Term
| Delusional or psychotic major depression is a severe form of _____ ____characterized by delusions or hallucinations. |
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Definition
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Term
| A patient with what disease presents with a history of one or more major depressive episodes and no history of manic or hypomanic episodes. |
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Definition
| MDD major depressive disorder (MDD) |
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Term
| Every time you have an episode of MDD, your chances of another episode go which way? Up or down? |
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Definition
Up.
At least 60% of people can expect to have a second episode, individuals who have experienced two episodes of major depression have a 70% chance of experiencing a third, and those who have had three episodes have a 90% chance of future episodes |
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Term
| A diagnosis of MDD will have at least 1 of 6 prominent features involved. Name those 6 possible features. |
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Definition
psychotic features
melancholic features
atypical features
catatonic features
postpartum onset
seasonal features |
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Term
| what disease is characterized by a chronic depressive syndrome that is usually present for most of the day, more days than not, for at least 2 years |
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Definition
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Term
| what is the leading cause of disability in the United States. |
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Definition
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Term
| Is MDD more common in women or men? |
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Definition
| its twice as common in women, though men have a higher suicide rate |
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Term
| What is the most common psychiatric presentation with major depression? |
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Definition
| Mixed anxiety depression. It occurs with 70% of major depression cases. |
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Term
| Name 5 of the primary risk factors for depression |
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Definition
• Female gender
• Being unmarried
• Low socioeconomic class
• Early childhood trauma
• The presence of a negative life event, especially loss and humiliation
• Family history of depression, especially in first-degree relatives
• High levels of neuroticism (predisposition to respond to stress poorly)
• Postpartum period
• Medical illness
• Absence of social support
• Alcohol or substance abuse |
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Term
| name the 2 main neurotransmitters in the brain that are involved in mood. |
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Definition
| serotonin (5-hydroxytryptamine [5-HT]) and norepinephrine |
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Term
| Serotonin is an important regulator of |
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Definition
| sleep, appetite, and libido; therefore, serotonin-circuit dysfunction can result in sleep disturbances, decreased appetite, low sex drive, poor impulse control, and irritability |
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Term
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Definition
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Term
| what is a major factor in the development of depression? |
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Definition
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Term
| describe the diathesis-stress model for depression |
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Definition
| psychosocial stressors (aka life) trigger neurophysical and neurochemical changes in the brain. |
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Term
| early in life stressors can lead to neurochemicals in the brain that result in long term corticotropin over production. The long term effect of this is what? |
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Definition
| neuronal loss, which when the person is stressed results in an exaggerated stress responce. |
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Term
| What is the theory of learned helplessness? |
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Definition
| Although anxiety is the initial responce to a stressful situation, it is replaced by depression if the person feels no control over the outcome of the situation. |
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Term
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Definition
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Term
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Definition
| outward representation of a persons state of being refected outwardly on their face |
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Term
what are the vegitative signs of depression?
Vegitative signs refer to alterations in activities to support life and growth. (4 items) |
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Definition
| eating, sleeping, elimination, sex. |
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Term
| What is the major direction of acute phase depression interventions? |
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Definition
| reduction of depressive symptoms and restoration of phsychosocial and work functions |
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Term
| What is the major direction of continuation phase depression interventions? |
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Definition
| prevention of relapse through therapy, meds, education, ect |
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Term
| what is the major direction of maintenance phase depression interventions? |
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Definition
| treatment to reduce likeliness of future episodes. |
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Term
| Acute phase of depression lasts how long? |
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Definition
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Term
| the continuation phase of depression lasts how long? |
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Definition
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Term
| the maintenance phase of depression lasts how long? |
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Definition
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Term
| what is the key to illness management? |
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Definition
| identifying and coping with interpersonal relationships (family, occupation, social) |
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Term
| name 3 ways how involving family in discharge planning helps the patient |
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Definition
1)increases family understanding and acceptance of the depressed person during care.
