Depression
What are the hallmark symptoms of Major Depressive Disorder (MDD)?
Depressed mood, anhedonia, fatigue, sleep/appetite changes, feelings of worthlessness.
How does postpartum depression differ from "baby blues"?
PPD is more severe, lasts longer, and interferes with functioning. Baby blues are transient; PPD requires clinical attention and often treatment.
What is the most critical nursing action when a patient expresses suicidal ideation?
Ensure patient safety and initiate suicide precautions.
Immediate safety is the priority; this includes removing harmful objects and close monitoring.
What are hallmark symptoms of mania?
Elevated mood, decreased need for sleep, impulsivity, grandiosity.
These symptoms reflect dysregulation in mood and energy levels.
What is the difference between voluntary and involuntary commitment?
Voluntary is patient-initiated; involuntary is court-ordered
Which neurotransmitters are most commonly implicated in depression?
Serotonin, norepinephrine, dopamine
These neurotransmitters regulate mood, energy, and motivation. Imbalances are linked to depressive symptoms.
Name one risk factor for postpartum depression.
History of depression or anxiety. Hormonal shifts and psychosocial stressors increase vulnerability.
What is the difference between active and passive suicidal ideation?
Active involves a plan; passive involves thoughts without intent.
Differentiating helps assess risk level and urgency of intervention.
What medication class is commonly used to treat bipolar disorder?
Mood stabilizers (e.g., lithium, valproate)
These help prevent mood swings and stabilize neurotransmitter activity.
What criteria must be met for involuntary commitment?
Danger to self/others or inability to care for self
What is the first-line pharmacologic treatment for MDD?
SSRIs (e.g., fluoxetine, sertraline)
SSRIs increase serotonin availability and have fewer side effects than older antidepressants.
What is a key nursing intervention for a mother with PPD?
Encourage bonding and assess for safety. Promotes maternal-infant attachment and ensures safety for both.
What is a key component of a suicide risk assessment?
Assess for plan, means, intent, and history
These factors determine the immediacy and severity of risk.
How does Bipolar I differ from Bipolar II?
Bipolar I includes full manic episodes; Bipolar II includes hypomania and depression
What rights does a patient retain during involuntary commitment?
Right to informed consent, legal counsel, and humane treatment. Patients are protected under mental health laws even when committed.
What is the role of cognitive behavioral therapy (CBT) in treating depression?
Helps patients identify and reframe negative thought patterns.
CBT is evidence-based and effective in reducing depressive symptoms by changing maladaptive thinking.
What screening tool is commonly used for PPD?
Edinburgh Postnatal Depression Scale (EPDS)or The PHQ-9.
What scale is used in the clinical setting to assess suicidal ideation and behavior?
The Columbia-Suicide Severity Rating Scale (C-SSRS).
It’s a validated tool used in clinical settings to guide interventions.
What is a nursing priority during a manic episode?
Maintain safety and reduce stimulation
Patients may be impulsive or aggressive; calm environments help reduce escalation.
What is the role of the nurse in involuntary commitment?
Advocate for patient rights and ensure safety. Nurses must balance legal obligations with compassionate care.
How does Persistent Depressive Disorder (PDD) differ from Major Depressive Disorder (MDD)?
Definition: A chronic, lower-grade depression that lasts for a prolonged period.
Symptoms (must include at least 2): Low self-esteem, Poor appetite or overeating, Insomnia or hypersomnia, Fatigue or low energy, Difficulty concentrating or making decisions, Feelings of hopelessness
Timeframe: Depressed mood for most of the day, more days than not, for at least 2 years in adults (1 year in children/adolescents), with no symptom-free period longer than 2 months.
Course: Chronic – symptoms are continuous and long-lasting.
Severity: Milder than MDD but more persistent.
Diagnosis: Based on DSM-5 criteria requiring 2+ symptoms for 2+ years with functional impairment
Why is early detection of PPD critical?
Prevents long-term effects on mother and child. Untreated PPD can impair child development and maternal health.
An adolescent tells the school nurse that his friend confided in him about thinking of suicide. What is the nurse’s most appropriate initial response?
Assess the immediacy of the risk and notify appropriate mental health professionals or authorities while providing support to the adolescent. (Always assess first). Even if it's secondhand, the nurse treats seriously. Immediate safety assessment is critical. The nurse should engage the adolescent in a calm, supportive manner, gather details, and follow institutional protocols for suicide risk reporting. Confidentiality may be breached to protect life, and timely referral to mental health services is essential.
Why is medication adherence challenging in bipolar disorder?
Patients may feel “too good” during mania and stop meds.
Education on long-term management is essential to prevent relapse.
Why is documentation essential in involuntary commitment cases?
Legal accountability and continuity of care.
Accurate records support legal processes and patient advocacy.