NURS 6501 FINAL EXAM
Whatooisootheooroleooofootheooprimaryoocareooproviderooinoomentaloohealth?oo-ooans---
ooScreenooforoomentaloohealthooissues
-ooImproveoooutcomesooandooreduceoohealthoocareoocosts
-ooAssessooandoogiveoocareootooomild-
moderateoodisordersoooroopatientsoowithoostableoosevereoomentaloodisorders
-ooFromoostrongoolinksoowithoomentaloohealthoospecialtyoocareooforoocomplexoocases
Sharingoopatientooinfooo(ex:oomedsooused)
aboutooPHQ2
-oowhatoodoesooitooscreenoofor,oowhatooareootheooquestions,ooscoringoo-ooans---
ooScreensooforooMDD
-ooItooisootheoofirstootwoooquestionsooofootheooPHQ9
-
ooInootheoolastootwoooweek,oohaveooyouoobeenoofeelingootheseoo(notooatooall,ooseveralooda
ys,oomoreoothanoohalfootheooday,oonearlyooeveryday):
-ooLittleoointerestoooroopleasureooinoodoingoothings?
-ooFeelingoodown,oodepressed,oooroohopeless?
Scoring:
Aoosingleooyesooorooscoreoo>3oo(outooofoo0-
6)oo=oopossibleooclinicaloodepressionoo⇒oodueootheooPHQ9
Ifootheooptooscreensoo(+)oo⇒oocontinueootoooevaloowithootheooPHQ9
aboutooPHQ9
-oowhatooitsoousedoofor,ooquestions,ooscoringoo-ooans--
Usedooforooscreening,oodiagnosing,ooandootreating
-ooItooasksooaboutoofunctioningooimpairmentsoowhichooisooneededooforootheooDSM-
basedoodiagnosis
Includesooaskingooaboutoosuicideoooroohurtingooself
Scoring:
0-27ooavailable
0-4:ooMinimal/none
Monitor;oomayoonotoorequireootreatment
5-9:ooMild
Useooclinicaloojudgment;oofollow-upooinoooneoomonth
, 10-14:ooModerate
Useooclinicaloojudgment;oomayooneedoomedsooifoofunctionallyooimpaired
15-19:ooModeratelyooSevere
Warrantsooactiveootreatmentoowithoopsychotherapy,oomeds,oooroocombo
20-27:ooSevere
Warrantsooactiveootreatmentoowithoopsychotherapy,oomeds,oooroocombo
Whatooisootheooappropriateooinitiationoodoseooforoofluoxetineooforooadultsooandoogeriatricoo
adults?oo-ooans--20mgooPOooonceoodailyooinootheooAM
-ooMayoo↑oodailyoodoseooafterooseveralooweeksooifooinadequateooresponse
-ooFullootherapeuticooeffectoomayoobeoodelayedoo4ooweeksoooroolonger
-ooMaxoodose:oo80mg/day
Whatoolabsoowouldoobeooappropriateootooodrawooifooyouooinitiateoofluoxetineooinooaoogeriat
ricoopatient?oo-ooans--Sodiumoolevels
-ooBaselineooscreeningoo&ooafteroo3-4ooweeksooinoohigh-
riskoopatientsoo(>oo65yrs,oopreviousoohxooofooantidepressant-
inducedoohyponatremia,oolowoobodyooweight,ooconcomitantoouseooofoothiazidesooorooothe
roohyponatremia-inducingooagents)
-oomonitorooregularlyooinootheooelderly
WhatooareoopotentialoosideooeffectsooofooSSRIoomedications?
-oowhatooareootheoocommonooSSRIs,ooLEAPooofoothem,ooandoozoloftooAEoo-ooans--
CommonooSSRIs:
Lexapro,oocelexa,oopaxil,oozoloft,ooprozac
Loo=oodecreasedoolibidoooandoosleep
Eoo=ooNeutralooeffectooonooenergy
Aoo=ooneuralooeffectooonooaddiction
Poo=oocelexaoomayoostopooworkingooafterooawhileoo(increaseooorooswitch)
ZoloftooAE:
Insomnia,oosomnolence,oofatigue,ooabnormalooejaculation,oosuicidaloothoughts
WhatooareoocharacteristicsooofoomajoroodepressiveoodisorderooorooMDD?oo9oo-ooans--
Diagnosticsooneedoo5oooroomoreooofootheoofollowing:
-ooSSoooccuroomoreoodaysoothanoonotooinooaoo2ooweekooperiod
-ooSSoocauseoosignificantooimpairmentooinooanyoorealmooofoofunctioning
-ooDepressedoomood
-ooLossooofoointerest
-ooSignificantoounintendedoo▲ooinooweightooorooappetite
-ooSignificantoo▲oosleep
-oo▲oopsychomotorooactivityoo(restlessness)
-ooFatigue,oolossooofooenergy
-ooWorthlessness,ooguilt
Whatooisootheooroleooofootheooprimaryoocareooproviderooinoomentaloohealth?oo-ooans---
ooScreenooforoomentaloohealthooissues
-ooImproveoooutcomesooandooreduceoohealthoocareoocosts
-ooAssessooandoogiveoocareootooomild-
moderateoodisordersoooroopatientsoowithoostableoosevereoomentaloodisorders
-ooFromoostrongoolinksoowithoomentaloohealthoospecialtyoocareooforoocomplexoocases
Sharingoopatientooinfooo(ex:oomedsooused)
aboutooPHQ2
-oowhatoodoesooitooscreenoofor,oowhatooareootheooquestions,ooscoringoo-ooans---
ooScreensooforooMDD
-ooItooisootheoofirstootwoooquestionsooofootheooPHQ9
-
ooInootheoolastootwoooweek,oohaveooyouoobeenoofeelingootheseoo(notooatooall,ooseveralooda
ys,oomoreoothanoohalfootheooday,oonearlyooeveryday):
-ooLittleoointerestoooroopleasureooinoodoingoothings?
