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NU 306 Mental Health > Exam 3 Depression > Flashcards

Exam 3 Depression Flashcards

1
Q

What are protectice factors for depression?

A

Responsible for others
pregnancy
reliigous beliefs
sasifaction with life
social support
health care alliance
sobriety
resilience
future orianted thinking
effectove coping skills

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2
Q

What assessment tools do we use for suicide?

A
  • Columbia Suicide Severity Rating Scale
  • sad persons (sex, age, depressed, previous attempts, ethanol abuser, rational thinking loss, social support lacking, organized plan, no spouse, sickness)
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3
Q

Acute risk of suicide is characterized by what acronym?

A

IS PATH WARM

  • Ideation
  • Substance Abuse
  • Purposelessness
  • Anxiety
  • Trapped
  • Hopelessness
  • Withdrawal
  • Anger
  • Recklessness
  • Mood
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4
Q

What is a safety plan?

A

A template that goes over things such as warning sings, coping strategies, people/social distractions, social support (people I can ask), professional agencies for crisis contact, safe environment

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5
Q

What do we do with a safety plan?

A

We as the nurse develop it with the patient, they can take it home, put it on their fridge, and use the numbers to get help if they have suicidal thoughts

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6
Q

When would a patient need 1:1 observation? (criteria)

A

*Patient is currently verbalizing a clear intent to harm self

*Patient is unwilling to make a no-harm contract (or not convincingly contracts for safety)

*Patient shows no insight into existing problems

*Patient has poor impulse control

*Patient has already attempted suicide in recent past by lethal method

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7
Q

Three important questions to assess lethality (suicide related)

A

1.Is there a specific plan with details?

2.How lethal is the proposed method?

3.Is there access to the planned method?

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8
Q

Higher risk examples of lethality (suicide)

A
  • Using gun
  • jumping off high place
  • hanging
  • poisoning with carbon monoxide
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9
Q

Lower risk examples of lethality (suicide)

A
  • Cutting wrists
  • Inhaling natural gas
  • Overdose with nonprescription drugs
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10
Q

What is the Six Step Approach for Recovery for self harm (ex. cutting, burning)

A
  • Limit setting for safety
  • Developing self esteem
  • Discovery of motive/role
  • Learning that it can be controlled
  • Replacing self injury with coping skills
  • Entering maintenance phase
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11
Q

Non-Suicidal Self Injury may include what actions

A

cutting, burning, biting, skin picking, hitting and interfering with healing

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12
Q

Non-Suicidal Self Injury may last

A

at least a year and happen repeatedly

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13
Q

What is SAD PERSONS used for?

A

suicide risk assessment

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14
Q

What ISPATHWARM

A

mnemonic for warning signs

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15
Q

Most people with Non-Suicidal Self Injury do not seek

A

professional help

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16
Q

Intent of Non-Suicidal Self Injury is to

A

alleviate psychiatric pain/punish self/get attention

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17
Q

13%-23% of people with Non-Suicidal Self Injury are what age group?

A

adolescents

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18
Q

Non-Suicidal Self Injury is a global problem that declines after age

A

29

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19
Q

Non-Suicidal Self Injury is comorbid with

What disorders?

A
  • depression
  • anxiety
  • eating disorders
  • substance use disorders
20
Q

In the “real world” we assess daily for risk- and do what?

A

determine how SAFE our environment is

21
Q

In NONPSYCHIATRIC settings, ____ is the norm

A

1:1 observation

22
Q

With grieving consider

A

cultural variances

23
Q

Problems arise when grieving is

A

prolonged, impairs functioning, causes distress

24
Q

Kubler-Ross 5 Stages

A
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance:
  • Rarely that neat/linear
  • And not any given specific time frame
25
Q

What are Horowitz’s Stages of Loss and Adaptation (ATI)

A
  • Outcry
  • Denial and Intrusion
  • Working Through
  • Completion
26
Q

Worden: 4 Tasks of Mourning (ATI)

A
  • Accepting the reality of loss
  • Processing the pain of grief
  • Adjusting to a world without the lost loved one
  • Creating an enduring connection while debarring on new life

(usually takes about a year-varies by person)

27
Q

What factors affect grief?

