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Exam 4 > Depression > Flashcards

Depression Flashcards

1
Q

How is depression characterized?

A

By a sad despondent mood

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2
Q

What are the symptoms associated with depression?

A
  • Lack of energy
  • Abnormal eating
  • Sleep disturbances
  • Feelings of despair
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3
Q

Where are the majority of depressed clients found?

A

In mainstream settings

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4
Q

What are the risk factors for depression?

A
  • history of abuse, neglect, loss
  • Age greater than 65 yrs
  • Stressful life events
  • Poor social support
  • dysfunctional family relationships
  • family history or personal history of mental illness, substance abuse
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5
Q

Is there a definitive way to prevent depression?

A

No.

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6
Q

What things are helpful for the possible prevention of depression?

A

Exercise, proper diet and rest, avoiding drugs; illicit drugs

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7
Q

What is MDD?

A

Major depressive disorder

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8
Q

How is major depressive disorder defined?

A

a change in several aspects of individual’s emotional state and functioning for TWO WEEKS

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9
Q

What kind of feelings might a person struggling with MDD have?

A

Sadness, discouragement, hopelessness,

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10
Q

Does MDD consist of a single episode or more than one?

A

Either one, depress on person and situation

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11
Q

What is the DSM-5?

A

Diagnostic criteria to diagnose MDD. You have to have at least 5 on the list to be diagnosed.

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12
Q

What are the 9 things, or criteria, of the DSM-5 test?

A
  • depressed mood
  • sleep disturbance
  • anhedonia
  • weight increase or decrease
  • increase or decrease in motor activity
  • fatigue, decreased energy
  • feelings of guilt, worthlessness, self-blame
  • dismissed ability to concentrate
  • suicidal ideation
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13
Q

What is postpartum depression?

A

Depression that starts anytimes up to four weeks after birth of a child.

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14
Q

What is dysthymic disorder?

A

A milder form of depression, with early onset, (childhood or adolescence)

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15
Q

How long does dysthymic disorder typically last?

A

At least two years in adults, with no more than 2 months being symptom free.

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16
Q

How many clinical findings of depression does dysthymic disorder find?

A

At least 3

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17
Q

Do the symptoms of MDD or dysthymic disorder tend to be more severe?

A

MDD

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18
Q

Dysthymic disorder tends to be …

A

Chronic.

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19
Q

What is SAD?

A

Seasonal affective disorder.

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20
Q

How is seasonal affective disorder defined?

A

Depressive disorder that relates to seasons

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21
Q

What time of year do people usually experience SAD?

A

Winter months

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22
Q

What is the #1 treatment for SAD?

A

Light therapy

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23
Q

What is the medication indicated for SAD?

A

Bupropion extended release.

May help to prevent major depressive episodes

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24
Q

Who is the calllaboration team made up of for pts with depression?

