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22 Cards in this Set

  • Front
  • Back
Mood
an individual's emotional tone
Affect
the behavioral expression. appropriate or inapporpriate
Types of mood
-delayed grief reaction
-Major depression
-dysthymic disorder
-bipolar mood
delayed grief reaction
maladaptive response to the loss
major depressive symptoms
-any age
-don't seek help
-more common in women/most common in elderly
-psychotic(not in touch with reality)
-melancholy(sad/unhappy)
-atypical(random behavioral change)
-seasonal(SAD)-lack of sunlight-fix with phototherapy
-post-partum psychosis(after giving birth/becomes psychotic)
Suicide in depression
-all depressed people feel it
-8th leading cause of death in usa
-seen in 60+ and 15-24
-highest when coming out of depression(have energy to do it)
how does a nurse assess suicide intention(SI)?
-ask directly(ever think about suicide?
-what is your plan?
-have you done it before?
-family Hx of suicide? alcoholism?
-SI= 1:1 care
dysthymic disorder
all is chronic
-mild depression
-unhappy-low self-esteem
-dont know if they can feel better.
-treateble with meds and psychotherapy
highest priority when caring for patient?
-safety
-talk about feelings
-long term goal is >self esteem
-keep environment free of danger
-keep from "hording meds"
-openly takl about SI
-1:1
-provide group activities
Neorotransmitters
Norepinephrine(depression/mania)
serotonin(depression/mania)
list antidepressant meds for Tx
tricyclic
monoamine axidase inhibitors(MAOI)
selective serotonin reuptake inhibitors(SSRI)
atypical anti-depressants
tricyclic
elavil tofrini siequin norpamine

-70's
-increase norepinephrine and serotonin at synapstic sites
-takes 4-6 wks to work
-se(< peristalsis/cotton mouth/dry nasal/blurred vision/cardiac/orthostatic hypotension/sedation/weight gain
-lethal if overdose
MAOI
nardil parnate Marplan
-inhibits monoamine oxidase
-controls tyramine(which >bp)
-cannot eat fermented foods
-changing to tryciclic or SSRI means stopping MAOI for at least 2 weeks
SSRI
paxil prozac zoloft luvox celexa
-rarely fatal if overdose
-fewer anticholinergic S/E than triciclic
-not effective is low serotonin
-most md start with SSRI cuz it works with 70 people
-takes weeks to achieve therapeutic effect.
-problems with orgasm/ erection
atypical anti-depressants
wellbutrin
-have an effect on both morepi and sero
electroconvulsive therapy
aka shock therapy
-effectiev
-done if meds dont work
-ect needs court approval
-lasts 30-45 sec, wake up 30-45 min
-depression is alleviated
-S/E short term memory loss
bipolar disorder(manic depression)
-equal in both sexes
-1st episode in early 30's
-genetic disosition
-hypomania/cyclothymic
-mania(talks fast incoherently) not with reality/no patience/assaultive/no bounderies
symptoms of bipolar
-euphoria and elation
-mood is labile
-flight ideas
-loquaciosness
-pressured speech
-paranoid/grandiose/delusion
-excessive psychomotor activity
-sexually uninibitied
-inexhaustible energy
-diminished sleep
-disorganized/flamboyant
what is the goal of taking care of bipol person?
-safe physically and phisiologically

Nursing interventions
-they do stupid thigns/poor judgement
-sleep/rest/nutrition
-bring mood down to communicate with them
-give food
-decrease stimuli
-give them purpousfull work like sweep clean
-set limits
-give meds to decrease manic state
bipolar meds used
lithium
anticonvulsants
-most poorly compliant people cuz they like manic episodes
-mood stabalizers are the main group of meds
lithium
salt which effects neurotransmitters
-can be lethal so check level 0.5-1.5
-if toxic then needs dialysis to cleanse body
-need good kidney
-s/e of toxicity is some tremors N/V muscle weakness
-when pt is manic the litium will not brin them out.
anticonvulants
depakote neurontin tegretol topamax lamictel
-check axis 3 for seisure. if not then i know its of bipolar.