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NUR 210 > Mood and Affect > Flashcards

Mood and Affect Flashcards

1
Q

what is mood

A

the sustained emotional theme that influcences behaviors and perception
it is subjective

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2
Q

what is affect

A

outward expression of internal experience
what we observe

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3
Q

what is euthymia

A

normal healthy fluctuations in mood

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4
Q

what determines severity of mood spectrum disorder

A

degree of loss of functional status

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5
Q

what are unstable affective states

A

crying
rage
euphoria
screaming
blunting

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6
Q

what can happen in severe mania/severe melancholy

A

disabled
acute confusion
hallucinations/delusions

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7
Q

optimal fxn of mood regulatio requires….

A

coordination and balance of neurons, neurotransmiters, and several parts of the brain

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8
Q

dopamine, norepi, and serotonin regulate

A

Appetite
Sleep
Thought
Emotion
Learning
Mood
Memory
Motivation
Concentration

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9
Q

how many hours of sleep

A

6-8

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10
Q

mood regulation in infants

A

Emotion (smiles, frown, crying) is regulated by the degree of physical comfort and by cues from adults

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11
Q

mood regulation in toddlers

A

Able to recognize the emotions of others and mimic behaviors. Hugging others in attempt to sooth others in distress

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12
Q

mood regulation in preschool

A

Observing parents and caregivers, expectations
on how to behave

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13
Q

mood regulation of childhood

A

Express feelings of sadness or anger to parent more than peers. Understand different emotional states

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14
Q

mood regulation in adolescents

A

developed skills to regulated emtions (talking w/ parent/friend/coach, listening to music, journal etc)
aware of social circumstances r/t emotional regulation
ex not socially acceptable to throw a tantrum or outburst
more variability in mood state than adults (hormone imbalance or developing emotional regulation)

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15
Q

mood regulation in older adults

A

Mood regulation is overall consistent
Despite physical and cognitive decline, they report
higher levels of well being than younger adults
Use emotional regulation processes to
compensate for negative stimuli

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16
Q

mood regulation in elderly

A

Bereavement overload
Increased risk of suicides among elderly
Symptoms of depression often confused with symptoms of neurocognitive disorder (e.g., dementia vs pseudodementia)

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17
Q

what happens when mood cycle is below euthymic range

A

melancholy (depression)

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18
Q

which gender becomes more depressed

A

women

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19
Q

where are there higher rates of depression

A

older adults in nursing or assisted living facilities and those with acute and chronic conditions

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20
Q

etiology on mood and affect disorders

A

Genetics (twin and adoption studies)
Neurochemical dysfunction (deficiency of norepinephrine, serotonin, and dopamine
has been implicated & excessive cholinergic transmission may also be a factor)
Low birth weight
Early life adversity (ACEs)
Stressful life events
Social factors
Psychological factors (learned helplessness, object loss theory)
Physiological causes (electrolyte disturbances, hormonal disorders, nutritional
deficiencies)
Secondary depression from general medical disorders
Secondary depression from medications (anticholinergics, anticonvulsants,
antihypertensives, antiparkinsonian agents, etc.)

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21
Q

depressive symptoms

A

Depressed mood
Anhedonia
Change in appetite/weight (high or
low)
Sleep disturbance (high or low)
Fatigue or loss of energy
Neurocognitive dysfunction
Psychomotor agitation or retardation
Feelings of worthlessness or
excessive guilt
Suicidal ideation and/or behavior

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22
Q

what is anhedonia

A

Loss of pleasure in
interests or activities

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23
Q

neurocognitive dysfxn symptoms

A

Attention
Concentration
Cognitive flexibility
Executive function
Information processing
speed
Memory
Verbal fluency
Social cognition

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24
Q

what is PHQ-9

A

patient health questionaire

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25
Q

what is transient depression

A

life’s everyday disappointments

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26
Q

what is mild depression

A

normal grief response

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27
Q

what is moderate depression

A

dysthymia
long lasting
also called persistent depressive disorder
feelings of sadness and emptiness, loss of interest in life

28
Q

what is severe depression

A

major depressive disorder

29
Q

how many symptoms to be diagnosed with depression

A

5 or more

30
Q

MDD core symptoms

A

Sad, irritable or anxious mood
Anhedonia
Impaired concentration and decision
making
Worthlessness and inappropriate guilt
Hopelessness
Fatigue or loss of energy

31
Q

what is the duration of MDD

A

> = 2 wks

32
Q

what does MDD cause

A

impairment in social and/or occupational fxning

33
Q

subtypes of MDD

A

melancholic depression, anxious
depression, atypical depression, psychotic
depression, seasonal depression

34
Q

adolescent presentation of MDD

A

est clue that differentiates depression
from normal adolescent behavior: a
visible manifestation of behavioral
change that lasts for several weeks*
Anger, aggressiveness
Running away
Delinquency
Social withdrawal
Sexual acting out
Substance abuse
Restlessness, apathy

