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Aprils Notes: NUR114 > Mood and Affect > Flashcards

Mood and Affect Flashcards

1
Q

Mood Disorder

A

Mental DO characterized by periods of depression often alternating with a period of mania

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2
Q

What is the statistical prevalence of depression in the US?

A

16.5% older than 18 will have MD episode in lifetime
Women 70% more likely to experience
18% of preadolescents
11.2% ages 13-18 (associated w/substance abuse and antisocal behavior)
6-9% over 65 w/major Depression
17-19% over 65 w/Chronic

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3
Q

Comorbidity of depressive syndrome with other psych. DO

A
  1. Anxiety DO
  2. Schizophrenia
  3. Substance abuse
  4. Eating DO
  5. Schizoaffective DO
  6. Personality DO
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4
Q

Etiology of Depression

A

Changes in neurotransmitter-receptor relationships in brain:

  1. Limbic (emotional)
  2. Prefrontal cortex (depressed mood, concentration)
  3. Hippocampus (memory impairments; feelings of hopelessness, guilt, worthlessness
  4. Amygdala (anxiety and decreased motivation)
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5
Q

What is dysthymia?

A

depressive symptoms that have present for 2 years - more chronic than MDD

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6
Q

What are indications of depression in Adolescents?

A
  1. Irritability
  2. Changes in Social Network
  3. Acting out
  4. Cutting
  5. Misuse of sex
  6. Risk Taking
  7. SI-attempts
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7
Q

What areas are assessed for Depression?

A
  1. SI/attempts/risk factors
  2. Mood (anhedonia, anergia, anxiety, guilt, worthlessness, guilt…)
  3. Vegetative signs
  4. Cognition
  5. Communication
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8
Q

Defense Mech. of depression

A

Repression
Regression
Introjection

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9
Q

What is the focus in the milieu?

A

Safety

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10
Q

Benefits of SSRIs

A

Less anticholinergic effects, less cardiotoxicity, faster onset than TCAs,

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11
Q

Benefits of atypical antidepressants

A

energizing, less sexual side effects, good for anxiety

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12
Q

Types of Interventions for Safety

A
  1. location of room
  2. Level of monitoring i.e. 1:1, irregular rounds
  3. Contract for Safety

you can never decrease the MDs orders for monitoring. You can increase the level for the pts safety. (Must obtain MD order after you increase.)

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13
Q

What is contracting for safety?

A

Pt is invested in the agreement. Pt will help in keeping themselves safe by contracting with caretaker/social worker/MD

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14
Q

Most common SE of SSRI’s

A

GI irritations

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15
Q

Worst side effect of MAOIs

A

Hypertensive Crisis:

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16
Q

What is a safety procedure that can be done for Pt with SI during med admin?

A

Check mouth for ‘cheeking’

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17
Q

Poor SE of TCAs

A 
ACH effects
OH
CHF
Sexual Dys
Overdose
18
Q

When do we monitor the pts the closest?

A

First couple of weeks of new meds, they may now have the E to act on SI

19
Q

Nurses responsibility in ECT for depression?

A

Rubinal - Dries up secretions

20
Q

Educating pt of SE of ECT would include:

A
  1. anterograde or retrograde amnesia (lasts up to 3 weeks)
  2. Disorientation
  3. Confusion
  4. Possible: HA, muscular aches, ataxia, amenorrhea, blurred vision
21
Q

BP1 vs BP2

A

BP1= one episode of mania alternating with major depression
Psychosis may be present.

BP2=hypomanic episodes alt with major depression (psychosis absent)

22
Q

What is cyclothymia?

A

hypomanic episodes alt w/minor depressive episode.

These individuals tend to have irritable hypomanic episodes.

23
Q

Interventions in the Milieu for BP pt

A

Safety
Basic Needs - depressed pt high calorie foods, small portions
manic depression: foods to go, walk with
both catagories need sleep, establish pattern
Restrictive Interventions (least)
Administer meds, ensure compliance

24
Q

Pharmacological Interventions for BP DO

A
  1. Lithium
  2. Anti-convulsants
  3. Antipsychotics
  4. Anxiolytics
  5. Antidepressants
25
Q

Effects of Lithium Carbonate

A

Antimanic
Monitor levels - therapeutic 0.8 - 1.2 initially
maintenance 0.4 - 1.3
kidney toxicity 1.5 and up

26
Q

SS of lithium toxicity

A

polyuria, GI distress, hypothyroidism, fine hand tremors, hypOtension

27
Q

why are anticonvulsants used for BP d.o.?

A

Mood stabilizer
mania
blood levels drawn
s/s anxiety, depression

28
Q

Adverse effects of antiepileptic:

A

agranulocytosis
renal toxicity
aplastic anemia

29
Q

What is a common comorbidity with depression?

A

Chronic medical condition or substance abuse. Depression can also be a sequela of grief or bereavement.

30
Q

Which group has the highest rate of depression?

A

Whites>AA + MexAm
Asian Americans have the lowest rate.

women 2x > men
divorced + single > married

31
Q

Mood is sad, anxious, depressed

A

Depression

32
Q

Onset is rapid

A

Mania

33
Q

Thought process is retarded, decreased ability to concentrate and make decisions (ambivalence)

A

Depression

34
Q

Mood is elated, euphoric, expansive, irritable, labile (switches back and forth)

A

Mania

35
Q

Feelings of low self esteem, worthlessness, excessive guilt

A

Depression

36
Q

Self esteem is grandiose, inflated

Increased energy; does not acknowledge fatigue

A

Mania

37
Q

What is the safety risk with a depressed pt?

A

Harm to self - Si

38
Q

What is the risk to a Manic pt?

A

harm to self and/or others

i.e. self = exhaustion; heart gives out

39
Q

Is mania more common in men or women?

A

Equal distribution between the sexes.

40
Q

Name some primary risk factors for Depression.

A 
Hx of prior episodes
Family Hx
Hx of attempts or family Hx
Female
40 y.o. or more
Post partum
Chronic med illness
No social support
EtOH or other substance abuse
Hx of sexual abuse
41
Q

Name some common side effects of Depresssion.

A
  1. Mood of sadness, despair, emptiness
  2. Anhedonia
  3. Low self esteem
  4. Apathy
  5. excessive emotional sensitivity
  6. Irritability
  7. SI
42
Q

Characteristics of MDD

A
  1. Substantial pain
  2. Inability to function normally
  3. excessive guilt
  4. possible delusions
  5. fatigue, tired, anergia
  6. slowed thinking, speaking, moving
  7. anhedonia
  8. behave differently: cog, social, emo, phys)
  9. SI
  10. Physiological changes - bowel, bladder
  11. Crying
  12. Somatization
  13. Different thinking

Aprils Notes: NUR114 (3 decks)

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