MENTAL HEALTH ati ch 13 Depressive Disorders

A nurse is caring for a client who has depression. The client states, "I am too tired and depressed to attend group therapy today." Which of the following responses should the nurse make?

"Attending group therapy, even if you're tired, is an important part of your treatment"

A nurse is assessing a client who has a new diagnosis of major depressive disorder. Which of the following questions is the priority for the nurse to ask?

"Do you ever think about suicide?

A nurse is teaching a client who has a new prescription for amitriptyline to treat depression. Which of the following client statements indicates an understanding of the teaching?

"I should take this medication before bedtime"

A nurse in an acute care mental health facility is assisting with the evaluation of the plan of care for a client who has major depressive disorder and was admitted 1 week ago following a suicide attempt. Which of the following client statements should indicate to the nurse that the treatment plan has been effective?

"I was feeling completely hopeless when I tried to kill myself"

A nurse is teaching a client who has seasonal affective disorder (SAD) about the use of light therapy. Which of the following statements should the nurse make?

"Light therapy suppresses the natural nighttime release of melatonin"

A nurse is reinforcing teaching with a client who reports depression and has a new prescription for an SSRI medication. Which of the following statements should the nurse make?

"The effect of the medication may take several weeks to b felt"

What is the client education for use of Citalopram, Fluoxetine, and Sertraline? SATA

-Adverse effects can include nausea, headache, agitation, insomnia, anxiety -Sexual dysfunction can occur, and notify provider if effects are intolerable. -Observe for manifestations of serotonin syndrome. If any occur, withhold the medication and notify the provider. -Avoid the concurrent use of St. John's wort -Follow a healthy diet and exercise regimen because weight gain can occur with long-term use

What is the client education for use of Duloxetine? SATA

-Adverse effects include nausea, insomnia, weight gain, diaphoresis, and sexual dysfunction. -Caution in administering to clients who have a history of hypertension

A nurse is helping evaluate the plan of care for a client who has antisocial personality disorder. Which of the following client actions indicates that he is making progress with the treatment? (Select all that apply.)

-Assisting another client who has depression to fill out a menu -Requesting a weekend pass to go home

What is the client education for use of Phenelzine? SATA

-Avoid foods with tyramine (avocado, meats, fish) -Avoid OTC meds without discussing them with the HCP

What is the client education for use of Amitriptyline? SATA

-Change positions slowly to minimize dizziness from orthostatic hypotension. -Chew sugarless gum -Eat foods high in fiber -Increase fluid intake to 2 to 3 L/day from food and beverage sources

What meds are the leading treatment for depression?

-Citalopram -Fluoxetine -Sertraline

What qualifies as Major Depressive Disorder (MDD)? (must occur almost every day for minimum of 2 weeks and last most of the day?

-Depressed mood -Difficulty sleeping or excessive sleeping -Indecisiveness -Decreased ability to concentrate Suicidal ideation -Increase or decrease in motor activity -Inability to feel pleasure -Increase or decrease in weight of more than 5% of total body weight over 1 month

The nurse is reinforcing teaching to the client about the newly prescribed benzodiazepine. Which of the following information should the nurse include? (select all that apply)

-Do not consume alcohol -Do not take more than what is prescribed -It may cause drowsiness and dizziness -Do not drive or operate machinery

What are some risk factors for depression? (Select all that apply)

-Family history and a previous personal history of depression are the most significant risk factors -Depressive disorders are twice as common in females than in males -Neurotransmitter deficiencies (a serotonin deficiency [affects mood, sexual behavior, sleep cycles, hunger, and pain perception] or a norepinephrine deficiency [affects attention and behavior]

What is the client education for use of Bupropion? SATA

-Observe for headache, dry mouth, GI distress, constipation, increased heart rate, nausea, restlessness, or insomnia, and notify the provider if they become intolerable. -Monitor food intake and weight due to appetite suppression. - Avoid administering if at risk for seizures

Continuation phase of depression treatment generally lasts

4 to 9 months

What does postpartum onset mean?

A depressive episode that begins within 4 weeks of childbirth (known as postpartum depression) and can include delusions, which can put the newborn infant at high risk of being harmed by the mother

What is seasonal affective disorder (SAD)?

A form of depression that occurs seasonally, usually during the winter, when there is less daylight

A nurse is caring for a client who is undergoing electroconvulsive therapy (ECT) to treat major depression. Following the procedure, which of the following actions should the nurse take?

Administer oxygen

A nurse in a mental health clinic is collecting data from an older adult client who is tearful and reports sleep disturbances. The client tells the nurse, "All of my friends have died, and my children are too busy for me." Which of the following actions should the nurse take first?

Administer the Geriatric Depression Scale

A nurse on a mental health unit is caring for a client who has depression. Which of the following actions should the nurse take to foster a therapeutic environment for this client?

Build trust with the client by sitting quietly with him

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to obtain prior to administering the medication?

Electrocardiogram

What is the first line of treatment for seasonal affective disorder (SAD)?

Light therapy

What should you monitor during Acute phase of depression?

Monitor suicide risk, and implement safety precautions or one-to-one observation as needed

A nurse is reinforcing teaching with a client who has depression and is scheduled for transcranial magnetic stimulation (TMS). The nurse should reinforce with the client that TMS can cause which of the following adverse effects?

Seizures

A nurse is reinforcing teaching with a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client?

Stop taking the herbal supplement while taking the mdeication

What are psychotic features?

The presence of auditory hallucinations (such as voices telling the client they are sinful) or the presence of delusions (such as the client thinking that they have a fatal disease

A nurse in a mental health facility is meeting with a client who has a diagnosis of major depression. During the conversation, the client stops speaking, and the nurse sits silently next to the client for several minutes. The nurse should identify that the therapeutic communication technique of silence is used for which of the following purposes?

To encourage the client to express feelings or concerns

How long is treatment for Acute phase of depression?

Treatment is generally 6 to 12 weeks in duration. -Potential need for hospitalization, reduction of depressive manifestations is the goal of treatment.

Depression is

a mood (affective) disorder that is a widespread issue, ranking high among causes of disability

A nurse is caring for a client who has a stimulant use disorder. Which of the following manifestations should indicate to the nurse that the client is experiencing withdrawal?

depression

Persistant depressive disorder (dysrhythmic disorder) is a milder form of

depression that usually has an early onset (in childhood or adolescence) and lasts at least 2 years for adults (1 year for children). Persistent depressive disorder contains at least three clinical findings of depression and can, later in life, become major depressive disorder

A nurse is collecting data from a client who takes an MAOI for the treatment of depression. Which of the following findings is the priority for the nurse to report to the provider?

elevated blood pressure

Maintenance phase of depression can

last for years

A client who has depression has a potential risk for

suicide, especially if they have a family or personal history of suicide attempts, comorbid anxiety disorder or panic attacks, comorbid substance use disorder or psychosis, poor self-esteem, a lack of social support, or a chronic medical condition