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22 Cards in this Set
- Front
- Back
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Mood
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an individual's emotional tone
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Affect
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the behavioral expression. appropriate or inapporpriate
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Types of mood
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-delayed grief reaction
-Major depression -dysthymic disorder -bipolar mood |
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delayed grief reaction
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maladaptive response to the loss
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major depressive symptoms
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-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) |
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Suicide in depression
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-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) |
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how does a nurse assess suicide intention(SI)?
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-ask directly(ever think about suicide?
-what is your plan? -have you done it before? -family Hx of suicide? alcoholism? -SI= 1:1 care |
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dysthymic disorder
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all is chronic
-mild depression -unhappy-low self-esteem -dont know if they can feel better. -treateble with meds and psychotherapy |
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highest priority when caring for patient?
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-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 |
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Neorotransmitters
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Norepinephrine(depression/mania)
serotonin(depression/mania) |
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list antidepressant meds for Tx
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tricyclic
monoamine axidase inhibitors(MAOI) selective serotonin reuptake inhibitors(SSRI) atypical anti-depressants |
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tricyclic
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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 |
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MAOI
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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 |
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SSRI
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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 |
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atypical anti-depressants
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wellbutrin
-have an effect on both morepi and sero |
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electroconvulsive therapy
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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 |
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bipolar disorder(manic depression)
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-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 |
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symptoms of bipolar
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-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 |
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what is the goal of taking care of bipol person?
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-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 |
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bipolar meds used
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lithium
anticonvulsants -most poorly compliant people cuz they like manic episodes -mood stabalizers are the main group of meds |
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lithium
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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. |
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anticonvulants
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depakote neurontin tegretol topamax lamictel
-check axis 3 for seisure. if not then i know its of bipolar. |
