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NUR 114 > Module 2 > Flashcards

Module 2 Flashcards

1
Q

mood (average affect and activity

A

euthymic

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2
Q

Mood disorders are the most common psychiatric diagnoses associated with suicide; …

A

depression is one of the most important risk factors for suicide.

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3
Q

CATEGORIES OF MOOD DISORDERS

A

major depressive disorder and bipolar disorder (formerly called manic-depressive illness)
(Book)

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4
Q

one or more manic or mixed episodes usually accompanied by major depressive episodes

A

Bipolar 1 disorder

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5
Q

one or more major depressive episodes accompanied by at least one hypomanic episode

A

Bipolar 2 disorder

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6
Q

is a distinct period during which mood is abnormally and persistently elevated, expansive, or irritable.

A

Mania

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7
Q

Other disorders classified with similarities to mood disorders include:

A

•Persistent depressive (dysthymic) disorder
•Disruptive mood dysregulation disorder
•Cyclothymic disorder
•Substance-induced depressive or bipolar disorder
•Seasonal affective disorder (SAD)
•Postpartum or “maternity” blues
•Postpartum depression
•Postpartum psychosis
•Premenstrual dysphoric disorder
•Nonsuicidal self-injury

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8
Q

is the most common complication of pregnancy in developed countries. The symptoms are consistent with those of depression (described previously), with onset within 4 weeks of delivery.

A

Postpartum depression

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9
Q

has two subtypes. In one, most commonly called winter depression or fall-onset, people experience increased sleep, appetite, and carbohydrate cravings; weight gain; interpersonal conflict; irritability; and heaviness in the extremities beginning in late autumn and abating in spring and summer. The other subtype, called spring-onset, is less common, with symptoms of insomnia, weight loss, and poor appetite lasting from late spring or early summer until early fall. Often treated with light therapy.

A

SAD Seasonal Affective Disorder

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10
Q

This has many roles in behavior: mood, activity, aggressiveness and irritability, cognition, pain, biorhythms, and neuroendocrine processes (i.e., growth hormone, cortisol, and prolactin levels are abnormal in depression).

A

Serotonin

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11
Q

This may be deficient in depression and increased in mania

A

Norepinephrine levels

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12
Q

Emotion focused strategies

A

Deep breathing, guided imagery, distractions, and progressive relaxation.

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13
Q

Problem focused strategies

A

Role playing, learn problem solving methods, applying process to identify problems and solutions, improving social skills may help to build relationships.

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14
Q

How long does a major depressive episode last?

A

At least 2weeks

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15
Q

Onset of postpartum depression?

A

With in 4 keeks of delivery

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16
Q

S/S of child with depression

A

Cranky, school, phobia, hyper, active, learning disorders, failing, grades, and antisocial behaviors

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17
Q

S/S of Adolescent w/ depression.

A

Abuse of substances, joining a game, risky behavior, underachiever, and dropping out of school.

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18
Q

S/S adult depression

A

Substance abuse, eating disorder, compulsive behaviors (workaholic, gambling, and hypochondriac) Cranky and argumentative.

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19
Q

What are the major categories of antidepressants?

A

Cyclic antidepressants, monoamine, oxidase, inhibitors(MaIO’s), Selective serotonin reuptake inhibitors(SSRI’s), And atypical antidepressants.

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20
Q

What is the rule about discontinuing antidepressant therapy

A

They must be tapered

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21
Q

What length of time is proven to show, fear, relapses, and depression, with antidepressant therapy?

A

18-24months

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22
Q

Patients who do not respond to antidepressants I have bad side effects candidates for this type of treatment

A

Electroconvulsive therapy(ECT)

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23
Q

What is considered the most effective treatment for depressive disorders, and both children and adults?

A

Psychotherapy

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24
Q

This may underlie the cycling of mood disorders as well as addiction

A

Kindling

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25
Q

These are the oldest antidepressants used

A

Tricyclic -Because of their anticholinergic side effects, tricyclic antidepressants must be used cautiously in clients who have glaucoma, benign prostatic hypertrophy, urinary retention or obstruction, diabetes mellitus, hyperthyroidism, cardiovascular disease, renal impairment, or respiratory disorders

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26
Q

NURSING INTERVENTIONS
For Depression:

A

Provide for the safety of the client and others.
•Institute suicide precautions if indicated.
•Begin a therapeutic relationship by spending nondemanding time with the client.
•Promote completion of activities of daily living by assisting the client only as necessary.
•Establish adequate nutrition and hydration.
•Promote sleep and rest.
•Engage the client in activities.
•Encourage the client to verbalize and describe emotions.
•Work with the client to manage medications and side effects.

