Chapter 8 Flashcards
(41 cards)
The nurse learns at report that a newly admitted manic patient is demonstrating grandiosity. Which statement would be most consistent with this symptom?
Im the worlds most astute financier.
The nurse will base a discussion of dysthymia on the fact that the condition:
Is chronic low-level depression
What is the priority nursing diagnosis for a patient exhibiting signs of acute mania that include exaggerated physical activity, agitation, insomnia, and anorexia?
Noncompliance
A patient has been admitted with a diagnosis of atypical depression. In planning interventions, the nurse would expect to consider the characteristic symptom of:
Leaden paralysis
An inappropriately dressed patient has not slept for 3 days while making excessive, expensive long-distance phone calls. When the patient can be heard singing loudly in the examining room, the nurse makes initial plans to focus on:
Assessing needs for food, liquids, and rest
Which statement by the patient would indicate the need for additional education regarding the prescribed lithium treatment regimen?
I will restrict my daily salt intake
The nurse would evaluate that patient education regarding lithium therapy for an individual with bipolar disorder as effective if the patient states:
I will probably need to take the lithium for the rest of my life.
A patient who has been taking lithium carbonate 300 mg tid comes to
the Outpatient Department with a list of medications he is taking. Which of themedications on the list would require re-evaluation of lithium dosage?
HydroDIURIL daily
Which outcomes would be appropriate to determine early favorable response to antidepressant medication?
The patient will complete own self-care activities.
Prior to initiating medication therapy with phenelzine (Nardil), the nurse should plan to determine the patients:
Cognitive ability to understand information about the medication
A patient who has a history of bipolar disorder recently underwent orthopedic surgery and was discharged to return home. When visited by the home care nurse, the nurse documented the following: slow and soft speech; sad facial expression; and patient crying when describing extreme fatigue, low mood, and the feeling that he will never get well. He has refused to bathe and perform ADLs for several days. Which nursing diagnosis would be appropriate?
Self-care deficit secondary to possible depression
The nurse caring for an extremely withdrawn patient with depression wants to assist her to become more interactive. The best approach would be to say:
I need another person for a card game and Id like you to be my partner.
Which nursing diagnosis would relate to the primary nursing concern related to a recently written prescription for amitriptyline (Elavil) 50 mg tid?
Risk for self-injury
What information concerning amitriptyline (Elavil) 50 mg tid would the nurse give the patient regarding the expected outcome of this medication therapy?
This medication is expected to improve brain chemical imbalance.
Which principle should the nurse apply when planning nursing care for a patient who was voluntarily admitted after a suicide attempt?
The more specific the plan, the greater the risk for suicide.
An appropriate nursing strategy to assist a patient who was involuntarily admitted after a suicide attempt is:
Encouraging patient to verbalize personal feelings
Which principle should the nurse apply when planning care for a patient who is diagnosed with bipolar disorder and currently in the manic phase?
Detailed activities will facilitate the patients ability to self control behavior.
Which nursing intervention is most therapeutic when the nurse is managing the aggressive, disruptive behaviors of a manic patient whose attempts to control the milieu has been rejected by the other patients?
Accompanying the patient to a quieter part of the unit
What information would serve as the basis for the nurses reply when asked whether the cycling of moods from depressed to manic is a constant pattern seen in bipolar disorders?
Clinical observation tells us that mood disorders tend to remit and recur.
The individual who displays the history and symptoms most consistent with a medical diagnosis of seasonal affective disorder (SAD) is:
26 years of age and complains of 3 consecutive years of depressed mood beginning in November and remitting in April
A patient with suspected seasonal affective disorder asks the nurse, Ive been feeling down for 3 months. Will I ever feel like myself again? The response that builds on an understanding of this disorder is:
People who have seasonal mood changes often feel better when spring comes.
A Chinese-American patient comes to the mental health clinic after referral by her primary care physician. She complains of nervousness, headaches, fatigue, and vague GI symptoms for which no organic basis has been established. The symptoms began about 9 months ago when her favorite aunt died. The most appropriate independent nursing action would be to:
Confer with the psychiatrist about the cultural association between depression and somatic symptoms.
A patient with melancholic depression paces and wrings her hands for hours at a time while repeating, Im a bad person. Staff members have been unsuccessful in their attempts to promote rest. Which intervention is most appropriate in promoting rest?
Asking the patient to fold and stack bath towels and washcloths
What measure will facilitate communication with a patient who is depressed and evidencing psychomotor retardation and withdrawal?
Arrange to spend time with the patient at prearranged intervals.
