Depression In The Older Adult

Which physical disease processes are commonly associated with contributing to depression? Select all that apply. Ulcers Pneumonia Hip fracture Multiple sclerosis Myocardial infarction Acquired immune deficiency syndrome

Hip fracture Hip fracture frequently results in limited mobility and increased disability and limited function, which can contribute to depression. Multiple sclerosis Multiple sclerosis can lead to chronic pain and loss of functional status, which can lead to feelings of loneliness and depression. Myocardial infarction Myocardial infarction can result in chronic illness and lifestyle changes, in addition to numerous new medications, which can lead to increased incidence of depression. Acquired immune deficiency syndrome Acquired immune deficiency syndrome (AIDS) compromises the immune system, which can lead to opportunistic infections. This is not curable and is often fatal, and those affected can develop depression.

As the nurse is obtaining a health history on a patient, which would be considered reliable sources when assessing symptoms of depression? Select all that apply. The patient The medical record Family members of the patient Nonverbal cues from patient and family Family history of depression or anxiety

The patient The patient can provide information about recent mood and changes in health or lifestyle. Family members of the patient Family members may be more aware of changes in the patient's mood and affect than the patient. Nonverbal cues from patient and family Nonverbal cues can indicate discomfort and agitation related to changes in the patient's behavior.

Which important information can be obtained during a physical examination of a depressed individual? Depression is usually not identified in a physical assessment Any atypical presentation of a medical illness before identifying depression Determination of whether or not the patient is being truthful in reporting symptoms Obtaining a complete baseline physical status, which can help determine the course of treatment of depression

Any atypical presentation of a medical illness before identifying depression A medical illness can present in an atypical manner, especially in older adults. It is important to rule out the presence of a physical illness before moving forward in assessing depression.

An elderly patient has been diagnosed with depression. His family did not realize the patient was depressed, but noticed some changes in function. Which symptom associated with early depression in an older adult should the nurse inform the family? Hearing loss Decreased mobility Cognitive impairment Changes in bowel habits

Cognitive impairment Depression in older adults is commonly manifested in early stages as cognitive impairment.

An 81-year-old male patient is being evaluated by his health care provider. His family has come in with him and they report that he has become forgetful and needs more and more assistance with daily activities. Which diagnostic tests does the nurse anticipate being ordered to screen for the presence of depression rather than another illness? Select all that apply. EKG CT scan Lab tests Mental status exam Geriatric Depression Scale

EKG EKG is used to rule out a cardiac abnormality that may be contributing to functional status changes. CT scan A CT scan is done to screen for any brain abnormality that may be contributing to functional status changes. Lab tests Lab tests may be used to screen for any abnormality that is contributing to a change in functional status or overall health.

A 78-year-old female patient has begun treatment for depression with psychotherapy and antidepressant medication. What are the expected functional outcomes that would indicate successful treatment of her depression? Select all that apply. Increased appetite Resolution of physical illnesses Improved management of medication regimen Increased energy and participation in activities Improved ability to make decisions and concentrate Improved self-esteem and resuming previous activities

Increased appetite Increased interest in food and better eating habits is an expected outcome of effective treatment of depression in older adults. Increased energy and participation in activities Older adults who are successfully treated for depression will exhibit increased energy and interest in participating in activities. Improved ability to make decisions and concentrate One component of depression is a decreased ability to concentrate and make decisions. Improved concentration and decision-making abilities is an indication of improvement of depression. Improved self-esteem and resuming previous activities A patient who has long-term depression and undergoes successful treatment will exhibit improved self-esteem and express interest in resuming normal activities.

Which characterizes dysthymia in older adults, when symptoms have been ongoing for more than two years? Select all that apply. Insomnia Irritability Increased self-esteem Feelings of hopelessness Difficulty making decisions Thoughts of death or suicide

Insomnia Sleep disturbances over a prolonged period of time are characteristic of dysthymia. Feelings of hopelessness Chronic feelings of hopelessness are characteristic of long-term depressive mood. Difficulty making decisions Inability to make decisions or concentrate is frequently seen in dysthymia, as the depression becomes the underlying mood.

Which elements of a patient's history can provide information valuable to the assessment of depression? Select all that apply. Medications Recent illnesses Duration of symptoms of depression Recent intermittent episodes of constipation Increased difficulty in affording new medications

Medications Medications can contribute to depression and should be assessed, especially in older adults. Recent illnesses Assessment of recent illness can elicit information about factors contributing to depression. Duration of symptoms of depression Duration of symptoms can indicate whether the depression is an episode, a mild case, or severe.

Which is an accurate statement regarding depression in older adults? Older men have the highest rate of suicide of any demographic group. Depression is not as common in older adults as it is in younger age groups. Although depression is common in those over 80, suicide rates are not as high as in younger groups. Rates of depression decrease in older adults, and suicide is very uncommon in adults over 65.

Older men have the highest rate of suicide of any demographic group. Rates of depression in men over 85 is almost double that of ages 65-74. Depression is associated with the highest rate of suicide in this age group.

Which clinical presentations would indicate a further need for evaluation for depression in an older adult? Select all that apply. Increased alertness Abnormal perception of reality Psychomotor slowing or agitation Depressed mood lasting weeks to months Thought processes indicating helplessness or hopelessness

Psychomotor slowing or agitation Clinical depression is associated with mood changes, which may be accompanied by slowed responses or agitation. Depressed mood lasting weeks to months Any depressed mood that lasts weeks or months should be evaluated for possible depression. Thought processes indicating helplessness or hopelessness Persistent negative, hopeless feelings should be considered as possible depression in older adults.

An 80-year-old male patient has been diagnosed with severe depression and is being treated by his health care provider. Which options should the nurse anticipate as being part in his treatment plan? Select all that apply. Psychotherapy Barbiturate medications Electroconvulsive therapy Amphetamine medications Selective serotonin reuptake inhibitors

Psychotherapy Psychotherapy can provide valuable cognitive behavior therapy related to management of coping skills and decision-making. Electroconvulsive therapy In cases of severe depression, electrical stimulation of the brain has been shown to be effective. This is done under anesthesia. Selective serotonin reuptake inhibitors This class of drug is the most effective in the treatment of older adults for depression. The patient should be cautioned about gastrointestinal side effects.

Which are common manifestations of depression in elderly persons for which nurses should assess? Select all that apply. Weight changes Unexplained crying Weakness and diarrhea Changes in sleep patterns Renewed interest in hobbies Slowing in psychomotor abilities

Weight changes Weight gain or weight loss is a common manifestation of depression, due to changes in eating habits. Unexplained crying Unexplained crying indicates intensity of emotion and can be a sign of developing depression. Changes in sleep patterns Alterations in sleep patterns are often seen as a manifestation of depression. Slowing in psychomotor abilities Depression leads to decreased mobility as a result of diminished movements and decreased energy levels.