How do biochemical factors effect depression?
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Biochemical factors: changes in the neurotransmitters and the límbic
system, hypothalamus, prefrontal cortex, hippocampus and amygdala. Low
serotonin and norepinephrine, and dysfunction in glutamate, dopamine,
GABA and acetylcholine.
*PET scan reveals a less active brain
What are the causes of depression?
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, Genetics
Biochemical factors
Stressful life situations
Diathesis-stress model
Cognitive theory
Learned helplessness
What are side effects and potential long term effects or electroconvulsive therapy?
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Confusion and disorientation, headache, body soreness, nausea and short
term memory loss
*patient not to drive for 24 hours post ECT
•anterograde: difficulty remembering new things
•retrograde: difficulty remembering memories before/leading up to the
event (up to 6 months)
•amnesia
*ECT does NOT cause brain damage
What are nursing considerations for lithium?
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•blood levels are drawn before first morning dose (10-12 hours after the last
dose)
•should be taken with meals to reduce nausea
•usually contraindicated with renal disease, thyroid disease, cardiovascular
disease and in pregnancy
•major long terms side effects: hypothyroidism and kidney impairment to
concentrate urine
•the body cannot distinguish between lithium and sodium (inverse
relationship) decreased sodium increases lithium and increased sodium
, decreased lithium. Do not take diuretics or NSAIDS. Stop taking if
experiencing diarrhea, vomiting or sweating.
What are some mental status assessment findings in patients with bipolar disorder?
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•appearance: inappropriate dress, bizarre garb, disheveled
•speech: rapid, pressured, loud, disorganized, flight of ideas, clang,
incoherent
•mood: irritable, angry, elevated mood, euphoria, depression
•hallucinations/delusions: altered sensory perceptions, paranoia,
grandiosity
•disruptive behavior: sarcastic, guarded, demanding, threatening behavior,
assaultive
•insight/judgement, impaired: hypersexual, intrusive, in depression:
unrealistically negative
Assess physiological safety: dehydration, cardiac status, not eating, not
sleeping, wether patient is a danger to self or others: poor impulse control,
inappropriate sexual activity, anger
Assess for coexisting conditions: substance abuse, cardiac problems,
financial crisis, family crisis
What is the stress-diathesis model of depression?
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A biopsychosocial theory that explains depression from an environmental,
interpersonal and life-events perspective (stress) combined with biological
vulnerability/predisposition (diathesis). States that stressful events can
cause brain changes that lead to depression in a vulnerable brain.
, What are obsessions?
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Thoughts, impulses or images that persist and recur so they cannot be
dismissed from the mind. They are often senseless but still cause anxiety.
•hurting a loved one
•fear of contamination
•needing things to be symmetrical
What are the three types of bipolar disorders and their characteristics?
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•BP 1: characterized by at least one episode of mania, commonly includes
major depressive episodes and psychosis. Marked impairment of social and
occupational functioning.
•BP 2: characterized by at least one period of hypomania (never full mania)
alternating with one or more periods of depression.
•Cyclothymic disorder: characterized by alternating hypomania and
dysthymia (not major depression) for at least 2 years duration.
What is obsessive-compulsive personality disorder
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Characterized by a preoccupation with orderliness, perfection, and mental
and personal control even at the expense of openness or efficiency. They
are inflexible, poor at delegation and high achievers. Their devotion to work
may exclude pleasurable activities and relationships.
Treatment:
Give this one a try later!
Biochemical factors: changes in the neurotransmitters and the límbic
system, hypothalamus, prefrontal cortex, hippocampus and amygdala. Low
serotonin and norepinephrine, and dysfunction in glutamate, dopamine,
GABA and acetylcholine.
*PET scan reveals a less active brain
What are the causes of depression?
Give this one a try later!
, Genetics
Biochemical factors
Stressful life situations
Diathesis-stress model
Cognitive theory
Learned helplessness
What are side effects and potential long term effects or electroconvulsive therapy?
Give this one a try later!
Confusion and disorientation, headache, body soreness, nausea and short
term memory loss
*patient not to drive for 24 hours post ECT
•anterograde: difficulty remembering new things
•retrograde: difficulty remembering memories before/leading up to the
event (up to 6 months)
•amnesia
*ECT does NOT cause brain damage
What are nursing considerations for lithium?
Give this one a try later!
•blood levels are drawn before first morning dose (10-12 hours after the last
dose)
•should be taken with meals to reduce nausea
•usually contraindicated with renal disease, thyroid disease, cardiovascular
disease and in pregnancy
•major long terms side effects: hypothyroidism and kidney impairment to
concentrate urine
•the body cannot distinguish between lithium and sodium (inverse
relationship) decreased sodium increases lithium and increased sodium
, decreased lithium. Do not take diuretics or NSAIDS. Stop taking if
experiencing diarrhea, vomiting or sweating.
What are some mental status assessment findings in patients with bipolar disorder?
Give this one a try later!
•appearance: inappropriate dress, bizarre garb, disheveled
•speech: rapid, pressured, loud, disorganized, flight of ideas, clang,
incoherent
•mood: irritable, angry, elevated mood, euphoria, depression
•hallucinations/delusions: altered sensory perceptions, paranoia,
grandiosity
•disruptive behavior: sarcastic, guarded, demanding, threatening behavior,
assaultive
•insight/judgement, impaired: hypersexual, intrusive, in depression:
unrealistically negative
Assess physiological safety: dehydration, cardiac status, not eating, not
sleeping, wether patient is a danger to self or others: poor impulse control,
inappropriate sexual activity, anger
Assess for coexisting conditions: substance abuse, cardiac problems,
financial crisis, family crisis
What is the stress-diathesis model of depression?
Give this one a try later!
A biopsychosocial theory that explains depression from an environmental,
interpersonal and life-events perspective (stress) combined with biological
vulnerability/predisposition (diathesis). States that stressful events can
cause brain changes that lead to depression in a vulnerable brain.
, What are obsessions?
Give this one a try later!
Thoughts, impulses or images that persist and recur so they cannot be
dismissed from the mind. They are often senseless but still cause anxiety.
•hurting a loved one
•fear of contamination
•needing things to be symmetrical
What are the three types of bipolar disorders and their characteristics?
Give this one a try later!
•BP 1: characterized by at least one episode of mania, commonly includes
major depressive episodes and psychosis. Marked impairment of social and
occupational functioning.
•BP 2: characterized by at least one period of hypomania (never full mania)
alternating with one or more periods of depression.
•Cyclothymic disorder: characterized by alternating hypomania and
dysthymia (not major depression) for at least 2 years duration.
What is obsessive-compulsive personality disorder
Give this one a try later!
Characterized by a preoccupation with orderliness, perfection, and mental
and personal control even at the expense of openness or efficiency. They
are inflexible, poor at delegation and high achievers. Their devotion to work
may exclude pleasurable activities and relationships.
Treatment:
