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This type of disorder exists for at least 2 weeks
A. Major Depressive Episode
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This type of disorder lasts at least one week for most of the day, nearly every day
B. Manic Episode
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This type of disorder lasts at least 4 consecutive days for most of the day, nearly every day
B. Hypomanic
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A treatment for depression in which a brief electrical current is passed through the brain...
ECT (electroconvulsive therapy)
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Involves the placement of a permanent implant to stimulate the vagus nerve which changes the levels of serotonin, nor-epi, GABA, and glutamate
Vagus nerve stimulation
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Involves exposing an individual to an artificial light source during winter months to relieve seasonal depression
Light therapy
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The underlying hypothesis for this treatment is that a time-varying magnetic field will induce and electrical field...
Transmagnetic stimulation
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Pathological depression occurs when
adaptation is ineffective and the symptoms are significant enough to impair functioning
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loss of interest in things that gave you pleasure
Anhedonia
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During depression, when changes in appetite, sleep patterns and cognition - lack of what chemical is the cause?
Seratonin
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What is the most prevalent psychiatric disorder?
Major depressive disorder
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Common characteristics of Major Depressive Disorder (MDD)
- Feelings of guilt - many times delusional
- Difficulty concentrating
- Anergia - lack of energy, fatigue
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Characteristics of Dysthymic Disorder
- just blah most of the time
- chronically depressed, sad, down in the dumps
- no psychosis
- must have for at least 2 years
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Characteristics of Premenstrual dysphoric disorder
- Start the week before (luteal phase)
- Food cravings
- Hormonal
- Physical symptoms
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This disorder happens mostly during winter and in gloomy areas
Seasonal Affective Disorder (SAD)
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What is the treatment for SAD (seasonal affective disorder)?
light therapy
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What is cause of SAD (seasonal affective disorder)?
too much melatonin causes depression
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Depression of the elderly often associated with bereavement overload?
Senescence
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What type of treatment for depression do the elderly react better to?
ECT
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This occurs in 80% of post-partum women, they are tearful, sad, guilty for about 2 weeks?
Baby blues
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This occurs in 10-20% of post-partum women, and if they have a history of depression then they are more likely to suffer
Post Partum Depression
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This happens to 1/1000 post-partum women and can happen right away
Post Partum Psychosis
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Name the symptoms of transient depression
- Affective: The “blues” (feeling down)
- Behavioral: Some crying
- Cognitive: Some difficulty getting mind off of one’s disappointment (thinking about it)
- Physiological: Feeling tired and listless
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Name the symptoms of mild depression
- Affective: Anger, anxiety
- Behavioral: Tearful, regression
- Cognitive: Preoccupied with loss
- Physiological: anorexia, insomnia
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Name the symptoms of moderate depression
- Affective: Helpless, powerless
- Behavioral: Slowed physical movements, slumped posture, limited verbalization
- Cognitive: Retarded thinking processes, difficulty with concentration
- Physiological: Anorexia or overeating, sleep disturbance, headaches
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Bipolar disorder is characterized by ?
- Mood disorders with recurrent episodes of depression and mania
- Periods of normal functioning alternate with periods of illness.
- Can exhibit psychotic, paranoid and/or bizarre behavior during mania
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Four or more episodes of hypomania or mania within 1 year
Rapid cycling
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One episode of mania alternating with major depression - what type of depressive disorder?
Bipolar I
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One or more hypomanic episodes alternating with major depressive - what type of depressive disorder?
Bipolar II
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At least 2 years of hypomanic manifestations that do not meet the criteria for true hypomania
Cyclothymic disorder
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Name some characteristics of mania
- Labile mood with euphoria
- Agitation and irritability
- Restlessness, decreased sleep
- Increase in talking and activity
- Flight of ideas
- Grandiosity
- Impulsivity, poor judgment
- Attention-seeking
- Delusions, hallucinations
- Easily distracted
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What are nursing interventions for a patient with mania?
- Safety
- Decrease stimulation
- Implement frequent rest periods
- Provide outlets for physical activity
- Monitor sleep
- Use a calm, matter of fact approach
- Limit-setting
- Medications: Mood stabilizers
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What is the therapeutic range for Lithium?
0.6-1.2
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Name three anticonvulsants that are prescribed for Bipolar disorder
- Carbamazepine
- Valproate
- Lamotrigine
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Lithium is a salt, therefore anything that makes you retain or excrete sodium will make you ?
retain or excrete Lithium
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client and family education related to antidepressants
- Continue to take medication for 4 weeks.
- Do not discontinue medication abruptly.
- Report sore throat, fever, malaise, yellow skin, bleeding, bruising, persistent vomiting or headaches, rapid heart rate, seizures, stiff neck and chest pain to physician.
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When taking MAOI's what foods should patients avoid?
- Avoid foods and medications high in tyramine when taking MAOIs. These include
- Aged cheese
- Wine; beer
- Chocolate; colas
- Coffee; tea
- Sour cream; yogurt
- Smoked and processed meats
- Beef or chicken liver
- Canned figs
- Caviar
- Raisins
- Pickled herring
- Yeast products
- Broad beans
- Soy sauce
- Cold remedies
- Diet pills
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Myth: Abused spouses can end the violence by divorcing their abuser. What is the REALITY?
Reality: Over 75% of all spousal attacks occur between people who are separated or divorced.
Woman is at most danger after she leaves
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What is the #1 cause of death of pregnant women?
Homicide by their partner
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Biochemical influences are thought to predispose individuals for abusive behaviors. What biochemicals?
- LOW SEROTONIN
- HIGH NOREPI AND DOPAMINE
- testosterone
- cortisol
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Name other predisposing factors thought to be associated with abusive behaviors
- Possible hereditary factor
- Genetic karyotype XYY has been implicated
- Organic brain syndromes
- Brain tumors/trauma
- Encephalitis
- Temporal lobe epilepsy
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Name the cycles of battering
- Phase I: Tension-building phase
- Phase II: Acute battering incident
- Phase III: Calm, loving, respite (honeymoon) phase
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The highest risk group for rape:
between 16 and 34 years of age
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Name this type of reaction to rape that may be seen on assessment:
overt and consists of emotional outbursts, including, crying, laughing, hysteria, anger, and incoherence
Expressed reaction pattern
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Name this type of reaction to rape that may be seen on assessment:
ambiguous, can appear calm and have blunted affect but can also be confused, have difficulty making decisions and feel numb
Controlled reaction pattern
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Name this type of reaction to rape that may be seen on assessment:
can occur later , muscle tension, headaches, sleep disturbances, gastrointestinal and genitourinary manifestations
Somatic reaction pattern
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Name other reactions to rape that may be seen later
- Post-traumatic stress disorder
- Compound rape reaction - depression, substance abuse
- Silent rape reaction - doesn't tell, nightmares, anxiety, phobias
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