Psycsocial Quiz 4

Front 1

Depression

Back 1

Has been described as feelings of despair, gloom, or emptiness; a sense of foreboding, numbness, hopelessness, or agony, or a negative sense of self-worth.

Front 2

Symptoms of depression

Back 2

Cry for no reason, quiet with little to say, isolation, fatigue, restlessness, sleep affected and eating.

Some brain chemistry changes are involved with depression even if there is a psychological trauma.

Front 3

DSM ICD

Back 3

Diagnostic and statistical manual and intervention classification of disease. Diagnostic criteria for depression. There are no blood tests or scans possible to diagnose. DSM and ICD alleviate confusion with depression diagnosis.

Front 4

Treatment of depression

Back 4

Treatment and recovery from depression brain chemistry returns to normal even without meds. treated with meds and Psychotherapy. Meds treat symptoms and Psychotherapy treats the causes.

Front 5

Two types of depression

Back 5

Major and minor depression. Major depression has eight subtypes.

Front 6

Clinical depression

Back 6

When symptoms are severe enough to disrupt the clients daily life and treatment is required.

Front 7

Minor depression

Back 7

Is a lesser used term for a subclinical depression that does not meet criteria for major depression.

Front 8

Dysthymic disorder

Back 8

Is characterized by a chronic low-level depression that lasts for a minimum of two years. Jumps to major depression after.

Front 9

Symptoms of minor depression

Back 9

Changes in thinking, feeling, behavior, and physical well-being. Short term memory- forgetting things. Inability to concentrate,negative, and pessimistic. lack of motivation, apathetic, helplessness, hopelessness, anger or temper outbursts, excessive crying, decreased sexual drive, fatigue, decreased appetite, weight loss, not feeling well.

Front 10

Major depression

Back 10

Is the most severe category of depression.

Symptoms same as minor depression but more intense and severe.

Causes one single life traumatic event or develop slowly as a consequence of numerous personal disappointments or life problems.

Front 11

DSM diagnosis requirements for major depression

Back 11

Presence of at least one major depressive episode.

An episode includes(3)

Lasts at least two weeks

Represent a change from previous functioning.

Cause some impairment in a person's social or occupational functioning

Also five or more symptoms including depressed mood or loss of interest in previously enjoyable activities

Front 12

8 subtypes of major depression

Back 12

1. Reactive depression

2. Endogenous depression

3. Involutional depression

4. Unipolar disorder

5. Bipolar disorder

6. Seasonal affective disorder

7. Postpartum depression

8. Substance induced mood disorder

Front 13

Reactive depression

Back 13

Adjustment disorder with depressed mood. Most temporary. Follow the death / loss of a family member, divorce, loss of job, no promotion. Loss of anything of meaning to the individual.

Front 14

Symptoms and treatment of reactive depression

Back 14

Decreased appetite and weight loss, worsening depression as the day progresses, difficulty falling asleep, slowi by of body functions. Meds not recommended time equals healing. Family and sympathy group best with therapeutic responses. Listen to patients verbal and nonverbal. Don't Force patients to open up. Encourage individuals to share feelings. Tears can be therapeutic.

Front 15

Endogenous depression

Back 15

Comes from within and implies there is no discernible cause for the depression. Endogenous depression tends to be cyclic it appears during certain life cycles or the same time each year. Common example would be middle-aged or around Christmas and spring time. Causes family tendencies can be hereditary biochemical in nature.

Front 16

Symptoms and treatment of endogenous depression

Back 16

Substantial weight loss greater than 10 pounds. Depression comes on gradually and out of the blue. No precipitating event. Wake up feeling worthless improves as the day progresses. Depression time-limited and runs its course.

Treatment equals medication elevators can turn urine a different color and may have a delayed affect. Communicate to pt symptoms and side effects of meds to ensure patient doesn't stress over them.

Front 17

Involutional depression

Back 17

Usually occurs during middle age or later. Women 40-55, Men 50-65 is target group. Personality of Individuals described as rigid over conscientious and emotionally unstable. No previous history of mental illness.

