NR326 Mental Health Exam 2 Study Set: Key Concepts
and Quick Review
Brexanolone
Brexanolone is the first therapeutic drug to be approved by the FDA, specifically for the treatment of
postpartum depression.
Non-Pharmacological Therapy for Major Depressive Disorder
(CBT) Cognitive behavioral therapy teaches different ways of thinking and reacting to situations.
Suicide Risk Factors
Previous attempts, some history of suicide, sudden loss such as loved one, relationship, job, home,
history of mental illness, substance abuse, lack of social support, history of personal trauma or abuse,
impulsive tendencies, belief that suicide is a noble resolution.
Intervention for Substance Induced Mania
Provide a safe environment through withdrawal.
Two Types of Mood Disorders
Major Depression: (Unipolar) (Severe Depression) periods of depression only
Common in women over 30, more common in women more than men.
Onset is gradual, few episodes
Bipolar: Clients alternate between two moods depression and mania.
Teens-30, affects both female and male
Onset is abrupt, multiple episodes
Post Partum Psychosis
Severe form of postpartum depression.
Delusions, hallucinations, mania, and paranoia may also be at risk for suicide.
It is a medical emergency!
Suicide Risks and Safey
, Create a safe environment and continuous monitoring of client's safety is essential in psychiatric care.
Client with previous attempt takes priority.
Suicide Risk: If a client gives any clues of contemplating or attempting suicide, immediate action is
needed. Notify the health care team and the provider without delay.
Remove any potentially harmful objects (sheets, blankets, scrubs, laces, etc.)
Assessing risk: "Have you thought about harming yourself in any way?" "Do you have a plan to harm
yourself?"
Acknowledge, listen, and validate their feelings.
electroconvulsive therapy (ECT)
Effective and rapid treatment for severe depression by applying electrical current to induce seizures in
the brain.
Nursing interventions: check labs prior to procedure including UA and pregnancy test, EKG vitals,
Written and signed consent on file, remove jewelry, place patient in a gown, provide support of the
anxious patient (Do not medicate with Benzos), educate on memory loss and re-orient patient after
procedure as short term memory loss is a common side effect post procedure, ensure patient safety and
open airway throughout the procedure. Have suction available in case of secretions.
Bipolar 1 Disorder
More severe than type 2.
Diagnostic Criteria: At least 1 manic episode lasting > 1week requiring hospitalization.
Manic episodes may be preceded or followed by hypomanic or major depressive episodes.
Symptoms cause significant impairment or require hospitalization.
Clinical manifestations: Rapid cycling, excessive shopping etc, manipulative when they become manic.
Treatment: Mood stabilizers (Lithium, Depakote), Lamotrigine.
Antipsychotics: Olanzapine, Quetiapine.
Psychotherapy: CBT, Psychoeducation. Hospitalization may be needed for severe mania.
Bipolar 2 Disorder
Diagnostic criteria: At least 1 hypomanic episode that lasts more than 4 days, at least 1 major
depressive episode, no history of manic episode, hypomanic episodes do not cause marked impairment.
Clinical manifestations: Hypomania (an elevated or irritable mood, increased activity or productivity,
Depression (low mood, fatigue, loss of interest, guilt). Mood shifts are noticeable but less impairing than
bipolar 1.
Psychotherapy: CBT, interpersonal therapy
and Quick Review
Brexanolone
Brexanolone is the first therapeutic drug to be approved by the FDA, specifically for the treatment of
postpartum depression.
Non-Pharmacological Therapy for Major Depressive Disorder
(CBT) Cognitive behavioral therapy teaches different ways of thinking and reacting to situations.
Suicide Risk Factors
Previous attempts, some history of suicide, sudden loss such as loved one, relationship, job, home,
history of mental illness, substance abuse, lack of social support, history of personal trauma or abuse,
impulsive tendencies, belief that suicide is a noble resolution.
Intervention for Substance Induced Mania
Provide a safe environment through withdrawal.
Two Types of Mood Disorders
Major Depression: (Unipolar) (Severe Depression) periods of depression only
Common in women over 30, more common in women more than men.
Onset is gradual, few episodes
Bipolar: Clients alternate between two moods depression and mania.
Teens-30, affects both female and male
Onset is abrupt, multiple episodes
Post Partum Psychosis
Severe form of postpartum depression.
Delusions, hallucinations, mania, and paranoia may also be at risk for suicide.
It is a medical emergency!
Suicide Risks and Safey
, Create a safe environment and continuous monitoring of client's safety is essential in psychiatric care.
Client with previous attempt takes priority.
Suicide Risk: If a client gives any clues of contemplating or attempting suicide, immediate action is
needed. Notify the health care team and the provider without delay.
Remove any potentially harmful objects (sheets, blankets, scrubs, laces, etc.)
Assessing risk: "Have you thought about harming yourself in any way?" "Do you have a plan to harm
yourself?"
Acknowledge, listen, and validate their feelings.
electroconvulsive therapy (ECT)
Effective and rapid treatment for severe depression by applying electrical current to induce seizures in
the brain.
Nursing interventions: check labs prior to procedure including UA and pregnancy test, EKG vitals,
Written and signed consent on file, remove jewelry, place patient in a gown, provide support of the
anxious patient (Do not medicate with Benzos), educate on memory loss and re-orient patient after
procedure as short term memory loss is a common side effect post procedure, ensure patient safety and
open airway throughout the procedure. Have suction available in case of secretions.
Bipolar 1 Disorder
More severe than type 2.
Diagnostic Criteria: At least 1 manic episode lasting > 1week requiring hospitalization.
Manic episodes may be preceded or followed by hypomanic or major depressive episodes.
Symptoms cause significant impairment or require hospitalization.
Clinical manifestations: Rapid cycling, excessive shopping etc, manipulative when they become manic.
Treatment: Mood stabilizers (Lithium, Depakote), Lamotrigine.
Antipsychotics: Olanzapine, Quetiapine.
Psychotherapy: CBT, Psychoeducation. Hospitalization may be needed for severe mania.
Bipolar 2 Disorder
Diagnostic criteria: At least 1 hypomanic episode that lasts more than 4 days, at least 1 major
depressive episode, no history of manic episode, hypomanic episodes do not cause marked impairment.
Clinical manifestations: Hypomania (an elevated or irritable mood, increased activity or productivity,
Depression (low mood, fatigue, loss of interest, guilt). Mood shifts are noticeable but less impairing than
bipolar 1.
Psychotherapy: CBT, interpersonal therapy
