Chapter 14: Depressive Disorders

Question 1

Depression lasting minimum of ____ (length of time) is considered Major Depressive Disorder

Answer 1

2 weeks

Question 2

Disruptive mood dysregulation disorder

Affects …

Describe….

Consider developmental level and r/o autism

Answer 2

Children 6 - 18

Frequent temper tantrums, persistent irritable mood

Question 3

Persistent depressive disorder - Formerly: Dysthymic Disorder- Adults

How long does the depression last….

Causes social / Job distress but hospitalization is not needed.

Answer 3

2 years

Question 4

When do PMDD physical discomfort start and stop

Affects 2.5 - 5.5 % women

Answer 4

1 week prior to menstruation- onset of period

Question 5

When does Substance/ Medication Induced Depressive Disorder occur…

Answer 5

When using or withdrawl from drugs

Question 6

What is the leading cause of disability worldwide

Answer 6

Depression

Question 7

Can infants have depression?

Answer 7

Yes

Question 8

Biological factora of Major Depression Disease

Hyper / Hypoactivity in HPA

Answer 8

Hyperactivity

Question 9

Describe depression rates for women before puberty & after menopause

Answer 9

Lower

Question 10

Psychological factors for depression:

Cognitive Theory: Thoughts result in emotions

Early life experiences contribute to negative, illogical, Irrational thoughts activated by times of stress.

Negative self deprecating view of self
Negative view of world
Negative reinforcement will continue in the future…..

Describes

Answer 10

Becks triad

Question 11

PHQ-9 (Patient Health Questionnaire-9)
Purpose…..

Answer 11

Quick and effective for nurses to assess depression, essential for early intervention.

Question 12

PHQ-9 (Patient Health Questionnaire-9)
Purpose…..

Answer 12

Quick and effective for nurses to assess depression, essential for early intervention.

Question 13

Assess for suicide FIRST

____% of MDD will commit suicide

Answer 13

15

Question 14

What questionire is used to screen for alcohol alcohol use?

Answer 14

C ut down?
A nnoy others with your drinking
G uilty about drinking
E ye opening event

1 positive = problems
2 positive = clinically significa

Question 15

If CAGE has 2 or more positive (possibly 1 positive) then conduct this….

Answer 15

SBIRT

Screening (Reveal how bad drug addiction is)

Brief Intervention: Give them feedback of their Drug Problem & Encourage behavior change

Referral to treatment

Question 16

Which feeling associated with depression is most concerning, why?

Answer 16

Hopelessness, correlated to suicide

Question 17

Age considerations in depression.

Teenagers Sx

Older adults Sx

Answer 17

Teenagers anger & irritability

Older adults physical illness/ pain

Question 18

When does assessment for suicide need to happen.

Answer 18

Every contact

Question 19

Suicide ideation is criteria for involuntary hospitalization

T or F

Answer 19

T

Question 20

Risk for suicide include

Prior attempt
Emotionally close relative woth attempted for completed suicide
Male
Anxiety/ chronic pain
And this personality type….

Answer 20

Borderline

Question 21

What percentage of people who commit suicide have been seen by care provider within 1 month of the act

Answer 21

44%
Half of these have seen medical professionals within 1 week

Question 22

Open ended comminuted for Depression

BATHE

Answer 22

B othering What is bothering you?
A ffecting How is it affecting you?
T rouble What about the problem troubles you the most
H andling How are you handling the problem
E mpathy I can see how this would make you feel ____. I hear you telling me you feel ___ about this problem.

Question 23

Risk for suicide
Hopelessness
Impaired coping
Social isolation
Spiritual Distress
Self-care deficit
Chronic low self esteem

What is the mental problem

Answer 23

Depression

Question 24

Number for the suicide hotline

Answer 24

988

Question 25

Promote self care in depressed Small high calorie food OOB during day, encouraging groups Relaxation, reduce stimulus at HS Step by step ADL reminders What does OOB mean

Answer 25

Out of bed. Record this in mental health patients

Question 26

Safety Suicide precautions for suicide idealation GSP / ASP General/ Acute suicide precautions Q15MIN checks, sharps with supervision, No OWP What does OWP mean

Answer 26

Observation without Physical Contact. Watching from across the room is an example

Question 27

Safety Plan No harm contracts I will contact my nurse before I act upon my suicide ideas

Answer 27

125,000$ Psych NP job. Benefits & Vacations

Question 28

Serotonin syndrome- Fever Sx To relieve use cooling blankets and thorazine T or F

Answer 28

T

Question 29

TCAs Which are Stimulating/ Sedative Desipramine, Amitriptyline, Doxepin

Answer 29

Stimulate Desipramine Sedative Amitriptyline / Doxepin

Question 30

Do urinary retention/ Constipation warrant immediate attention with TCAs

Answer 30

Yes

Question 31

How long for full effect of TCAs

Answer 31

4 - 8 wks

Question 32

Will Drowsiness, Dizziness, OH Orthostatic Hypotension go away in a few weeks after the start of tricyclic antidepressants

Answer 32

Yes

Question 33

Cephalgia means...

Answer 33

Headache

Question 34

Procardia / Regitine maybe taken for...

Answer 34

Hypertensive Crisis- MAOI

Question 35

ECT electroconvulsive therapy 2 - 3 treatments wkly. Total 6 - 12 Contradictions.... Nursing responsibilities

Answer 35

No absolute Contradictions Assess cardiac conditions, subdural hemotomas, Brain tumors Nurse responsibilities: Informed consent EEG & EKG monitor General anesthetic & muscle paralyzing agent

Question 36

What does Electroconvulsive therapy consist of...

Answer 36

30 - 60 sec seizures induced by electrodes attached to head

Question 37

Primary focus for ECT Awake in....

Answer 37

15 mins Plus, airways / VS

Question 38

Transcranical magnetic stimulation (TMS) Noninvasive: 30 mins 5 x weekly (For how long)...... Awake & Alert during procedure Common complaint

Answer 38

4 - 6 week Head & Jaw Pain

Question 39

Describe procedure for vagus nerve stimulation to improve depression....

Answer 39

Surgical Implantation wraps around vagus nerve on left side of neck

Question 40

Deep brain stimulation. Surgical Implantats used to treat resistant major depression T or F

Answer 40

T

Question 41

What type of depression might Light Therapy be used for...

Answer 41

SAD seasonal affective disorder Morning is best time. SE: headache, jittery

Question 42

Exercise may lower depression by decreasing the HPA axis, increase availability of serotonin, improves sleep. Which group is it most helpful with

Answer 42

Menopausal women