Ch 14 Depressive Disorders

Antidepressants

-Selective serotonin reuptake inhibitors (SSRIS) First-line therapy Rare risk of serotonin syndrome -Serotonin norepinephrine reuptake inhibitors (SNRIS) SSRIS may be tolerated better -Tricyclic antidepressants Anticholinergic adverse reactions -Monoamine oxidase inhibitors Effective for unconventional depression

A patient with major depression walks and moves slowly. Which term should the nurse use to document this finding? A. Psychomotor retardation B. Psychomotor agitation C. Vegetative sign D. Anhedonia

A. Psychomotor retardation

Jeff was just diagnosed with a major depressive disorder. Which medication is the health care provider most likely to start the patient on? A. SSRI B. SNRI C. Tricyclic antidepressant D. Monoamine oxidase inhibitor

A. SSRI Examples are fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), and fluvoxamine (Luvox).

Which question would be a priority when assessing for symptoms of major depression? A. "Tell me about any special powers you believe you have." B. "You look really sad. Have you ever thought of harming yourself?" C. "Your family says you never stop. How much sleep do you get?" D. Do you ever find that you don't remember where you've been or what you've done?"

B. "You look really sad. Have you ever thought of harming yourself?"

Which assessment finding in a patient with major depression represents a vegetative sign? A.Restlessness B. Hypersomnia C. Feelings of guilt D. Frequent crying

B. Hypersomnia

Jeff's parents have described his lack of interest in things he used to enjoy, like games with his friends, and his classes, which he used to like. This may be best described by the term A. Inappetance B. Impetance C. Indolence D. Anhedonia

D. Anhedonia refers to (an "without" + hedone "pleasure" = inability to feel happy).

Major Depressive Disorder

Five (or more) of the following in 2-week period: Weight loss and appetite changes Sleep disturbances Fatigue Worthlessness or guilt Loss of ability to concentrate Recurrent thoughts of death PLUS-at least one symptom is also either: Depressed mood or Loss of interest or pleasure (anhedonia)

St. John's Wort

Flower processed into tea or tablets Thought to increase serotonin, nerepinephrin, and dopamine in the brain Useful in mild to moderate depression

Major Depressive Disorder (cont.)

Persistent for minimum 2 weeks to 6 months Chronic: Lasting more than 2 years Recurrent episodes common Symptoms cause distress or impaired function Episode not attributed to physiological effects Absence of a manic or hypomanic episode