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mood disorders Flashcards

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1
Q

MOOD DISORDER OVERVIEW

A

-impairs functioning
- persuasive alteration in mood and affect
elevated
depressed
cycling

  • not appropiriate
  • out of proportion
  • rapid/dramatic change in mood
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2
Q

CONTRIBUTING FACTORS

A 
biological
- hormonal dysregulation 
- neurotransmitter changes 
- neuroantonomy 
-sleep neurophysiology 
immunological disturbance

genetic
-highly heritable

psychosocial

  • stress
  • personality
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3
Q

ROLE OF STRESS

A

-stressful life events precede onset mood disorders
variable thought on degree of influence

  • theory that brain’s biology changes
    increases risk of subsequent episodes
  • resilience important in determining impact of stress
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4
Q

RESILIENCE

A

-the ability to adapt well to stress
emotional pain and distress experience

  • factors that promote resilience
    caring and supportive relationships
    the capacity to make plans and complete a goal
    positive view of self
    communication and problem solving skills
    ability to manage strong feelings and impules
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5
Q

MOOD DISORDERS

A
  • adjustment disorder with depressed mood
  • major depressive disorder
  • bipolar disorder
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6
Q

ADJUSTMENT DISORDER WITH DEPRESSED MOOD

A
  • change in mood and affect following a stressor
    (situational depression)
  • symptoms begin within 3 months of stressor
  • symptoms do not last beyond 6 months
  • distress out of proportion to the stressor
    causes impairment in functioning
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7
Q

CLINICAL MANIFESTATIONS OF ADJUSTMENT DISORDER WITH DEPRESSED MOOD

A
  • sleep disturbances
  • feeling hopeless and sad
  • loss of self esteem
  • irritability
  • difficulty concentrating
  • inability to feel pleasure (anhedonia)
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8
Q

NURSING ASSESSMENT FOR ADJUSTMENT DISORDER

A
  • precipitating stressor
  • patient symptoms
  • depression risk factors
  • resilience factors
    -current coping strategies
  • safety
    -screening tool
    -
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9
Q

NURSING DIAGNOSES ADJUSTMENT DISORDER WITH DEPRESSED MOOD

A 
helplessness
disturbed sleep pattern 
disrupted family processes
situational low self -esteem 
ineffective coping
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10
Q

NURSING PLAN AND GOAL ADJUSTMENT DISORDER WITH DEPRESSED MOOD

A 
adequate sleep and rest 
impulse control 
daily functioning
self esteem 
safety
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11
Q

NURSING INTERVENTIONS ADJUSTMENT DISORDER WITH DEPRESSED MOOD

A 
promote hope 
identify areas of control 
encourage belief in themselves 
assist in problem solving process
identify sources of support 
encourage functioning
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12
Q

COLLABORATIVE INTERVENTIONS ADJUSTMENT DISORDER WITH DE[RESSED MOOD

A 
cognitive behavioral therapy 
family therapy 
antidepressant medication 
antianxiety mediaction 
exercise
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13
Q

MAJOR DEPRESSIVE DISORDER OVERVIEW

A 
single episode or recurrent 
change in emotional state and functioning 
average age onset mid 20's  
women more affected than men 
hereditary
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14
Q

CLINICAL MANIFESTATIONS MAJOR DEPRESSIVE DISORDER

A 
depressed mood most of the day 
diminished interest or pleasure 
weight loss or gain 
insomnia or hypersomnia 
fatigue 
feeling worthless 
diminished concentration 
recurrent thoughts of death
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15
Q

MAJOR DEPRESSIVE DISORDER LIFESPAN CONSIDERATION

A 
children/adolescents 
-usually assessed within context of home /school situation 
- decreased school performance
problems with parents or teachers 
irritability

older adults

  • memory problems
  • social withdrawal
  • sleep disturbances
  • appetite
  • delusions/ hallucinations
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16
Q

NURSING ASSESSMENT MAJOR DEPRESSIVE DISORDER

A
  • symptoms of depression
  • difficulty completing simple tasks
  • tearfulness
  • somatic complaints
  • withdrawal / social isolation
  • differentiate from grief
  • comorbidities
  • suicide assessment
17
Q

