Depression Unit 2 (2)

Question 1

Interventions

Answer 1

1. Use kind, warm, firm attitude
2. Assess for suicidality
3. Reassure that the present state is temporary
4. Initiate breif, frequent contacts
5. Encourage expression of thoughts and feelings
6. Assist in daily decision making
7. Allow more time to complete activities
8. Provide schedule and routine
9. Set small immediate goals
10. Avoid false reassurance
11. Encourage participation in activities
12. Teach about illness, meds, suicide ideation, psychotherapy, support groups, NAMI

Question 2

amitriptyline (Elavil)

Answer 2

Antidepressant, Tricyclic

Major depression

• Seizures
• Heart issues
• Paralytic ileus

Question 3

paroxetine (paxil)

Answer 3

Antidepressant, SSRI, Phenylpiperidine derivative

MDD, OCD, panic disorder, GAD, PTSD, premenstrual symptoms, social anxiety disorder

• withdrawal symptoms
• ECG
• EPS (geriatric especially)
• Renal status
• postural hypotension

Question 4

citalopram (Celexa)

Answer 4

Antidepressant, SSRI

MDD

• Mental status
• Serotonin syndrome
• ECG

Question 5

fluoxetine (prozac)

Answer 5

Antidepressant, SSRI

MDD, OCD, bulemia nervosa, panic disorder, PMDD

• Seizures
• Neuroleptic malignant syndrome
• Tachycardia, Bradycardia
• Hemorrhage
• Stevens Johnson syndrome
• Skin reactions
• Do not use with St. John’s Wort

Question 6

bupropion (Wellbutrin)

Answer 6

Antidepressant, aminoketone

depression, smoking cessation, seasonal affective disorder

• Effect might take 2-4 weeks
• Caution when driving
• Avoid alcohol
• Do not use with nicotine patches
• Watch for urinary retention
• Risk of seizures

Question 7

veniafaxine (Effexor)

Answer 7

Antidepressant, SNRI

MDD, depression at end of life, general anxiety disorder, panic disorder, social anxiety disorder

• Watch for signs of hives, rash, allergic reactions, bleeding
• Use caution when driving
• Avoid alcohol
• Do not stop abruptly
• Photosensitivity may occur
• Monitor BP with hypertension

Question 8

Monoamine oxidase inhibitor (MAOI) Diet

Answer 8

1. Avoid foods containing high tryamine:
   1. Aged Cheeses
   2. Rasins, fava beans, flat italian beans, Chinese pea pods
   3. Red Wines
   4. Smoked and processed meats
   5. Caviar, pickled herring, corned beef, chicken/beef liver
   6. Soy sauce, brewer’s yeast, MSG
2. Can ocassionally eat foods with moderate tryamine:
   
   1. Gouda cheese, American cheese, mozzarella, yogurt, sour cream, avocados, bananas
   2. Beer, white wine, coffee, colas, tea, hot chocolate
   3. Meat extracts (bouillon)
   4. Chocolate
3. Limit quantities of food with low tryamine:
   
   1. Pasteurized cheeses
   2. Figs
   3. Distilled spirits

Question 9

Indications for Electro-Convulsive Therapy (ECT)

Answer 9

1. A client’s thinking is not clear or is unrealistic
2. A client can no longer unction on a day to day basis
3. A client has serious thoughts of commiting suicide
4. A client whose physical condition is in danger from lack of food, fluids, and sleep

Question 10

Primary Prevention

Answer 10

Development of a positive self-concept as demonstrated by self-confidence, self respect, self-esteem and striving for self-actualization

Question 11

Secondary Prevention

Answer 11

Treating a newly diagnosed client

Question 12

Tertiary Prevention

Answer 12

Managing any complications of the illness, rehabilation, medications, psychotherapies, ECT, support groups and support services`

Question 13

Communication Tips Depression

Answer 13

1. Quiet, warm accepting approach
2. Avoid being cheerful or overly optimistic
3. Do not offer false reassurance
4. Speak slowly and allow client adequate time to respond
5. Do not try to talk client out of their sadness
6. Give positive reinforcement
7. Help client understand symptoms are part of the illness+30.