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67 Cards in this Set
- Front
- Back
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Atropine sulfate -ECT
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given prior to ECT to decrease secretion and increase heart rae
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Succinylcholine- ECT
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muscle relaxant given to prevent bone fractures
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Thiopental Sodium
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administered as a short acting anesthetic
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only absolute contraindication for ECT
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intracranial pressure
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most common side effect of ECT
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temporary memory loss & confusion
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Major Depression
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Major indication for ECT
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Oxygen
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Administered prior to, during, and after ECT
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Informed Consent
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required before ECT can be initialted
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Norepinephrine and serotonin
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thought to be increased by ECT
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Recent Myocardial Infarction
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most common cause of mortality associated with ECT
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the average number of ECT treatments given and the timing of administration
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one treatment every other day for a total of 6 to 12
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priority nursing intervention before starting ECT
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ensure the consent form has been signed
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insulin coma therapy
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the induction of a hypoglycemic coma aimed at alleviating psychotic symptoms; a dangerous procedure, questionably effective, no longer used in psychiatry
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pharmacoconvulsant therapy
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no longer used; IM injections like pentylenetetrazol (metrazol) or inhalant flurothyl
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hypomania
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milder degree of manic episode in bipolar disorders; no psychotic symptoms
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Bipolar disorder I vs II
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I: with mania
II with hypomania |
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Cyclothymic disorder
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chronic mood disturbance >2yrs
hypomania, lesser severity of depression; never without mood disturbance for more than 2 months |
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substance induced mood disorders
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-intoxication
-withdrawal -heavy metal and toxins -medications |
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biological influence to depressive illness
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biogenic amines: neurotransmitter depression of norepinephrine, serotonin, dopamine, and receptor sites
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neurological disorders that may affect mood
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-CVA, Brain tumors, Alzheimer's Parkinsons, Huntingtons, MS
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electrolyte disturbances that affect mood
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(+) sodium bicarb, calcium,
(-) magnesium, sodium (+,-) potassium |
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hormonal disturbances for mood
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adrenal cortexes: addison's, cushing's
thyroid estrogen, progestrone |
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nutritional deficiencies that affect mood
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vita B12, B6, B1, noacin , vita C, iron, folic acis, zinc, calcium, potassium
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indicator that differentiates mood disorder form the typical stormy behavior of adolescence
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visible manifestation of behavioral change that lasts for several weeks
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Fluoxetine (Prozac)
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the only medication approved to treat depression in children and adolescence
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most common psychiatric disorder in elderly
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depression
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bereavement overload predisposes this group to depressive illness
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elderly
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symptoms of depression in elderly are often misdiagnosed as this
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senile dementia: b/c of memory loss, confusion, apathy
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medications commonly used by elderly that can produce depressant effect
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antihypertensives, corticosteroids, analgesics
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safest most effective treatment of depression in the elderly
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ECT if acute suicidal risk or can't tolerate meds
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the "blues"
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associated with postpartum depression
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therapeutic range for acute mania with lithium
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1.0 to 1.5 mEq/L
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a drug that's effective in the treatment of bipolar mania
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Carbamezepine (Tegretol)
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Anticonvulsants used to treat bipolar disorder
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-carbamazepine (Tegretol)
-clonazepam (Klonopin) -valproic acid (depakote) -lamotrigine (Lamictal) -gabapentin (Neuronitin) -topirimate (Topamax) -oxcarbazepine (Trileptal) |
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biological influences to bipolar disorder
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elevated intracellular calcium
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existing medical conditions that may be factor of bipolar
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electrolyte imbalances, cerebral lesions, med side effects
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frequent use of this med may be factor to bipolar
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steroid for M.S or lupus, other somatic illnesses;
amphetamines, antidepressants, anticonvulsants, carcotics |
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most common comorbid condition in children and adolescence with bipolar
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ADHD, stimulants can exacerbate mania
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feelings of blues in response to everyday disappointments
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transient depression
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clouding of consciousness occurs
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delirious mania
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outlook is gloomy and pessimistic
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dysthmic disorder
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characterized by mood swings between hypomania and mild depressiveness
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cyclothymic disorder
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feelings of total depsair and hopelessness
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Major Depressive disorder
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physical mvmnt may come to a standstill
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Major Depressive d/o
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paranoid and grandiose delusions are common
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BIpolar d/o (mania)
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client feels best in the morning and worse as day progresses
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dysthmic disorder
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excessive interest in sexuality
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bipolar d/o (mania)
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able to carry out thoughts of destructive behavior
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dysthymic d/o
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Accelerated pressure speech
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bipolar mania (mania)
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frenzied motor activity characterized by agitated purposeless mvmnt
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delirious mania
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transient depression
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life's everyday disappointements
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mild depression
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normal grief response
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moderate depression
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dysthymic d/o
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severe depression
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major depressive d/o
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3 stages of mania
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stage 1, hypomania
stage 2, acute mania stage 3, delirious mania |
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lithium treatment for bipolar requires what to be monitored
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s & s of toxicity: n &v, stomach pains, dizziness, weakness, tremors, ataxia, nystagmus, slurred speech, seizures
CHECK blood levels once a month |
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pharm t/x of depressive d/o
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SSRU- most widely used: inhibits cns uptake
MAOI- developed for TB TCA- developed (but ineffective) for schizophrenia |
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SSRI's
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citalopram (Celexa), escitalopram (Lexapro,) fluvoxamine (Luvox),
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serotonin syndrome s&s
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s &s - 1. confusion, agitation, tachycardia, hypertension, nausea, abdominal pain, myoclonus, muscle rigidity, fever swetaing, tremor ->>rhabydomyolysis, cardivascular collapse, coma, death
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serotonin syndrome t/x
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d/c drug, monitor v/s, use cooling blanket, cyproheptadine, and dantrolene
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amoxapine - heterocyclic, t/x for depression
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can cause NMS and tardive dyskinesia
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heterocyclics:
bupropion, maprotiline trazadone |
risk of seizures
risk of priapism |
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first line to treat major depressive d/o
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SSRI, SNRI
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second line to treat major depressive d/o
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tricyclics
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third line to treat major depressive d/o
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MAOI
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lithium level for maintenance
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0.6 to 1.2 mEq/L
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lithium toxicity
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monitored weekly initialliy, than monthly for maintanence
s & s blurred vision, tinnitus, n/v, diarrhea eliminated by kidneys |
