NURS 5461 Depression Exam With Accurate Answers
(A+) Newest 100% Verified
GROUP THERAPY FOR DEPRESSION - ANSWER Is beneficial for the person who has
issues in maintaining or experiencing relationship difficulties with others. ▪ Merges the
individual's goals along with others within the group which, in itself is supportive since a
person would feel like part of the group. ▪ Good to be with a group of people with
similar struggles. Members sometimes give validation and support for an individual
dealing with the same issues, and struggling to get over depression due to similar
causes: loss of a loved one, or a new diagnosis.
FAMILY THERAPY FOR DEPRESSION - ANSWER Illness in one family member may be a
symptom of a larger family problem. helps the family focus less on the member who has
been identified as ill and focus more on the family as a whole; teaches ways to handle
conflicts and changes within the family differently.
LIGHT THERAPY USED FOR SAD - ANSWER sit in front of a light box built to deliver more
light to the eyes. It is fitted with a special fluorescent light which has a plastic diffuser on
top to filter out ultra violet light for 15 minutes up to 1 1/2 hour each day
Guidelines for Antidepressant management - ANSWER See patient weekly for side
effect, symptom monitoring. Use objective measurements such as depression scales to
guide decision-making (outcomes) ▪ If only 20% improvement in 4-6 weeks: maximize
dose before switching to another antidepressant, must be symeptom free for6-12m b4
taper
Refer to psych - ANSWER ▪Failure to respond to normal dosing ▪Severe suicidal
features ▪Pregnancy ▪Severe impairment needing hospitalization ▪Coexisting medical
problems ▪Psychosis or bipolar disorder ▪OCD, eating disorder, substance abuse
▪Lack of time to see regularly
TCA's - ANSWER Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine,
doxepin, amoxapine.
, THIRD to FOURTH line treatments now ▪Side effects: ▪Muscarinic (anticholinergic)
▪Alpha 1: postural hypotention ▪H1: weight gain, sedation ▪Toxicity: ▪Prolongs QTc
on EKG (cardiac toxicity) ▪> 1000 mg overdose can cause death (risk of death if OD
-give only 1 week at a time)
SSRI's- ANSWER Fluoxetine, paroxetine, sertraline, citalopram (celexa)▪First line
treatment for depression ▪Safer in suicide attempt than tricyclic antidepressants
▪Less cardiac toxicity ▪Start low in patients with anxiety disorder-used for GAD but can
activate anxiety, also can activate mania so caution in Bipolar
SSRI how do they work? - ANSWER Immediate blockade of serotonin transporter on
axon terminals in areas of serontonergic neuron ▪Delayed down
regulation/desensitization of serotonin receptors ▪Delayed "turning off" of serotonin
release from axon terminals
SSRI SA ANSWER ▪Nausea/Vomiting/Diarrhea, especially Zoloft;▪Sexual Dysfunction
ranging from problems with libido to problems with ejaculation/ anorgasmia; less c
Viibryd ▪Mild akathisia restless; sweating, tremor ▪Weight gain over time except for
Prozac ▪Lethargy and fatigue especially Celexa; Paxil, take at HS ▪Discontinuation
syndrome - especially Paxil; less with Prozac; same as TCAs ▪Pregnancy concerns:
cardiac issues; many in first trimester; persistent pulmonary hypertension for baby c
Paxil D, in 3rd trimester. Know pregnancy risk categories!
Serotonin WD syndrome - ANSWER ▪Flu like symptoms when abruptly stopping most
SSRIs. ▪Taper off of these meds slowly: especially **paxil ▪No risk with Prozac due to
long half life
serotonin syndrome - ANSWER too much serotonin-medical emergency Mental status
changesconfusion ▪Myoclonus- muscle twitching ▪Shivering ▪Hypomania
▪Hallucinations ▪Headaches ▪Sweating ▪Hyperthermia ▪Muscular rigidity ▪Tremor
▪Nausea/Diarrhea ▪Hypertension/ tachycardia ▪Hyperreflexia: clonus ▪Death
causes of Serotonin Syndrome - ANSWER ▪Triptans- 5HT agonist for migraines*
▪MAOIs ▪SNRIs ▪St. John's Wort ▪Panex ginseng ▪Nutmeg ▪Tryptophan ▪Buspirone
(A+) Newest 100% Verified
GROUP THERAPY FOR DEPRESSION - ANSWER Is beneficial for the person who has
issues in maintaining or experiencing relationship difficulties with others. ▪ Merges the
individual's goals along with others within the group which, in itself is supportive since a
person would feel like part of the group. ▪ Good to be with a group of people with
similar struggles. Members sometimes give validation and support for an individual
dealing with the same issues, and struggling to get over depression due to similar
causes: loss of a loved one, or a new diagnosis.
