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Psurg > Depression Psurg > Flashcards

Depression Psurg Flashcards

1
Q

healthy individuals are able to to experience the full range of emotions (x) to situation.

A

appropriate

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2
Q

In healthy individuals, changes in mood are restored to harmony through (x)

A

adaptation

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3
Q

Global Assessment Functioning (GAF) should be higher than

A

70

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4
Q

Range of mood

A

bright, euphoric/awesome, elated/happy, euthymia/ok, labile/ever changing, sad, dysthymic/down in the dumps, despairing/hopeless, depressed, anxious, guilty all the time, fearful, irritable

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5
Q

types of depressive d/o

A

major depressive, dysthymic d/o, premenstrual dysphoric d/o, mood d/o d/t general medical condition (GMC)

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6
Q

pt with depression manifest with

A

sadness, despair, pessimism, loss of interest, change in eating (seratonin)/sleeping pattern, vague somatic symptom, adhedonia; can present with anxiety too, diminished libido

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7
Q

Atypical depression pts eat a lot of

A

carbs

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8
Q

depressive d/o impairs

A

interpersonal functioning, social functioning, occupational functioning; ; don’t wanna do/go anything/where

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9
Q

Diagnostic criteria for major depressive d/o

A

5+ of depressed most of time, marked decrease in pleasure, weight gain/loss, sleep too little/much, fatigue most of time, feeling worthless/guilt, can’t think, recurrent thoughts of death; NO manic episode; s/s affect functioning; r/o drugs or low TSH, brain tumor, endocrine d/o, anemia, parkinson, adrenal d/o; r/o bereavement; s/s at least 2 wks

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10
Q

Major depressive d/o comorbidities

A

etoh abuse/dependence, OCD, anxiety d/o, low TSH

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11
Q

major depressive d/o classifications

A

single or recurrent, severity (catatonic?), chornic, seasonal patterns, psychosis

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12
Q

If with psychosis, what are mood congruent psychotic delusions?

A

nihilistic (no stomach) and somatic (pregnant 70 yo) delusions

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13
Q

Major Depression r/t GMC

A

chronic pain, alt tissue perfusion: cerebral, head injury, brain tumor, endocrine d/o

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14
Q

Major Depression Biological factors

A

Mainly Norepinephrine and serotonin, then dopamine and acetcholine

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15
Q

cimetidine (tagament) does what?

A

cause depression; H2 typically for gastric secretion from parietal cells and vasodilation; H2 blocked = decreased level for hypothalamus functions wakefulness, pain, and inflammatory response

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16
Q

how does depression affect hippocampus?

A

low memory, worthless, hopeless, guilt

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17
Q

how does depression affect amygdala?

A

anhedonia, anxiety, low motivation

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18
Q

how does depression affect hypothalamus?

A

sleep/appetite alteration, low energy, low libido

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19
Q

how does depression affect frontal cortex?

A

depressed mood, problem concentrating

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20
Q

how does depression affect cerebellum?

A

psychomotor retardation/agitation

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21
Q

How does depression affect limbic system?

A

emotional alteration

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22
Q

Major Depression etiology

A

high hypothalmic Pituitary Adrenocortical Axis activity leads to increase cortisol (a stress hormone); hypothyroidism; genetic/familial fx

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23
Q

Physiological factors for major depression

A

learned helplessness; personality factors; cognitive theory of negative self perception, world is hostile and demanding, and the future holds suffering and failure. Nurse should give a positive perspective as it leads to a physical change in brain.

24
Q

what do you call depressive s/s that occur as a consequence to a non-mood d/o or a/e of meds?

A

secondary depression

25
Q

3-5 yo depression

A

stop play, play alone

26
Q

6-8 yo depression

A

not doing well in school

27
Q

9-12 yo depression

A

behavior to hurt self, this thinking becomes more permanent

28
Q

teen depression

A

problem solving and decision making skill not intact

29
Q

why is teen depression difficult to recognize

A

because perception of normal emotional stresses of that age

30
Q

Depression is a major cause of suicide among (x), especially when prescribed (x)

A

teens; SSRI. So don’t give SSRI

31
Q

Depression is the most common (x) in what population? Why?

A

most common psychiatric illness in elderly because of bereavement overload.

32
Q

Suicide rate higher in (x) than any other population because (x)

A

higher in the elderly because they have the means

33
Q

Why would nursing homes cause depression?

A

being in a nursing home means a loss of function.

34
Q

describe dythymic d/o

A

like being down in the dumps FOR 2 YEARS; regular low mood

35
Q

describe premenstrual dysphoric d/o

A

happens 1 week prior to menstruation; day 21 of cycle

36
Q

how to treat premenstrual dysphoric d/o

A

herbal chamomile, tumeric

37
Q

how NOT to treat premenstrual dysphoric d/o

A

hormanal tx don’t usually work

38
Q

What do you assess with major depression?

A

“Tell me how do you feel about that?” Affect (flat/blunted), behavior (isolation), cognitive (jumbled writing), physiological (constipation, altered eating)

39
Q

Nursing Dx for major depression?

A

risk for suicide; complicated grieving, low self-esteem, powerlessness, social isolation, imbalance nutrition, insomnia, self-care deficit (catatonic, melancholic)

40
Q

Nursing Approach

A

Maintain safety and ADLs

41
Q

Patient teaching

A

nature of illness (what, why, s/s, stages of grief); management of illness (meds s/s, take regularly, length of time to take affect, diet), assertiveness/stress mgmt/boost self esteem techniques; electroconvulsive therapy; support services (suicide hotline, support groups, legal/financial assistance).

42
Q

Evaluation of tx

A

Effect on cognition and behavior

43
Q

Treatment modalities of major depression?

A

group, cognitive behavioral, family (etiology is familial/genetic) therapies, peer support group

44
Q

Indication for Electroconvulsive Therapy in major depression

A

suicidal with psychotic symptoms, psychomotor retardation; for pts with major depression, mania, schizophrenia

45
Q

Contraindication for Electroconvulsive Therapy

A

Intracranial Pressure; leads to increase cerebrospinal fluid pressure which leads to brainstem herniation

46
Q

s/e of Electroconvulsive Therapy?

A

temporary memory loss and confusion; retrograde amnesia (@ onset of ECT)

47
Q

Nursing role for Electroconvulsive Therapy?

A

assess cardiovascular and pulmonary status, lab/urine studies, verify informed consent, inform pt ECT in voluntary and can be withdrawn anytime; allay fears; pt into hospital gown; ensure airway patency (suction if needed); monitor VS and cardiac function; Post tx: VS q15min, orient to tipe and place, reassure confusion and memory loss is temporary, let pt verbalize anxiety, stay with pt till able to do self care, provide structured routine for less confusion

48
Q

Postpartum depression affect how many %?

A

10-15%

49
Q

Onset of postpartum depression

A

acute or insidious

50
Q

Maternity blues s/s (lasts 2 days - 2 weeks)

A

tearfulness, despair, anxiety, decreased concentration,

51
Q

Postpartum depression s/s

A

more bad than good days, worse towards evening, fatigue, irritability, loss of appetite, sleep disturbance, loss of libido

52
Q

Effect on activities of postpartum depression

A

mother ignore baby who wants attention; baby rocks itself

53
Q

Psychosocial support for postpartum depression is

A

very important

54
Q

Medication for postpartum depression

A

takes 2-4 wks to work; expressed in breast milk, so do cost-benefit analysis

55
Q

Continuum of depression

A

transient everyday dissappointment, mild normal grief response, moderate dysthymic d/o, severe major depressive d/o

Psurg (15 decks)

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