Mood Disorders Flashcards Preview

Sophomore 2 Test 1 > Mood Disorders > Flashcards

Flashcards in Mood Disorders Deck (38):
1

Mood

The prominent, sustained, overall emotions that a person expresses and exhibits; inhibits one's perception of the world and how one functions

2

Blunted

Significantly reduced intensity of emotional expression

3

Flat

Absent or nearly absent affective expression

4

Inappropriate

Discount affective expression accompanying the content of speech or ideation

5

Labile

Varied, rapid, and abrupt shifts in affective expression

6

How long before a "depressed" patient can be diagnosed with Major Depressive Disorder?

Two weeks

7

How long before a "depressed" patient can be diagnosed with Dysthymia disorder/Persistent Depressive Disorder?

Two years
- Doesn't usually affect ADLs

8

Depression typically develops in response to:

1. Loss
2. Disappointment
3. Failure

9

Depressive Moods are marked by what kind of feelings?

1. Helplessness
2. Hopelessness
3. Worthlessness

10

Risk Factors for Depression

1. Lack of coping abilities
2. Presence of life and environmental stressors
3. Current substance use or abuse
4. Medical comorbidity
5. Prior episode of depression
6. Family history of depression
7. Lack of social support

11

Neurotransmitters that make you "happy"

1. Serotonin
2. Norepinephrine
3. Dopamine

12

Five Cardinal Signs of Depression

1. Sleep disturbances
2. Appetite changes
3. Poor concentration
4. Decreased energy
5. Excessive guilt or worthlessness

13

Nursing Interventions for Depressive Disorders

1. Assess for suicidal ideation
2. Establish trust/rapport
3. Encourage expression of feelings
4. Provide non-threatening environment
5. Provide activities client able to complete
6. Promote adequate rest/nutrition

14

Characteristics of Dysthymic Depression

1. Mild-moderate depression
2. Maladaptive use of defense mechanisms
3. S/Sx most days for at least 2 years
4. NO mania

15

SSRI Drugs

1. Citalopram
2. Escitalopram
3. Fluoxetine
4. Paroxetine
5. Sertraline

16

SNRIs

1. Venlafaxine
2. Duloxetine
3. Bupropion

17

Acute Phase of Psychiatric Medication Use

The primary goal of therapy for the acute phase is symptom reduction or remission. The objective is to choose the right match of medication and dosage for the patient. Careful monitoring and follow-ups are essential during this phase to assess patient response to medications, adjust the dose if necessary, identify and address side effects, and provide patient support and education

18

Continuation Phase of Psychiatric Medication Use

The goal of this treatment phase is to decrease the risk for relapse (a return of the current episode of depression). If a patient experiences a response to an adequate trial of medication, use of the medication generally is continued a the same dosage for at least 4-9 months after the patient returns to a clinically well state.

19

Maintenance Phase of Psychiatric Medication Use

For patients who are at high risk for recurrence, the optimal duration of maintenance treatment is unknown but is measured in years, and full-dose therapy is required for effective prophylaxis

20

Discontinuation Phase of Psychiatric Medication Use

The decision to discontinue active treatment should be based on the same factors considered in the decision to initiate maintenance treatment. These factors include the frequency and severity of past episodes, the persistence of dysthymic symptoms after recovery, the presence of comorbid disorders, and patient preference. Many patients continue taking medications for their lifetime

21

Tricyclic Drugs

1. Amitriptyline

22

MAOI's

Monoamine Oxidase Inhibitors
1. Phenelzine

23

S/Sx of Mania

1. Elation (grandiose)
2. Hyperactivity
3. Agitation
4. Accelerated thinking/speaking
5. Abnormal and persistent
6. Elevated mood (euphoria/elation)
7. Expansive mood (lack of restraints in expression)
8. Overvalued self-importance
9. Irritable; demanding; destructive
10. Use of sarcasm, profanity
11. Excessive spending
12. Increased libido; risk taker/poor judgement

24

Hypomania

- Mild form of mania
- Excessive hyperactivity, but not severe enough to cause impairment in functioning or require hospitalization

25

Rapid Cycling

- Extreme form of mood lability (bipolar I and II)
- Continuous cycling between mania and depression and hypomania and depression
- Essential feature of Bipolar: four or more mood episodes that meet criteria for manic, mixed hypomanic, or depressive episode during the previous 12 months

26

Bipolar I

Manic episode or mixed and depressive episode

27

Bipolar II

Major depression and hypomania

28

Cyclothymia

Hypomania and depressive episodes not meeting full criteria for major depressive episode
- Lasting at least 2 years

29

Nursing Interventions for Mania

1. Provide safety
- assess suicidal/homicidal ideations
2. Promote sleep/nutrition
3. Decrease stimuli
4. Accept client (provide social support)
5. Utilize energy
6. Antipsychotics
7. Encourage effective expression of feelings
8. Reinforce reality (DON'T focus/challenge delusions)
9. Identify manipulative behaviors

30

Therapies for Manic Disorders

1. Individual : support until able to effectively participate
2. Group: focus on self-esteem, reality, and relationships
3. ECT: usually for major depression
4. Family therapy
5. Cognitive therapy

31

Side Effects of ECT

- Memory loss
- Confusion

32

Who can not have ECT?

1. Increased ICP
2. Recent MI
3. CVA
4. Retinal detachment
5. Pheochromocytoma
6. Those at risk for complications of anesthesia

33

Antimanic Drug

Lithium carbonate

34

Lithium levels

1.0 - 1.5 for acute mania

0.6 - 1.2 for maintenance

35

Antiepileptics

1. Carbamazepine
2. Valproic acid
3. Divalproex sodium
4. Lamotrigine

36

Anoxiolytics

1. Clonazepam

37

Antipsychotics

1. Olanzapine
2. Haloperidol
3. Risperidone

38

Lithium

- Needs to be combined with antipsychotics and benzodiazepines
- If you take lithium, you will need regular blood tests and monitoring of your kidney and thyroid function for drug toxicity levels