FAMILY THERAPY FOR DEPRESSION - ANSWER Illness in one family member may be a
symptom of a larger family problem. helps the family focus less on the member who has
been identified as ill and focus more on the family as a whole; teaches ways to handle
conflicts and changes within the family differently.
LIGHT THERAPY USED FOR SAD - ANSWER sit in front of a light box built to deliver more
light to the eyes. It is fitted with a special fluorescent light which has a plastic diffuser on
top to filter out ultra violet light for 15 minutes up to 1 1/2 hour each day
Guidelines for Antidepressant management - ANSWER See patient weekly for side
effect, symptom monitoring. Use objective measurements such as depression scales to
guide decision-making (outcomes) ▪ If only 20% improvement in 4-6 weeks: maximize
dose before switching to another antidepressant, must be symeptom free for6-12m b4
taper
Refer to psych - ANSWER ▪Failure to respond to normal dosing ▪Severe suicidal
features ▪Pregnancy ▪Severe impairment needing hospitalization ▪Coexisting medical
problems ▪Psychosis or bipolar disorder ▪OCD, eating disorder, substance abuse
▪Lack of time to see regularly
TCA's - ANSWER Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine,
doxepin, amoxapine.
, THIRD to FOURTH line treatments now ▪Side effects: ▪Muscarinic (anticholinergic)
▪Alpha 1: postural hypotention ▪H1: weight gain, sedation ▪Toxicity: ▪Prolongs QTc
on EKG (cardiac toxicity) ▪> 1000 mg overdose can cause death (risk of death if OD
-give only 1 week at a time)
SSRI's- ANSWER Fluoxetine, paroxetine, sertraline, citalopram (celexa)▪First line
treatment for depression ▪Safer in suicide attempt than tricyclic antidepressants
▪Less cardiac toxicity ▪Start low in patients with anxiety disorder-used for GAD but can
activate anxiety, also can activate mania so caution in Bipolar
SSRI how do they work? - ANSWER Immediate blockade of serotonin transporter on
axon terminals in areas of serontonergic neuron ▪Delayed down
regulation/desensitization of serotonin receptors ▪Delayed "turning off" of serotonin
release from axon terminals
SSRI SA ANSWER ▪Nausea/Vomiting/Diarrhea, especially Zoloft;▪Sexual Dysfunction
ranging from problems with libido to problems with ejaculation/ anorgasmia; less c
Viibryd ▪Mild akathisia restless; sweating, tremor ▪Weight gain over time except for
Prozac ▪Lethargy and fatigue especially Celexa; Paxil, take at HS ▪Discontinuation
syndrome - especially Paxil; less with Prozac; same as TCAs ▪Pregnancy concerns:
cardiac issues; many in first trimester; persistent pulmonary hypertension for baby c
Paxil D, in 3rd trimester. Know pregnancy risk categories!
Serotonin WD syndrome - ANSWER ▪Flu like symptoms when abruptly stopping most
SSRIs. ▪Taper off of these meds slowly: especially **paxil ▪No risk with Prozac due to
long half life
serotonin syndrome - ANSWER too much serotonin-medical emergency Mental status
changesconfusion ▪Myoclonus- muscle twitching ▪Shivering ▪Hypomania
▪Hallucinations ▪Headaches ▪Sweating ▪Hyperthermia ▪Muscular rigidity ▪Tremor
▪Nausea/Diarrhea ▪Hypertension/ tachycardia ▪Hyperreflexia: clonus ▪Death
causes of Serotonin Syndrome - ANSWER ▪Triptans- 5HT agonist for migraines*
▪MAOIs ▪SNRIs ▪St. John's Wort ▪Panex ginseng ▪Nutmeg ▪Tryptophan ▪Buspirone