SUICIDE ASSESSMENTS

A

suicidal ideation

  • passive vs. active
  • frequency

Plan

  • lethality
  • realistic
  • available means

intent
past attempts
reasons to not complete

18
Q

suicide precautions

A
  • nursing suicide assessment
  • documentation
  • patient transport considerations
  • physical environment
  • observation level 1:1 Q15 checks
  • restriction (supervised bathroom)
  • contraband
19
Q

NURSING DIAGNOSIS MAJOR DEPRESSIVE DISORDER

A

risk for self directed violence
chronic low self esteem
hopelessness social isolation
ineffective health maintenance

20
Q

NURSING PLAN /GOAL MAJOR DEPRESSIVE DISORDER

A

remaining free from self injury
participation in recreational activities
knowledge that feeling better follows engaging in activities
adherence to treatment regimen

21
Q

nursing interventions major depressive disorder

A 
develop therapeutic relationship 
provide distraction from self focus
 encourage activities 
recognize accomplishments
set limits on time spent discussing failures 
teach assertiveness
22
Q

COLLABORATIVE INTERVENTIONS MAJOR DEPRESSIVE DISORDER

A 
laboratory tests 
-thyroid 
electrolytes
urinalysis 
toxicology 
liver function tests 
pregnancy test

ANTIDEPRESSANTS
CBT THERAPY
ECT
TMS

ALTERNATIVES 
-exercise 
-supplements 
- acupuncture
-animal companionship 
music therapy
23
Q

PHARMACOLOGY INTERVENTION FOR DEPRESSION

A

SSRIS

  • increase available serotonin
  • first line medication
  • fluoxetine , citalopram , sertraline, escitalopram

SNRIS

  • increase serotonin and norepinephrine
  • venlafaxine, duloxetine

TCAS AND MAOIS
older with significant side effects

ATYPICAL ANTIPSYCHOTICS

  • used with SSRI for severe depression
  • apripiprazole, risperidone
24
Q

COGNITIVE BEHAVIORAL THERAPY

A

identifies negative thoughts and behaviors
replaces disordered thought processes
mindfulness training

25
Q

PSYCHOTHERAPY

A

most effective when combined with medication

both effective when used independently

26
Q

ELECTROCONVULSIVE THERAPY

A

-electric current is passed through the brain to induce a seizure

  • given under anesthesia
  • NPO 4 hrs before
  • receive muscle relaxant
  • monitor EEG,EKG,oxygen saturation , vtal signs
  • short term memory loss expected (usually restored)
  • typically 2-3 times per week for 12 treatments
27
Q

BIPOLAR DISORDERS

A

mood alternatives between extremes

  • depression
  • mania
  • interspersed with neutral mood

Bipolar 1
greater than or equal to 1 manic episode and greater than 1 major depressive episode

Bipolar 2
greater than 1 major depressive episode and at least 1 hypomanic episode

28
Q

MANIC EPISODE

A

-abnormally exspansive elevated or irritable mood
- increased goal directed activity
-most of the day every day
plus 3 or more of the following

  • inflated self esteem
  • decreased need for sleep
  • more talkative than usual
  • flight of ideas
  • distractibility
  • psychomotor agitation
  • increased pleasurable activities
29
Q

MANIC

A
  • symptoms last at least 1 week
    -mood disturbance causes
    marked impairment in functioning
    psychotic features
    necesaritates hospitalization
30
Q

HYPOMANIC

A

-symptoms last at least 4 days
-mood disturbances causes
change in functioning
uncharacteristic behaviors
observable by others
no hospitalization

31
Q

NURSING ASSESSMENT FOR BIPOLAR DISORDER

A
  • changes in thought processes
  • inflated self esteem
  • delusions
  • ignoring fatigue, hunger, hygiene
  • distractibility
  • hallucinations
  • surprising sense of well being
32
Q

nursing assessment bipolar disorder

A

-rapid loud pressured speech
-flight of ideas
- poor judgement/impulsivity
shopping, drugs,sex
- unusual appearance
dressing inappropriately

33
Q

nursing diagnosis examples

A
  • risk for injury
  • disturbed thought process
  • impaired social interaction
  • self care deficit
  • sleep deprivation
  • risk for suicide

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