CH 24- Depression Boyd/prep U

A nursing instructor is teaching about depressive disorders and identifies a need for further instruction when a student states what?

"Dysthymic disorder is less chronic than major depression." Persistent depressive disorder (dysthymic disorder) is a long duration mood disorder that has a lower intensity of depressive symptomatology. It may precede major depression.

A client taking an antidepressant has experienced a 12 pound weight gain in 1 month as a side effect of the medication. Which of the following are nursing interventions to help this patient with this problem? Select all that apply.

Advocate with the physician to consider changing the medication. Recommend a nutritionally balanced diet. Recommend daily exercise. To relieve the side effect of weight gain from an antidepressant, appropriate nursing interventions are to help the client explore a change in medication, promote a nutritionally balanced diet, and recommend regular exercise.

Which must be present in a client diagnosed with serotonin syndrome? Select all that apply.

Agitation Diaphoresis Ataxia Fever The symptoms of serotonin syndrome include altered mental status, autonomic dysfunction, and neuromuscular abnormalities. At least three of the following must be present for a diagnosis: mental status changes, agitation, myoclonus, hyperreflexia, fever, shivering, diaphoresis, ataxia, and diarrhea.

A client who is prescribed a tricyclic antidepressant is brought to the emergency department with a suspected overdose. Which would the nurse assess to support this suspicion? Select all that apply.

Blurred vision Urinary retention In acute overdose, almost all symptoms develop within 12 hours. Anticholinergic effects are prominent and include dry mucous membranes, warm and dry skin (not pale, moist skin), blurred vision, decreased bowel motility (not diarrhea), and urinary retention. Central nervous system suppression (ranging from drowsiness to coma) or an agitated delirium may occur. Headache is a side effect of monoamine oxidase inhibitors.

A nurse suspects that a client has overdosed on the prescribed tricyclic antidepressant. Which assessment finding would support this suspicion? Select all that apply.

Confusion Hallucinations Agitation In acute overdose, almost all symptoms develop within 12 hours. Confusion, hallucinations, and agitation are signs of overdose. CNS suppression (ranging from drowsiness to coma) or an agitated delirium may occur. Orthostatic hypotension and headache are side effects of MAOIs.

An elderly client is admitted to the hospital with fatigue and weight loss of 20 pounds in 1 month. Upon further assessment, the client is diagnosed with depression. What other thing should the nurse assess this client for based on the weight loss?

Dehydration When there is a significant wight loss in older adults with moderate to severe depression, they need to be assessed for dehydration as well as weight changes. They also need to be monitored for suicide, sleep disturbance, and decreased energy, but they are not related to nutrition and the weight loss.

After teaching a group of nursing students about major depression, the instructor determines that the education was successful when the group identifies which information is accurate?

Depression is twice as common in women than in men. The onset of depression can happen at any age; onset is more commonly seen in the 20s. Depression is not correlated with low intellectual ability.

A client on a medical unit has a comorbid diagnosis of depression and has been taking mirtazapine for several months prior to the current admission. The nurse's responsibilities related to the administration of this medication include what? Select all that apply.

Monitoring the client's mood and affect over the course of the admission. & Ensuring that the client is not cheeking or stockpiling the medication. With any antidepressant, the nurse should monitor the client's mood and ensure that he or she is not stockpiling medication for a suicide attempt. Antidepressants do not have a short-term affect on mood, so assessment 30 minutes after administration is unnecessary. Mirtazapine is not associated with hypertensive crises and dietary modifications are unnecessary.

A depressed older adult client is being treated with a tricyclic antidepressant (TCA). For which clinical manifestations should the nurse monitor the client?

Orthostatic hypotension and urinary retention Orthostatic hypotension and urinary retention are common side effects of TCAs. Photosensitivity, skin rashes, pseudoparkinsonism, and tardive dyskinesia are common side effects of older antipsychotics. Diarrhea and electrolyte imbalances are side effects of lithium.

A client with major depression is scheduled to receive electroconvulsive therapy. The nurse understands that this treatment is typically used in which situation?

the patient is experiencing catatonia Electroconvulsive therapy is an effective treatment for clients with severe depression. It is generally reserved for those whose disorder is refractory or intolerant to initial drug treatments and who are so severely ill that rapid treatment is required (e.g., clients with malnutrition, catatonia, or suicidality).