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27
Q

True or False we still have to asses mood when taking an antidepressant.

A

True

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28
Q

A salt contained in the body.

A

Lithium

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29
Q

This med stabilizes bipolar disorder by reducing the degree and frequency of cycling or eliminating manic episodes

A

Lithium

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30
Q

periods of euphoria, exuberant activity, grandiosity, and false sense of well-being

A

Mania

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31
Q

NURSING INTERVENTIONS
For Mania:

A

•Provide for the client’s physical safety and those around.
•Set limits on the client’s behavior when needed.
•Remind the client to respect distances between self and others.
•Use short, simple sentences to communicate.
•Clarify the meaning of the client’s communication.
•Frequently provide finger foods that are high in calories and protein.
•Promote rest and sleep.
•Protect the client’s dignity when inappropriate behavior occurs.
•Channel the client’s need for movement into socially acceptable motor activities.

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32
Q

What is not metabolized; rather, it is reabsorbed by the proximal tubule and excreted in the urine?

A

Lithium

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33
Q

When the physician should be contacted if the client has diarrhea, fever, flu, or any condition that leads to dehydration with which med

A

Lithium

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34
Q

This is an episode Of depression and loss of pleasure in nearly all activities, that lasts at least two weeks.

A

Major depressive disorder

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35
Q

Symptoms of major depressive disorder colon

A

Changes in eating habits, unplanned, weight loss, or gain, Colorado, hypersomnia, or insomnia, impaired concentration, impaired decision-making, impaired, problem-solving, abilities, and ability to cope with daily life, feelings of worthlessness, hopelessness, guilt, or despair, overwhelming for fatigue, and thoughts of death or suicide

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36
Q

What percentage of major depressive disorder, patients experience, delusions, or hallucinations combined with psychotic depression?

A

20%

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37
Q

A significant disturbance in mood that is a direct physiological consequence of ingested substances, such as alcohol, drugs, or toxins

A

Substance induced depressive, and bipolar disorder

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38
Q

This can occur in winter or spring

A

Seasonal affective disorder

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39
Q

Increased sleep, appetite, carb cravings, weight gain irritability.

A

Fall onset

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40
Q

Insomnia, weight loss, poor appetite

A

Spring onset

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41
Q

Mild predictable mood disturbance occurring in the first several days after delivery of a baby

A

Postpartum or maternity blues

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42
Q

Symptoms of postpartum/maternity blues:

A

Labile mood and affect, crying, spells, sadness, insomnia, anxiety

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43
Q

Most common complication of pregnancy in developed countries

A

Postpartum depression

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44
Q

Symptoms of postpartum depression:

A

Symptoms that are consistent with depression and the onset within four weeks of delivery

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45
Q

Severe/debilitating psychiatric illness with acute onset in days following childbirth

A

Postpartum psychosis

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46
Q

Symptoms of postpartum psychosis:

A

Fatigue, sadness, emotional liability, poor memory, confusion That progresses too delusions, hallucinations poor insight and judgment. This is a medical emergency and requires treatment.

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47
Q

Recurrent moderate, psychological and physical symptoms that occur during the week of menses and resolved with menstruation

A

Premenstrual dysphoric disorder

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48
Q

Symptoms of premenstrual, dysphoric disorder:

A

Labile mood, irritability, increased, interpersonal conflict, difficulty, concentrating, feeling, overwhelmed, or unable to cope, anxiety, tension, or hopelessness

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49
Q

Deliberate, intentional, cutting burning, scraping hitting, or interference with wound healing

A

Non-suicidal self injury

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50
Q

Describe: Genetic theory of Major depression

A

Patience with first-degree relative diagnosed with a major depressive disorder are twice as likely at developing a disorder than others in the population

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51
Q

What Neurochemically occurs in people with depression?

