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Mental Health > Depressive Disorders > Flashcards

Depressive Disorders Flashcards

1
Q

List some common Si/Sx of MDD

A
  1. Anhedonia
  2. insomnia,
  3. anergia
  4. feeling hopleless, helpless, or worthless
  5. flat affect
  6. negative though process
  7. Decrease in sexual libido
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2
Q

What are the key Sx of depression?

A

depressed mood and anhedonia

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3
Q

Which gender is most at risk, be specific w/ age group?

A

ratio is equal until adolescents where females are at a higher risk

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4
Q

What is a common reason older adults experience depression?

A

risk of depression increases as health deteriorate

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5
Q

T/F There is a single cause for depression

A

False, it is a multifaceted

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6
Q

What is the concordance rate for depression for identiacal twins?

A

50%

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7
Q

What are the 2 main neurotransmitters that affect depression?

A
  1. serotonin

2. NE

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8
Q

What is important to assess when you pt is depressed?

A

suicial ideation

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9
Q

Which factors increase the risk of suicide?

A
  1. hopelessness
  2. Substance Use
  3. Recent loss or separation
  4. History of suicide attempts
  5. Acute suicidal ideation
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10
Q

What are some ways the elderly experience depression differently?

A
  1. irritability
  2. cognitive changes
  3. longer recovery time
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11
Q

List some nursing Dx for depression

A
  1. Risk for suicide- highest priority
  2. Ineffective coping
  3. Hopeless
  4. Social Isolation
  5. Spiritual distress
  6. Self-care deficit
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12
Q

What is the MOA of SSRIs?

A

block the reuptake of serotonin in the synaptic cleft making serotonin more available

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13
Q

List some side effects of SSRIs

A
  1. seizures
  2. abnormal bleeding
  3. weight gain
  4. N/V
  5. tension headache
  6. Serotonin Syndrome
  7. Akathisia
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14
Q

Serotonin Syndrome

A

drug rxn that causes the body to have too much Serotonin that occurs when 2 drugs affect are taken simultaneously

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15
Q

List some Sx/Si of SE Syndrome

A
  1. Tachycardia
  2. Hypertensive
  3. Delirious
  4. Muscle Spasms
  5. diaphoresis
  6. pyrexia
  7. diarrhea
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16
Q

What are some contraindications for SSRIs?

A

Do not mix with

  • Tramadol
  • Triptans
  • other SSRIs and SNRIs
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17
Q

List the SSRIs

A
  1. Celexa (citalopram)
  2. Lexapro (escitalopram)
  3. Prozac (fluoxetine)
  4. Luvox (Fluvoxamine)
  5. Paxil (paroxetine)
  6. Zoloft (sentraline)
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18
Q

What is the worst SSRIs? Explain why it is the worse

A

Paxil, the worse because it has horrible DC process

19
Q

What is the MOA of SNRIs?

A

They block the reuptake of SE and NE

20
Q

List the SNRIs

A
  1. Effexor (venlafaxine)
  2. Pristiq (Desvenlafaxine Succinate)
  3. Cymbalta (Duloxetine)
  4. Fetzim (levomilnacipran)
21
Q

What are some side effects of SNRIs?

A
  • N/V
  • insomnia
  • weight gain
  • diaphoresis
  • sexual dyfxn
22
Q

What is the MOA of tricyclics?

A

inhibit the reuptake the NE and SE in the presynaptic cleft

23
Q

List some side effects of TCAs

A
  1. anticholinergic effects ( urinary retention, blurred vision, dry mouth, tachycardia, constipation, esophageal reflux)
  2. orthostatic hypotension
  3. weight gain
  4. arrhythmias
24
Q

When is the best time to administer a TCA? Why?

A

bed time because it has sedating effects

25
Q

TCAs are contraindicated in what type of pts?

A
  1. cardio pts (MI, arrhythmias, heart block, tachycardia)
  2. CVA pts
  3. Pregnant women
  4. Seizures
  5. Narrow-angle glaucoma
26
Q

List the TCAs

A
  1. Elavil (amitripyline)
  2. Anafranil (clomipramine)
  3. Nopramin (desipramine)
  4. Sinequan (Doxepine)
  5. Tofranil (Imipramine)
  6. Pamelor (nortriptyline)
27
Q

What is the MOA for MAOIs?

A

monamine oxidase is responsible for inactivating or breaking down monoamine neurotransmitters in the brain (dopamine, SE,NE, and Tyr)

28
Q

What are side effects of MAOIs?

A
  1. orthostatic hypotension
  2. weight gain
  3. edema
  4. vertigo
  5. muscle twitching
  6. weakness and fatigue
29
Q

If Lee is on Nardil and he tells you that he eats avocados and raisins, are you concerned or is this okay? Explain

A

I am concerned b/c these foods contain tyramine which is contraindicated for those who are taking MAOIs

30
Q

Why can’t someone taking Marplan or Parnate eat tyr- riched foods?

A

MAOIs block the breaking down of tyr in the liver and intestines which result in an increase of try and lg amts of NE to be released

31
Q

List some tyr- riched foods

A
  1. aged cheese (blue, gouda, romano, parmesan, swiss, etc..)
  2. wine
  3. beer
  4. avocado
  5. beef or chicken liver
  6. caffeine
  7. olives
32
Q

What is Lee at risk for he is taking Nardil and eats avocados and raisins?

A

he is at risk for hypertensive crisis which is a medical ER

33
Q

What type of pts are MAOIs contraindicated?

A
  1. Cerebrovascular disease
  2. HTN and CHF
  3. Liver disease
  4. Recurrent or severe headaches
34
Q

What type of antidepressant is contraindicated for pts with suicidal ideation?

A

TCAs

35
Q

Is it okay for a pt to just stop taking their Lexapro?

A

No, all antidepressants should be taperd slowly

36
Q

What is the one thing any pt should avoid while taking antidepressants?

A

ETHOL

37
Q

Do therapeutic effects occur w/in 30-45 mins of administration?

A

No, the full therapeutic effect may take several weeks w

38
Q

What is some pt. teachings while taking Prozac or Celexa?

A
  1. Obs for signs of serotonin syndrome
  2. Avoid the concurrent use of St. Johns Wort
  3. Follow a healthy diet and exercise regimen
39
Q

What are some pt. teachings for someone taking Elvail or Norpamin?

A
  1. Change positions slowly
  2. Chew sugarless gum
  3. Eat high fiber foods
  4. Increase fluid intake to 2-3 L/day
40
Q

What are some pt. teachings for a pt taking Nardil or MARPLAN?

A
  1. Avoid ty-riched foods

2. Avoid OTC meds

41
Q

What is the MOA if St. John’s Wort?

A

increases the amt of SE, NE, and dopamine in the brain

42
Q

Who most benefits from light therapy?

A

pts. w/ seasonal affective disorder

43
Q

What is the MOA of light therapy?

A

influences light on melatonin so exposure to light suppresses the nocturnal secretion of melatonin

44
Q

If a client plans to take control of one life situation by discharge, which nursing Dx is the pt addressing?

A

Powerlessness

Mental Health (16 decks)

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