A
  • Current stage of development
  • Support
  • Significance of loss
  • Culture/ethnicity
  • Prior experience with loss
  • Socioeconomic status
  • Spiritual beliefs
28
Q

What are Risks for Maladaptive Grieivng

related to death

A
  • Dependence of deceased
  • Unexpected death- young age or by socially unacceptable means (suicide/murder)
  • Inadequate coping skills
  • Lack of support
  • Preexisting mental health concerns
29
Q

What are factors of Maladaptive Grief (delayed or inhibited)?

A
  • Extended denial phase
  • Does not go through stages
30
Q

What are factors of Maladaptive Grief (distorted/exaggerated)

A
  • Extended anger phase
  • Impairs function

-Clinical depression

31
Q

What are factor of Maladaptive Grief (Chronic/Prolonged)

A

Varies

  • Impacts ADLs
  • Not accept reality of loss
32
Q

Nursing interventions for depression?

A

Allow time

*Educate

*Open & Therapeutic communication

*Assess for ineffective coping

*Referral/groups

*Debriefing

*Protect from abandonment & isolation

*Support grieving families

33
Q

What are risk factors for depression?

A

Gender (higher in women)
 Prior episode of depression
 Family History
 Stressful life event
 Current substance abuse
 Medical illness
 Few social supports

34
Q

What are s/s of major depressive disorder?

A

Recurrent thoughts of suicide
Decrease/increase in appetite
Inability to concentrate
Difficulty in making decisions
Feeling worthless and self-blame
Decreased energy
Disturbed sleep

(must have 5 or more for at least 2 weeks)

35
Q

What are s/s of persistent depressive disorder

A

Poor appetite or overeating
Insomnia or hypersomnia
Low energy/fatigue
Low self-esteem
Poor concentration
Feelings of hopelessness

Lasts at least 2 years or more

36
Q

What are s/s of disruptive mood dysregulation syndrome?

A

Introduced in 2013 in response to excessive number of
children being diagnosed with BIPOLAR
 Constant and severe irritability and anger in ages 6-18 years
old
 Temper tantrums out of proportion with situation 3x week
 Impacts at home, school and with peers

37
Q

What is premenstrual dysphoric disorder?

A
  • ast week before onset of period in women
  • Mood swings, irritability, depression, anxiety,
    feelings of being overwhelmed, difficulty
    concentrating
  • Lack of energy, overeating, insomnia or
    hypersomnia, aching, bloating, weight gain
38
Q

How do we treat premenstrual dysphoric disoder?

A

Regular aerobic exercise,
complex
carbohydrates,
sleep,
acupuncture,
light therapy,
relaxation therapy

39
Q

What is the first line treatment for depression?

A

SSRIs

40
Q

What are possible AE of SSRIs

A

nausea, vomiting, diarrhea, headache,
nervousness, anxiety, light-headedness, and loss of libido
* Possible lethal reaction: Serotonin Syndrome

41
Q

What is postpartum depression?

A

Usually begins within the first few months
after delivery.

42
Q

What is season affective disorder?

A

Related to decreased melatonin production
* Treated with Light Therapy
* 30-45 minutes daily

43
Q

What is the special concern for men with trazadone?

A

priapism

44
Q

What is the risk with tryciclic antidepressants?

A

ot recommended for SUICIDE risk patients (10-day supply can be lethal)

45
Q

What are common side effects of triclinic antidepressants

A

dry mouth, constipation, blurred vision, urinary retention,
dizziness, and urinary retention

46
Q

What disorder is most likely to interpret neutral expressions as angry?

A

DMDD

47
Q

What assessment tools do we use for depression?

A
  • Beck
  • Hamilton D
  • Mental Status Exam

NU 306 Mental Health (13 decks)

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