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PSYCHIATRIC NURSING QUIZ FINALS > QUIZ 1 > Flashcards

QUIZ 1 Flashcards

mood disorders

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1
Q

Are pervasive alterations in emotions that are manifested by depression, mania, or both?

A

Mood Disorders

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2
Q

Are the most common psychiatric diagnoses associated with suicide?

A

Mood Disorders

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3
Q

the most risk factor

A

with suicide

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4
Q

They interfere with a person’s life plaguing the client with long-term

A

sadness, agitation, or elation

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5
Q

Biblical personalities who suffered from depression

A

King Saul, King Nebuchadnezzar and Moses

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6
Q

Famous personalities

A

Queen Victoria, Abraham Lincoln, artist Vincent Van Gogh

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7
Q

Categories of Mood Disorder

A

Primary Mood disorders

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8
Q

Primary Mood disorders

A

Major Depressive Disorder
Bipolar Disorder

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9
Q

Some people with a combination of hallucinations, and delusions

A

Psychotic Depression

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10
Q

diagnosed when a person’s mood cycles between extremes of mania and depression.

A

Bipolar disorder

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11
Q

distinct period during which mood is abnormally and persistently elevated, expansive, or irritable. Typically this period lasts about 1 week

A

Mania

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12
Q

Accompanying symptoms of a manic episode

A

Inflated self-esteem or grandiosity
Decreased need for sleep
Pressured speech ( unrelenting, rapid, often loud talking without pauses)
Flight of ideas ( racing often unconnected thoughts)
Distractibility

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13
Q

period of abnormally and persistently, elevated, expansive, or irritable mood lasting 4 days and including three or four of the additional symptoms

A

Hypomania

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14
Q

when the person experiences both mania and depression nearly every day for at least 1 week.

A

Mixed episode

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15
Q

Bipolar Disorders are described are follows ( for the purpose of medical diagnoses)

A

Bipolar I disorder
Bipolar II disorder

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16
Q

one or more manic or mixed episodes usually accompanied by major depressive episodes.

A

Bipolar I disorder

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17
Q

one or more major depressive episodes accompanied by at least one hypomanic episode.

A

Bipolar II disorder

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18
Q

Related Disorders Classified in the DSM IV TR as mood disorders

A

Dysthymic Disorder
Cyclothymic Disorder
Substance-Induced Mood Disorder
Mood Disorder due to a General Medical Condition

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19
Q

cha by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode.

A

Dysthymic Disorder

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20
Q

cha by 2 years of numerous periods of both hypomanic symptoms that do not meet the criteria for bipolar disorder.

A

Cyclothymic Disorder

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21
Q

cha by a prominent and persistent disturbance in mood that is judged to be a direct physiologic consequence of ingested substances such as alcohol, other drugs, or toxins.

A

Substance-Induced Mood Disorder

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22
Q

cha by a prominent and persistent disturbance in mood that is judged to be a direct physiologic consequence of a medical condition

A

Mood Disorder due to a General Medical Condition

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23
Q

Other disorders that involve changes in mood

A

Seasonal Affective Disorder (SAD)
Postpartum or Maternity Blues
Postpartum Depression
Postpartum Psychosis

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24
Q

Subtypes of SAD & which is the most and less common?

A

Winter depression or fall onset (most
common)
Spring onset (less common)

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25
Q

Manifestation of winter depression or fall onset of SAD

A

Increased sleep
Increased appetite
Carbohydrate craving, weight gain
Interpersonal conflict, irritability
Heaviness in the extremities

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26
Q

Symptoms of Spring onset SAD

A

Insomnia
Weight loss
Poor appetite

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27
Q

frequent normal experience after delivery of a baby.

A

Postpartum or maternity blues

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28
Q

Symptoms maternity blues

A

Labile mood and affect
Crying spells
Sadness
Insomnia
Anxiety

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29
Q

meets all the criteria for a major depressive
episode with onset within 4 weeks of delivery

A

Postpartum Depression

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30
Q

psychotic episode developing within 3 weeks of delivery and beginning with fatigue, sadness, emotional lability, poor memory, and confusion and progressing to delusions, hallucinations poor insight, and judgment, and loss of contact with reality.

A

Postpartum Psychosis

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31
Q

Genetic studies implicate transmission of major depression in the 1st-degree relatives who have ______ the risk of developing depression.

A

twice

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32
Q

implicate transmission of major depression in 1st-degree relatives who have twice the risk of developing depression.

A

Genetic studies

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33
Q

1st-degree relatives of people with bipolar disorder have ____ risk for developing bipolar disorder compared with ____in the general population.

