Mood disorders Flashcards
what are 2 parts of bipolar disorder?
depression and mania
in order to avoid lithium toxicity, the client must maintain adequate___ and ___ intake
sodium and water
what are the most important interventions for a manic episode?
1- keep the person safe. remove hazardous objects from the place
2- give them a private room if possible (limit group activities)
3- reduce environmental stimuli
4- provide high calorie finger foods (since thy won’t sit still)
5- avoid competitive games
6- provide gross motor movements like walking
in depression, patients may experience
____ which is when the person feels better at a certain time of the day
or
_____ when a person has persistent thoughts about and discussion of a particular subject
diurnal variation
ruminatiom
intervention for depression after a manic episode
- assess for suicidal or homicidal ideation
- keep patient and everyone safe
- NEVER leave the client alone for a long time
- give them easy games to play so they can build self confidence/esteem
- offer them small, high calorie, high protein snacks during the day
- spend time with the client before bedtime
this treatment is used when antidepressants/ medications don’t work for severely depressed clients, or bipolar clients who are in manic phase for too long and not respond to treatment.
ECT
What happens in the ECT?
an electrical current is delivered through electrodes attached to the temples that cause a brief seizure within the brain.
you’ll see subtle outward movements of hands, feet, or toe because the client is pre-medicated with a muscle relaxant
which clients cannot get an ECT?
- recent MI
- Brain lesion/tumor
- any client with abnormality to the brain
with voluntary client to get ECT, an informed consent must be signed by the client. what about the involuntary client?
informed consent must be obtained by the next of kin…. in some states, by the court.
what are some important things to tell the client before an ECT?
- NPO after midnight or at least 4 hours before procedure
- pee before
- no hairpins, contact lenses, or dentures during the procedure
what must you do during the ECT?
- continual vital signs monitoring (BP, O2 ETC)
- 1st give a short acting anesthetic and then the muscle relaxant
- they get 100% o2 via positive pressure
- an airway or bite-block is placed so they can’t bite their tongue
what do you do after the ECT?
- continual V.S
- Client can leave PACU when o2 is %90 or >, VS is stable, and mental status is good
- Assess the gag reflex before giving fluids, or anything to swallow
major side effects of ECT?
- MAJOR= short term memory loss, confusion, disorientation
- memory deficits may occur but it usually recovers completely. it may take some people like 6 months to get it back fully
T OR F?
YOU MUST MONITOR BOTH DEPRESSED AND CLIENT WHO JUST STARTED TAKING AN ANTIDEPRESSANT FOR SUICIDE
T
What happens when a depressed client or client who just started taking antidepressant now have much energy?
they can be at risk for suicide because they now have the energy to do it
what is chlordiazepoxide?
Librium= helps with alcohol withdrawal symptoms… benzodiazepine
Dissulirum is?
antabuse= used to sensitize alcoholic patient to alcohol. they will get sick if they ingest any alcohol
No alcohol must be consumed for at least 12 hours before taking the 1st dose.
After dissulfirum has been DC,d how long does the patient have to wait before drinking again?
14 days… or else, they’ll get sick.
they should avoid all alcohol containing substances.
when does a client start experiencing alcohol withdrawal symptoms?
a few hours and peaks at 2-3 days/ 48 to 72 hours.
This is a medical emergency around 2-3 days during alcohol withdrawal
withdrawal delirium
everything increases/ they get fever and hallucinations and delusions
with CNS depressants, what are the interventions for an overdose?
awake versus comatose
awake= give activated charcoal
comatose= maintain airway patentcy, gastric lavage with activated charcoal, and initiate seizure precautions
What is the antidote for benzodiazepine?
Flumazenil (Romazicon)
T OR F?
Benzodiazepines can be used to treat alcohol withdrawal
t! they’re both depressants
T OR F?
Abrupt withdrawal of substance abused like a CNS depressant can lead to death
T!
Alcohol, benzodiazepines, and barbiturates (barbital) are all____
CNS depressants
Amphetamines like ritalin, cocaine, and crack are all____
CNS stimulants
withdrawal of CNS stimulants are treated with ____ because___
antidepressants because after their “manic” episode, they feel really depressed after. It’s an opposite effect of feeling “stimulated”
opium heroin morphine sulfate codeine sulfate methadone hydromorphone oxycodone hydrocodone fentanyl
are all
opioids= pain killers
CNS depressant
Naloxone is the antidote for___
Opioid overdose
Lysergic acid diethylamid (LSD), mescaline, psilocybin (mushrooms), and phencyclidine (PCP) are all___-
Hallucinogens
antianxiety meds are used to treat
hallucinogens
