

What is the black box warning on antidepressants?

A

increase risk for suicide

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36
Q

At what ages do these symptoms occur in childhood depression: feeding problems, excessive tantrums, lack of playfulness, no emotional expressiveness, failure to thrive or delays in speech & gross motor development?

A
37
Q

What is senescence?

A

the elderly

38
Q

What medication use is successful in childhood depression?

A

SSRI’s

39
Q

At what ages do these symptoms occur in childhood depression: accident proneness, excessive phobias, lack of attention & self-reproach (“I’m terrible & ugly)?

A

3-5

40
Q

Loss by death, abandonment, divorce, neglect, move or lack in academics is what in relation to childhood depression?

A

Precipitating factors

41
Q

What is the main focus of therapy for childhood depression?

A

Alleviate symptoms & strengthen coping skills

42
Q

At what age do these symptoms occur in childhood depression: physical complaints (stomach/headaches), aggressive behavior, clinging behavior, lag in social skills & academic competence?

A

6-8

43
Q

What is the best clue that differentiates depression from normal stormy adolescence behavior?

A

visible behavioral change that lasts for several weeks.

44
Q

At what age do these symptoms occur in childhood depression: morbid thoughts, excessive worrying (maybe about parents dying), feeling of disappointment to parents & lack of interest?

A

9-12

45
Q

What is needed, including meds, to help w/ adolescent depression?

A

support, Prozac, or Lexipro

46
Q

At what age do these symptoms occur in childhood depression: anger, aggressiveness, running away, delinquency, social withdrawal, sexual acting out, substance abuse, restless & apathy?

A

Adolescence

47
Q

What med should a nurse not use for depression in adolescence?

A

Paroxetine

48
Q

At what age do these symptoms occur in depression: memory loss, confused thinking & apathy?

A

Elderly

49
Q

Symptoms of depression in the elderly are often confused with the symptoms of what disorder?

A

Neurocognitive disorder

50
Q

These side effects are associated w/ what medication: dry mouth, sedation, nausea, discontinuation syndrome?

A

Antidepressants

51
Q

These side effects are associated w/ which med: Insomnia, agitation, headache, weight loss, sexual dysfunction, & serotonin syndrome?

A

SSRI’s & SNRI’s

52
Q

These side effects are associated with which med: hypertensive crisis like severe headache, palpations, N/V, fever, sweating, chest pain & coma, or application site reactions like rash, itching, erythema, swelling, or urticarial lesions?

A

MAOI’s

53
Q

The use of what medication is rarely used anymore because it has a poor risk-to-benefit ratio & can cause serious/chronic health problems?

A

Tricyclic’s

54
Q

What is the term used to describe a severe form of depressive disorder where symptoms are exaggerated & interest or pleasure in all activities is lost?

A

Melancholia

55
Q

What is an amino acid precursor of serotonin shown to enhance efficacy of antidepressant meds & on occasion to be effective as an antidepressant itself?

A

Tryptophan

56
Q

What is the term used to describe depressive symptoms that occur as a consequence of a non-mood disorder or an adverse effect of certain medications?

A

Secondary depression

57
Q

What theory did Freud use for his belief that melancholia occurs after the loss of a loved object & the hostility felt for that lost object is turned inward against the ego?

A

Psychoanalytic theory

58
Q

What theory did Seligman use experiments w/ dogs & electrical stimulation then later theorized that learned helplessness predisposes people to depression imposing a feeling of lack of control over their life situation?

A

Learning theory

59
Q

What theory suggests depressive illness occurs as a result of having been abandoned by or separated from significant other during 1st 6 months of life (mother is main source of security @ this time)?

A

Object loss theory

60
Q

What is the term used to describe an individual experiencing so many losses in life that they are unable to resolve 1 grief response before another one begins?

A

Bereavement overload

61
Q

In the continuum of depression which level is associated with: being depressed time to time bc of everyday disappointments in life, but can subside quickly?

A

Transient

62
Q

In the continuum of depression which level is associated with: grief process is triggered in response to loss of a valued object & may subside in a few weeks?

A

Mild

63
Q

In the continuum of depression which level is associated with: grief process is prolonged or exaggerated; fixed on anger stage & anger is turned inward on self, so unable to function w/o assistance?

