Looks like no one added any tags here yet for you.
What are the criteria for diagnosis for major depressive disorder?
must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure
How is major depressive disorder treated? (2)
antidepressants
CBT
What is the main difference between major depressive disorder and persistent depressive disorder (dysthymia)
PDD has fewer symptoms, but they last longer (2 years vs. 2 weeks for diagnosis)
What are the crtieria for diagnosis for persistent depressive disorder (dysthymia)?
Depressed mood present 'more days than not' over at least a 2-year period
How is persistent depressive disorder (dysthymia) treated? (2)
antidepressants
CBT
What is a validation tool nurses use to assess depression in adults and in children/teens?
Beck Depression Inventory (BDI)
What are obsessions?
recurring, unwanted thoughts, ideas, or
sensations
What are compulsions?
repetitve actions to deal with obsessions
What are some treatments / interventions for OCD? (4)
CBT
Group therapy
Exposure therapy
Antidepressants
What is panic disorder?
Frequent and unexpected panic attacks. These attacks are characterized by a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger.
What physical assessment findings can be present with panic disorder? (3)
Sweating
Tachycardia
Tachypnea
What is the GAD-7? What does it aim to assess?
Screening tool for generalized anxiety disorder.
Measures the severity of anxiety symptoms.
What are treatments / interventions for panic disorder? (4)
Group therapy
Psychotherapy (talk therapy)
Mindfulness techniques
Antidepressants
What is the continuum of bipolar disorders? (3)
Bipolar I
Bipolar II
Cyclothymic disorder
What is the difference between bipolar I and bipolar II?
Bipolar II do not experience as severe highs (hypomania, not fully mania)
What is the difference between bipolar and cyclothymia?
Cyclothymic disorder is a milder form of bipolar disorder involving many "mood swings. They do not reach mania or as severe depressive episodes.
What is the diagnostic criteria for bipolar I?
Mania lasting at least 1 week
What is the diagnostic criteria for bipolar II?
at least one hypomanic episode and at least one major depressive episode, never a manic episode
What is the diagnostic criteria for cyclothymia?
many periods of elevated mood (hypomanic symptoms) and periods of depressive symptoms for at least two years
What are the phases of bipolar I, and the goals of care for each? (3)
Acute phase - prevent injury
Continuation phase - relapse prevention
Maintenance phase - limit severity and duration of future episodes
What are some non-pharmacological treatments for bipolar disorders? (3)
Electroconvulsive therapy (ECT)
Milieu management
Support groups
What are medications used to treat bipolar disorders? (3)
Lithium
Anticonvulsants
2nd gen antipsychotics
What can staff members do to manage splitting or manipulative behaviours?
Set limits consistantly
What are some differences between anorexia nervosa and bulimia? (3)
People with bulimia often have normal body weight, where people with anorexia often are underweight.
People with anorexia experience amenorrhea and cold intolerance.
People with bulimia experience scaly skin, and tooth / gum deterioration.
What are the similarities between anorexia nervosa and bulimia? (2)
Obsessive desire to lose weight
Fluid / electrolye imbalance
What are the severe 6 signs / symptoms of anorexia nervosa?
1. Extreme weight loss (less than 75% expected weight)
2. Fluid and electrolyte imbalance - hypokalemia = potassium below 3.5 (cardiac dysrhythmias)
3. Lanugo (thin hair)- rare
4. Amenorrhea (no menstruation) due to low body fat, estrogen production
5. Cold intolerance
6. 3 Low’s: Low temp, Low BP, Low HR
What is binging?
eating much larger amounts than normal in a short period of time
What is purging?
actions to compensate for excessive food intake, can include:
self-induced vomiting
misuse of laxatives
excessive exercising
What evidence might be present to support a nursing diagnosis of imbalanced nutrition and risk for dehydration for eating disorders? (6)
Electrolyte imbalance
Skin pallor
Poor skin turgor
Laxative abuse
Abnormal ECG
Reduced caloric intake
What medications can help manage bulimia? (3)
Fluoxetine
Citalopram
Sertraline
What is addiction?
