Mental Health Depression

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Author:
jtac1911
ID:
12201
Filename:
Mental Health Depression
Updated:
2010-03-28 01:39:07
Tags:
Test 2
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Description:
Mental Health Test 2 Depression
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  1. Depression is:
    • 4th leading cause of diable in US
    • Occurs early as age 3
    • Elderly- Major Health Problem from undiagnosed
  2. Depressive D/O MDD
    • Changes in Px level of function
    • Significant Distress or impairment in social or other functioning levels
    • 5 or more depressive symptoms nearly everyday for most waking hours over 2week period
  3. Depressive D/O DD
    • Occurs over 2 years
    • Significant distress or impairment or social occupational or other areas
    • 2 or more depressive symptoms
  4. Risk Factors: Depression:
    • Prior Hx
    • Family Hx
    • Hx of suicide or Fhx of suicide
    • Female
    • Age <40
    • Postpartum
    • Medical Illness
    • Absence of social support
    • Negative stressful life events
    • Active ETOH or substance Abuse
  5. Nursing Process Application: Assessment
    • Safety
    • Cognitive
    • Behavioral
    • Physical
    • Affect/Mood
    • Thought Process
    • Psychosocial
  6. Plannes Care for Depressed pt.
    • #1= Safety
    • Planning Geared toward phase of depression and symptoms present
    • Combo of therapy most effective
  7. Nursing Interventions
    • Acute Phase: Reduction of depressive symptoms & restoration of psychosocial and work function. MAY REQUIRE HOSPITALIZATION
    • Continuation Phase: Prevention of relapse through pharmacotherapy education & depressive-specific psychotherapy
    • Maintenance Phase: Prevention of further episodes
  8. Specific Interventions for Depression
    • Counseling/Communication
    • Health-Teaching
    • Self-Care Activities
    • Milleu Therapy
    • Psychopharmacology
    • ECT- p269
    • Complementary & Integrative Approaches
  9. Psychopharmacology- SSRI
    • Celexa
    • Lexapro
    • Prozac
    • Luvox
    • Paxil
    • Zoloft
    • First line of Tx
    • Decreased risk of lethal overdose
    • SE: agitation, insomnia, ha, NV, sexual dysfunction, hyponatremia
    • Taper off slowly, quick stopped (dizziness, insomnia, agitation)
  10. Psychopharmacology- TCAs (-il)
    • Elavil
    • Anafranil
    • Norpramin
    • Adapin, Sinequan
    • Tofranil
    • Aventyl, Pamelor
    • Vivactil
    • Can worsen cardiac condition
    • SE: Dry mouth, constipation, urinary retention, blurred vision, orthostatic hypotension, cardiac toxicity, sedation, tachycardia)
    • Anticholinergic Effect
    • High Sedation
    • Non-addictive
    • Lethal Overdose
    • Contraindications: cardiac d/o, elevated intraocular pressure, urinary retention, hyperthyroidism, sz d/o, liver/kidney d/o
  11. Psychopharmacology- MAOIs
    • Nardil
    • EMSAM patch
    • Parnate
    • SE: wt gain, edema, insomnia, agitation, confusion, nausea
    • Avoid tyramine rich foods (avocados, soybean, figs, bananas, smoked fermented meats liver, bologna, pepperoni, salami, smoked or cured fish, all chesse, yeast extract, chianti wine, imported beer, soy sauce)

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