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30 Cards in this Set
- Front
- Back
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what is depression?
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an alteration in mood that is expressed by feelings of sadness, despair, and pessimism. there is a loss of interest in usual activities, and somatic symptoms may be evident.
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what is mania?
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an alteration in mood that is expressed by feelings of elation, inflated self esteem, grandiosity, hyperactivity, agitation, and accelerated thinking and speaking.
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how is major depressive disorder characterized?
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major depressive disorder is characterized by depressed mood or loss of interest or pleasrue in usual activities, impaired soical and occupational functioning that has existed for at least 2 weeks, no history of manic behavior.
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what is the characteristics of dysthymic disorder?
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chronically depressed most of the day,more days than not > 2 years - milder symptoms than MMD.
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what organic causes should be ruled out before diagnosis of major depression?
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hypothyroidism, dementia, brain tumors.
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what organic causes should be ruled out before diagnosis of Bi-polar?
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hyperthyroidism, drug induced (cocaine, amphetamines, steroids), neoplasm.
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name at least 3 signs that must be present for 1 week for the criteria of Mania
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gradiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, psychomotor agitation excessive involvement in pleasureable activities w/o regard for the consequences.
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what are some predisposing factors of Bi-polar?
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more common in women, high heredity factors-genetic link, usually dusl diagnosed (alcohol, cocaine)
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what can trigger manic episodes?
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non-compliance with meds, external stressor.
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how long can manic episodes last?
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can last days to weeks, and always followed by a depressive episode (severity of depression varies)
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what interventions can a nurse do for impaired social interaction for a manic patient?
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set limits on manipulative behavior, with clear and consistent consequenes. do not arue, bargain or try to reason with client. provide prositive reinforcement for non-manipulative behavior. redirect when pt. verbalizes grandiosity.
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why is ECT used?
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it is used for psychotic depresion, chronic. electric currents passed through the brain causing seizure like activity.
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how often is ECT used?
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two to three times a week for 6 - 12 treatments.
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what is major side effect of ECT?
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short term memory loss.
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why is atropine sulfate given 30 minutes before an ECT?
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to decrease secretions.
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why is a skeletal muscle relaxer given with ECT therapy?
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a muscle relaxant is given (usually succinylcholine chloride) (Anectine) intravenously to prevent severe muscle contractions during the seisure, thereby reducing the possiblity of fractured or dislocated bones.
patient is also ventilated because anectine paralyzes respiratory muscles as well! |
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Name SSRI drugs and some of thier side effects
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paxil, prozac, celexa, zoloft, lexapro
SE: headache, insomnia/sedation (take in AM or HS), nausea (usually transient, taking with food may not help), diarrhea (transient, lasts 2-3 weeks), constipation, sexual dysfunction, excessive sweating (learn to tolertate it). |
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name SNRI drugs
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Effexor, cymbalta
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what are some SE of effexor (norepinephrine and serotonin)?
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sight increase in BP (monitor BP), sexual dysfunction possible but less than SSRIs, once a day capsules now available
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what are some SE of Wellbutrin? (dopamine, serotonin & norepinephrine)
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increase in seizure risks, it's helpful in quitting smoking, no weight gain, no sexual dysfunction, may increase anxiety.
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name the atypical (non-SSRI's)
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remeron, pristiq
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what are some SE of the atypical (Remeron -histamine)?
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wt. gain of 5 to 8 lbs (usually used in pt. that need weight), sedation (take at night)
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what are some SE of the atypical Pristiq?
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not for patients under 24 years. caution in pt with: bi-polar, liver or kidney disease, heart diease, or hypertension, history of stroke, glaucoma, seizures, bleeding disorders, high cholesterol (baseline creatinine, lip panel,BP)
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Name some MAO inhibitors
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Nardil, Parnate
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what special diet should someone taking MAO inhibitors be on?
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low tyramine diet (no age cheese, red wine, MSG, processed meats) MAO inhibitors can cause hypertensive crisis and stroke!
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name a tricyclic antidepressant
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Tofran/Imipramine
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what are some SE of tricyclics?
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can cause tachycardia, fatigue, seizures, HTN and risk for cardiotoxicity. photosensivity (must use sunblock)
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what is the theraputic level for Lithium?
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0.5 - 1.5, if high stop meds. easy to get toxic if dehydrated-unsafe in overdose, maintain salt intake, hydration.
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where is lithium metabolized?
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kidneys not the liver.
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name some mood stabilizers
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depokote
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