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Psychiatric Nursing > Mood disorders > Flashcards

Mood disorders Flashcards

1
Q
  1. Tricyclics
  2. Selective Serotonin Reuptake Inhibitors
  3. Monoamine Oxidase Inhibitors
A

Antidepressants

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2
Q

Increase the concentration of norepinephrine, serotonin, and/or dopamine in the body - blocking the reuptake of those neurotransmitters ; also occurs when enzyme - monoamine oxidase (MAO) is inhibited at various sites in the nervous system.

A

Antidepressants - action

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3
Q

Inactivate norepinephrine , serotonin and dopamine

A

MAO function

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4
Q

Amitriptyline (Elavil)

A

Tricyclic antidepressant (TCA)

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5
Q

Doxepin ( Tofranil)

A

Tricyclic antidepressant (TCA)

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6
Q
  1. Blurred vision
  2. Constipation
  3. Urinary retention
  4. Orthostatic hypotension
  5. Reduction of seizure threshold
  6. Tachycardia , arrhytmias
  7. Photosensitivity
  8. Weight gain
A

side effects of Tricyclic antidepressant (TCA)

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7
Q

Citalopram ( Celexa )

A

Selective Serotonin Reuptake Inhibitors (SSRI) antidepressants

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8
Q

Fluoxetine ( Prozac)

A

SSRI antidepressants

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9
Q

Paroxentine ( Paxil )

A

SSRI antidepressants

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10
Q

Sertaline ( Zoloft )

A

SSRI antidepressants

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11
Q

Escitalopram ( Lexapro )

A

SSRI antidepressants

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12
Q
  1. Insomnia, agitation
  2. Headache ( analgesics )
  3. Sexual dysfunction
  4. Serotonin syndrome
A

side effects of SSRI antidepressants

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13
Q
  1. Take dose early in the day
  2. Avoid caffeine
  3. Relaxation before bed
A

Insomnia interventions

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14
Q
  1. Changes in mental status
  2. Restlessness
  3. Hyperreflexia
  4. Myoclonus (muscle twitching )
  5. Tachycardia, labile BP
  6. Diaphoresis, shivering, tremors.
A

Serotonin syndrome

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15
Q

Cyproheptadine

A

antihistaminic and antiserotonergic agent; treat symptoms of serotonin syndrome

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16
Q

Phenelzine ( Nardil )

A

MAOI antidepressant

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17
Q

Tranylcypromine sulfate ( Parnate )

A

MAOI antidepressant

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18
Q
  1. Hypertensive crisis
  2. Weight gain
  3. Changes in cardiac rhythm
  4. Hypotension
  5. Sedation
  6. Insomnia
A

side effects of MAOI antidepressants

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19
Q

Occurs if the individual consumes foods containing tyramine while receiving MAOI therapy

A

Hypertensive crisis

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20
Q
  1. Severe occipital headache
  2. Palpitations
  3. Nausea/vomiting
  4. Nuchal rigidity (neck stiffness )
  5. Fever, sweating
  6. Increase in BP, chest pain, coma
A

Hypertensive crisis

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21
Q
  1. Discontinue drug
  2. Monitor vital signs
  3. Short-acting antihypertensive medication
  4. External cooling methods to control hyperpyrexia
A

TX of hypertensive crisis

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22
Q

Aged cheese ; wine, beer; chocolate, colas, coffee, tea, sour cream, smoked and processed meats, beef or chicken liver, canned figs, soy sauce , overripe and fermented foods, pickled herring, raisins, caviar, yogurt, yeast products, broad beans, cold remedies, diet pills.

A

Do not consume while taking MAOIs

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23
Q

Aged cheese ; wine, beer; chocolate, colas, coffee, tea, sour cream, smoked and processed meats, beef or chicken liver, canned figs, soy sauce , overripe and fermented foods, pickled herring, raisins, caviar, yogurt, yeast products, broad beans, cold remedies, diet pills.

A

Do not consume while taking MAOIs

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24
Q
  1. Do not stop taking the drug abruptly - withdrawal symptoms : nausea, vertigo, insomnia, headache, malaise, nightmares.
  2. The therapeutic effect may not bee seen for as long as 4 weeks
  3. Not drink alcohol - potentiate the effects of each other
A

Antidepressants - teaching

25
Q
  1. Do not stop taking the drug abruptly - withdrawal symptoms : nausea, vertigo, insomnia, headache, malaise, nightmares.
  2. The therapeutic effect may not bee seen for as long as 4 weeks
  3. Not drink alcohol - potentiate the effects of each other
A

Antidepressants - teaching

26
Q

Avoid smoking - it is increases the metabolism of tricyclics

A

Tricyclic antidepressants - teaching

27
Q

Avoid smoking - it is increases the metabolism of tricyclics

A

Tricyclic antidepressants - teaching

28
Q

5 symptoms have been present during the same 2 -weeks period ; at least one of the symptoms is either - depressed mood or loss of interest or pleasure

A

Diagnostic criteria for major depressive disorder

29
Q
  1. Depressed mood
  2. Loss of interest or pleasure
  3. Weight loss / gain
  4. Insomnia / hypersomnia
  5. Fatigue/ loss of energy
  6. Feelings worthlessness / excessive guilt
  7. Recurrent thoughts of death
A

Symptoms of major depression disorder

30
Q

Characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy

A

Bipolar disorders

31
Q

Lasting one week ( or more if hospitalization is necessary )

  1. Grandiosity
  2. Decreased need for sleep
  3. Talkative
  4. Racing thoughts
  5. Distractibility
  6. Increase in goal-directed activity
  7. Involvement in pleasurable activities - painful consequences
A