A

There is a deficit of serotonin tryptophan, Or a metabolite of serotonin.
There is also maybe a deficit in Norepinephrine.
There is a dis regulation of acetylcholine and dopamine that is believed to play a role in mood disorders

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52
Q

Theory of Neuroendocrine influences on major depression

A

Hormonal fluctuations (postpartum, or psychosis)
Endocrine d/o thyroid, adrenal, parathyroid, pituitary glands

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53
Q

Typically involves 2 weeks or more of a lack of interest in life activities

A

Major depression

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54
Q

Symptoms can vary from mild to severe many people have a single bout in a lifetime about 50 to 60% will have a reoccurrence later in life

A

Depression

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55
Q

Referred to as adjustment disorder

A

Situational depression

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56
Q

Treatment for limiting mild situational depression

A

Regular exercise, well, balanced, diet, regular, sleeping habits, communicating with friends, or loved ones, joining a support group, Participating in fun activities. Other treatments include meds and therapy.

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57
Q

The two neurotransmitters that are believed to be decreased in depression

A

Norepinephrine and serotonin

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58
Q

Types of antidepressants

A

SSRIs, cyclic, atypical, And MAOI’s

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59
Q

This medication produces less sedating, anticholinergic, and CV side effects.

A

SSRI

60
Q

These are the oldest antidepressant, and should not be given to Liver or in MI patients. Cannot be given W/MAOIs

A

Cyclic antidepressants

61
Q

Which antidepressant or do you use cautiously and clients with glaucoma BPH, urinary retention DMCV, hypothyroidism, renal impairment, and respiratory disorders?

A

Cyclic antidepressants

62
Q

These are given when a patient has an inadequate response or has side effects from SSRIs

A

A typical anti-depressants
Such as bupropion, duloxetine, and venlafaxine

63
Q

This is also used in Parkinson’s disease

A

MAOIs

64
Q

This antidepressant requires diet restriction includes monitoring of blood, pressure and other medication’s

A

MAOIs
Isocarboxazid

65
Q

What is the major WARNING sign when taking antidepressants?

A

Increased activity improved mood from years of anti-depressants can provide energy for suicidal clients to carry out plans to kill themselves. Must assess the client for suicidal ideation, even when states they feel better after being on man’s.

66
Q

This is a medical treatment reserved for patients who do not respond to antidepressants, or cannot tolerate the side effects.

A

ECT

67
Q

Name the types of psychotherapy?

A

Interpersonal therapy(relationships), behavioral therapy(improve social skills), cognitive therapy(how a person thinks about themselves and others)

68
Q

This medical treatment is used for major depression and clients resistant to treatment this is a investigational treatment

A

TMS (Trans Magnetic stimulation)

69
Q

Anhedonia

A

Loss of sense of pleasure from activities they formerly enjoyed.

70
Q

Repeatedly going over thoughts

A

Ruminate

71
Q

Name scales used to write and evaluate depression

A

Hamilton rating scale, Zhang self rating depression scale, Beck depression inventory

72
Q

What is recommended in therapeutic communication for depression?

A

Avoid asking yes or no questions try to use open ended questions when attempting to gain information

73
Q

This is the ability to express positive and negative ideas and feelings in an open honest and direct way

A

Assertive communication

74
Q

List types of nonverbal communication:

A

Are usually expression, body language, vocal cues, eye, contact, and silence

75
Q

Depression coping strategies

A

Progressive, relaxation, deep, breathing, guided, imagery, and distractions.

76
Q

Social skills to encourage with depressed patients

A

Encourage eye contact when speaking, attentive, listening, taking turns with talking, practice empathy, being mindful of body language, verbal and nonverbal. Communication went around others, staying calm, sharing, being kind, respectfulness.

77
Q

This disorder involves extreme mood, swings from mania to depression, moods may last for weeks, pattern of behavior, decisions and ascends.

A

Bipolar disorder

78
Q

A distinct. During which mood is abnormally or persistently, elevated, expensive, or irritable. This period of time last for one week or more for some individuals.