A

3% to 8% & 1%

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34
Q

Monozygotic ( identical )twins have a concordance rate ( both twins having the disorder) ______ higher than that of dizygotic (fraternal)twins.

A

2 to 4 times

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35
Q

two major biogenic amines implicated in mood disorders

A

serotonin and norepinephrine

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36
Q

Roles of serotonin in behavior

A

Mood, activity, aggressiveness, and irritability
Cognition, pain, biorhythms, and neuroendocrine processes

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37
Q

found in the blood or cerebrospinal fluid occur in people with depression.

A

Serotonin deficits

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38
Q

Norepinephrine levels may be deficient

A

Depression

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39
Q

Norepinephrine levels may be increased

A

Mania

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40
Q

energizes the body to mobilize during stress

A

catecholamine

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41
Q

process by which seizure activity in a specific area of the brain is initially stimulated

A

Kindling

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42
Q

inhibit kindling, which may explain their efficacy in the treatment of bipolar disorder.

A

Anticonvulsants

43
Q

being studied in relation to mood disorders.

A

Dysregulation of acetylcholine and dopamine

44
Q

alter mood ,sleep neuroendocrine function

A

Cholinergic drugs

45
Q

seems to be implicated in depression and mania.

A

acetylcholine

46
Q

are being studied in relation to depression.

A

Hormonal fluctuations

47
Q

How many % of clients with depression have evidence of increased cortisol secretion and elevated glucocorticoid activity associated with the stress response.

A

40%

48
Q

How many % of people with depression have thyroid dysfunction

A

About 5% to 10%

49
Q

looked at the self-appreciation of people with depression and attributed that self-reproach to anger turned inward related to either a real or perceived loss.

A

Freud

50
Q

believed that one’s ego aspired to be ideal

A

Bibring

51
Q

compared the state of depression to a situation in which the ego is powerless, helpless child victimized by the superego

A

Jacobson

52
Q

viewed depression as a reaction to a distressing life experience such as an event with psychic causality.

A

Meyer

53
Q

believed that children raised by rejecting or unloving parents were prone to feelings of insecurity and loneliness making them susceptible to depression and helplessness.

A

Horney

54
Q

saw depression as resulting from specific cognitive distortions in susceptible people

A

Beck

55
Q

depression often appear cranky, have SCHOOL PHOBIA hyperactivity or learning disorders, failing grades, and antisocial behaviors

A

Children

56
Q

depression may abuse of substances, JOINING GANGS, engaging in risky behavior underachievers, or dropping out of school.

A

Adolescents

57
Q

substance abuse, eating disorders, compulsive behaviors such as workaholism and gambling, and HYPOCHONDRIASIS.

A

Adults

58
Q

who are cranky and ARGUMENTATIVE may actually be depressed.

A

Older adults

59
Q

Typically it involves 2 or more weeks of sad mood or lack of interest in life activities with at least four other symptoms of depression

A

Major Depressive Disorder

60
Q

symptoms of depression (MDD)

A

anhedonia, and changes in weight, sleep, energy, concentration, decision-making, self-esteem, and goals.

61
Q

depression ______ with age in women, and ______ with age in men.

A

decreases & increases

62
Q

% of people who have one episode of depression will have another.

A

50% to 60%

63
Q

second episode of depression there is ___ chance of recurrence

A

70%

64
Q

Some people with severe depression ___% have psychotic features

A

9%

65
Q

Treatment and Prognosis (MDD)

A

Psychopharmacology
Major categories of antidepressants

66
Q

Major categories of antidepressants

A

Selective Serotonin Reuptake Inhibitors
(SSRIs)
Cyclic Antidepressants
Atypical Antidepressants
Monoamine Oxidase Inhibitors (MAOIs)

67
Q

the choice of which antidepressant to use is based on:

A

symptoms
age
physical health needs
drugs that have or have not work in the past

68
Q

Symptoms of Major Depressive Disorder
according to DSM-IV-TR diagnostic criteria

A

Depressed mood
Anhedonism
Unintentional weight change of 5% or more in a month
Change in sleep pattern
Agitation or psychomotor retardation
Tiredness
Worthlessness
Difficulty thinking, focusing, or making decisions
Hopelessness, helplessness, and/or suicidal ideation

69
Q

newest category of antidepressants and effective for most clients

A

Selective Serotonin Reuptake Inhibitors(SSRIs)

70
Q

produces a slightly higher rate of mild agitation and weight loss but less somnolence.

A

Prozac or Fluoxetine

71
Q

was introduced for the treatment of depression in the mid-50s and the oldest antidepressant.

