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
S/S of panic disorder
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
Thinking about death, wishing to be dead or contemplating methods to accomplish death
Suicidal Ideations
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
Name two high risk methods of suicide
Gun, hanging, jumping off a high place, car crash, carbon monoxide
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
Name two protective factors for suicide
religion, access to mental health care, social connections, marriage, family (children), problem solving skills
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
Name three risk factors for suicide
previous attempt, Hx of suicide in family, substance use, mood disorders, access to lethal means, trauma and abuse, chronic illness
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
Natural disasters
Violence
Terrorism
Accidents
Worries include inadequacy in interpersonal relationships, job responsibilities, finances, and health of family member.
Putting things off
GAD
Name two environmental guidelines to minimize suicidal behavior
plastic utensils, no private rooms for suicidal patients, jump proof/hang proof bathrooms, non-patient areas locked
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