35
Q

what is the 2nd leading cause of death in adolescents

A

suicide

36
Q

if SI is present what do you ask

A

nature of the ideation, intent, plans, available means (e.g., firearms), and actions
prior hx of suicide attempts, comorbid psychiatric and general medical illnesses, and family history of suicide

37
Q

what is a saftey plan

A

therapeutic communication, use of soothing or distracting coping skills, and one-to-one monitoring

38
Q

what are SSRIS

A

Selectively block reuptake of the neurotransmitter serotonin in the synaptic space, thereby intensifying the effects of serotonin
first line for depression
increase energy

38
Q

side effects of ssris

A

n/v
headache
wt loss or gain
sexual dysfunction

39
Q

interactions which ssris

A

increased risk for bleeding with asprin, NSAIDS, warfarin

40
Q

other SSRIs

A

citlopram
esitalopram
fluoxetine
proxetine
sertraline

41
Q

what are SNRIs

A

selective norepi and serotonin reuptake inhibitors
selectively block reuptake of norepinephrine and serotonin in the
synaptic space, thereby intensifying the effects of both these NTs.
Common agents for depression
Adverse effects are usually mild and go away after the first few weeks of
treatment. Take with food to avoid nausea

42
Q

adverse effects of SNRIs

A

Nausea, sweating, insomnia, tremors, sexual dysfunction

43
Q

SNRIs

A

desvenlafaxine
duloxetine
levomilnacipran
venlafaxine

44
Q

what are atypical antidepressants

A

change the levels of one or more neurotransmitters, dopamine, serotonin
or norepinephrine
Because atypicals work in different ways, each has their own characteristics and different possible side effects

45
Q

ex of atypical antidepressants

A

bupropian
mirtazapine
nefazodnoe
trazodone
vilazodone
vortioxetine

46
Q

what is bupropion

A

Low risk of sexual side effects and weight gain, can increase anxiety, lowers seizure threshold, contraindicated with hx of head injury, seizure, or eating disorder

47
Q

what is mirtazapine

A

Increases appetite, can be beneficial for elderly or those with poor intake, Adverse effects: weight gain, fatigue, elevated cholesterol

48
Q

what is trazodone

A

Used in combination with SSRI to treat insomnia, side effects
of sedation and rare priapism (prolonged erection of penis)

49
Q

adverse effects of TCAs

A

Anticholinergic effects
Orthostatic hypotension
Sedation
Cardiac arrhythmias, tachycardia
Lethal toxicity in OD
Excessive sweating
Increased appetite/weight gain
Sexual dysfunction

50
Q

contraindications in TCAs

A

seizure disorder
CAD, diabetes, urinary retention
Highly toxic, assess OD risk, may increase suicide risk

51
Q

examples of TCAS

A

Amitriptyline
Amoxapine
Desipramine (Norpramin)
Doxepin
Nortriptyline (Pamelor)

52
Q

what are TCAs

A

Used to treat conditions other than depression, e.g. obsessive-compulsive
disorder, anxiety disorders, nerve-related (neuropathic) pain
Take at bedtime, causes sedation, amitriptyline, doxepin, imipramine, and
trimipramine
Cause weight gain, amitriptyline, doxepin, imipramine, and trimipramine
Nortriptyline and desipramine are tolerated better than other TCAs

53
Q

what are monoamine oxidase inhibitors

A

Increase norepinephrine, dopamine, and serotonin in brain
Risk for hypertensive crisis; must avoid tyramine in diet
Orthostatic hypotension
Required 14-day “washout” period if switching meds

54
Q

interactions with MAOIs

A

SSRIs
TCAs
OTC decongestants, etc.
Antihypertensives
Amphetamines, caffeine
HF, CVD, renal disease, pheochromocytoma (tumor on adrenal gland, irregular secretion of epinephrine and norepinephrine – increases bp,
palpitations, and HA)

55
Q

examples of MAOis

A

isocarboxazid
phenelzine
selegiline
tranylcypromine

56
Q

what is serotonin syndrome

A

rare
Most often occurs when 2 medication that raise the level of serotonin are
combined
Other antidepressants
Some pain or headache medications
Herbal supplement, St. John’s wort

57
Q

s/s of serotonin syndrome

A

Anxiety
Agitation
High fever
Sweating
Confusion
Tremors
Restlessness
Lack of coordination
Major changes in BP
Tachycardia
Pupil Dilation

58
Q

nonpharm treatments

A

Electroconvulsive therapy (ECT)
Light therapy
Tanscranial magnetic stimulation (TMS)
Vagal nerve stimulation
Deep brain stimulation
Peer support
Exercise
Complementary medicine: St. John’s Wort
-Not regulated by FDA
-Photosensitivity
-Risk for serotonin syndrome if taken with Rx agents

59
Q

mechanism of action with ECT

A

Thought to increase levels of biogenic amines (i.e., neurotransmitters)

60
Q

side effects of ECT

A

temp memory loss and confusion

61
Q

risks of ECT

A

mortality
permanent memory loss

62
Q

post procedure ECT

A

monitor ABCs and vitals

63
Q

recovery period of ECT

A

rest, quiet environment, falls prevention

64
Q
A

NUR 210 (10 decks)

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