-ooFeelingoodown,oodepressed,oooroohopeless?
Scoring:
Aoosingleooyesooorooscoreoo>3oo(outooofoo0-
6)oo=oopossibleooclinicaloodepressionoo⇒oodueootheooPHQ9
Ifootheooptooscreensoo(+)oo⇒oocontinueootoooevaloowithootheooPHQ9
aboutooPHQ9
-oowhatooitsoousedoofor,ooquestions,ooscoringoo-ooans--
Usedooforooscreening,oodiagnosing,ooandootreating
-ooItooasksooaboutoofunctioningooimpairmentsoowhichooisooneededooforootheooDSM-
basedoodiagnosis
Includesooaskingooaboutoosuicideoooroohurtingooself
Scoring:
0-27ooavailable
0-4:ooMinimal/none
Monitor;oomayoonotoorequireootreatment
5-9:ooMild
Useooclinicaloojudgment;oofollow-upooinoooneoomonth
, 10-14:ooModerate
Useooclinicaloojudgment;oomayooneedoomedsooifoofunctionallyooimpaired
15-19:ooModeratelyooSevere
Warrantsooactiveootreatmentoowithoopsychotherapy,oomeds,oooroocombo
20-27:ooSevere
Warrantsooactiveootreatmentoowithoopsychotherapy,oomeds,oooroocombo
Whatooisootheooappropriateooinitiationoodoseooforoofluoxetineooforooadultsooandoogeriatricoo
adults?oo-ooans--20mgooPOooonceoodailyooinootheooAM
-ooMayoo↑oodailyoodoseooafterooseveralooweeksooifooinadequateooresponse
-ooFullootherapeuticooeffectoomayoobeoodelayedoo4ooweeksoooroolonger
-ooMaxoodose:oo80mg/day
Whatoolabsoowouldoobeooappropriateootooodrawooifooyouooinitiateoofluoxetineooinooaoogeriat
ricoopatient?oo-ooans--Sodiumoolevels
-ooBaselineooscreeningoo&ooafteroo3-4ooweeksooinoohigh-
riskoopatientsoo(>oo65yrs,oopreviousoohxooofooantidepressant-
inducedoohyponatremia,oolowoobodyooweight,ooconcomitantoouseooofoothiazidesooorooothe
roohyponatremia-inducingooagents)
-oomonitorooregularlyooinootheooelderly
WhatooareoopotentialoosideooeffectsooofooSSRIoomedications?
-oowhatooareootheoocommonooSSRIs,ooLEAPooofoothem,ooandoozoloftooAEoo-ooans--
CommonooSSRIs:
Lexapro,oocelexa,oopaxil,oozoloft,ooprozac
Loo=oodecreasedoolibidoooandoosleep
Eoo=ooNeutralooeffectooonooenergy
Aoo=ooneuralooeffectooonooaddiction
Poo=oocelexaoomayoostopooworkingooafterooawhileoo(increaseooorooswitch)
ZoloftooAE:
Insomnia,oosomnolence,oofatigue,ooabnormalooejaculation,oosuicidaloothoughts
WhatooareoocharacteristicsooofoomajoroodepressiveoodisorderooorooMDD?oo9oo-ooans--
Diagnosticsooneedoo5oooroomoreooofootheoofollowing:
-ooSSoooccuroomoreoodaysoothanoonotooinooaoo2ooweekooperiod
-ooSSoocauseoosignificantooimpairmentooinooanyoorealmooofoofunctioning
-ooDepressedoomood
-ooLossooofoointerest
-ooSignificantoounintendedoo▲ooinooweightooorooappetite
-ooSignificantoo▲oosleep
-oo▲oopsychomotorooactivityoo(restlessness)
-ooFatigue,oolossooofooenergy
-ooWorthlessness,ooguilt