NUR2488 / NUR 2488 / NU 249 Exam 2 Concept / Study Guide (Latest ): Mental Health Nursing - Rasmussen College
NU249/NUR2488- Concept Guides- Exam 2
Mood:
Depression
Define common symptoms- memory difficulties, suicidal, worthlessness, helplessness,
anhedonia-loss of pleasurable in things they once loved, anergia-lack of energy.. Severe=not
eating or drinking. Given up. High protein, high calorie diet. Around the clock observation,
suicide=1on1.
Beck’s Cognitive Triad (p. 250)
1.A negative, self-deprecating view of self: “I really never do anything well; everyone else
seems smarter.”
2.A pessimistic view of the world: “Once you're down, you can't get up. Look around,
poverty, homelessness, sickness, war, and despair are every place you look.”
3.The belief that negative reinforcement (or no validation for the self) will continue: “It
doesn't matter what you do; nothing ever gets better. I'll be in this stupid job the rest of
my life.”
Risk for suicide- Questions to ask,
Are you feeling suicidal? Do you have a plan? Do you have the means?
High vs low risk (Ch 23)
Nursing Diagnosis (Table 15-2)
Risk for suicide, self mutilation, decisional conflict, impaired memory, acute confusion,
ineffective coping, interrupted family process, risk for impaired parent/infant/child attachment,
ineffective role performance, hopelessness, chronic low self esteem.
Physical Interventions (Table 15-5)
Nutritional interventions (high calorie meals for those not eating), encourage sleep, emphasize
self care measures.
Medications-
Classes:
SSRI- first line! black box warning=increase suicidal ideation. Selexa, fluoxetineProzac. Don’t
start within 14 days of last MAOI dose=serotonin syndrome-hyperactivity, seizures
Citalopram† Celexa Common side effects Minimal interaction Possible initial anxiety
include: with other drugs,
minimal weight
, NU249/NUR2488- Concept Guides- Exam 2
gain, sedation
•Headache, which
usually dissipates in a few
days Possible initial anxiety
Minimal interaction,
Lexapr
Escitalopram† •Nausea, which sedation, and weight
o 18 yr or older; 12-17 yr
usually dissipates in a few gain for MDD
days
•Sleeplessness and/or Possible interaction
drowsiness during day, with other drugs, initial
Fluoxetine† Prozac which usually dissipates in Activating anxiety
a few weeks (energizing)
8 yr or older
•Tremors and/or
dizziness
8 yr or older for OCD
Fluvoxamine Luvox •Sexual problems:
only
reduces sexual drive,
problems having and
enjoying sex
Weight gain, interacts
Good antianxiety with other meds,
Paroxetine† Paxil •Agitation, feeling
benefit contraindicated in
jittery and nervous; rare
pregnancy
serotonin syndrome; rare
activation of suicidal
ideation
Sertraline† Zoloft
TCA= amitryptiline, imipramine .anticholinergic effects, get dr attention for urinary retention.
Cardiotoxicity with overdose
Amitriptyline Elavil Common side effects include:
•Dry mouth
10 yr or older only
ClomipramineAnafranil
•Constipation for OCD
•Bladder problems (hard to empty bladder,
Desipramine Norprami weak urine stream, men with enlarged prostate
NU249/NUR2488- Concept Guides- Exam 2
Mood:
Depression
Define common symptoms- memory difficulties, suicidal, worthlessness, helplessness,
anhedonia-loss of pleasurable in things they once loved, anergia-lack of energy.. Severe=not
eating or drinking. Given up. High protein, high calorie diet. Around the clock observation,
suicide=1on1.
Beck’s Cognitive Triad (p. 250)
1.A negative, self-deprecating view of self: “I really never do anything well; everyone else
seems smarter.”
2.A pessimistic view of the world: “Once you're down, you can't get up. Look around,
poverty, homelessness, sickness, war, and despair are every place you look.”
3.The belief that negative reinforcement (or no validation for the self) will continue: “It
doesn't matter what you do; nothing ever gets better. I'll be in this stupid job the rest of
my life.”
Risk for suicide- Questions to ask,
Are you feeling suicidal? Do you have a plan? Do you have the means?
High vs low risk (Ch 23)
Nursing Diagnosis (Table 15-2)
Risk for suicide, self mutilation, decisional conflict, impaired memory, acute confusion,
ineffective coping, interrupted family process, risk for impaired parent/infant/child attachment,
ineffective role performance, hopelessness, chronic low self esteem.
Physical Interventions (Table 15-5)
Nutritional interventions (high calorie meals for those not eating), encourage sleep, emphasize
self care measures.
Medications-
Classes:
SSRI- first line! black box warning=increase suicidal ideation. Selexa, fluoxetineProzac. Don’t
start within 14 days of last MAOI dose=serotonin syndrome-hyperactivity, seizures
Citalopram† Celexa Common side effects Minimal interaction Possible initial anxiety
include: with other drugs,
minimal weight
, NU249/NUR2488- Concept Guides- Exam 2
gain, sedation
•Headache, which
usually dissipates in a few
days Possible initial anxiety
Minimal interaction,
Lexapr
Escitalopram† •Nausea, which sedation, and weight
o 18 yr or older; 12-17 yr
usually dissipates in a few gain for MDD
days
•Sleeplessness and/or Possible interaction
drowsiness during day, with other drugs, initial
Fluoxetine† Prozac which usually dissipates in Activating anxiety
a few weeks (energizing)
8 yr or older
•Tremors and/or
dizziness
8 yr or older for OCD
Fluvoxamine Luvox •Sexual problems:
only
reduces sexual drive,
problems having and
enjoying sex
Weight gain, interacts
Good antianxiety with other meds,
Paroxetine† Paxil •Agitation, feeling
benefit contraindicated in
jittery and nervous; rare
pregnancy
serotonin syndrome; rare
activation of suicidal
ideation
Sertraline† Zoloft
TCA= amitryptiline, imipramine .anticholinergic effects, get dr attention for urinary retention.
Cardiotoxicity with overdose
Amitriptyline Elavil Common side effects include:
•Dry mouth
10 yr or older only
ClomipramineAnafranil
•Constipation for OCD
•Bladder problems (hard to empty bladder,
Desipramine Norprami weak urine stream, men with enlarged prostate
