Somatic Symptom Disorders
Bipolar Disorders
Suicidal thoughts and Behaviors

tendency to experience an communicate physical symptoms in response to psychologic distress, although no medical test demonstrate no medical basis, people continue to seek help/relief

-multiple physical symptoms, significant distress, impaired functioning, obsession with health concerns, actively seek medical release. actively seek medical relief 


-somatic symptom disorder


Name the primary risk factors for depression.

-history/family history of depression

-history/family history of Suicide attempts/Suicide

-member of LGBTQ community


-age 40 or younger


-chronic medical illness

-absence of social support


-Active alcohol or substance use disorder

-history of sexual abuse


T/F a person should avoid salt while taking lithium?

S/S of lithium toxicity(early)? 


- Increased nausea, vomiting, diarrhea, thirst, polyuria, slurred speech, muscle weakness.


If a client admits to hearing a voice tell them to hurt themselves or another person what is that called?

What should be our first intervention as a nurse?

Command hallucination

Assess safety, is pt going to act on the command?


greatest # of suicides occur in 

young adults


What is the difference between factitious disorder and somatic symptom disorder?

factitious= a person will fabricate the symptom or self injury without obvious potential reward (Also known as Munchausen syndrome).


What is the difference between major depressive disorder and persistent depressive disorder?

MDD- the individual may not be unable to function normally, symptoms may lessen or even resolve within three months or even a year without treatment.

PDD- the person can function at work and in social situations but not the optimal level, has been persistent for at least two years


Name the preferred medication for bipolar disorder during pregnancy?

lamotrigine, an antiepileptic 


What is the prodromal phase?

What are some of the symptoms?

Signs and symptoms that precede the acute, fully manifested signs and symptoms of disease.

Social withdrawal, deterioration in functioning, depressive mood, perceptual disturbances, magical thinking, and to kill your behavior and peculiar behavior. Changes in self-care, sleeping or eating patterns, and school or work performance may also be evidence.


a suicidal individual has been checked into the hospital. how often should you check on them?

Q15 min at random.


What is it called when a person fakes an injury for obvious reasons such as monetary gain, or not wanting to face something?



remember this for serotonin syndrome, SHIVERS= ?

When is this risk at greatest?

S shivering, H hyperreflexia and myoclonus; muscle rigidity, I increased temp, V vitals; labile blood pressure, E encephalopathy; confusion; mental status changes, R restlessness, S sweating.

-when an SSRI is adm. with another serotonin enhancing agent.  -wait 2-5 weeks from stopping previous SSRI or other antidepressant before starting MAOI.


Do not take OTC meds, especially ___ and ___ without checking with dr. first while taking lithium

NSAIDS and antacids 


Name the positive and negative symptoms of schizophrenia

Positive= hallucinations, delusions, bizarre behavior, catatonia, formal thought disorder. "I am POSITIVE there is a bear in the corner"

Negative= apathy, lack of motivation, anhedonia, Limited or flat affect, poverty in speech, social withdrawal "I feel so negative"


meds that contribute to suicide.



Calcium channel blockers


Hormonal meds and pain killers


How does Dissociative amnesia with fugue differ than dissociative amnesia.

Bewildered wandering or purposeful TRAVEL maybe part of the clinical picture of a Fugue state.


MAOIs can have food-drug and drug-drug interactions causing serotonin syndrome and/or hypertensive crisis. What would this look like?

Are these safe with another antidepressant?

Severe increase in BP, Tachycardia, SOB, Chest pain, Severe H/A, N/V, Sweating, Severe anxiety, Nosebleeds.

-NEVER to be taken with another antidepressant.


A client can still take their lithium if they have the stomach flu, T/F?

False, lithium levels can fluctuate with fluid intake and output


extrapyramidal symptoms include what?

Acute dystonia= spasms of tongue, head, neck. eye deviation, back spasms that thrust the head and lower limbs backwards.

Akathisia= internal restlessness, pacing, fidgeting, psychotic agitation, or comorbid anxiety

Pseudoparkinsonism= stiffening of muscular activity in face(mask like), body arms, and legs; salivation, shuffling gait, tremor, bradykinesia.


hard verses soft methods of suicide

Highly lethal: Guns, hanging, carbon monoxide, staging a car crash

Lower risk: Slashing wrists, inhaling natural gas, ingesting pills


Is the unconscious defense mechanism to protect an individual against overwhelming anxiety.



ECT is indicated is the: SATA

a. pt is suicidal or homicidal

b. agitation or stupor is extreme 

c. life-threatening illness is a result of the refusal of foods or fluids.

d. history includes a poor drug response or a good ECT response

e. standard medical treatment has no effect

a, b, c, d, e


Which milieu activity should the nurse recommend to a client with acute mania? SATA

a. schedule rest periods

b. relaxation exercises

c. listening to soft music 

d. watching tv

e. taking a walk

a, b, c, e

watching tv would stimulate the client in acute mania


Metabolic syndrome is a side effect of SGAs. what all does this include

weight gain, insulin resistance, hypercholesterolemia, dyslipidemia, hypertension, diminished self-esteem r/t weight gain.


After a crisis a patient may be prescribed anti anxiety or an antidepressant. how much will they like be given? (how many days worth?)

1-3 days supply

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