-
-
affective disorders impair:
- mood (how we feel)
- affective (how others see us
-
major depression
disorder of mood where individual experiences one or more recurrent depressive episodes without signs of mania or hypomania
-
major depression
diagnostic criteria
- depressed mood
- anhedonia: lack of pleasure or of the capacity to experience it
- sleep pattern change
- tiredness
- unintentional weight change of 5% or more in 1 month
- agitation or psychomotor retardation
- worthlessness or guilt
- hopelessness (suicide)
- difficulty with thinking/making decisions
-
depression
assessment
- anhedonia
- apathetic
- not eating (weight loss)
- constipation
- amenorrhea
- fatigue
- not clean (poor hygiene)
- dejected facial appearance
- turned inward
- decreased sexual desire
-
depression
nursing interventions
- no injuries-safety
- promote independence
- promote socialization
- ADL's return to work/school
- may need to monitor and help at first until they can do it on their own
- compliance with antidepressant medication
- explain what the medication is used for
- teach side effects
- knowledge regarding symptoms of recurrence
- encourage client to verbalize and describe emotions
-
psychotic
- grossly disordered thinking and behavior
- hallucinations
: sensory impressions without external stimuli - illusions: misinterpreted stimuli
- delusions: false fixed belief (mostly seen in manic patients)
neurotic: disordered activity; disruption of daily life
-
bipolar
- one or more manic episodes with or without alternating major depressive episodes
- bipolar 1: depressive episodes and full manic episodes (interferes with ADL's/work/school
- bipolar 2: depressive episodes (causes problems with ADL's/work/school) with hypomanic episodes
-
diagnostic criteria for mania
must have 3 present for 1 week
- grandiose or agitated state
- sleeplessness
- pressured speech
- flight of ideas
- distractability
- increased energy
- exaggerated self esteem
- poor judgement
- risk taking
-
bipolar
assessment
- onset before age 30
- mood: elevated, expansive, irritable
- speech: loud/rapid, punning, rhyming, clanging, vulgar
- grandiose
- delusions
- distracted
- hyperactive
- decrease need for sleep
- inappropriateness
- flight of ideas
- begins suddenly escalates over several days
- risk taking
-
bipolar (manic)
nursing interventions
- safety to self and others
- suicide potential concern
- safety of others- remind client of others personal space
- set limits on client's behavior
- evaluation of personal qualities realistically
- socially appropriate
- medication compliance
- knowledge of recurrance
- use short simple sentences
- use distraction: cleaning, exercise, productive activities NO competitive activities
- provide finger foods
- protect the client's dignity
-
bipolar (manic)
teaching when mania subsides
- explain about medications and side effects
- educate about risk taking behaviors and ways to avoid
- teach about signs or relapse
- agitation
- sleeplessness
-
evaluation and prognosis
- major depression: stay on medication (up to 2 years) to prevent relapse often times can stop taking medication after that
- bipolar: stay on medication for life
-
schizophrenia
- disorder that is characterized by disturbances in reality, orientation, thought process and social involvement
- usually diagnosed in late adolescence
- peak men 14-24
- peak women 35-35
-
schizophrenia
diagnostic criteria
ambivalence
positive symptom
holding seemingly contradictory beliefs or feelings about the same person, event or situation
-
schizophrenia
diagnostic criteria
associative looseness
positive symptom
fragmented or poorly related thought and ideas
-
schizophrenia
diagnostic criteria
delusions
positive symptom
fixed false beliefs that have no basis in reality
-
schizophrenia
diagnostic criteria
echopraxia
positive symptom
imitation of the movements and gestures of another person whom the client is observing
-
schizophrenia
diagnostic criteria
flight of ideas
positive symptom
continuous flow of verbalization in which the person jumps rapidly from one topic to another
-
schizophrenia
diagnostic criteria
hallucinations
positive symptom
false sensory perception or perceptual experiences that do not exist in reality
-
schizophrenia
diagnostic criteria
ideas of reference
positive symptom
false impressions that external events have special meaning for the person
-
schizophrenia
diagnostic criteria
perseveration
positive symptom
persistent adherence to a single idea or topic; verbal repetition of a sentence, word, or phrase; resisting attempts to change the topic
|
|