A

Moderate

64
Q

In the continuum of depression which level is associated with: intensification of symptoms associated w/ moderate level & may have loss of contact w/ reality, complete lack of pleasure in all activities & think about suicide?

A

Severe

65
Q

What rating scales can be used to rate depression?

A

Hamilton, Zung, & Beck

66
Q

Name this level on the continuum of depression: pt is sad, has the “blues” may be crying, can’t get mind off of their disappointment & is tired?

A

Transient

67
Q

Name this level on the continuum of depression: gloomy, powerless, helpless, low self-esteem, no pleasure in activities. Has slow physical movements/speech, slumped posture, thinks of life’s failures/regrets, decrease in hygiene/grooming. Difficulty concentrating, negativism, pessimism, slow thinking. Is anorexic, hyper/insomnia, amenorrhea, decrease libido, lo energy level, better in AM get worse as day progresses?

A

Moderate

68
Q

Name this level on the continuum of depression: pt. is denial of feelings, anger, anxiety & guilt. Is restless, tearful, regression, agitated & preoccupied w/ loss & may blame self/others. Is anorexia or over eating & has insomnia?

A

Mild

69
Q

Name this level on the continuum of depression: Worthless, flat, apathy, emptiness, lonely. Has psychomotor retardation/behavior, agitated, purposeless movements, social isolation, delusional thinking, confusion, hallucination. Is sluggish digestion, constipated, urinary retention, impotence, weight loss, difficult falling asleep, worse in AM better as day progresses?

A

Severe

70
Q

What phase of treatment for depression assesses the extent of illness then info is given to the pt. regarding nature of depression, symptoms, course & alternative treatment?

A

Phase 1

71
Q

What phase of treatment for depression is when therapeutic alliance is terminated w/ emphasis on reassurance, clarification of emotional states, improvement of interpersonal communication, testing of perceptions & performance in interpersonal settings?

A

Phase 3

72
Q

What phase of treatment for depression focuses on helping the pt. resolve complicating grief?

A

Phase 2

73
Q

Name this automatic thought: “I’m the only one who failed.”

A

Personalizing

74
Q

Name this automatic thought: “I’m a complete failure”

A

All or nothing

75
Q

Name this automatic thought: “He thinks I’m foolish.”

A

Mind reading

76
Q

Name this automatic thought: “Other questions were so easy. Any dummy could’ve gotten them right.”

A

Discounting positives

77
Q

What is an induction of a grand mal seizure through application of electrical currents to the brain?

A

Electroconvulsive Therapy (ECT)

78
Q

What is the most common side effect of ECT?

A

short term memory loss & confusion around time of therapy

79
Q

Atropine sulfate or glycopyrrolate (Robinul) prevent aspiration & bradycardia for what & when should they be given intramuscularly?

A

Pre-treatment for ECT; 30 min before ECT

80
Q

Propofol (Diprivan) or Etomidate (Amidate) are meds used for what?

A

short-acting anesthetic for ECT

81
Q

Succinylcholine Chloride (Anectine) via IV is used to do what during the seizure of ECT?

A

muscle relaxer

82
Q

What is the procedure used to treat depression by stimulating nerve cells in the brain through very short pulses of magnetic energy that do not cause seizures & is used for mood regulation?

A

Transcranial Magnetic Stimulation

83
Q

What is MDD that reoccurs w/ seasonal patterns & may be r/t presence of hormone melatonin?

A

Seasonal Affective Disorder (SAD)

84
Q

What therapy is the 1st line of treatment for winter “blues” & as an adjunct in chronic MDD or dysthymia w/ seasonal exacerbations & involves pt. sitting in front of box w/ 10,000 lux lights w/ eyes wide open?

A

Light therapy

85
Q

These side effects are associated w/ what: headache, eye strain, nausea, irritability, photophobia, insomnia, & hypomania?

A

Light therapy

86
Q

This drug elevates mood & alleviates other symptoms associated w/ moderate to severe depression by increasing concentration of norepinephrine, serotonin, & dopamine?

A

Antidepressants

87
Q

What is the term used to describe absorption by a presynaptic nerve ending of a neurotransmitter that it has secreted & increases serotonin?

A

Reuptake

88
Q

What neurotransmitter is involved in motivation, concentration & pleasure?

A

Dopamine

Mental Health- Exam 2 (7 decks)

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