Front 18

Symptoms and treatment of involutional depression

Back 18

Delusions of sin, guilt, or poverty. Obsession with death, agitation, irritability, and pessimism.

Illnesses low with increase in hypochondriasis (abnormal anxiety or fear regarding one's own health) and delusions associated with an exaggerated paranoid ideation (suspicion treated unfairly). Will go to healthcare professionals with subjective disorders dr. Will say nothing is wrong they will begin to distrust the doctor and the diagnosis and go elsewhere. Prognosis without treatment is poor.

Treated with antidepressants or electroconvulsive therapy both have been found effective.

Front 19

Unipolar disorder

Back 19

The client experience is solely episodes of depression. Children of unipolar parents can inherit unipolar disorder.

Front 20

Bipolar disorder

Back 20

The client experiences both depression and Elation or Mania both highs and lows not observed until well into the illness and can be inherited. Children of individuals with bipolar disorder can inherit unipolar or bipolar disorder.

Front 21

Bipolar disorder

Back 21

Also known as Manic depression and manic depressive illness alternate between extreme highs of mania and lows of depression. Once pattern identified Mania/ depression is predictable. Starts in adolescence or early adulthood and continues throughout life.

Front 22

Symptoms of bipolar disorder depressed phase

Back 22

Depressed phase-persistent sad, anxious, or empty mood with feelings of helplessness, guilt or worthlessness. Pessimistic, loss of pleasure in usual activities, irritable or Restless, sleep disturbances, decrease in energy, loss of appetite, suicide may be contemplated.

Front 23

Symptoms of bipolar disorder manic phase

Back 23

Excessive high or euphoric feelings combined with sustained periods of unusual, even bazaar behavior, with significant risk taking. Increased energy, activity rapid talking and thinking, and agitation, and maybe extremely irritable and easily distracted. Poor judgement, deny problems, unrealistic believe in their own abilities. Little sleep and increased sex drive.

Front 24

Treatment of bipolar disorder

Back 24

Medication with Psychotherapy. Psychotherapy helps client cope with cyclical nature of the disease and can lead to better compliance with bipolar disorder

Front 25

Medication for depression used in two ways

Back 25

First way control symptoms that are out of control and need immediate attention=acute phase. Medications treat severe depression / suicidal Behavior / depressive episodes, help control dangerous, psychotic behavior.

Meds for first line of defense are lithium valproate carbamazepine lamotrigine and olanzapine which are used to stabilize mood. small dosages prevent future episodes=chronic phase or preventive medicine

Front 26

Seasonal affective disorder

Back 26

Subtype of major depression caused by decreased sunlight and Northern parts of the world during winter months. 5% of adults affected, 25% experience winter Blues vary in severity. Winter blahs ➡ winter doldrums➡ SAD

Front 27

Symptoms of SAD

Back 27

Decreased in interest normally pursued during winter. Weight gain, sleep disturbance, overheating, depression, despair, misery, and anxiety. Family and social problems, irritability, antisocial Behavior, loss of sex drive.

Physical symptoms- joint pain, stomach problems, suppressed immune system, lethargy.

Front 28

Treatment of SAD

Back 28

Light therapy, phototherapy, as much sunlight as possible. Vacation in Sunny areas during winter period symptoms disappear in the spring.

Front 29

Postpartum depression

Back 29

Is a severe form of baby blues lasting anywhere from 3 months to one year. 10% of new mothers more common in women who have already experienced a form of depressive illness.

Cause= stress, changes with new baby lack of sleep and hormone changes.

Front 30

Symptoms and treatment of postpartum depression

Back 30

Occurred in few days after giving birth. Similar to other depressions. Miscarriage or loss of infant previously, no support from father or family.

Drug therapy but with caution due to breastfeeding.

Support groups allows them to not feel alone and can lead to recovery.

