Mood and Affect Flashcards
(42 cards)
Mood Disorder
Mental DO characterized by periods of depression often alternating with a period of mania
What is the statistical prevalence of depression in the US?
16.5% older than 18 will have MD episode in lifetime
Women 70% more likely to experience
18% of preadolescents
11.2% ages 13-18 (associated w/substance abuse and antisocal behavior)
6-9% over 65 w/major Depression
17-19% over 65 w/Chronic
Comorbidity of depressive syndrome with other psych. DO
- Anxiety DO
- Schizophrenia
- Substance abuse
- Eating DO
- Schizoaffective DO
- Personality DO
Etiology of Depression
Changes in neurotransmitter-receptor relationships in brain:
- Limbic (emotional)
- Prefrontal cortex (depressed mood, concentration)
- Hippocampus (memory impairments; feelings of hopelessness, guilt, worthlessness
- Amygdala (anxiety and decreased motivation)
What is dysthymia?
depressive symptoms that have present for 2 years - more chronic than MDD
What are indications of depression in Adolescents?
- Irritability
- Changes in Social Network
- Acting out
- Cutting
- Misuse of sex
- Risk Taking
- SI-attempts
What areas are assessed for Depression?
- SI/attempts/risk factors
- Mood (anhedonia, anergia, anxiety, guilt, worthlessness, guilt…)
- Vegetative signs
- Cognition
- Communication
Defense Mech. of depression
Repression
Regression
Introjection
What is the focus in the milieu?
Safety
Benefits of SSRIs
Less anticholinergic effects, less cardiotoxicity, faster onset than TCAs,
Benefits of atypical antidepressants
energizing, less sexual side effects, good for anxiety
Types of Interventions for Safety
- location of room
- Level of monitoring i.e. 1:1, irregular rounds
- Contract for Safety
you can never decrease the MDs orders for monitoring. You can increase the level for the pts safety. (Must obtain MD order after you increase.)
What is contracting for safety?
Pt is invested in the agreement. Pt will help in keeping themselves safe by contracting with caretaker/social worker/MD
Most common SE of SSRI’s
GI irritations
Worst side effect of MAOIs
Hypertensive Crisis:
What is a safety procedure that can be done for Pt with SI during med admin?
Check mouth for ‘cheeking’
Poor SE of TCAs
ACH effects OH CHF Sexual Dys Overdose
When do we monitor the pts the closest?
First couple of weeks of new meds, they may now have the E to act on SI
Nurses responsibility in ECT for depression?
Rubinal - Dries up secretions
Educating pt of SE of ECT would include:
- anterograde or retrograde amnesia (lasts up to 3 weeks)
- Disorientation
- Confusion
- Possible: HA, muscular aches, ataxia, amenorrhea, blurred vision
BP1 vs BP2
BP1= one episode of mania alternating with major depression
Psychosis may be present.
BP2=hypomanic episodes alt with major depression (psychosis absent)
What is cyclothymia?
hypomanic episodes alt w/minor depressive episode.
These individuals tend to have irritable hypomanic episodes.
Interventions in the Milieu for BP pt
Safety
Basic Needs - depressed pt high calorie foods, small portions
manic depression: foods to go, walk with
both catagories need sleep, establish pattern
Restrictive Interventions (least)
Administer meds, ensure compliance
Pharmacological Interventions for BP DO
- Lithium
- Anti-convulsants
- Antipsychotics
- Anxiolytics
- Antidepressants
