MDD
This medical disorder mimics major depressive disorder.
What is hypothyroidism?
Hypothyroidism may cause changes in weight, sleep disturbances, decreased energy, and changes in thought processes that mimic a major depressive episode.
These types of beverages should be avoided when taking a tricyclic antidepressant.
What are alcoholic beverages?
CNS depressants should be avoided when taking tricyclics because they can increase the TCA level and cause adverse side effects.
This is the therapeutic lithium range.
What is 0.6 to 1.2 mEq/L?
Toxicity starts at levels above 1.5 mEq/L
This is a priority intervention for the patient experiencing alcohol detox.
What is restoration and maintaining fluid and electrolyte imbalances?
"I just don't like going to the movies like I use to" is an example of this.
What is anhedonia?
Anhedonia is the diminished capacity to experience pleasant emotions/interest in activities. It is seen in MDD and is also considered a negative symptom in schizophrenia.
This neurotransmitter is implicated in major depressive disorder.
What is serotonin?
A patient taking an MAOI should avoid these types of foods.
What are aged foods high in tyramine, such as wine, aged cheese, ripe avocadoes, or pepperoni?
A patient taking lithium develops diarrhea. This should be done next.
What is discontinuation of the medication?
Diarrhea can lead to dehydration which then can lead to higher levels of lithium in the blood, leading to lithium toxicity.
Diarrhea is also a sign of lithium toxicity, which would warrant discontinuation.
This inquiry is important when performing a psychosocial assessment related to substance use disorders.
What is investigating how one's substance use has affected their occupational functioning?
Inquiring about performance at school or work is appropriate for a psychosocial assessment.
Women with a history of depression are at higher risk for this disorder.
What is PPD?
Risk of this is particularly high in a patient with a depressive disorder and substance abuse.
What is suicide risk?
The risk of suicide is increased in patients who have a history of depression and substance use.
This syndrome occurs when multiple serotonergic medications are combined and symptoms can range from diaphoresis, tremors, and headaches to tachycardia, HTN, and seizures.
What is serotonin syndrome?
This medication may be given for a patient who presents with mania and is unresponsive to redirection and becomes threatening.
What is olanzapine IM?
Olanzapine is a second-generation antipsychotic that works quickly to reduce agitation.
This would be an important discharge discussion following hospitalization for ETOH withdrawal.
What is connecting with AA immediately?
Name 3 negative symptoms associated with schizophrenia.
What are blunted affect; poverty of thought (alogia, a reduction in the amount and content of speech), anhedonia, avolition, apathy, asociality [lack of desire for social relationships]?
Electroconvulsive therapy may cause these possible side effects.
What are mild confusion, headache, and short-term memory loss?
These medications are first line agents for depressive disorders.
What are SSRIs? Selective serotonin reuptake inhibitors.
Zoloft, Paxil, Lexapro, Prozac, Luvox, Celexa
An increase in this neurotransmitter is associated with the fight-or-flight response of a restless, agitated patient.
What is norepinephrine?
Norepinephrine is associated with the fight-or-flight response. It produces activity in the sympathetic postsynaptic nerve terminal and is associated with the regulation of mood, cognition, perception, locomotion, sleep, and arousal.
These medications are given for ETOH withdrawal and also amphetamine withdrawal.
What are benzodiazepines, such as diazepam (Valium) and lorazepam (Ativan)?
This is the inability to think abstractly. For example, a nurse might ask what brought the patient to the hospital and the patient answers "a cab" rather than explaining a suicide attempt.
What is concrete thinking?
Concreteness reduces one's ability to understand and respond to concepts requiring abstract reasoning such as love or humor.
This would be the nurse's follow-up question when a patient states that their spouse would be better off without them.
What is asking if the patient is having thoughts of harming themself?
It is the nurse's priority to determine the seriousness of the patient's intent and whether or not the patient has a plan, and how lethal the plan.
A patient who has not responded to SSRIs asks if they can add an MAOI. How should you respond?
What is discussion of low-calorie options and avoiding significant sodium intake?
Weight gain is a common side effect of lithium and occurs through several mechanisms such as carbohydrate craving, increased thirst, fluid consumption, and reduced metabolism secondary to hypothyroidism. Nurses must provide helpful strategies for the patient so that they adhere to the medication.
This term describes the administration of a central nervous system depressant during alcohol withdrawal.
What is substitution therapy?
Substitution therapy may be required to reduce the life-threatening effects of intoxication or withdrawal from some substances. Benzodiazepines are the most widely used group of drugs for substitution therapy in alcohol withdrawal.
This neurotransmitter is responsible for the hallucinations experiencing in psychotic states.
What is dopamine?