Mental Health Exam 3

MDD symptoms

• sleep/appetite disruption

• concentration disruption

• agitation

• low energy

• retardation

• excessive guilt

• worthlessness

• suidical ideation

True or false: MDD has manic behavior

false

three facts abt persistent depressive disorder

1. chronic depression >2 years

2. less severe symptoms

3. no psychotic symptoms

what is PMDD

mood swings 1 week before period

disruptive mood dysregulation disorder is

• severe irritability

• frequent temper outburst

how do we grade depression

• Transient - not dysfunctional

• Mild - normal grieving

• Moderate - dysthymia

• Severe - psychotic symptoms

anhedonia

loss of pleasure

common s/s of anhedonia

depressed mood

worthlessness

suidical ideation

top nursing priority for depression

risk for suicide

other nursing priority for depression

low self esteem

powerlessness

imbalance nutrition

self care deficit

insomnia

complicated grieving

intervention/support for depression

suicide hotline - 988

support groups

who is highest risk group for depression

older adults

SSRI action

blocks serotonin reuptake

how long does it take for SSRI to work

4 weeks

SE for SSRI

sexual dysfunction

SSRI risks

increase suicidal thoughts

what do you want to avoid with SSRI

other serotonergic drugs it can cause serotonin syndrome

tricyclic antidepressant action

block NE + serotonin reuptake

tricyclic antidepressant SE

orthostatic hypotension

anticholinergic effects

MAOIs major risk

serotonin syndrome

hypertensive crisis

avoid what with MAOIs

tyramin foods like aged cheese, wine, beer, processed eat

what does ECT do

increases biogenic amines

when do we use ECT

medications doesnt work for severe depression/catatonia

SE to ECT

temporary memory loss and confusion

nurse priority for ECT

airway

safety

monitor seizures

type I bipolar disorder

full manic episode

needs sleep and eatin

type II bipolar disorder

hypomania less severe

cyclothymic disorder

chronic mood instability

mania stages

hypomania

acute mania

delirious mania

imbalance nutrition for bipolar disorder

give finger food

offer preferred food

dont bargain

risk for injury with bipolar disorder

avoid competition

walk with pt

risk for violence with bipolar disorder

avoid group settings

remove dangerous objects

disturbed thought processes with bipolar disorder

give antipsychotics

key nurse tips with bipolar disorder

let manic pt sleep when they crash

place away from nurse station and other manic pt

lithium you want to maintain what

fluid and sodium drink 6-8 glasses of water/day

monitor levels for how long with lithium

every 1-2 months

therapeutic levels of lithium

acute - 0.8-1.4

maintenance - 0.4-1.0

toxic lithium causes

neuro changes

peplaus level of anxiety

• Mild - stage fright

• Moderate - low perception

• Severe - greatly low perception

• Panic - no perception

panic attack symptoms

• Sweating

• Trembling

• SOB

• CP

• Nausea

• Dizziness

• numbness/tingling

what should we rule out when a pt has panic attack symptoms

MI

panic disorder

panic attacks

GAD

excessive worry

phobias

irrational fear

agoraphonia

fear of no escape

social anxiety

fear of judgment

panic disorder/GAD nursing diagnosis

panic anxiety

powerlessness

phobia nursing diagonsis for anxiety

fear

agoraphobia nursing diagnosis for anxiety

social isolation

communication with panic attack pt you should

short, simple commands

dont ask abt feelinga

communication with pt with fear

include pt in decisions

explore feelings

treatments for anxiety

SSRIs

benzo PRN only

buspirone (scheduled)

propanolol for physical symptoms

benzo risk

addiction

overdose

withdrawal causes seizures

benzo antidote

flumazemil

CBT used for

anxiety disorder

what does CBT do

journaling

thought processing

phobia treatment

systematic desensitizartion

implosion therapy

OCD definition of each word

obsession - intrusive thought

compulsion - repetitive behaviors

OCD diagnosis criteria

1hr/day

causes distress

not due to substances

nursing care for OCD

dont stop rituals abruptly

gradually set limits

encourage independence

treatment for OCD

SSRIs

CBT

trichotillomia

hair pulling

excoriation

skin pickin

body dysmorphic disorder

insecure about body

hoarding

need for control

PTSD criteria

• Intrusive symptoms

• Avoidance

• Negative mood/thoughts

• Hyperarousal

• Duration >1month

PTSD symptoms

flashbacks

nightmares

survivors guiltn

nurse care with PTSD

ensure safety

teach coping strategies

avoid triggers

treatment for PTSD

CBT

group/family therapy

EMDR

acute stress disorder

symptoms last <1 month

somatic symptoms disorder

multiple physical complains and distress

illness anxiety disorder

fear of serious illness

conversion disorder

neuro symptoms without medical cause

factitious disorder

faking illness (munchausen)

amnesia types

localized - forget specific event period

selective - forget parts of event

dissociative identity disorder

multiple personalities

depersonalization

altered self perception

derealization

altered environment perception