depressive disorder Flashcards
who is at risk for depression?
women, white, socioeconomic status, and seasonaliy
what is the etiology of depression?
genetics, biochemical (neurotranmsitter and cortisol), hormones, inflammatory, and diathesis stress
What is major depression disorders?
- five or more of the following
-weight loss
-sleep prob
-fatigue
-psychomotor aggitation or retardation
-loss of concentration
-recurrent thoughts of death - one of the following
-depressed mood
-loss of intersest or pleasure (anhedonia)
to be chronic must be longer than 2 years
How is a child or teen diagnosed with MDD?
must have depressed or crankiness, anehdonia and any 3 of the following
- weight loss
-insomnia or hypersomia
-fatigue
-decreased concentration or indecisiveness
-thoughts of death
what s/s of depression in those under the age of 3?
-failure to thrive
-feeding problems
-lack of playfulness
-lack of emotionsal expression
-delay in speech
what s/s of depression in those aged 3-5?
prone to accidents
-phobias
-aggressiveness
-excessive self reproach
what s/s of deprerssion in ages 6-8?
-vague physical complaines
-aggressive
-cling to parents
-avoid anything new
-behind in social skills/academics
s/s of depression in aged 9-12
morbid thoughts
-excessive worrying
-lack of interest
-think they have disappoiinted parents
What is disruptive mood dysregulation disorder?
must be diagnosed before age 10 with severe irritability with outbursts at least 3 times a week.
what is persistent depressive disorder?
a low level of depressive feelings through most days and must have two or more of the following Decreased appetite or overeating, insomnia or
hypersomnia, low energy, poor self-esteem, difficulty
thinking, and hopelessness
what is prementrual dysphoric disorder?
symptom cluster in the week prior to a period.
only has to take medication during week prior to period
what is substance induced depressive disorder
when a person doe snot experience depressive symptoms in the absence of substance use or withdrawl
what are common depression assessments?
PHQ scale
primary care screening
what areas should be assessed for depression?
-affect
-thought process/content
-mood
-judgement/insight
-physical behavior
-communication
-religious belief
Name the different affects in order from normal to none
-full/broad range
-constricted
-blunted
-flay
what is psychomotor retardation?
slowness of movement or speech that is mental related
What is psychomotor aggitation?
an increases in activity brought on by mental tension, such as passing or fidgeting
what is the recovery model?
a way of identifying outcomes for those with depression that include the following
-Focus on patient’s strengths to improve health and reach
full potential
Treatment goals mutually developed
Based on patient’s personal needs and values
Measurable
what are the phases and timelines associated with the treatment of depression?
- acute phase (6-12 weeks)
- continuation phase (4-9 months)
- Maintenance (1 or more years)
what are the common classes of antidepressants?
-SSRIs
-SNRIs
-Tricyclic
-MAOIs
what is the most important education points with antidepressant medication?
- may become suicidal with increased energy
- takes weeks to months to work
- NEVER stop abruptly
- do NOT drink alcohol
what meds are SSRIs?
fluoxetine, paroxetine, sertaline, citalopram, escitalopram
what meds are SNaRIs
venlafaxine, duloxetine
what meds are SNRIs?
desvenlaflaxine
what are the common s/e or SRIs?
dry mouth, sexual problems, tension h/a, and blurred vision
what is the life threatening complication associated with SRIs?
serotonin syndrome
what are the s/s of serotonin syndrome?
mental status change, ANS, neuromuscular twictching, N/V/D
when is serotonin syndrome first noted?
within 6 hr of first dose of new med, dose change, or overdose
what is the treatment for serotonin syndrome?
STOP med, benzos, oxygen, IVF, and symptomatic care (HR and BP meds)
what is the danger with taking tricyclic antidepressants?
the danger of overdose
what are the nursing implications with TCAs
check EKG and cardiac
s/e of TCAs
anticholenerginic effects, sedation, weight gain, sex probs, sleep probs,
s/e of MAOIs
dry mouth ,nausea, diarrhea or constipation, h/a, drowsy, insomnia, dizzy, skin reaction
what are the diet restrictions with MAOIs?
-aged, smoked, fermented, marinated, or processed meats and cheeses
overripe produce
-beans
-condiments
-alcohol or nonalcoholic beer/wine or cold medicine
-avoid caffeine
HYPERTENSIVE CRISIS
how do we treat a hypertensive crisis?
give regitine or procardia
contraindications of bupropion
eating d/o or seizures
