Chapter 25 Depression

Evidence-Based Nursing Care of Persons with Depressive Disorder

1. Physical health

   • Review physical systems

   • Review medication history

2. Symptoms

   • Appetite & Weight changes

   • Sleep Disturbance

   • Tiredness and fatigue

SSRIs

• Takes time to work, but works well

• First med. choice

• Cause GI Disturbances

• Overdose isn’t lethal

• Needs to be weaned

Tricyclic Antidepressants (TCA)

• Cheaper medication

• 1 week supply only

• Lethal dose is cardiotoxic

• Requires ICU and IV to dilute medication in bloodstream

Persistent depressive disorder (dysthymia)

Major depressive disorder symptoms lasting for 2 years (adult) and 1 year (children and adolescents)

Premenstrual dysphoric disorder

Recurring mood swings, feelings of sadness, or sensitivity to rejection in the final week prior to menses

Disruptive mood dysregulation disorder

• Severe irritability and outbursts of temper

• Begins before the age of 10

• Similar to pediatric bipolar disorder