A

Mania

79
Q

A period of time where symptoms are not as severe as mania, but the person may have three or more symptoms of bipolar

A

Hypomania

80
Q

Symptoms of bipolar:

A

Abnormally, upbeat, jumpy, or wired.
Increase activity, energy or agitation.
Exaggerated sense of well-being and self-confidence(euphoria)
Decreased need for sleep.
Unusual talkativeness.
Racing thoughts.
Distractibility.
Poor decision, making financially or sexually.

81
Q

What would be a purpose for a bipolar patient to stop taking your meds?

A

Some clients like the way they feel when they are manic they have more energy.

82
Q

Bipolar diagnosis requires a lifetime medication regimen using either:

A

•Anti-manic agent or lithium
•Anticonvulsant medication

83
Q

Disordered thinking, including delusions, hallucinations, and illusions can occur During an acute stage of mania or depression, patients may be prescribed.

A

An antipsychotic agent

84
Q

List the maintenance level treatment level and toxic level for lithium

A

Maintenance level .5 to 1.
Treatment level is .8 to 1.5.
Toxicity level is 1.5+.

85
Q

What is lithium?

A

It’s a salt… A trace element found in the body. It affects calcium, potassium, magnesium ions glucose metabolism. It is potentially fatal an overdose.

86
Q

This medication is used for a diagnosis of bipolar, panic disorder, seizures

A

Clonazepam

87
Q

What we need to be monitored when taking the drug carbamazepine?

A

Drug serum levels, white blood, count, monitor, hypertension, skin, and ability to walk

88
Q

Is it true that Clonazepam is given as a single drug treatment

A

False, clonazepam cannot be taken alone with a bipolar disorder.

89
Q

This medication is considered an antipsychotic med. The disease is an adjunct other mood stabilizers

A

Aripiprazole

90
Q

List, three anticonvulsant drugs:

A

Carbamazepine, Divalproex, And Gabapentin

91
Q

Combined with medication, this therapy can reduce risk of suicide and injury, provide support for client and family, and help client to accept diagnosis and treatment plan.

A

Psychotherapy

92
Q

If a patient drinks too much water or eats too much salt or are they at risk of where lithium is concerned

A

Low Lithium levels

93
Q

What Can happen to lithium levels of a patient becomes dehydrated?

A

Lithium levels can become too high

94
Q

This is the second leading cause of death among 15 to 24-year-old

A

Suicide

95
Q

What ages is suicide increasing most rapidly among?

A

45 to 65-year-old

96
Q

This is when a person thanks about, and six ways to commit suicide

A

Active suicidal ideation

97
Q

The patient is thinking about wanting to die or wishes here she were dead that has no plans to cause his or her self harm

A

Passive, suicidal ideation

98
Q

What time of year do my suicides occur and why?

A

Spring, because increased sunlight, and an increase in natural energy is believed to help patients follow through with suicide

99
Q

What questions are involved in a Lethality assessment?

A

Does the client have a plan? If so, what is it and is the plan specific, are the means available to carry out this plan, if the client carries out the plan, is it likely to be lethal, As the client made preparation for death, where and when.

100
Q

Ethnicities with the highest risks of suicide

A

American Indians, Alaskan natives, and non-Hispanic whites

101
Q

Having a baseline, cognitive impairment, older age & certain medication, Progressive severity of illness are respecters of what cognitive disorder?

A

Delirium

102
Q

Describe the difference between onset in children and older adults with delirium

A

Delirium and children comes on fast with a high fever.
Delirium in older adults comes on over hours to days.

103
Q

True or false delirium can be prevented?

A

True

104
Q

What is the ability to process retain and use information?

A

Cognition

105
Q

Common causes of delirium

A

Physiologic/metabolic, infection, or drug related

106
Q

Give examples of physiologic/metabolic causes of delirium

A

Hypoxemia, electrolyte, imbalance, hypo/hyperglycemia, dehydration, insomnia, head injury, Renal/hepatic failure, brain tumor

107
Q

Give examples of the two types of infections that can cause delirium

A

Systemic- Sepsis, UTI, pneumonia
Cerebral – meningitis, encephalitis, HIV, syphilis

108
Q

Treatment for delirium And examples

A

Determine the underlying cause, and then treat.
Deescalate before medicating, using IV fluids, nutrition, or supervision to prevent injury

