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COC N126 Psych 🧠 > Midterm 2 Material Depression (Chp 15), Bipolar Disorder (Chp 16), Anxiety (Chp 11), Violence (Ch24), Anger + Aggression, Chapter 10 Trauma Informed Care > Flashcards

Midterm 2 Material Depression (Chp 15), Bipolar Disorder (Chp 16), Anxiety (Chp 11), Violence (Ch24), Anger + Aggression, Chapter 10 Trauma Informed Care Flashcards

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1
Q

Differentiate major depression disorder MDD (5) vs Persistent Depression Disorder PDD (3)

A

Major Depressive Disorder (5)
- Suicidal Ideation
- Unable to function
- May have psychosis
- Anorexia
- Depressed mood in nearly all activities

Persistent Depressive Disorder (3)
- Symptoms less severe (not hospitalized)
- Overeating
- Chronic, must be depressed for 2 years to be diagnosed PDD

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2
Q

Children and Adolescents may display what type of depressive symptoms? (4)

A
  • Anxiety
  • Somatic symptoms
  • Decreased interactions/avoidance
  • Irritable rather than sad mood; high suicide risk
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3
Q

In older adults, when does suicide peak? Second peak?

A

Middle age
Second peak at age 75

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4
Q

True or false: Depressive disorders in older adults is commonly associated with chronic illness

A

True, depression is typically secondary to a chronic illness in the geriatric population

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5
Q

What is the highest priority assessment for a depressed individual?

A

Risk of suicide

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6
Q

How do you assess for depression? What does it stand for?

A

Sad mood/Sleep distrubances
Interest diminished (Anhedonia)
Guilt/Feelings of worthlessness

Energy loss (Anergia)/Esteem loss

Concentration diminished
Appetite changes
Psychomotor retardation
Suicidal ideation

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7
Q

Risk factors of Depression? (11)

A

First degree family history of depressive disorders
Age 40 years or younger
Member of the LGBTQ community

Postpartum period
History of prior episodes of depression/ suicide attempts
Absence of social support
Negative, stressful life events, particularly early trauma

Chronic medical illness
History of sexual abuse
Active alcohol or substance use disorder
Female gender

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8
Q

Cognitive theory is the theory that…

A

the triad of negative beliefs cause depression due to a negative reaction to the world:
- Negative view of self
- Negative view of the world
- Belief that only bad things will happen in the future

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9
Q

Learned Helplessness is the…

A

Belief that negative events are their fault and can’t fix them

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10
Q

Diathesis-stress theory is…

A

The combination of events (stressors) and biological factors (neurotransmitter imbalance or genetics) cause depression

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11
Q

What is the most commonly used assessment tool for depression?

A

Hamilton Depression Scale

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12
Q

What should you assess for someone with depression? (6)

A
  • Evaluate patient’s risk of suicide or harm to others
  • Determine if the depression is primary or secondary to another disorder
  • Assess for history of depression
  • Assess support systems
  • Assess for triggering events
  • Complete a psychosocial and spiritual assessment
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13
Q

What are the nursing care plans for depression? (Name at least 4/9)

A
  • Risk for suicide
  • Ineffective coping
  • Low self esteem
  • Hopelessness
  • Helplessness
  • Self care deficit
  • Risk for self-mutilation
  • Despair
  • Depressed mood
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14
Q

What are nursing interventions for depression? (7)

A
  • Therapeutic communication
  • Medication therapy
  • Health teaching and health promotion
  • Milieu therapy
  • Mindfulness-Based cognitive therapy
  • Group Therapy
  • First-line psychotherapy interventions
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15
Q

What is the first-line treatment for depression?

A

SSRIs

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16
Q

Side effects of SSRIs
Common (7)
Serious (2)

A

Common:
- Sexual dysfunction
- Increased weight
- Headache
- Dizziness
- Constipation/diarrhea
- Insomnia
- Anxiety

Serious:
- Serotonin syndrome
- Mania

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17
Q

Possibly not on the exam
Second-line treatment for depression are? Examples?

What effect do they have on SSRI’s?

A

SNRIs: duloxetine, venlafaxine
SNDIs: mirtazapine

Augment the effects of SSRIs

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18
Q

How do TCAs work?
What are some common side effects? (8)

A

Blocks the reuptake of norepinephrine and serotonin

Common side effects:
- Anticholinergic side effects (4)
- Adrenergic side effects
- Tachycardia
- Orthostatic hypotension
- Cardio-toxicity
- Dizziness
- Weight gain
- Sedation

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19
Q

MAOIs work by…

Side effects…(8)

Should caution eating…

A

Blocking the enzyme involved in breaking down monoamines resulting in an increase in; norepinephrine, dopamine, serotonin

Side effects include
- Hyertensive crisis
- Weight gain
- Fatigue
- Sexual dysfunction
- Hypotension
- Muscle cramps
- Urinary retention
- Constipation

Should caution eating tyramine rich foods such as
- Chocolate
- Cheese
- Meat
- OTC cough medication
- Alcohol
- Tofu
- Died fruits and veggies
- Avocados

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20
Q

What is the number 1 most effective treatment to date for depression?