Diagnostic criteria for manic episode

32
Q
  1. Hippocampus
  2. Amygdala
  3. Hypothalamus
  4. Frontal cortex
  5. Cerebellum
A

Areas of the brain affected - major depression

33
Q

memory impairments, feeling of worthlessness , hopelessness and guilt

A

Hippocampus

34
Q

anhedonia (no pleasure) , anxiety, reduced motivation

A

Amygdala

35
Q

Increased/ decreased sleep and appetite, decreased energy and libido

A

Hypothalamus

36
Q

depressed mood, problem concentrating

A

Frontal cortex

37
Q

psychomotor retardation/agitation

A

Cerebellum

38
Q
  1. Risk for suicide
  2. Complicated grieving
  3. Low-self esteem
  4. Powerlessness
  5. Spiritual distress
  6. Social isolation
  7. Disturbed though process
  8. Imbalanced nutrition
  9. Insomnia
  10. Self care deficit
A

Major Depression - nursing diagnoses

39
Q
  1. Hypomania - cheerful, ideas of great worth, increased motor activity, inappropriate behaviors (calling President )
  2. Acute mania - “high” / anger; flight of ideas; hallucinations/delusions; poor impulse control ; days without sleep;
  3. Delirious mania - labile mood; extremely distractible ; delusions of grandeur or persecution ; purposeless movement .
A

Manic states

40
Q
  1. Risk for injury
  2. Risk for violence: Self - Directed or Other-Directed
  3. Imbalanced nutrition less than body requirements
  4. Disturbed thought process
  5. Disturbed sensory perception
  6. Impaired social interaction
  7. Insomnia
A

Bipolar Mania - nursing diagnoses

41
Q
  1. High protein, high calorie finger foods
  2. Juice and snacks on unit
  3. I&O, calorie count, daily weight
  4. Provide favorite foods
  5. Supplement with vitamins and minerals
  6. Sit with client during meals
A

Imbalanced nutrition interventions

42
Q

The induction of a generalized seizure through the application of electrical current to the brain (6-12 treatments ; 3 times a week)

A

Electroconvulsive Therapy

43
Q
  1. Major depression - after meds has proved ineffective
  2. Mania
  3. Schizophrenia - depression or mania symptoms
A

Indications for ECT

44
Q
  1. Increased intracranial pressure (from brain tumor, cardiovascular accident, cerebrovascular lesion)
  2. Cardiovascular problems - at risk
  3. Severe osteoporosis
  4. Acute and chronic pulmonary disorders
  5. High-risk or complicated pregnancy
A

Contraindications - ECT

45
Q

Most common:

  1. Temporary memory loss
  2. Confusion
A

Side-effects of ECT

46
Q

2 per 100,000 treatments ; major cause - cardiovascular complications (usually in individuals with previously compromised cardiac status )

A

Mortality - ECT

47
Q
  1. Ensure safety
  2. Manage client anxiety
  3. Provide education
  4. Administer Atropine - decrease secretion to prevent aspiration
A

Role of the nurse in ECT

48
Q
  1. Short-acting anesthetic - thiopental sodium ;
  2. Muscle relaxant - succinylcholine chloride
  3. Pure oxygen - resp. muscles paralyzed
  4. Blood pressure cuff on the lower leg before muscle relaxant to observe seizure activity
  5. Electrodes placed (bilaterally or unilaterally) on the temples to deliver electrical stimulation
A

ECT - implementation

49
Q

ECT is thought to effect a therapeutic response by …

A

increasing the levels of serotonin , norepinephrine , and dopamine

50
Q

Lithium Carbonate

A

Antimanic -

51
Q
  1. Drowsiness, dizziness, headache
  2. Dry mouth, thirst
  3. GI upset, nausea/vomiting
  4. Fine hand tremors (decrease dose, propranolol)
  5. Hypotension, arrhythmias, pulse irregularities
  6. Polyuria, dehydration
  7. Weight gain
A

Side effects of Lithium

52
Q

The usual ranges of therapeutic serum concentration of Lithium are :

A
  1. 0-1.5 mEq/L - for acute mania

0. 6 - 1.2 mEq/L - for maintenance

53
Q

Serum lithium should be monitored once or twice a week after initial treatment until stable ; then monthly during maintenance therapy

A

Lithium toxicity > 1.5

54
Q
  1. Blurred vision, ataxia , tinnitus , N&V, diarrhea
  2. Excessive output of dilute urine , tremors, psychomotor retardation, mental confusion
  3. Coma, MI, cardiovascular collapse
A

Lithium toxicity > 1.5

55
Q

Lithium is similar in chemical structure to sodium ; if sodium intake is reduced - - lithium is reabsorbed by the kidneys - toxicity

A

Adequate records of intake , output, and pts weight should be kept on a daily basis

56
Q
  1. Adequate sodium intake
  2. 2500-3000 mL of fluid
  3. call doctor - vomiting/ diarrhea
  4. Risk - pregnancy
A

Lithium - Teaching

57
Q

Valproic acid (Depakote)

A

anticonvulsant (antiepileptic) ; used in treatment of bipolar disorder

58
Q
  1. Hypothyroidism
  2. Impairment of the kidneys ability to concentrate urine
    Periodic follow ups required to assess thyroid and renal function
A

Major long term risks of lithium therapy

59
Q

When a patient is experiencing a severe manic episode , which bodily system is most at risk for decompensation

A

Cardiac - death from cardiac collapse

Psychiatric Nursing (11 decks)

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