109
Q

This is a mental disorder involving multiple cognitive deficits, including memory impairment

A

Dementia

110
Q

Deterioration of language function

A

Aphasia

111
Q

Impaired motor function

A

Apraxia

112
Q

Inability to recognize or name objects

A

Agnosia

113
Q

In ability to think abstractly

A

Executive functioning

114
Q

Compare delirium in dementia

A

Delirium: rapid onset, brief duration , LOC impaired/fluctuates, short term memory impairment, speech may be slurred/rambling/irrelevant, temporarily disorganized.
Dementia: gradual onset, progressive Duration, LOC, unaffected, short & then long-term memory impairment, Speech is normal in early stages, and impaired thinking/eventual loss of thinking ability

115
Q

What is the Hallmark sign for Mild dementia?

A

Forgetfulness

116
Q

What is a moderate clinical sign of dementia?

A

Confusion along with progressive memory loss

117
Q

A severe sign of dementia

A

Personality and emotional changes

118
Q

What is the lifespan after a diagnosis of Alzheimer’s?

A

10 years

119
Q

What is another name for mad cow disease?

A

Kreutzfeldt – Jakob disease

120
Q

Name a cognitive disease that is hereditary and causes cerebral atrophy

A

Huntington’s disease

121
Q

Prognosis for dementia

A

It’s a progressive deterioration of physical and mental abilities until death

122
Q

List populations, ethnicities, and sexes that are at higher risk for Alzheimer’s

A

African-American, Hispanic Americans, lower education levels, lower socioeconomic status, and women.

123
Q

Is Alzheimer’s a normal part of aging?

A

No

124
Q

What are the likely causes of Alzheimer’s?

A

Genetics and environmental factors.

125
Q

What is the most definitive way to diagnose Alzheimer’s?

A

Autopsy

126
Q

Pathophysiology of Alzheimer’s

A

Amyloid plaques, Neurofibrillary tangles, loss of connection between neurons, and neuron death

127
Q

What is moderate manifestations of Alzheimer’s?

A

Personal hygiene is affected, loss of ability to concentrate, agitation & aggression

128
Q

Severe manifestations of Alzheimer’s

A

Loss of medication, dependent on others, bedridden, and Brainstem death

129
Q

A process by which degenerative mechanisms in dementia, reverse those of normal human development

A

Retrogenesis theory

130
Q

Mild Stage of Alzheimer’s, developmental age

A

8yo -adulthood

131
Q

Severe stage of Alzheimer’s, developmental age

A

1mo-15mo

132
Q

These are twisted fibers of proteins found within neurons

A

Neurofibrillary tangles

133
Q

Diagnostic studies for Alzheimer’s

A

CT, MRI, PET

134
Q

This is used to differentiate Alzheimer’s disease from other types of dementia

A

PET scan

135
Q

What cognitive assessments is used to determine Alzheimer’s?

A

Mini-cognitive test & Mini-mental state exam

136
Q

What is a mini-cognitive exam?

A

Give the patient three words that you will have them repeat back to you and draw the face of a clock

137
Q

What is a mini-mental state examination?

A

Sing the alphabet backwards or counting only even numbers

138
Q

What is observed in an assessment for Alzheimer’s?

A

Patient history, general appearance, motor behavior, mood, affect, thought process, content, sensorium, intellectual processes, judgment, inside, rolls, responsibilities

139
Q

What exam access is cognitive abilities, such as memory, concentration and abstract processing

A

MMSE

140
Q

Medication is given for Alzheimer’s

A

Cholinesterase inhibitors, NMDA, SSRIs, atypical, antidepressants, and antipsychotics

141
Q

List some antipsychotic meds

A

Haloperidol, risperidone, and olanzapine

142
Q

Why are antipsychotics given?

A

To manage delusions, hallucinations, paranoia, agitation, or aggression

143
Q

Which medication given, for Alzheimer’s is to slow the progression in moderate to severestages? Example.

A

NMDA receptor antagonist
(Memantine)

144
Q

Lester drag given to slow the progress of dementia

A

Donepezil And rivastigmine

145
Q

List two types of medication that can cause/worsen delirium

A

Benzodiazepines and antidepressants

NUR 114 (3 decks)

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