Mental
Health
N356
Exam
2
What
disorder
goes
hand
in
hand
with
mood
disorders?
-
ANSWER-ANXIETY
Comorbidities:
*substance
abuse
*schizophrenia
*eating
disorders
Medical
diagnoses
often
concurring
with
depression
-
ANSWER-*diabetes
*cancer
*stroke
*epilepsy
*cardiac
disease
Serotonin
Syndrome
-
ANSWER--caused
by
excess
intra-synaptic
serotonin
-
occurs
from
combining
serotonin
enhancing
drugs
-occurs
from
administering
SSRIs
too
close
to
the
discontinuation
of
MAOIs
Serotonin
Syndrome
Symptoms
-
ANSWER--mania
-ataxia,
myoclonus
(muscle
twitiching)
-nausea
-Diarrhea
-Tremors
-headache,
confusion
-diaphoresis
-restlessness
-hyper-reflexia
(over
responsive
reflexes)
Serotonin
syndrome
treatment
-
ANSWER-discontinue
all
serotonin
medication
and
provide
symptomatic
support
Electroconvulsive
Therapy
(ECT)
-
ANSWER--
grand
mal
seizure
caused
by
electrical
currents
via
electrodes
applied
to
temples
-unilateral
application
for
fever
cognitive
SE -bilateral
application
for
severally
ill
Indications
for
ECT
-
ANSWER--postpartum
psychosis
-need
for
rapid
response
-severe
Major
Depression
(90%)
-prior
positive
responses
to
ECT
-depression
with
psychotic
features
-
failure
of
meds
and/or
psychotherapy
-Bi-polar
disorder
unresponsive
to
medication
-Schizophrenia
with
catatonic
or
affective
symptoms
Preparing
pts
for
ECT
-
ANSWER--void
-remove
prostheses
-no
NPO
6-8
hrs
prior
to
treatment
-Pretreatment
lab
tests
Pre
ECT
Medications
-
ANSWER--Iv
injection
of
anesthetic
(brevital
sodium)
-IV
injection
of
muscle
relaxant
(succinylocholine-anctine
25-75
mg)
Risk
of
Suicide
-
ANSWER--prior
episodes
of
depression
-family
history
of
depression
-prior
suicide
attempts
-female
gender
-medical
co-morbidities
-lack
of
social
support
-stressful
life
events
-personal
history
of
sexual
abuse
-current
susbstance
disorder
What
is
important
for
a
nurse
to
assess
when
she
has
a
depressed
patient?
-
ANSWER-Assess
for
suicide
ideation
How
do
we
assess
suicide?
-
ANSWER-Ask
directly
about
any
suicidal
thinking,
impulses
or
past
attempts,
and
personal/family
history
of
suicide
attempts.
Ask
if
they
have
a
plan,
is
it
well
thought
and
can
pt
carry
through?
Health
N356
Exam
2
What
disorder
goes
hand
in
hand
with
mood
disorders?
-
ANSWER-ANXIETY
Comorbidities:
*substance
abuse
*schizophrenia
*eating
disorders
Medical
diagnoses
often
concurring
with
depression
-
ANSWER-*diabetes
*cancer
*stroke
*epilepsy
*cardiac
disease
Serotonin
Syndrome
-
ANSWER--caused
by
excess
intra-synaptic
serotonin
-
occurs
from
combining
serotonin
enhancing
drugs
-occurs
from
administering
SSRIs
too
close
to
the
discontinuation
of
MAOIs
Serotonin
Syndrome
Symptoms
-
ANSWER--mania
-ataxia,
myoclonus
(muscle
twitiching)
-nausea
-Diarrhea
-Tremors
-headache,
confusion
-diaphoresis
-restlessness
-hyper-reflexia
(over
responsive
reflexes)
Serotonin
syndrome
treatment
-
ANSWER-discontinue
all
serotonin
medication
and
provide
symptomatic
support
Electroconvulsive
Therapy
(ECT)
-
ANSWER--
grand
mal
seizure
caused
by
electrical
currents
via
electrodes
applied
to
temples
-unilateral
application
for
fever
cognitive
SE -bilateral
application
for
severally
ill
Indications
for
ECT
-
ANSWER--postpartum
psychosis
-need
for
rapid
response
-severe
Major
Depression
(90%)
-prior
positive
responses
to
ECT
-depression
with
psychotic
features
-
failure
of
meds
and/or
psychotherapy
-Bi-polar
disorder
unresponsive
to
medication
-Schizophrenia
with
catatonic
or
affective
symptoms
Preparing
pts
for
ECT
-
ANSWER--void
-remove
prostheses
-no
NPO
6-8
hrs
prior
to
treatment
-Pretreatment
lab
tests
Pre
ECT
Medications
-
ANSWER--Iv
injection
of
anesthetic
(brevital
sodium)
-IV
injection
of
muscle
relaxant
(succinylocholine-anctine
25-75
mg)
Risk
of
Suicide
-
ANSWER--prior
episodes
of
depression
-family
history
of
depression
-prior
suicide
attempts
-female
gender
-medical
co-morbidities
-lack
of
social
support
-stressful
life
events
-personal
history
of
sexual
abuse
-current
susbstance
disorder
What
is
important
for
a
nurse
to
assess
when
she
has
a
depressed
patient?
-
ANSWER-Assess
for
suicide
ideation
How
do
we
assess
suicide?
-
ANSWER-Ask
directly
about
any
suicidal
thinking,
impulses
or
past
attempts,
and
personal/family
history
of
suicide
attempts.
Ask
if
they
have
a
plan,
is
it
well
thought
and
can
pt
carry
through?