A chronic, relapsing brain disorder that results from the prolonged effects of exposure of the brain to drugs
What is intoxication?
A reversible substance-specific syndrome due to ingestion or exposure to a substance
What is withdrawal?
A substance-specific maladaptive behavioral change due to stopping or reducing the consumption following heavy and prolonged substance use
What is the difference between addiction and compulsive behaviour?
Urge versus need
A compulsion is an insatiable urge to do something.
Addiction is a need to do something to experience pleasure or remove discomfort
How do opioids work? (4)
Attaches to proteins in the brain called opioid receptors.
Stops messages being sent from the body to the brain.
Triggers the release of endorphins.
Endorphins block the perception of pain and boosts feelings of pleasure.
What are the signs of opioid intoxicaiton? (5)
Drowsiness
Flu like symptoms
Changes in sleep habits
Lack of hygiene
Isolation from family and friends
What are the signs of opioid overdose? (8)
Difficulty walking
Difficulty talking
Difficulty staying awake
Clammy and cold skin
Confusion
Drowsiness
Extremely dialated pupils
Unconciousness
What are the signs of opiod withdrawal? (7)
Sweating
Chills
Anxiety
Agitation
Muscle aches
Nausea / vomiting
Stomach cramping
What is the COWS scale used for?
Clinical opiate withdrawal scale, determines the severity of opioid withdrawal.
Why are Methadone and Suboxone used? How do they differ from other opioids?
Methadone: a synthetic opioid dispensed daily from a pharmacy.
Suboxone: a synthetic opioid mixed with an opiate antagonist
What happens to neurotransmitters during addiction?
Many drugs cause dopamine to flood the reward pathway 10 times more than a natural reward. The brain remembers this surge and associates it with the addictive substance
What harm reduction techniques can nurses teach patients who use substances (4)
Medical grade drugs instead of street drugs
Never using alone
Sanitary techniques
Never mixing drugs
What is Narcan and how does it work?
Narcan reverses an opioid overdose by blocking the effects of opiates on the brain and restoring breathing
What are the guidelines for alcohol consumption?
For women:
Limit alcohol to no more than 2 drinks per day, or 10 drinks per week.
For men:
Limit alcohol to no more than 3 drinks per day, or 15 drinks per week.
What is considered a “drink" for beer, malt liquor, wine, and hard liquor?
Beer (5%): 12 ounces
Malt liquor (7%): 8-9 ounces
Wine (12%): 5 ounces
Hard liquor (40%): 1.5 ounces
What is CAGE and what are the questions?
Screening assessment for excessive drinking and alcoholism.
Have you ever felt you should CUT down on your drinking?
Have people ANNOYED you by criticizing your drinking?
Have you ever felt GUILTY about your drinking?
Have you ever had a drink first thing in the morning to steady your nerves or get yourself going for the day? (EYE-opener)
What pharmacological interventions are available in Canada for alcoholism? (3)
Naltrexone
Disulfiram
Gabapentin
How do Naltrexone and Gabapentin work?
Naltrexone and Gabapentin decrease cravings for alcohol by decreasing the pleasurable effects of drinking.
What is the CIWA assessment?
Clinical Insitute Withdrawal Assessment for Alcohol, assesses alcohol withdrawal
What neurotransmitter is impacted in BPD?
For people with BPD, the serotonin gene 5-htt has shorter alleles, which is linked to lower levels of serotonin
What is emotional dysregulation?
trouble controlling your emotions and how you act on those feelings
What patterns would a person with BPD present with? (6)
Intense and unstable relationships
Rapid mood swings
Intense fear of abandonment
Impulsivity
History of trauma
Self harm
What is the mortality rate of BPD?
