Clinical Judgment in Mental Health Nursing: Mood & Affect

Vocabulary flashcards focusing on key concepts, diagnostic mnemonics, medication details, and toxicity levels in mental health nursing.

Mood

How a patient feels inside as reported by themselves (e.g., "I feel hopeless").

Affect

The outward expression of emotion observed by the nurse (e.g., flat, labile, euphoric).

Congruence

A state where a patient's self-reported mood and outward affect match (e.g., patient says they are sad and looks tearful).

Euthymia

A stable, normal mood, which is the goal of treatment for most mood disorders.

DIG FAST

A mnemonic for identifying manic symptoms in Bipolar Disorder: Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity ↑, Sleep ↓, Talkativeness.

Selective Serotonin Reuptake Inhibitors (SSRIs)

First-choice antidepressants (such as Fluoxetine, Sertraline, Escitalopram, and Paroxetine) that block serotonin reabsorption, take 2–4 weeks to work, and carry a Black Box Warning for increased suicidal thoughts in patients under 25.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Antidepressants (such as Venlafaxine, Duloxetine, and Desvenlafaxine) that keep serotonin and norepinephrine active; Duloxetine is specifically indicated for depression with chronic pain.

Tricyclic Antidepressants (TCAs)

Antidepressants (such as Amitriptyline, Nortriptyline, and Imipramine) that increase serotonin and norepinephrine while blocking other receptors, causing anticholinergic side effects; dangerous in overdose due to risk of deadly heart arrhythmias.

Monoamine Oxidase Inhibitors (MAOIs)

Last-resort antidepressants (such as Phenelzine, Tranylcypromine, and Selegiline patch) that block the enzyme breaking down serotonin, norepinephrine, and dopamine; patients must avoid tyramine-rich foods to prevent dangerous blood pressure spikes.

Atypical Antidepressant (NDRI)

An antidepressant class represented by Bupropion (Wellbutrin, Zyban) that boosts norepinephrine and dopamine without causing sexual side effects or weight gain, but lowers the seizure threshold.

Therapeutic Lithium Level

An ongoing safe blood concentration of $0.6 - 1.2\,\text{mEq/L}$ (or $0.8 - 1.2\,\text{mEq/L}$ during acute manic episodes) requiring blood draws 12 hours after the last dose.

Mild Lithium Toxicity

Toxicity occurring at blood levels of $1.5 - 2.0\,\text{mEq/L}$, characterized by poor coordination, confusion, sedation, GI discomfort, nausea, coarse tremors, vomiting, and diarrhea.

Moderate Lithium Toxicity

Toxicity occurring at blood levels of $2.0 - 2.5\,\text{mEq/L}$, characterized by seizures, stupor, extremely diluted urine, blurred vision, respiratory complications, tinnitus, and jerking movements.

Severe Lithium Toxicity

Life-threatening toxicity occurring at blood levels above $2.5\,\text{mEq/L}$, which can cause coma, respiratory complications, and death.

Valproic Acid (Depakote)

An anticonvulsant mood stabilizer that boosts GABA to treat acute mania in Bipolar I and rapid cycling; requires drug level monitoring ($50 - 125\,\text{mcg/mL}$), liver function checks, and blood count monitoring.

Lamotrigine (Lamictal)

An anticonvulsant mood stabilizer used for long-term bipolar depression and Bipolar II that must be titrated slowly to avoid Stevens-Johnson Syndrome.

Carbamazepine (Tegretol)

A second-choice anticonvulsant mood stabilizer used for bipolar disorder and nerve pain; requires monitoring drug levels ($4 - 12\,\text{mcg/mL}$), liver function, and white blood cell counts.

Stevens-Johnson Syndrome

A serious, life-threatening skin rash associated with Lamotrigine (Lamictal) administration; requires immediate cessation of the drug.

Serotonin Syndrome

A medical emergency associated with antidepressant therapy characterized by fever, agitation, muscle twitching, and sweating.

Therapeutic Communication

Nursing communication techniques—including tone of voice, open body language, sitting at eye level, active listening, and comfort with silence—that help build trust and support patients in crisis.