objective 8 Flashcards
impairment in feeling, tone, and emotional state which can influence persons behavior and perception or events
mood disorders
what are the 2 main categories of mood disorders?
depressive
bipolar
sadness “the blues”
appropriate response to stress
may c/o physical discomfort
less responsive to env
recovers within short period of time
mild depression
depressed most of the day for a 2 yr period
less severe than major
do not include psychotic features
complain always been depressed
verbalize feelings of guilt, inadequacy and irritability
feels better in AM
dysthymia (moderate depression)
depressed mood, including emotional, cognitive, physical, and behavioral symptoms and impairing functioning
major depressive disorder
what are the subtypes of MDD?
psychotic features
melancholic features
atypical features
catatonic features
postpartum onset
seasonal features
disorganized thinking, delusions, or hallucinations
psychotic features
endogenous depression
severe apathy, weight loss, profound guilt, symptoms worse in AM, suicidal ideation
melancholic features
vegetative symptoms
accompanies by anxiety
atypical features
nonresponsiveness
extreme motor retardation
withdrawal, negativity
catatonic features
within 4 weeks after childbirth
psychotic features common, delusional thoughts of infant
postpartum onset
Inhibition of melatonin (Begin fall/winter, remit spring)
Reduced metabolic activity
Anergia (lack of energy or activity)
Hypersomnia (excessive daytime sleep)
Overeating, weight gain, carb cravings
Responds to light therapy
seasonal affective disorder
Refers to a cluster of symptoms that occur in the last week
before the onset of a woman’s period
Causes problems severe enough to interfere with the ability
of a woman to work or interact with others
Symptoms include mood swings, irritability, depression,
anxiety, feeling overwhelmed, and difficulty concentrating
Other physical manifestations include lack of energy,
overeating, hypersomnia or insomnia, breast tenderness,
aching, bloating, and weight gain
Symptoms decrease significantly or disappear with the
onset of menstruation
premenstrual dysphoric disorder
Diagnosed when feelings of depression occur most of the
day, for the majority of days
Feelings last at least 2 years in adults and 1 year in children
and adolescents
Individuals with this disorder have at least two of the
following:
decreased appetite or overeating, insomnia or hypersomnia, low
energy, poor self-esteem, difficulty thinking, hopelessness
persistent depressive disorder
Most new moms will get the “baby blues” (up to 85 percent)
Hormonal changes can cause anxiety, crying and restlessness
that goes away within the first two weeks after giving birth.
Mild and temporary form of depression that goes away once
hormones level out.
postpartum blues
It can happen anytime during pregnancy, to several months after
childbirth.
It can affect first-time mothers or mothers who have already had
children before, and it can also affect those who are adopting
postpartum depression
what are the risk factors of PPD?
- Past episodes of depression or anxiety
- Stress
- Societal pressures
An extremely serious condition where a new mother may have problems
with seeing or hearing things which aren’t there, in addition to thoughts of
harming others (even her children) in order to protect them
PP psychosis
Focus on patient’s strengths
Treatment goals mutually developed
Based on patient’s personal needs and values
recovery model
what are the 3 phases of implementation?
acute phase
continuation phase
maintenance phase
6 to 12 weeks
acute phase
4 to 9 months
continuation phase
1 year or more
maintenance phase
First-line therapy
Indications
Adverse reactions
Potential toxic effects
selective serotonin reuptake inhibitors (SSRIs)
Neurotransmitter effects
Indications
Adverse effects
Toxic effects
Adverse drug interactions
Contraindications
Patient and family teaching
tricyclic antidepressants (TCAs)
Neurotransmitter effects
Indications
Adverse/toxic effects
Interactions
Drugs
Food
Contraindications
monamine oxidase inhibitors (MAOIs)
“Shock treatment”
Somatic therapy
Places electrodes at precise locations on pt head
& uses electrical current to induce convulsive
seizures
Thought to correct biochemical abnormalities in
the brain
ECT
Mood swings, alternating from depression to elation
with periods of normality between episodes
bipolar disorder
what are the categories of Bipolar disorder?
bipolar I
bipolar II
cyclothymic disorder
at least one episode of mania alternating with major depression
Bipolar I
hypomanic episodes alternating with depression
Bipolar II
exaggerated feeling well being
euphoria
extreme happiness
elation
falls between normal euphoria and mania
hypomania
prevent injury
Medical stabilization
Maintaining safety
Self-care needs
acute phase
Excessive elation, inflated self-esteem & grandiosity
Rapid cycling- the occurrence of four or more mood
episodes during previous 12 months
mania
Manipulative
Demanding
Splitting
manic patient
Maintain medication adherence
Psychoeducational teaching
Referrals
continuation phase
limit severity and duration of future episodes
prevent relapse
maintenance phase
Indications
Therapeutic and toxic levels
Therapeutic blood level: 0.8 to 1.4 mEq/L
Maintenance blood level: 0.4 to 1.3 mEq/L
Toxic blood level: 1.5 mEq/L and above
Adverse effects and toxicity (Table 14.4, pg. 260)
Patient and Family Teaching: pg. 261
lithium carbonate
what are the dimensions of hospice palliative care nursing?
Valuing
Connecting
Empowering
Doing for
Finding meaning
In addition to providing practical care, nurses
practise enhanced skills in…?
Communication
Coordination
Management skills
Self-care
Recognizing and attending to the meaning in suffering
what are the four gifts resolving relationships?
forgiveness
love
gratitude
farewell
what are the types of grief?
disenfranchised grief
complicated grief
what are the tasks of mourning?
Accept the reality of the loss
Experience the pain of grief
Adjust to an environment without the loved one
(externally, internally, and spiritually)
Relocate and memorialize the loved one