30%
What criteria is required for a diagnosis of PTSD?
experiencing intrusive recurring symptoms that persist longer than one month and interfere with daily life
What objective assessment findings would a nurse identify in an individual with PTSD? (6)
Anxious, fidgeting
Inability to sit still
Stuttering
Changes in speech rate and volume
Instability in mood
Exhaustion
What is ADHD?
A neurodevelopmental disorder that begins in early childhood, causing functional impairment across the lifespan
What is executive functioning?
brain functions that activate, organize, integrate and manage other functions. It enables individuals to account for short- and long-term consequences of their actions and to plan for those results.
What is self regulation?
the means by which an individual manages themselves in order to attain their goals
How is dopamine effected with ADHD?
inadequate dopamine decreases motivation and focus and affects learning and memory. it also effects reward processes
what is CBT?
CBT is a type of psychotherapy that involves changing unhealthy ways of thinking, feeling, and behaving. This tends to be a short-term treatment
What is DBT?
DBT is a type of talking therapy that is most commonly used for people who feel their emotions very intensely. This treatment is usually long-term.
What conditions can coexist with PTSD? (4)
Major depressive disorders
Substance use disorder
Anxiety
Suicidality
What are the 3 types of ADHD?
• Inattentive
• Hyperactive-impulsive
• Combined
What are the red flags of ADHD? (6)
Family history of ADHD
Poor self-regulation
Family / marital problems
Substance use disorder
History of driving violations / accidents
Difficulty managing finances
How can ADHD present in preschoolers?
behavioural disturbances
How can ADHD present in school-aged children? (3)
difficulty with social relationships
difficulty with academics
negative self-esteem
How can ADHD present in adolescents? (4)
Experimentation with drugs / alcohol
Risky sex
Accidents
Academic problems
How can ADHD present in university / college? (2)
Academic failure
Reliance on substances
How can ADHD present in adults? (3)
Difficulty with finances
Difficulty with relationships
Occupational challenges
What is the multimodal approach to treating ADHD? (4)
Lifestyle modification (exercise, high protein, sleep hygiene)
Counselling (behavioural psychotherapy)
Mindfulness (yoga, meditation)
Pharmacotherapy
What are 1st line therapy medications for ADHD? (2)
Psychostimulants:
Methylphenidates - ex. Concerta
Amphetamines - ex. Vyvanse
What are 2nd line therapy medications for ADHD? (2)
Non-stimulants:
NDRI - ex. Wellbutrin
NRI - ex. Strattera
What are common side effects of ADHD medications? (7)
Decreased appetite / weight loss
Nausea
Dry mouth
Tremors
Mood changes
Anxiety
Palpitations
What are contradictions to prescribing ADHD medication? (6)
Family history of sudden cardiac death
History of severe hypertension
Heart disease
Mania / psychosis
Substance use disorders
Tic disorders
How do methlyphenidates act on the brain to achieve effective treatment?
Methylphenidate increases extracellular dopamine levels in the brain by blocking the dopamine transporters in the synapse
What are risk factors for the development of mental health disorders? (4)
Parent with depression
Parent’s inability to model effective coping stratagies
Children who have been abused or neglected
Exposure to intimate partner violence
What resilient behaviors can be developed in children to prevent mental health disorders? (5)
Adaptability to changes in the environment
Ability to form nurturing relationships with other adults
Ability to distance self from emotional chaos
Good social intelligence
Good problem solving skills
What preventative programs exist in NB to help children develop resilient behaviors? (5)
Healthy Learners Program
Integrated Service Delivery Program
NB Social Pediatrics
Parent-child Assistance program
Strengthening Families program
What are the cardinal symptoms of delirium? (4)
Inability to direct, focus, or sustain attention
Abrupt onset
Clinical features fluctuate with periods of lucidity
Disorganized thinking and poor executive functioning
Aphasia
Loss of language ability
Agnosia
Loss of sensory ability to recognize objects
Apraxia
Loss of purposeful movement