Psychiatric Nursing: ECT, Loss, Mood Disorders, and Anxiety

Vocabulary flashcards covering Electroconvulsive Therapy (ECT), Loss and Grief stages, Mood Disorders (MDD and Bipolar), Psychopharmacology, and Anxiety levels based on Psychiatric Nursing notes.

Atropine sulfate

A medication administered per IV prior to Electroconvulsive Therapy (ECT) to decrease saliva production.

Brevital

A medication administered per IV prior to Electroconvulsive Therapy (ECT) to promote the absence of pain.

Succinylcholine

A medication administered per IV prior to Electroconvulsive Therapy (ECT) to decrease tonic-clonic muscle contractions.

Loss

The absence of something or someone important in one's life, recognized as a universal and subjective human experience categorized into normal and abnormal types.

Grief

An emotional response to a loss characterized by a variety of feelings such as sadness, anger, and anxiety.

Anticipatory Grief

A type of common grief that occurs when something or someone is expected to be lost.

Disenfranchised Grief

A type of complicated grief where a person is forced to suppress feelings because the loss is socially unacceptable (e.g., miscarriage, mistress).

Empathy

The ability to put one's feet in someone else's shoes and feel with another person who is going through an ordeal.

Mourning

The outward expression of grief, which is culturally bound and influenced by personal beliefs.

Bereavement

The process of grieving, modeled by Elizabeth Kübler-Ross's 5 stages of grieving (Denial, Anger, Bargaining, Depression, Acceptance).

Denial

The initial defense mechanism in grieving characterized by non-acceptance of the reality of loss, shock, disbelief, and statements like 'No! This is not happening!'

Anger

The second stage of grieving characterized by intense emotion, state of frustration, spiritual distress, defense mechanisms like displacement or projection, and asking 'why?'

Bargaining

The third stage of grieving involving a trade-off, transaction, or negotiation (give and take) in a state of desperation, where the most coveted item is time.

Depression (Grieving Stage)

The lowest point of grieving characterized by helplessness, hopelessness, loneliness, potential suicidality, and the feeling that 'It's sad…'

Acceptance

The goal of grieving characterized by coming to terms with the reality of loss, embracing its irreversibility, and entering a state of moving on.

Euthymia

A normal and balanced mood state.

Major Depressive Disorder (MDD)

An affective disorder characterized by an extremely low mood disturbance lasting throughout the day for at least 2 weeks, referred to as the 'common flu of mental disorders'.

SIGECAPS

Mnemonic for the symptoms of depression: Sleep deprivation/excess, Interest diminished, Guilt, Energy diminished, Concentration lowered, Appetite changes, Psychomotor retardation/agitation, and Suicidal ideation.

Suicidal Ideation

The occurrence of suicidal thoughts only, distinguished from suicidal threats (expressed) and suicidal attempts.

Hamilton Depression Rating Scale

A clinician-administered questionnaire used to measure the severity of depressive symptoms in adults and track treatment response, where a score higher than 23 indicates severe depression.

SADPERSONS Scale

An assessment tool used to establish a client's level of suicidal tendency and risk, where higher scores indicate a more suicidal client.

No-Suicide Contract

A behavioral deterrent agreement where a client commits NOT to attempt suicide for a specified time frame, such as 24 hours.

Selective Serotonin Reuptake Inhibitors (SSRI)

First-line antidepressant class (-xetine, -lopram) with a 2-3 week downtime; common side effects include sexual dysfunction, increased appetite, and insomnia.

Serotonin Syndrome

An adverse effect of SSRIs caused by overwhelming serotonin levels, characterized by increased vital signs, agitation/restlessness, and seizures.

Tricyclic Antidepressants (TCA)

Second-line antidepressant class (-triptyline, -pramine) with a 4-6 week downtime; side effects include obesity, anticholinergic effects, sedation, and cardiotoxicity.

Monoamine Oxidase Inhibitors (MAOI)

Third-line antidepressant class with a 2-4 week downtime that requires avoiding tyramine-rich foods to prevent life-threatening hypertensive crisis.

Hypertensive Crisis

An adverse effect of MAOIs characterized by a systolic BP of at least 180 and neurological manifestations, which can lead to heart attack or brain attack.

Bipolar Disorder Type I

Classic acute, severe type of bipolar disorder characterized by at least 2 weeks of major depression followed by at least 7 days of severe mania.

Bipolar Disorder Type II

Hypomanic acute, mild type of bipolar disorder characterized by at least 2 weeks of major depression followed by less than 7 days of mild mania.

Bipolar Disorder Type III

Cyclothymic chronic, mild type of bipolar disorder persistent for at least 2 years, characterized by cycles of at least 1 week of minor depression and 1 week of hypomania.

DIGFAST

Mnemonic for the symptoms of mania: Distractability, Impulsivity, Grandiosity, Flights of ideas, Agitation, Sleep deprivation, and Talkativeness.

Lithium

The drug of choice and mood stabilizer for bipolar disorders, requiring strict monitoring due to a narrow therapeutic serum level of 0.6-1.2 meq/L.

Mild Anxiety

A level of anxiety characterized by 'butterflies in the stomach', sharpened senses, quick reflexes, and increased focus.

Moderate Anxiety

A level of anxiety characterized by automatisms, normal-range elevated vital signs, and tolerable pain.

Severe Anxiety

A level of anxiety characterized by ritualism, abnormally elevated vital signs, and intolerable pain.

Panic

An extreme level of anxiety characterized by fight/flight/freeze responses, suicidal behavior, psychosis, and feelings of doom.