2)increases patients use of aftercare facilities in the community
3) contributes to higher overall adjustment in the patient after discharge |
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Term
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Definition
| loss of ability to experience joy or pleasure in living |
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Term
| what is the first line antidepressant for depression? |
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Definition
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Term
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Definition
| labido issues, tremor, sleep disturbance, anxiety, agitation, tension headache. |
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Term
| seretonin overdose can lead to seritonin syndrome. What are the effects? |
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Definition
| ab pain, diarrhea, sweating, fever, tachycardia, elevated blood pressure, dylerium, muscle spasms, increased muscle activity, irritability, hostility and mood changes. |
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Term
| Seritonin syndrom is very likely when you combine an SSRI with what? |
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Definition
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Term
| what do tricyclic antidepressants (TCAs) do? |
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Definition
| they inhibit the reuptake of norepinephrine and serotonin by the presynaptic neurons in the CNS |
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Term
| what type of drug is Nefazodone (serozone) |
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Definition
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Term
| what type of drug is Buprpion (wellbutrin) |
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Definition
| NDRI (norepinephrine dopamine reuptake inhibitor |
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Term
| What type of drug is Mirtazapine (remeron) |
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Definition
| SNDI )serotonin norepinephrine disinhibitor |
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Term
| patients must take TCAs for how long to start to feel effects? How long for full effects to take hold? |
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Definition
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Term
| desipramine (norpramin), and protriptyline (vivactil) are what type of drugs? |
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Definition
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Term
| what two side effects of TCA's warrant immediate medical attention? |
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Definition
| urinary retention and severe constipation |
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Term
| contrandications for TCA's |
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Definition
| MI, glaucoma, seizure history, pregnancy. |
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Term
| what type of drug is reboxetine? |
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Definition
| NRI Norepinephrine Reuptake Inhibitors |
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Term
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Definition
Phenelzine (Nardil)
Selegiline Transdermal System Patch (EMSAM)
Tranylcypromine (Parnate) |
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Term
| MAOIs are particularly effective for people with what type of depression? |
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Definition
atypical depression
(characterized by mood reactivity, oversleeping, and overeating) |
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Term
| common adverse reactions of MAOI's |
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Definition
| orthostatic hypotension, weight gain, edema, change in cardiac rate and rhythm, constipation, urinary hesitancy, sexual dysfunction, vertigo, overactivity, muscle twitching, hypomanic and manic behavior, insomnia, weakness, and fatigue. |
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Term
| Adverse effects of MAOI's |
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Definition
Hypertensive crisis:
• Severe headache
• Tachycardia, palpitations
• Hypertension
• Nausea and vomiting |
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Term
| What is the remission rate for ECT? |
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Definition
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Term
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Definition
• When a patient is suicidal or homicidal, and there is a need for a rapid, definitive response
• If previous medication trials have failed
• When there is marked agitation, marked vegetative symptoms, or catatonia
• For major depression with psychotic features |
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Term
| how long are ECT treatments? |
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Definition
| 2 or 3 treatments per week to a total of 6 to 12 treatments. |
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Term
| Contraindications for ECT |
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Definition
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Term
| What is a noninvasive treatment modality that uses MRI-strength magnetic pulses to stimulate focal areas of the cerebral cortex. |
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Definition
| Transcranial magnetic stimulation (TMS) |
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Term
| electrical stimulation of the vagus nerve is believed to do what? |
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Definition
| Researchers believe that electrical stimulation of the vagus nerve results in boosting the level of neurotransmitters, thereby improving mood and also improving the action of antidepressants |
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Term
| first line treatment for Seasonal Affective Disorder? |
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Definition
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Term
| Herbal suppliment that is an antidepressant? |
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Definition
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Term
| what are the 2 main psychotherapys used in treating depression? |
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Definition
| Cognitive behavioral therapy (CBT), interpersonal therapy (IPT), |
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Term
1. The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states, “I hear voices of aliens trying to contact me.” The nurse should recognize this presentation as which type of major depressive disorder (MDD)?
1. Catatonic
2. Atypical
3. Melancholic
4. Psychotic |
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Definition
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Term
2. Which patient statement indicates learned helplessness?
1. “I am a horrible person.”
2. “Everyone in the world is just out to get me.”
3. “It's all my fault that my husband left me for another woman.”
4. “I hate myself.” |
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Definition
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Term
3. The nurse is planning care for a patient with depression who will be discharged to home soon. What aspect of teaching should be the priority on the nurse's discharge plan of care?
1. Pharmacological teaching
2. Safety risk
3. Awareness of symptoms increasing depression
4. The need for interpersonal contact |
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Definition
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Term
4. The nurse is reviewing orders given for a patient with depression. Which order should the nurse question?
1. A low starting dose of a tricyclic antidepressant
2. An SSRI given initially with an MAOI
3. Electroconvulsive therapy to treat suicidal thoughts
4. Elavil to address the patient's agitation |
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Definition
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Term
5. A female patient tells the nurse that he would like to begin taking St. John's wort for depression. What teaching should the nurse provide?
1. “St. John's wort should be taken several hours after your other antidepressant.”
2. “St. John's wort has generally been shown to be effective in treating depression.”
3. “This supplement is safe to take if you are pregnant.”
4. “St. John's wort is regulated by the FDA, so you can be assured of its safety.” |
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Definition
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