L7- Depression Flashcards
A nurse monitors older adults in a long-term care facility. Which symptom would require follow-up by the nurse to assess for depression in the older adult?
Select one:
a.
Labile affect
b.
Weakness
c.
Impaired perceptions
d.
Anorexia
D- Anorexia
A nurse educator teaches about theories of late-life depression. Which statement by a student shows that the material is understood?
Select one:
a.
“Depression is caused by decreased activity in the hypothalamic–pituitary–adrenal axis.”
b.
“Older adults with depression and chronic illness have more serious negative functional consequences.”
c.
“Adverse events impair your ability to evaluate yourself.”
d.
“Researchers have identified a cause-and-effect relationship between depression and dementia.”
b
When risk factors to potential suicide have been identified, a nurse must further assess the actual risk for a suicide attempt. Which question would be appropriate for initial assessment to determine the presence or absence of suicidal thoughts in an older adult with risk factors?
Select one:
a.
“Do you have a plan for taking your life? What action would you take if you were to harm yourself?”
b.
“Do you think about harming yourself? Do you ever think about committing suicide?”
c.
“Under what circumstances would you take your life? Have you ever started to act on a plan to harm yourself?”
d.
“Does your life feel worthless? Do you ever think about escaping from your problems?”
D
A gerontological nurse conducts an assessment of an older adult who has a history of depression. Assessment reveals that the client has been drinking up to two bottles of wine each day for the last several months. What should the nurse teach the client about alcohol use and depression?
Select one:
a.
“Alcohol has been shown to contribute to depression and vice versa.”
b.
“We recommend that everyone over the age of 70 abstain from drinking alcohol.”
c.
“If you quit drinking, your depression will likely improve.”
d.
“If you choose to use alcohol to address your depression, it’s best to limit it to four to five drinks each day.”
A
An older adult has been accompanied by an adult child to visit a primary care provider. The child has expressed concern about the client’s increasing apathy, isolation and apparent sadness over the past several months, and the client acknowledges many of the symptoms of depression. Which type of assessment should the nurse prioritize?
Select one:
a.
Functional
b.
Medication
c.
Cardiovascular
d.
Musculoskeletal
B
Which statement by residents of a nursing home should prompt a nurse to assess for depression?
Select one:
a.
“I’ve never been too prone to headaches, but these days I always seem to have one.”
b.
“I’ve got these cravings for sugary and salty snacks more than I used to.”
c.
“I don’t know why this sore on my ankle just won’t heal this time.”
d.
“Lately I wake up for the day at 4:00 or 5:00 in the morning and can’t fall asleep again.
D
An older adult was diagnosed with depression shortly after relocating to the nursing home 6 weeks ago. Which intervention should the nurse implement to address the depression?
Select one:
a.
Teach the client about the problem of suicide in older adults.
b.
Provide opportunities for the client to engage with other residents.
c.
Appoint another resident as a “buddy” to accompany the client during the day.
d.
Direct the client to list all the positive aspects of her present circumstances
B
Who is at highest risk for suicide?
Select one:
a.
60-year-old with kidney stones
b.
75-year-old woman living with her child and grandchildren
c.
18-year-old who has made an appointment with his primary health care provider
d.
85-year-old man whose spouse died 1 year ago
D
A nurse recognizes that depression has functional consequences. Late-life depression may lead to all of the functional consequences except…
Select one:
a.
Decreased functioning
b.
Higher level of pain
c.
Dementia
d.
Increased risk for suicide
C
An older adult is admitted to the hospital with weight loss and cognitive impairment. To assist in the diagnosis of major depressive disorder, the nurse assesses all of the following except…
Select one:
a.
Decreased deep tendon reflexes
b.
Psychomotor agitation
c.
Loss of interest or pleasure
d.
Sleep disturbances
A
Differences about OA depression
-less likely to admit depressive symptoms
-more likely to accompany other conditions
-more serious consequences from depression
-more likely to go unreported and under treated
-more physical and cognitive symptoms
-early waking (instead of trouble falling asleep)
-anorexia
-less talk but more successful attempts at suicide
Risk Factors for Depression in OA
-female
-family history
-loss of relationship
loneliness
-stressors
-current or previous experience of abuse and neglect
-being a caregiver
-disability
-chronic disease
-adverse med affects
-withdrawal
Neg Funct Consequences of Depression-Physical
-lead to other med problems
-worsen pain and pain worsens depression
-nutritional deficiencies (loss of appetite)
-alcohol and depression have a circular relationship
-weight loss
-insomnia/hypersomnia/early waking
-loss of energy/fatigue
-pain
-low libido
Psychosocial Funct Consequences of Depression
sad/low/flat affect
* absence of feelings
* diminished life satisfaction
* low self-esteem, passivity
* inattention to personal appearance
* slowed thinking, poor memory
* exaggeration of any mental deficits
* rumination about past and present problems
* feelings of guilt
* Hopelessness
* Unworthiness
* Uselessness
Nursing Assessment tool for Depression
Geriatric Depression Scale (GDS)
