NU249/NUR2488- Concept Guides- Exam 2
Mood: rehearsing new cognitive and behavioral
responses.
Depression
Risk for suicide- Questions to ask,
Define common symptoms: memory
difficulties, suicidal ideations or attempt, High vs low risk (Ch 23)
poor concentration, worthlessness,
Identify current feeling states, ask directly:
helplessness, anhedonia (losing pleasure in
if yes frequency, duration, & intensity, ask
things they once loved doing- key symptom
if they have a plan, determine lethality of
people w/ depression have)
the plan how detailed, how lethal,
Major depression causes pt to feel low self- availability of means, gather info about
worth risk factors, history of suicide attempts,
Severe – not eating, drinking: offer high Nursing Diagnosis (Table 15-2)
protein, high calorie food/drink: around the
Physical Interventions (Table 15-5)
clock observation (not necessarily 1:1), high
risk for suicidal ideation Institutional protocol- creating a safe
environment, keep records of pt behavior,
Beck’s Cognitive Triad: people
suicide precautions (1:1, ***maintain arm
acquire a psychological predisposition to
length away*** ), keep record of pts
depression through early life experiences.
activity q15, no-suicide contract, encourage
Depressed people process info in neg ways:
pt to talk about their feelings.
Negative, self-deprecating view of self: “I
Medications-
really never do anything well; everyone else
seems smarter”. Classes: SSRI, TCA, MAOIs
Pessimistic view of the world: “Once you’re SSRIs (selective serotonin reuptake
down, you can’t get up. Look around, inhibitors)- blackbox warning (chance of
poverty, homelessness, sickness, war, and increasing suicide ideation – constantly
despair are every place you look.” assess for that – pts need to be aware of this
and communicate feelings w/ someone) first
Belief that negative reinforcement (or no
line tx for depression
validation for the self) will continue: “it
doesn’t matter what you do; nothing ever Citalopram (Celexa), fluoxetine
gets better. I’ll be in this stupid job the rest (Prozac). Education: when starting it, do
of my life.” NOT start it within 14 days (2 weeks) of an
MAOI. SSRIs can cause serotonin syndrome
Automatic negative thoughts- thoughts that
(rare but can happen)- hyperactivity,
are repetitive, unintended, and not readily
seizures, restlessness, confusion, rapid HR
controllable.
& BP, dilated pupils, unconsciousness, high
GOAL: change the way the pt thinks help fever
relieve the depressive syndrome. Assist pt
MAOIs- always talk w/ provider before
in: identifying & testing neg cognition,
starting any OTC vitamin or anything
developing alternative thinking patterns,
like that (certain herbal meds or vitamins
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, NU249/NUR2488- Concept Guides- Exam 2
contain tyramine – MAOIs inhibit that rest periods, redirect violence
break down tyramine in liver); avoid through physical exercise, (acute
avocado, soy sauce, hard cheeses, mania) use antipsychotics and
pepperoni) tyramine free diet. seclusion to minimize physical
harm, observe for signs of lithium
****Cause hypertensive crisis- severely
toxicity, protect pt from giving
elevated BP!!!!!!!!
away possessions. m
Phenelzine, isocarboxide – when taking
Nursing Diagnosis related to disorder
phenelzine, always speak to pharmacist
(Table 16-2)
prior to taking OTC meds. Has food/drug
interactions. **
TCAs- common side effects: anticholinergic Medications- Lithium and other
effects (Blurred vision, dry mouth, anticonvulsants
dizziness) more severe & urgent – urinary
Lithium- mood stabilizer, small
retention, constipation – contact physician.
therapeutic window. Early
Cause cardiotoxicity – start low and go slow
toxicity- 1.5 lithium blood level
to build up (lethal w/ OD)
(nausea, vomiting, weakness,
Imipramine, amitriptyline- side effects: diaphoresis). 2.0-2.5 severely toxic
constipation, and urinary retention would (blurred vision, seizures). Typical
require med attention levels: 0.4-1.3 mEq/L. take meds
everyday to prevent relapses;
*Make sure to know specific meds
should not be stopped. (measured
within each class
at least 5 days after therapy has
Refer to boxes 15-3, 15-4, 15-5, and begun, after each dosage change,
15-7 then each month) takes 7-14 days
to reach therapeutic level.
Refer to tables 15-8, 15-9
*Make sure to know specific meds
Bipolar within each class
Nursing interventions for Refer to Table 16-1, 16-5, 16-6
interactions (Table 16-3, 16-4)
Flight ideas- nearly continuous flow
Firm & calm approach: “John, come of accelerated speech w/ abrupt
w/ me. Eat this sandwich.” Short & changes from topic to topic that are
concise explanations, remain neutral; usually based on understandable
avoid power struggles & value associations or plays on words
judgments, be consistent, have
frequent staff meetings to discuss Grandiosity – inflated self-regard
limits
Anxiety:
Maintain low level of stimuli in
Describe Generalized Anxiety
pt’s environment, structured
Disorder
activities, high-cal fluids, frequent
This study source was downloaded by 100000829216747 from CourseHero.com on 02-10-2022 01:53:44 GMT -06:00
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Mood: rehearsing new cognitive and behavioral
responses.
