Mood Disorders and Suicide
When is Postpartum depression diagnosed? When is major depression with peripartum Diagnosed?
Postpartum depression is the diagnosis used for unusually profound depression following 1 month after the birth of a child. Major depression with peripartum onset occurs during pregnancy and up to 4 weeks following birth.
cognitive behavioral therapy (CBT)
Psychosocial intervention that aims to challenge and change cognitive behaviors and distortions and to help the client emotionally regulate.
What substances are contributing factors in the development of substance induced depressive disorder?
Substance/medication-induced depressive disorder occurs soon after a client begins taking or withdrawing from a substance. Most common when a client is using alcohol, phencyclidine, hallucinogens, inhalants, opioids, amphetamines. This does not include Selective serotonin reuptake inhibitors, Nonsteroidal anti-inflammatory drugs, or Monoamine oxidase inhibitors
A school nurse is creating a presentation about mental health for a group of middle school students. Why is suicide an important topic to discuss for this demographic?
Suicide is the 2nd leading cause of death in clients ages 10 to 34. Assessing for and educating about risk factors for suicide is a task that should be prioritized to maintain client safety. By educating this group about factors that can contribute to suicide, the nurse is providing information that can help prevent self-harm.
What is persistent depressive disorder in reference to depression?
"Persistent depressive disorder is a mild chronic form of depression." Persistent depressive disorder is also known as dysthymia and is characterized as a less severe form of depression.
A nurse is caring for a client who is scheduled for transcranial Magnetic stimulation. When preparing the client for the procedure, what information should the nurse share about the procedure.
"This procedure is effective when combined with psychotherapy." The nurse should identify that transcranial magnetic stimulation has been proven to be very effective in the treatment of depression when coupled with psychotherapy.
SAFE T Steps
1: Identify Risk Factors 2: Identify Protective Factors 3: Conduct Suicide Inquiry 4: Determine Risk Level/Intervention5: Document
Beck Depression Inventory
A 21-item self-assessment of the usual characteristic behaviors and attitudes present in depression. can be used for adolescents as well as adults.
What is grandiosity
A Mania manifestations that exude inflated self-esteem or overconfidence.
premenstrual dysphoric disorder
A group of manifestations that occur only in the last week before a client menstruates. It is characterized by dysphoria.
Define depression
A mood characterized by hopelessness/worthlessness/guilt, loss of interest in activities, increased fatigue, sleep disturbances, weight changes, psychomotor changes, difficulty concentrating, and persistent thoughts of death.
Serotonin Syndrome
A potentially fetal medication reaction that can occur from medications such as SSRIs and SSNRIs.
transcranial magnetic stimulation (TMS)
A procedure using magnetic pulses that focuses on areas of cerebral cortex.
depression is more prevalent for which sex?
Adult females The nurse should identify that the prevalence of depression in U. S. adults aged 18 or older in 2017 was estimated at 17.3 million, with higher prevalence among females.
tricyclic antidepressant (TCA)
An older classification of antidepressants, used to balance neurotransmitters.
anhedonia vs anergia
Anhedonia is an inability to experience pleasure, while anergia is described as having a low level of energy.
Vegetative signs of depression
Changes in sleep, appetite, concentration, and energy.
Explain Bipolar II disorder?
Characterized hypomanic episodes, which are lower level and less dramatic manic shifts in mood than Bipolar I disorder.
cyclothymic disorder
Clients alternate between mania and mild to moderate depression for at least two years.
Hamilton Depression Scale (HDRS or Ham-D)
Depression instrument that has a version with 17 and a version with 21 questions, so it can be administered by a trained provider in about 30 min.
mood disorders
Disruptions of mood or predominating emotion.
A nurse is caring for a child, who is exhibiting tantrums, dysfunction in school, trouble with peers, and suicidal ideation. What diagnosis is consistent with the clients behaviors?
Disruptive mood dysregulation disorder The nurse should identify that disruptive mood dysregulation disorder is a disorder diagnosed in children who exhibit extreme irritability, tantrums, and trouble in school.
A nurse in an outpatient clinic is caring for a client who has major depressive disorder and has reported suicidal thoughts. What is the first information the nurse should try to obtain from the client?
Does the client have a suicide plan? Using the SAFE T/risk reduction priority framework, the first information the nurse should try to obtain is whether the client has a definite suicide plan.
The nurse reminds the client that they will stay awake w/ no anesthesia during the transcranial magnetic stimulation (TMS) procedure. What other information might a nurse give to a client before this procedure?
During the (TMS) procedure, the client may feel a slight tapping on the head, scalp contraction, or tightening of the jaw, + it is common to experience a mild headache following the procedure. This outpatient procedure lasts about 30 min. The client usually comes for treatment 5 days a week for 4 to 6 weeks, not 6 months.
What information might a nurse explain to a client who about electro, convulsive therapy, (ECT) for depression.
Electrical current will flow through electrodes placed on both sides of the forehead, not the torso. General anesthetic is given to induce sleep for the procedure so the client will not be awake. The client will need to remain NPO for several hours prior to the procedure.
Geriatric Depression Scale
Instrument to measure depression in older adults. the best depression assessment choice for a client who is suffering from dementia
Altman Self-Rating Mania Scale
Instrument to self-assess for mania (mood, self-confidence, speech, sleep, and activity).
What does Suicide Assessment - MILC stand for
Means - How does the person have access to enact the plan? Intent - Do they have a plan? Lethality - How deadly is their plan? Cues and Behaviors (covert and overt, verbal and nonverbal)
PHQ-9
Nine-question, self-administered assessment that clients can fill out to determine the amount and frequency of depression symptoms.
neuroplasticity
The ability of the brain to reorganize neurons and neural pathways in response to life events to promote growth and adjustment to changes in life circumstances.
euthanasia
The act of helping a client die by suicide.
Neuroplasticity
The brains ability to change its function over time. Explains why antidepressants take weeks for the intended effect to be noticed by the client.
Explain Bipolar I disorder?
The most severe form of bipolar disorder. Characterized by shifts in mood, energy, and functioning.
Using the SAD PERSONS scale, which age group and sex is at the highest risk of suicide?
The nurse should identify that clients who are less than 19 years of age and older than 45 years of age have an increased risk of suicide. Clients who are male also have an increased risk of suicide.
A nurse is providing teaching to a client who is to undergo electro, convulsive therapy, (ECT) for depression. What information should the nurse provide?
The nurse should inform the client that, to be effective, ECT usually requires several treatments over a period of several weeks.
A nurse is caring for a client who is admitted with suicidal ideation. How should the nurse create a protective environment if client tells the nurse they have several guns in their home?
Utilizing the safety/risk reduction priority framework, the nurse should identify that it is important for a client who has suicidal ideation to have reduced access to lethal means of self-harm. The nurse may need to recruit the help of others, such as a social worker or the client's family, to create a protective environment for the client by removing the guns from their home.
Explain Dysthymic disorder
a milder form of bipolar disorder characterized by difficulty sleeping and experiencing a mild level of depression.
Manifestations of Serotonin Syndrome
alterations in mental cognition, tremors, muscle rigidity, diaphoresis, extreme elevation in temperature, tachycardia, hypertension, dilation of the pupils, abdominal pain, and alterations in bowel activity.
Deliberate induction of seizures under anesthesia to treat depression.
electroconvulsive therapy (ECT)
Hormones that act as the body's natural pain relievers.
endorphins
What type of care describes giving fair and impartial care, not favoring certain clients because they ask for special favors.
equitable care
What are some manifestations of mania?
overactivity/impulsivity overeating, overspending, poor sleeping habits, pacing, and speaking rapidly.