What are the side effects of this procedure? (5)

A

ECT
Electroconvulsive therapy

Side effects
- Short-term memory loss
- Confusion
- Headache
- Muscle soreness
- Nausea

21
Q

Who does not qualify for ECT?

A

Patient’s with cardiac issues

22
Q

What patients should be cautioned for ECT? (3)

A

Head trauma
Seizure disorders
Brain tumors

23
Q

When is clinical depression considered treatment resistant?

A

When 2 or more pharmacological interventions fail

24
Q

When is ECT indicated? (5)

A
  • When drug therapy fails
  • There is a need for rapid, definitive response when a patient is suicidal or homicidal.
  • The patient exhibits extreme agitation or psychomotor retardation and stupor
  • The patient has severe mania
  • The patient develops a life-threatening illness because of refusal of foods and fluids
25
Q

Common cognitive disorders

What is filtering?

A

Taking negative details and magnifying them while filtering out all positive aspects of a situation

26
Q

Common cognitive disorders

Polarized thinking

A

Things are either “black or white”. We have to be perfect or we’re a failure-there is no middle ground or shades of gray.

27
Q

Common cognitive disorders

Overgenralization

A

Coming to a general conclusion based on a single incident or a single piece of evidence =. If something bad happens only once, we expect it to happen over and over again.

28
Q

Common cognitive disorders

Jumping to conclusions

A

Without individuals saying so, we think we know what they are feeling and why they act the way they do

29
Q

Common cognitive disorders

Catastrophizing

A

We expect disaster to strike, no matter what. We exaggerate the importance of insignificant events.

30
Q

Common cognitive disorders

Personalization

A

A distorted belief that everything others do or say is somehow about us.

31
Q

Common cognitive disorders

Control fallacies

A

We see ourselves as helpless, a victim of fate, having no control, or we assume total responsibility for the pain and happiness of everyone around us (over control).

32
Q

Common cognitive disorders

Fallacy of fairness

A

We feel resentful because we think we know what is fair, but other people won’t agree with us.

33
Q

Common cognitive disorders

Blaming

A

We hold other people responsible for our feelings and behaviors. Nobody can “make” us feel any particular way…only we have control over our own emotions and emotional reactions.

34
Q

Common cognitive disorders

Should

A

We have a lost of ironclad rules about how we and others should and must behave

35
Q

Common cognitive disorders

Emotional reasoning

A

We believe that what we feel must be true automatically. “I feel it; therefore it must be true”

36
Q

Common cognitive disorders

Global Labeling

A

We generalize one or two qualities into a negative global judgement. For example, “I’m a loser” verses “In one situation, I failed.”

37
Q

Common cognitive disorders

Always being right

A

I have to prove my opinions and actions are correct. Being wrong is unthinkable

38
Q

What does OARS stand for?

A

Open-ended questions
Affirmations
Reflective reasoning
Summaries

39
Q

What does BATHE stand for in motivational interviewing

A

Background
Affect
Trouble
Handle
E

40
Q

What does ICRA stand for?

A

I
C
R
A

41
Q

COC Conceptual Framework
(Inquiry and Caring (6)

Centerpiece of Inquiry and Caring (4)

A
  • Professionalism
  • Leadership
  • Communication
  • Critical Thinking
  • Patient-centered care
  • Safety
  • Person
  • Nursing
  • Health
  • Environment
42
Q

Adverse Childhood Experiences (ACEs) (3)
3

2

5

A

Abuse
- physical
- emotional
- sexual

Neglect
- physical
- emotional

Household challenges
- Mental illness
- Intimate partner violence
- Parental separation or divorce
- Incarceration
- Substance abuse

43
Q

Social Determinants of Health (5)

A
  • Education access and quality
  • Healthcare access and quality
  • Economic stability
  • Neighborhood and built environment
  • Social and community context
44
Q

Guiding Principles of Trauma Informed Care (6)

A
  • Safety (physical and psychological)
  • Trustworthiness and transparency
  • Peer support and mutual self-help
  • Collaboration and mutuality
  • Environment, voice, and, choice
  • Cultural, historical, and gender issues
45
Q

What are the symptoms of PTSD? (8)
How long do these symptoms last?

A
  • Helplessness/Hopelessness
  • Flashbacks
  • Nightmares
  • Persistent avoidance of stimuli r/t event
  • Persistent numbing of general responsiveness
  • Relationship issues
  • Cognitive distortions
  • Increased: arousal, exaggerated startle response, lack of trust

These symptoms last for more than 4 weeks

46
Q

Treatments for PTSD
Psychotherapy (6)

A
  • Prolonged exposure therapy
  • Cognitive process therapy
  • Eye movement desensitization and reprocessing
  • Cognitive behavior therapy
  • Family therapy
  • Relaxation/stress relieving techniques
47
Q

PTSD pharmacology tx (3)

A

SSRIs:
- Sertraline
- Paroxetine

Psilocybin Mushrooms

48
Q

True or False: Therapy in combination with medications is needed for medication to be effective for PTSD

A

True

COC N126 Psych 🧠 (9 decks)

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