Depressive Disorders
What does PDD stand for?
Persistent Depressive Disorder
Promotes mental health and reduces mental illness to decrease the incidence of crisis
Primary prevention
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
12. Fear of losing control or “going crazy”
13. Fear of dying
Orientation, working and termination
Phases of the group process
The absence of qualities that should be present. These include the inability to enjoy activities (anhedonia), social discomfort, or lack of goal-directed behavior.
Negative symptoms
Toxic Lithium level
>1.5
This medication is lethal in overdose
TCA
"You said you are depressed. Tell me what that is like for you.”
"When you feel depressed, what sort of thoughts do you have?”
"Have you had thoughts about ending your life?”
Statements to assess for suicide
Establishes intervention during an acute crisis to prevent prolonged anxiety from diminishing personal effectiveness and personality organization.
Secondary Prevention
A largely unconscious motivation to feel caring and concern for others and act for the well-being of others.
Alturism
Monopolizer, Silent member, Disruptive
Problematic behaviors in group
Involves words that rhyme or have a similar beginning sound (“On the track … have a Big Mac” or “Click, clack, clutch, close”).
Clang associations
Use short and concise explanations or statements.
Offer frequent, high-calorie protein drinks and finger foods (e.g., sandwiches, fruit, milkshakes).
Redirect aggressive behavior.
Interventions for manic patients
Class of medications cause sexual side effects and gastric upset
SSRI's
What rating scale is used to assess depression?
PHQ-9
Birth of a child or death of a parent
Maturational crisis
A husband who is hostile might blame his wife for having anger management issues.
Projection
Members realize that they are not alone with their problems, feelings, or thoughts
Universality
Known as typical antipsychotics or neuroleptics. They are dopamine (D2 receptor) antagonists.
1st generation antispsychotics
What distinguishes Bipolar I from Bipolar II
Mania/Hypomania
manifests in flu-like symptoms, diarrhea, fever
Serotonin syndrome
What are some contraindications for ECT?
Conditions such as brain tumors and subdural hematomas may increase the risk of using ECT.
Job loss or change, the death of a loved one, divorce, and psychiatric or physical illness.
Situational Crisis
A shorter-than-average man becomes assertively verbal and excels in business
Compensation
The leader shares optimism about the successes of group treatment, and members share their improvements.
Installation of hope
Acute, life-threatening emergency
Severe muscle rigidity and hyperpyrexia are the main feature: temperature over 103, hypertension, tachycardia, diaphoresis, incontinence
NMS -daily double to say full name
Protocols identify specific nursing responsibilities, such as how often to observe and document the patient’s behavior (e.g., every 15 minutes), how often to offer the patient food and fluids (e.g., every 30 to 60 minutes), and how often the patient can use the restroom (e.g., every 1 to 2 hours). Caregivers should measure vital signs frequently (e.g., every 1 to 2 hours).
Protocols for restraint and seclusion
What labs are monitored for Clozaril
ANC-CBC
What medication should be discontinued before ECT can be performed?
Benzodiazepines
Name 4 examples of an adventitious crisis
Violence
Terrorism
Accidents
Worries include inadequacy in interpersonal relationships, job responsibilities, finances, and health of family member.
Putting things off
GAD
Allowing the person to have extra time to formulate thoughts before responding.
Make an assignment that every person in the group respond to a certain topic or question.
Interventions for the silent group member
Weight gain, dyslipidemia (abnormal lipid levels), and increased insulin resistance leading to increased risk of cardiovascular disease, diabetes
Metabolic syndrome
Mood stabilizers used in BPD
Lithium, Depakote, Lamotrigine, Carbamazepine
People are taught to focus on pleasant images to replace negative or stressful feelings.
Guided Imagery