A

RN, MD, pharmacist, psychologist, family

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25
Who can diagnose a pt with depression?
A licensed mental health provider.
26
What are the diagnostic tests for depression?
There are none. There are only helpful screenings you can do.
27
What can influence medication therapy?
Existing medical illnessses
28
What is psychotherapy?
The treatment of a mental disorder with psychological rather than medical means.
29
What is psychotherapy usually given in addition to?
Medication.
30
For mild depression, how is psychotherapy used?
It is used alone, without medication.
31
How does psychotherapy help pts with depression?
Helps them manage specific symptoms, promotes coping skills, CBT, helpful positive ways of thinking
32
What is CBT?
Cognitive behavior therapy.
33
What is the most effective psychotherapeutic approach for depression?
CBT
34
What meds are given to depressed pts?
Antidepressants, SSRI’s, MAOI’s
35
What is the best way to find the right antidepressant drug?
Trial and error
36
A doctor will continue what until depressed pt is symptom free?
Maintenance and slow discontinuation of the medication.
37
What is the black box warning on antidepressants?
Huge risk for suicide.
38
What is the prototype drug of Tricyclic antidepressants?
Imipramine
39
What is the prototype drug of monoamine oxidases?
Phenelzine
40
What is the prototype or SSRI’s?
Fluoxetine
41
What are the signs of anticholinergic?
Can’t see, cant pee, cant spit, cant shit.
42
What are the indications for Imipramine?
Depression, enuresis, neuropathic pain
43
What is the action of Imipramine?
Inhibit reuptake of norepinephrine and serotonin
44
What are the contraindications of Imipramine?
CV disease, recent MI, liver dysfunction, angle closure glaucoma, urinary retention, history of seizures, pregnancy, and manic depression
45
What are the adverse affects of Imipramine?
Orthostatic hypotension, arrhythmias, sedation, bone marrow depression, anticholinergic effects
46
What are the drug to drug interactions for Imipramine?
MAOI’s, SSRI’s, St, Johns Wart, CNS depressants, antihypertensives, sympathomimetics, oral anticoagulants
47
What should you avoid while on Imipramine?
Alcohol and other CNS depressants.
48
Why should you change positions slowly while on Imipramine?
Because of the risk of orthostatic hypotension
49
Why do you need to be careful with driving while on Imipramine?
Because the sedation effects are unknown at first
50
Does Imipramine have a long half life?
Yes
51
Why should you avoid sunlight while on Imipramine?
It can make you sensitive to sunlight
52
How long until you see therapeutic effects of Imipramine?
2-6 weeks.
53
What is the action of Fluoxetine?
Inhibits CNS neuronal reuptake of serotonin with little effect on norepinephrine.
54
What are the indications for Fluoxetine?
Depression, OCD, panic attacks, bulimia, PMDD, PTSD, Social phobias, anxiety
55
What are the contraindications/cautions of Fluoxetine?
Pregnancy, lactation, impaired renal or hepatic function, cardiac disease, diabetes, severely depressed or suicidal patients
56
What are the adverse effects of Fluoxetine?
Headache, drowsiness, dizziness, insomnia anxiety, tremors, chest pain, agitation, sexual dysfunction, palpitations, increased appetite, hyponatremia
57
What are the drug to drug interactions of fluoxetine?
MAOI’s, TCA’s, St. John’s Wart.
58
What is important to monitor for while a pt is on fluoxetine?
Changes in behavior, effectiveness of therapy
59
What education is important concerning fluoxetine?
- Notify MD before taking other drugs - keep all follow up appointments - report side effects - dont stop drug abruptly - take most SSRI’s in the AM w/ food - exercise and caloric restriction to avoid weight gain
60
With SSRI’s what are the two considerations to be aware of?
Serotonin syndrome and discontinuation syndrome
61
What is serotonin syndrome?
Overstimulation with serotonin caused by giving with other drugs that increase serotonin, ie. MOAI’s, St. John’s Wart.
62
What is discontinuation syndrome?
Flu-like syndrome from abrupt withdrawal of drug
63
What is the action of Phenelzine?
Irreversibly inhibit MAO’s, allowing norepinephrine, serotonin, and dopamine to accumulate in the synaptic cleft
64
What is the indication for giving phenelzine?
Depression-for those who are unresponsive to or unable to take other antidepressive agents
65
What are the adverse effects of Phenelzine?
Dizziness, nervousness, mania, hyperreflexia, tremors, confusion, insomnia, agitation, liver toxicity, N/V, constipation, anorexia, weight gain, dry mouth, orthostatic hypotension, hypertension
66
How long until therapeutic effect for phenelzine?
4-8 weeks
67
What are the contraindications for phenelzine?
Pheochromocytoma, CV disease, hypertension, glaucoma, increased intercranial pressure, and renal or hepatic impairment
68
What are the drug to drug interactions for phenelzine?
Other antidepressants, sympathomimetics, insulin or oral antidiabetics agents, CNS depressants, opioid analgesics, general anesthetics
69
What are the food interactions for phenelzine?
Don’t eat anything aged-can cause BP to sky rocket
70
What are other therapies for depression?
- Electroconvulsive therapy. - transcranial magnetic stimulation - alternative or complementary therapies include St. John’s wart
71
What are some goals for nursing care?
Focus on safety Therapeutic communication Meet functional needs
72
What should you assess for in patients with depression?
Symptoms of depression, any history of manic episodes, comorbidities
73
Why should you assess for comorbidities in patients with depression?
Ensure there is not an underlying physical cause.
74
What kind of drugs can complicate depression?
Legal or illegal, depends on the drug
75
When you are assessing children that may have depression what should you include?
- rule out a physical illness - get full story fro parents, caregivers - have a child psychiatrist or psychologist involved
76
When you are assessing older patients for depression what should you include?
- it may be hard to tell what’s going on due to poly pharmacy - use geriatric depression scale(pts with cognitive impairments) - use cornell depression scale (pts with sever cognitive impairments)
77
What kind of attitude is important to adopt while maintaining confidence that client will feel better?
An emotionally neutral attitude.
78
It is important for the nurse to pay attention to his or her...
Personal feelings, mood.

Exam 4 (13 decks)

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