A

Tricyclic

72
Q

what symptoms are relieved by tricyclic

A

hopelessness, helplessness, anhedonia, inappropriate guilt, suicidal ideation, and daily mood variation

73
Q

Contraindications of tricyclic antidepressants

A

Severe impairment of liver function, myocardial infarction
They cannot be given concurrently with MAOI’s because of their anticholenergic side effects
Be used cautiously in clients with :
Glaucoma, benign prostatic hypertrophy, urinary obstruction or retention,
Diabetes mellitus, hyperthyroidism, cardiovascular disease, renal impairment, respiratory disorder

74
Q

Overdosage can cause

A

Confusion, agitation, hallucinations, hyperpyrexia, increased reflexes

75
Q

Tetracyclic Antidepressant

A

Amoxapine, Maprotiline

76
Q

may cause extrapyrimidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome

A

Amoxapine

77
Q

Amoxapine MAY CAUSE

A

may cause extrapyramidal
symptoms, tardive dyskinesia,
and neuroleptic malignant
syndrome
increases appetite and causes
weight gain and cravings for
sweets

78
Q

Maprotiline side effects

A

carries risk for seizures (esp. in
heavy drinkers)
severe constipation
urinary retention
stomatitis

79
Q

used when the client has an inadequate response to or side effects from SSRIs

A

Atypical Antidepressant

80
Q

Atypical Antidepressant

A

Venlafaxine
Buropion
Nefazodone
Mirtazapine

81
Q

blocks the reuptake of serotonin, norepinephrine, and dopamine

A

Venlafaxine

82
Q

modestly inhibits the reuptake of norepinephrine; weakly inhibits the reuptake of dopamine and has no effects on serotonin.

A

Buropion

83
Q

inhibits the reuptake of serotonin and norepinephrine and has few side effects. Its half-life is 4 hrs and it can be used in clients with kidney and liver disease.

A

Nefazodone

84
Q

inhibits the reuptake of serotonin and norepinephrine and it has few sexual side effects

A

Mirtazapine

85
Q

used infrequently because of potentially fatal side effects

A

Monoamine Oxidase Inhibitors ( MAOI’s)

86
Q

most serious side effects.A life-threatening condition that results when a client taking MAOIs ingests tyramine-containing foods and fluids or other medications.

A

Hypertensive crisis

87
Q

Hypertensive crisis symptoms

A

Occipital headache
Hypertension
Nausea
Vomiting
Chills
Sweating
Restlessness
Nuchal rigidity
Dilated pupils
Fever
Motor agitation

88
Q

Hypertensive crisis symptoms can lead to

A

hyperpyrexia, cerebral hemorrhage , and death.

89
Q

The MAOI- Tyramine interaction produces symptoms within ____ after ingestion.

A

20-60 mins.

90
Q

given for hypertensive crises to dilate blood vessels and decrease vascular resistance.

A

Phentolamine Mesylate

91
Q

Other medical treatments and psychotherapy

A

Electroconvulsive Therapy (ECT)
Psychotherapy
Interpersonal Therapy
Behavior Therapy
Cognitive Therapy
Investigational Treatments

92
Q

used to treat depressed clients I selective cases such as
those who do not respond to antidepressant or those who experience intolerable side effects
Pregnant women can safely have ECT with no harm to the fetus.

A

Electroconvulsive Therapy (ECT)

93
Q

results in less memory loss but needs more treatment to see substantial improvement

A

Unilateral ECT

94
Q

more rapid improvement but with increased short term memory loss

A

Bilateral ECT

95
Q

used to prevent relapse in depression

A

ECT

96
Q

a combination of psychotherapy and medication is still considered the most effective treatment for depressive

A

Psychotherapy

97
Q

focuses on difficulties in relationships

A

Interpersonal therapy

98
Q

the goals of combined therapy are

A

symptoms remission
Psychosocial restoration
Prevention of relapse or recurrence
Reduced secondary consequences such as marital discord or occupational difficulties
Increasing treatment compliance

99
Q

difficulties in relationships such as

A

Grief reaction
Role disputes
Role transitions

100
Q

helps the person to find ways to accomplish this developmental task.

A

Interpersonal therapy

101
Q

seeks to increase the frequency of the clients positively reinforcing interactions with the environment to decrease negative interactions.

A

Behavior Therapy

102
Q

focuses on how the person thinks about the self , others and the future and interprets his or her experiences.

A

Cognitive therapy

103
Q

Investigational treatments includes

A

Transcranial magnetic stimulation ( TMS)
Magnetic seizure therapy
Deep brain stimulation
Vagal nerve stimulation

104
Q

closest to approval for clinical use

A

Transcranial magnetic stimulation ( TMS)

PSYCHIATRIC NURSING QUIZ FINALS (3 decks)

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