MDD
This medical disorder mimics major depressive disorder.
What is hypothyroidism?
Hypothyroidism may cause changes in weight, sleep disturbances, decreased energey, and changes in thought processes that mimic a major depressive episode.
These types of medications 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 expected lithium level range.
What is 0.8 to 1.3 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 a loss of pleasure in activities that previously were interesting/pleasurable, and is seen in MDD.
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 'has your substance use affected your 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.
What is postpartum depression?
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.
A patient develops serotonin syndrome. Describe possible interventions.
What is stopping the potential agents, sedation with benzodiazepines, and preparing for intubation due to severe vital sign abnormalities and apnea?
This medication would be given stat 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?
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. This is the best response to the patient's inquiry.
What is combined use of other antidepressants with MAOIs can result in a potentially life-threatening hypertensive crisis?
A patient who began taking lithium experiences weight gain. This is the nurse's response to the patient.
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?