Mental Health Chapter 14

A client diagnosed with depressive disorder begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. What information should the nurse provide to the client and family?

Importance of reporting increased suicidal thoughts.

A client was diagnosed with seasonal affective disorder (SAD). During which month would this client's symptoms be most acute?

January

A client diagnosed with major depressive disorder repeatedly tells staff, "I have cancer. It's my punishment for being a bad person." Diagnostic tests reveal no cancer. What is the priority nursing diagnosis?

Risk for suicide

Major depressive disorder resulted after a client's employment was terminated. The client now says to the nurse, "I'm not worth the time you spend with me. I am the most useless person in the world." Which nursing diagnosis applies?

Situational low self-esteem

A client diagnosed with major depressive disorder says, "No one cares about me anymore. I'm not worth anything." Today the client is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this client?

"You're wearing a new shirt."

Transcranial Magnetic Stimulation (TCM) is scheduled for a client diagnosed with major depressive disorder. Which comment by the client indicates teaching about the procedure was effective?

"I might be a little dizzy or have a mild headache after each procedure."

A client became severely depressed when the last of the family's six children moved out of the home 4 months ago. The client repeatedly says, "No one cares about me. I'm not worth anything." Which response by the nurse would be the most helpful?

"I'd to sit with you for 10 minutes now and 10 minutes after lunch because I value spending time with you."

A client diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." Which response by the nurse will best assist the client to reframe this overgeneralization?

"Let's look at one bad thing that happened to see if another explanation exists."

A client being treated for depression has taken sertraline daily for a year. The client calls the clinic nurse and says, "I stopped taking my antidepressant 2 days ago. Now I am having nausea, nervous feelings, and I can't sleep." The nurse will advise the client to:

"Take a dose of your antidepressant now and come to the clinic to see the health care provider."

During a psychiatric assessment, the nurse observes a client's facial expression is without emotion. The client says, "Life feels so hopeless to me. I've been feeling sad for several months." How will the nurse document the client's affect and mood?

Affect flat; mood depressed

A client diagnosed with major depressive disorder does not interact with others except when addressed, and then only in monosyllables. The nurse wants to show nonjudgmental acceptance and support for the client. Which communication technique will be effective?

Make observations.

A nurse taught a client about a tyramine-restricted diet. Which menu selection would the indicate the client understood the information?

Mashed potatoes, ground beef patty, corn, green beans, apple pie

A client diagnosed with major depressive disorder refuses solid foods. In order to meet nutritional needs, which beverage will the nurse offer to this client?

Milk

Which documentation for a client diagnosed with major depressive disorder indicates the treatment plan was effective?

Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild.

An adult diagnosed with major depressive disorder was treated with medication and cognitive-behavioral therapy. The client now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?

Social skills training

What is the focus of priority nursing interventions for the period immediately after electroconvulsive therapy (ECT) treatment?

Supporting physiological stability

A client diagnosed with major depressive disorder received six electroconvulsive therapy (ECT) sessions and aggressive doses of antidepressant medication. The client owns a small business and was counseled not to make major decisions for a month. What is the correct rationale for this counseling?

Temporary memory impairments and confusion may occur with ECT.

A client diagnosed with major depressive disorder is receiving imipramine 200 mg at bedtime. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug?

Urinary retention

A client says to the nurse, "My life doesn't have any happiness in it anymore. I once enjoyed holidays, but now they're just another day." The nurse documents this report using what medical term?

anhedonia

What is the priority intervention for a client diagnosed with major depressive disorder and feelings of worthlessness?

careful unobtrusive observation around the clock.

When counseling clients diagnosed with major depressive disorder, what therapy would an advanced practice nurse address the client's negative thought patterns?

cognitive-behavioral

A nurse provided medication education for a client diagnosed with major depressive disorder who began a new prescription for phenelzine. Which behavior indicates effective learning? The client

confers with a pharmacist when selecting over-the-counter medications.

A client diagnosed with major depressive disorder began taking escitalopram 5 days ago. The client now says, "This medicine isn't working." What is the nurse's best intervention?

explain the time lag before antidepressants relieve symptoms.

A disheveled client in the acute phase of major depressive disorder is withdrawn, has psychomotor retardation, and has not showered for several days. What action will the nurse take?

firmly and neutrally assist the client with showering

A nurse instructs a client taking a medication that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of what?

hypertensive crisis.

A client is experiencing psychomotor agitation associated with major depressive disorder. Which observation presented by the client would the nurse associate with this symptom?

pacing aimlessly around the room.

A client diagnosed with major depressive disorder began taking a tricyclic antidepressant 1 week ago. Today the client says, "I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up." The nurse will implement which intervention?

teach the client strategies to manage postural hypotension.