Front 31

Substance induced mood disorder

Back 31

Cause buy prescription drugs. Cardiac drugs, hypertensiveness, sedatives, steroids, stimulants, antibiotics, and analgesics. These are known to cause depression. Self treatment with drugs, over the counter drugs, or alcohol will increase depressive moods. Drugs can cause clinical depression. Drugs make recovery more challenging it causes two diagnosis chemical dependency and depression.

Front 32

Depression in children

Back 32

Same symptoms and severity as adult depression can be misdiagnosed for ADD and ADHD. 4% of preschoolers, 23% of older children. Children are the fastest-growing antidepressant Market.

Front 33

Depression in adolescence

Back 33

8.3% of adolescents are depressed 7% of those commit suicide. Causes changes in body physical and hormonal increased stress and peer pressure.

Front 34

Depression in adults

Back 34

Depression women are more likely than men. Bipolar is the same for men and women. Women are more likely to seek help. Men apt to acting out such as alcoholism.

Front 35

Depression in elderly

Back 35

No family nearby, not apt to change. Experience large amount of loss and grief. Elderly talk about suicide less but more successful with attempts. Foster sense of dignity self esteem and value elderly will go a long way.

Front 36

Four stages of suicide

Back 36

Stage 1= individual needs not met. Anger / hostility develop anger turned inward. Help client identify source of frustration.

Stage 2= stressful situation becomes unbearable Panic sets in. Looks for means of Escape or to mobilize for help. Listen to concerns and move them to Stage 1.

Stage 3= in an effort to seek help, the individual will communicate his or her helplessness. You can make a difference at this point. Listen. Let them know they aren't alone. Keep in touch.

Stage 4= begins suicidal process. Person cannot help themselves. Feeling like no one cares. Make preparations to carry out plan. Intervention may be the only appropriate response.

Front 37

Danger signs of suicide

Back 37

Previous attempts at suicide

Depression

Situational risk factors such as stressful life events

Contagion is an exposure to Suicide or suicidal Behavior

Demographics males are more likely

Talking about death or suicide

Planning for suicide

Front 38

Communicating suicide

Back 38

Indirect= what would you do if I wasn't here to nag at you?

Direct= I wonder what it feels like to die

Loaded verbal messages= I hate Autumn everything is dying. Usually not personal

Front 39

Therapeutic response to suicide

Back 39

Listen

Do not give Pat answers and easy advice.

Make every effort to understand.

Communicate through the person's strong Learning Channel

Avoid arguments and power struggles

Let yourself feel some of the other person suffering, and acknowledge the reality of their suffering.

Front 40

Therapeutic response to depression

Back 40

Understand the disorder

Listen to the clients

Encourage client to seek professional help

Provide access to Community Resources

Front 41

Is path warm

Back 41

I-Ideation

S-substance abuse

P-purposelessness

A-anxiety

T-trapped

H-hopelessness

W-withdrawal

A-anger

R-recklessness

M-mood changes

Front 42

Three types of illness

Back 42

Acute illness

Chronic illness

Life-altering illness

Front 43

Acute illness

Back 43

Experienced a rapid onset of the illness with severe symptoms. Most often for a short duration. Can't do things they used to until illness runs its course. Inconvenience but no life changes.

Example would be cold, flu, rash. Left untreated can become chronic.

Symptoms include stomach ache, fever, vomiting.

Response is help client understand any implications of diagnosis. Assist them in making decisions regarding their Medical Care.

Front 44

Chronic illness

Back 44

Labeled chronic what symptoms longer or over a period of time. Last weeks, months, or lifetime. Impact patient and causes Life Changes. Attempt to cope comply with treatments , deal with side effects. Can gradually debilitate and shorten life span becomes life-threatening.

Examples are arthritis, MS, type 1 diabetes, cancer, AIDS, and COPD

Front 45

Stages of grief for chronic illness

Back 45

Same as for loss of a loved one

Denial anger bargaining depression and acceptance. May never reach acceptance. Stages are not lineal patient can Bounce Around. Knowing the stage the patient is in helps with therapeutic communication. Patient and family may experience stages differently and maybe in different stages then the patient causing complication in communication.

