Mental Health Module 4

Question 1

Biogenic amines

Answer 1

norepinephrine
serotonin
dopamine

Question 2

4 types of antidepressants

Answer 2

tricyclic antidepressants
monoamine oxidase inhibitors (MAO-i)
selective serotonin reuptake inhibitor (SSRI)
selective serotonin norepinephrine reuptake inhibitors (SNRI)

Question 3

MAOI MOA

Answer 3

prevent breakdown of biogenic amines

Question 4

SSRI MOA

Answer 4

block reuptake of serotonin in the synaptic cleft

Question 5

SNRI MOA

Answer 5

block reuptake of serotnin/norepinephrine in the synaptic cleft

Question 6

MAOI & diet specifications

Answer 6

cannot eat foods high in tyramine –> can lead to potentially fatal levels of NE (hypertension, cardiac arrhythmias, etc)

Question 7

Major Depressive Disorder

Question 8

Bipolar depression

Answer 8

depression characterized by periods of mania & major depression
categorized as bipolar I, bipolar II, unspecified

Question 9

Hypomania

Answer 9

> /= to 4 days
different than baseline behavior
has at least >/= 3 manic symptoms
does not interfere with ADLs/work/school
does not require hospitalization

Question 10

Acute mania

Answer 10

> /= to week
severe impact on ADL/work/school
may require hospitalization
elated, expanded mood
risky behaviors
lack of appetite/sleep
greater talkativeness
flight of ideas/racing thoughts
increased goal-directed activity
inflated self-esteem/grandiosity

Question 11

Bipolar medication

Answer 11

lithium

Question 12

Bipolar I disorder

Answer 12

one full-fledged manic episode & depressive episode

Question 13

Bipolar II disorder

Answer 13

major depressive episodes & at least on hypomanic episode
no full-fledged mania

Question 14

Depression symptoms

Answer 14

depressed mood
anhedonia
weight gain/weight loss
insomnia
psychomotor agitation/retardation
fatigue/loss of energy
feelings of worthlessness, excessive/inappropriate guilt
lack of concentration/decisiveness
suicidal ideation

Question 15

Risk of antidepressants

Answer 15

when first initiating treatment/increasing dose
results in an increase in energy which can increase risk of suicide
high safety risk if there is an increase in energy & depressed mood

Question 16

Mood stabilizers

Answer 16

anticonvulsants
lithium
atypical antipsychotics

Question 17

Are children likely to experience psychosis

Answer 17

no

Question 18

3 Treatments for depression

Answer 18

ECT
medication
psychotherapy

Question 19

Stimulants used to treat depression

Answer 19

dexedrine
ritalin

Question 20

Why are stimulants used to treat depression

Answer 20

treatment resistant depression –> for quick response
debilitated patients, stroke or chronic medical illness

Question 21

Types of psychotherapy

Answer 21

CBT
interpersonal
psychodynamic
individual counselling
family counselling
group counselling
milieu therapy

Question 22

Anticonvulsants

Answer 22

divalproex sodium
carbamazepine
gabapentin
lamotrigine
topiramate
valproic acid

Question 23

MOA of mood stabilizers

Answer 23

calm down hyperactivity in brain kindling

Question 24

Nursing considerations of lithium

Answer 24

narrow therapeutic window –> monitor serum levels. hold lithium if blood work not completed yet
interaction with sodium –> inverse reabsorption with sodium (higher salt lower lithium and vice versa)
fluid loss can lead to higher lithium levels
monitor s/s of lithium toxicity