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NRS232: Mental Health Nursing > Unit 6 > Flashcards

Unit 6 Flashcards

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1
Q

Dysthymic Disorder

A

persistent depressive disorder.

patient is still able to function but does not feel well.

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2
Q

What is leading cause of death in adolescence?

A

Suicide

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3
Q

What is leading psychosocial disorder in elderly?

A

Depression

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4
Q

What is important to watch in children to see if there is possibly a depression problem?

A

Watch behaviors & playing.

Kid with depression will typically have disruptive mood disregulation disorder -> angry outburst and/or irritability.

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5
Q

DSM criteria for Major Depressive Disorder

A

5 or more of the following occurring nearly everyday for most waking hours over the same 2 week period:
Depressed mood, anhedonia, significant weight loss or gain, insomnia or hypersomnia, increased or decreased motor activity, angeria, feelings of worthlessness, decreased concentration, recurrent thought of death or suicide.

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6
Q

DSM criteria for Dysthymic Disorder

A

Two or more of the following are present:
Decreased or increased appetite, insomnia or hypersomnia, low energy/chronic fatigue, decreased self-esteem, poor concentration, feelings of hopelessness or despair.

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7
Q

Biological theories about Depression

A

Genetic theories
Biochemical factors
Alterations in hormonal regulation
Sleep abnormalities

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8
Q

Psychodynamic influences and life events

Theory of depression

A

early life trauma - exaggerated stress response

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9
Q

Etiologic Theories of Depression

A 
Biological
Psychodynamic influences and life events
Cognitive Theory (negative thinking)
Learned helplessness
Integrated Approach
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10
Q

What does cognitive therapy do?

A

Retrains the brain to think differently

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11
Q

Nursing Diagnoses for Depression

A 
Risk for Suicide
Chronic Low Self-esteem
Hopelessness
Constipation
Ineffective Coping
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12
Q

SSRI

important facts

A
  • Therapeutic effect 1-4 weeks (longer in elderly)
  • low side effect profile: Sexual dysfunction, sleep disturbance, loose BM, N/V.
  • serious side effect - Serotonin Syndrome
  • don’t stop abruptly
  • avoid alcohol & other CNS depression.
  • Change positions slowly
  • Don’t take MAOIs or St. John’s wart with SSRIs
  • Approve all other drugs, including OTC, with physician before taking.
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13
Q

Novel Agents for Depression

important facts

A
  • 4-8 weeks onset (12 weeks geriatric)
  • includes SNRIs
  • do not stop abruptly
  • do not take with MAOIs
  • may cause weight gain.
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14
Q

Novel Agents for Depression

example drugs

A

-Buproprion (Wellbutrin) - may increase B/P, urinary retention
- Duloxentine (Cymbalta) - SNRI
- Mirtazapine (Remeron)
- Nifazodone (Serzone)
-Trazedone (Desyrl) - potent very drowsy
Venlafaxine (Effexor) - SNRI

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15
Q

Example of SSRI

A
  • Citalopram (Celexa)
  • Escitaloram (Lexapro)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
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16
Q

TCA’s (tricyclic antidepressant)

example drugs

A
  • amitriptyline (Elavil)
  • imipramine (Tofranil)
  • Nortriplyline (Pamelor)
17
Q

TCA’s

important facts

A
  • more sedating, take at night
  • risk for falls
  • Cardiovascular risks: MI, heart block, etc
  • Not recommended for elderly
18
Q

MAOI’s

example drugs

A
  • phenelzine (Nardil)

- tranyleypromine (Parnate)

19
Q

MAOI’s

important facts

A
  • onset 3-5 days, full effect takes 4 - 8 weeks
  • taken for 6 - 12 months then may start weening off
  • may become tolerant and need increased dose
  • NO TYRAMINE
  • Risks: HTN, stroke, or death
  • Many drug interactions, ask doctor before taking anything else (including OTC drugs and herbs)
20
Q

Electroconvulsive Therapy

A
  • Application of small doses of electricity to one or both sides or the brain.
  • Used for Major depressive disorder, Mania, some Schizoaffective Disorders.
  • usually takes multiple treatments, patient is put to sleep for procedure, short term memory loss is common.
21
Q

3 Types of bipolar disorders

A
  • Bipolar I Disorder
  • Bipolar II Disorder
  • Cyclothymic Disorder
22
Q

Bipolar I disorder

A

involves periods of severe mood episodes from mania to depression.

23
Q

Bipolar II disorder

A

is a milder form of mood elevation, involving milder episodes of hypomania that alternate with periods of severe depression.

24
Q

cyclothymic disorder

A

describes periods of hypomania with brief periods of depression that are not as extensive or long-lasting as seen in full depressive episodes.

25
Q

Mania/hypomania

A

distinct period of abnormally and persistently elevated, expansive or irritable mood

26
Q

S/S of mania and hypomania

A
  • inflated self esteem or gandiosity
  • decreased need for sleep
  • more talkative than usual
  • flight of ideas
  • destractability
  • increase in goal directed activity - psychomotor agitation
  • excessive involvement in pleasurable activities that have a high potential for painful consequences
27
Q

Causes of bipolar disorder

A
  • Genetic factors
  • Neurobiological causes (neurotransmitter alterations, neurobiological alterations)
  • Social status
  • Psychosocial factors
28
Q

Nursing Diagnoses - Mania

A
  • Disturbed thought processes
  • Imbalanced nutrition, less than body requirements
  • sleep deprivation
  • noncompliance
  • risk for self or other directed violence

NRS232: Mental Health Nursing (5 decks)

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