Depressive Disorders

Click on the data that are indicators of depression.​ Greg is a 40-year-old male who is being seen by his primary health care provider at the request of his wife. He has been married for 10 years and has two children, ages 10 and 7. A month ago he lost his business in a fire and had to take a job at a local factory to provide financially for the family. Lately, his family has noticed that he seems down and withdrawn from them. He has been missing work saying that he doesn't feel well. He sleeps most of the day and has a poor appetite. He has no prior medical conditions and is not taking any medications. He has a family history of depression

40-year-old seems down and withdrawn missing work sleeps most of the day poor appetite family history of depression

The health care provider suspects that Greg may have major depressive disorder. What other key questions should the health care provider ask? Select all that apply. A. "Have you had thoughts about hurting yourself or others?" B. "Do you drink alcohol or use drugs?" C. "For how long have you felt this way?" D. "Do you like your job?" E. "Are you able to concentrate and make decisions?"

A. "Have you had thoughts about hurting yourself or others?" B. "Do you drink alcohol or use drugs?" C. "For how long have you felt this way?" E. "Are you able to concentrate and make decisions?"

The health care provider prescribed escitalopram for Greg. After 3 days of taking the medication, the nurse called for follow-up. Greg stated that he didn't think the medication was working. What is the most appropriate response by the nurse? A. "Sometimes it takes a few weeks for the medication to improve symptoms." B. "Try not to think about your symptoms. It will just make them worse." C. "I will report this to the provider and maybe a different medication will be ordered." D. "We will need to increase your dosage and if you're not feeling better."

A. "Sometimes it takes a few weeks for the medication to improve symptoms."

A client diagnosed with major depressive disorder has been prescribed a tricyclic antidepressant. How long does it usually take before the client notices a significant change in depression? A. 2 to 4 weeks B. 3 to 5 days C. 12 to 36 hours D. 3 to 4 months

A. 2 to 4 weeks

The health care provider reviewed treatment options with Greg and his wife. Which treatment options would be indicated for Greg? Select all that apply. A. Antidepressants B. Light therapy C. Electroconvulsive therapy D. Psychotherapy E. Deep brain stimulation

A. Antidepressants D. Psychotherapy

A nurse is assessing a client and suspects she has a major depressive disorder. Which symptoms would suggest this disorder? Select that all apply. A. The client doesn't feel any pleasure going out with friends.​ B. The client says she has difficulty sleeping at night.​ C. The client started to feel sad at night for the past few days. D. The client states she feels fatigue when she awakens.

A. The client doesn't feel any pleasure going out with friends.​ B. The client says she has difficulty sleeping at night.​ D. The client states she feels fatigue when she awakens.

Which assessment finding is associated with a major depressive disorder? Select all that apply. A. The client feels hopeless and sad. B. The client has impaired recent and immediate memory. C. The client seems excessively excited. D. The client feels guilt or negative feelings about themselves. E. The client has difficulty concentrating and making decisions.

A. The client feels hopeless and sad. D. The client feels guilt or negative feelings about themselves. E. The client has difficulty concentrating and making decisions.

What should the nurse teach caregivers about depression in the elderly? A. Elderly are the least likely to be suicidal. B. Elderly may not directly complain about their mood. C. Elderly do not respond to conventional treatment. D. All depression presents the same way, regardless of age.

B. Elderly may not directly complain about their mood.

During an interaction with the nurse, a client states, "I'm no good for my family. Nothing I do is right. I feel so hopeless." Based on this information, which of the following nursing diagnoses should the nurse use when developing the client's plan of care? A. Spiritual distress B. Low self-esteem C. Impaired social interaction D. Disturbed thought processes

B. Low self-esteem

A nurse is providing medication education for parents of a 14-year-old who will be taking fluoxetine for the treatment of depression. Which statement made by the nurse should be included in the education? A. "Lab tests will be needed to monitor the therapeutic levels." B. " Adolescents who take antidepressants may have suicidal ideation." C. "Teens tend to have faster results than adults." D. "Your child will have to be on a special diet."

B. " Adolescents who take antidepressants may have suicidal ideation."

After 2 months of being on medication and going to counseling, Greg is doing better. He is here at the clinic for a follow-up appointment. Greg states that he is feeling happier and able to do stuff with family again. Greg wants to stop taking his medication and stop psychotherapy. How should the nurse address this request? A. Depression is a lifelong disease so he can not stop taking it. B. Medication should be continued 6 months to a year after the symptoms resolve. C. Greg can stop taking the medication, but he should taper the dose. D. Greg's symptoms are gone, so tell him to stop taking the medication.

B. Medication should be continued 6 months to a year after the symptoms resolve.

Which nursing diagnosis would be the top priority? A. Imbalanced nutrition: less than body requirements B. Risk for suicide C. Impaired sleep D.Social isolation

B. Risk for suicide

Greg openly admits he does not want to be at the appointment. His wife is in the room with him. How best might the nurse begin an initial therapeutic relationship with Greg? A. The nurse should tell Greg not to worry as depression is normal in many people. B. The nurse should sit, be attentive, and allow Greg to talk about the situation. C. The nurse should ask Greg if he is suicidal and if he has a plan to take his own life. D. The nurse should take vital signs and then get his primary health care provider.

B. The nurse should sit, be attentive, and allow Greg to talk about the situation.

How severe is Greg's depression? A. Transient B. Mild C. Moderate D. Severe

C. Moderate

A client has severe depression with a past suicide attempt. He cannot take antidepressant medications. The nurse is discussing electroconvulsive therapy (ECT) with the client. Which client statement would indicate his understanding of a major disadvantage of ECT? A. The seizures can cause dislocations of the joints. B. Brain damage occurs and continues for a long time. C. It requires many months of treatment before results are known. D. Memory impairment is common immediately after treatment.

D. Memory impairment is common immediately after treatment.

Dopamine is a neurotransmitter that creates _____ feelings. There is evidence that ______ dopamine levels contribute to depression. Norepinephrine is a hormone and a neurotransmitter made in the ______ and functions in the brain. It is part of the _______ response in the body. It is believed that ________ in norepinephrine may contribute to depression, while _________ levels contributes to mania. Serotonin is a monoamine neurotransmitter that stabilizes mood and feelings of happiness. It is theorized that ___________ serotonin levels are related to depression. Acetylcholine, the primary neurotransmitter of the_________ response in the body, may also play a role in depression. Evidence is accumulating that suggests ___________ levels of acetylcholine cause depression symptoms.

Positive Low Adrenal Glands "fight or flight" A decrease Increased Low "Rest and digest" High