Front 46

Nurse role in chronic illness

Back 46

Be warm and caring, genuine, honest, listen and function with sympathetic and empathetic ear. Assist clients and living their life to the fullest. Must be comfortable and non-judgemental and working with chronically ill and know resources for education and support for family and patient.

Front 47

Life-altering illness

Back 47

Chronic illnesses progressed to the stage where death is inevitable. Also known as life-altering illnesses. Create feelings of powerlessness and lack of control. Therapeutic responses should emphasize the positive. May be in denial after diagnosis. Last patient to come to terms with and cope with range of emotions they feel. Anger may be directed at physician / family / friends / medstaff when diagnosis processed and accepted. Many clients fear symptoms and pain not death itself. Once acceptance is restoring geared towards family. No final decisions such as power of attorney for updating will until the stage of acceptance.

Front 48

Final stages of illness

Back 48

Curing illness➡ prolonging life ➡ providing comfort ➡ focusing on palliative care

Front 49

Palliative care

Back 49

Provides relief from clients physical symptoms, as well as satisfying emotional needs, and helping with Stress Management for clients and Families.

Front 50

Hospice

Back 50

Philosophy affirms life, regards dying as a normal process, neither hastens or postpones death.

Front 51

Losses faced by individuals with life-altering illnesses

Back 51

Grieve the loss of good health. Their independence, their body image, their lifestyle, and sense of self-confidence. With constant care patient making privacy or modesty. Life changes can be job, activities finances, relationships, daily routine Interruption, sexual dysfunction. Keep as comfortable as possible. At end of physical needs, teach them how to safely monitor their meds, provide them with as much control as possible, answer questions honestly. Remember family concerns and embrace their culture as much as possible.

Front 52

Psychological effects of life-altering illness

Back 52

Psychological State can change because of illness once nice but now I mean, once was happy but can fall into depression. Personal relationships change friends can't cope with their own guilt so bad patient. Some cold by keeping busy when patient wants someone to sit with them, hold her hand and listen some might find it difficult to hold or caress dying person or dying person might rejected. Personal goals distract from primary illness and focus on therapeutic activities.

Front 53

Examples of goals

Back 53

Achieve something each week, walk, call friend, or write letter to friend.

Plan things to look forward to and long and short-term, daughter married or grandchild born.

Living will, durable power of Eternity of attorney for health care.

Update last will and testament arranged financial and personal affairs.

Discuss any worries about pain and symptom control. Learn about illness and what to expect.

Be tolerant and non-judgmental to family and client decisions. Respond to questions listen and be considerate, respectful and polite.

Front 54

Medication considerations

Back 54

When caregiver is in charge of Med giving, iterate the importance of giving the dosage as prescribed if not met can be rendered ineffective and patient may experience more pain than necessary.

Front 55

3 questions to ask in order to avoid end-of-life difficulties

Back 55

Has a living will or Physicians directive been signed?

Has a durable power of attorney for Health Care been established?

What cultural values and beliefs should be considered?

Front 56

Cultural influences

Back 56

Should client be told they have life-threatening illness? Americans yes. Mexican Americans field dying client shouldn't know their prognosis. China /japan position only tells family. Family decides to tell client. Some cultures consider insensitive to give patient feeling of hopelessness. May hasten dying process. Stress of knowing worsens condition. Hmong believe that if you tell someone they're dying that you are cursing them and the only way that they could die is if you kill them yourself. Don't impose American values on others and don't stereotype cultures.

Front 57

Therapeutic response

Back 57

Understand importance of cultural values and beliefs (no stereotyping).

Be prepared for mood swings (part of Coming to Terms process).

Encourage open and honest discussion about emotions and feelings.

Include family and client and discussions about treatment plan.

A long client to make decisions whenever possible.

Discuss client worries of pain and symptom management.

Educate family about illness and what to expect.

Help clients and family members manage their stress.

Deal with present here and now.