Depression
Risk for suicide- Questions to ask,
Define common symptoms: memory
difficulties, suicidal ideations or attempt, High vs low risk (Ch 23)
poor concentration, worthlessness,
Identify current feeling states, ask directly:
helplessness, anhedonia (losing pleasure in
if yes frequency, duration, & intensity, ask
things they once loved doing- key symptom
if they have a plan, determine lethality of
people w/ depression have)
the plan how detailed, how lethal,
Major depression causes pt to feel low self- availability of means, gather info about
worth risk factors, history of suicide attempts,
Severe – not eating, drinking: offer high Nursing Diagnosis (Table 15-2)
protein, high calorie food/drink: around the
Physical Interventions (Table 15-5)
clock observation (not necessarily 1:1), high
risk for suicidal ideation Institutional protocol- creating a safe
environment, keep records of pt behavior,
Beck’s Cognitive Triad: people
suicide precautions (1:1, ***maintain arm
acquire a psychological predisposition to
length away*** ), keep record of pts
depression through early life experiences.
activity q15, no-suicide contract, encourage
Depressed people process info in neg ways:
pt to talk about their feelings.
Negative, self-deprecating view of self: “I
Medications-
really never do anything well; everyone else
seems smarter”. Classes: SSRI, TCA, MAOIs
Pessimistic view of the world: “Once you’re SSRIs (selective serotonin reuptake
down, you can’t get up. Look around, inhibitors)- blackbox warning (chance of
poverty, homelessness, sickness, war, and increasing suicide ideation – constantly
despair are every place you look.” assess for that – pts need to be aware of this
and communicate feelings w/ someone) first
Belief that negative reinforcement (or no
line tx for depression
validation for the self) will continue: “it
doesn’t matter what you do; nothing ever Citalopram (Celexa), fluoxetine
gets better. I’ll be in this stupid job the rest (Prozac). Education: when starting it, do
of my life.” NOT start it within 14 days (2 weeks) of an
MAOI. SSRIs can cause serotonin syndrome
Automatic negative thoughts- thoughts that
(rare but can happen)- hyperactivity,
are repetitive, unintended, and not readily
seizures, restlessness, confusion, rapid HR
controllable.
& BP, dilated pupils, unconsciousness, high
GOAL: change the way the pt thinks help fever
relieve the depressive syndrome. Assist pt
MAOIs- always talk w/ provider before
in: identifying & testing neg cognition,
starting any OTC vitamin or anything
developing alternative thinking patterns,
like that (certain herbal meds or vitamins
This study source was downloaded by 100000829216747 from CourseHero.com on 02-10-2022 01:53:44 GMT -06:00
https://www.coursehero.com/file/63891451/Mental-Health-key-concepts-exam-2-052020docx/
, NU249/NUR2488- Concept Guides- Exam 2
contain tyramine – MAOIs inhibit that rest periods, redirect violence
break down tyramine in liver); avoid through physical exercise, (acute
avocado, soy sauce, hard cheeses, mania) use antipsychotics and
pepperoni) tyramine free diet. seclusion to minimize physical
harm, observe for signs of lithium
****Cause hypertensive crisis- severely
toxicity, protect pt from giving
elevated BP!!!!!!!!
away possessions. m
Phenelzine, isocarboxide – when taking
Nursing Diagnosis related to disorder
phenelzine, always speak to pharmacist
(Table 16-2)
prior to taking OTC meds. Has food/drug
interactions. **
TCAs- common side effects: anticholinergic Medications- Lithium and other
effects (Blurred vision, dry mouth, anticonvulsants
dizziness) more severe & urgent – urinary
Lithium- mood stabilizer, small
retention, constipation – contact physician.
therapeutic window. Early
Cause cardiotoxicity – start low and go slow
toxicity- 1.5 lithium blood level
to build up (lethal w/ OD)
(nausea, vomiting, weakness,
Imipramine, amitriptyline- side effects: diaphoresis). 2.0-2.5 severely toxic
constipation, and urinary retention would (blurred vision, seizures). Typical
require med attention levels: 0.4-1.3 mEq/L. take meds
everyday to prevent relapses;
*Make sure to know specific meds
should not be stopped. (measured
within each class
at least 5 days after therapy has
Refer to boxes 15-3, 15-4, 15-5, and begun, after each dosage change,
15-7 then each month) takes 7-14 days
to reach therapeutic level.
Refer to tables 15-8, 15-9
*Make sure to know specific meds
Bipolar within each class
Nursing interventions for Refer to Table 16-1, 16-5, 16-6
interactions (Table 16-3, 16-4)
Flight ideas- nearly continuous flow
Firm & calm approach: “John, come of accelerated speech w/ abrupt
w/ me. Eat this sandwich.” Short & changes from topic to topic that are
concise explanations, remain neutral; usually based on understandable
avoid power struggles & value associations or plays on words
judgments, be consistent, have
frequent staff meetings to discuss Grandiosity – inflated self-regard
limits
Anxiety:
Maintain low level of stimuli in
Describe Generalized Anxiety
pt’s environment, structured
Disorder
activities, high-cal fluids, frequent
This study source was downloaded by 100000829216747 from CourseHero.com on 02-10-2022 01:53:44 GMT -06:00
https://www.coursehero.com/file/63891451/Mental-Health-key-concepts-exam-2-052020docx/
