Nurs 663- Exam 1 Questions With Answers

Nurs 663- Exam 1 Questions With Answers Patient comes in with symptoms of mania followed by periods of depression; what is it? - ANSWER- bipolar 1 patient comes in with hypomania/regular mood (euthymic) followed by periods of depression, what is it? - ANSWER- bipolar 2 how many symptoms of mania must you have to have "full" mania? - ANSWER- seven of thirteen what is the difference between mania and hypomania? - ANSWER- hypomania has less severe symptoms; 3 symptoms over shorter period of time (hypomania) Cyclothymia - ANSWER- a disorder that consists of mood swings from moderate depression to hypomania and lasts two years or more moods are always irregular- not ever to a full extreme Dysthymia - ANSWER- a form of depression that is not severe enough to be diagnosed as major depression "eeyore" always kind of down and depressed SIADH - ANSWER- syndrome of inappropriate antidiuretic hormone will retain water hyponatremia will be observed what is something you should watch out for if a patient is on multiple antidepressants? - ANSWER- SIADH what medical problems mimic mood disorders? - ANSWER- hypothyroid- depression hyperthyroid- mania involuntary admission - ANSWER- hurt yourself hurt someone else inability to care for self Carbamazepine (Tegretol) - ANSWER- mood stabilizer indication: bipolar disorder major side effects: CYP 450: (inducer- speeds up metabolism of other drugs) patient education: what 3 medications must have blood draws associated with them? - ANSWERcarbamazepine, lithium, valproic acid Mood Disorder Questionnaire - ANSWER- Screens for Bipolar Disorder 7+ is a positive screening 4-5 might be hypomania how is the PHQ-9 scored - ANSWER- 1-4 minimal depression 5-9 mild depression 10-14 moderate depression 15-19 moderately severe 20 + severe PHQ-9 - ANSWER- assessment that evaluates the degree of depression What is the DSM criteria for Major Depressive Disorder? - ANSWER- **no history of mania, hypo, or mixed symptoms symptoms >2 weeks must have: sadness, anhedonia (loss pleasure/interest) 4 of following: - appetite/sleep changes, psychomotor retardation, lack of energy, guilt/worthlessness, issues w/ concentration, thoughts suicide/death What are the "frequency" modifiers for MDD? - ANSWER- episodic: symptoms dissipate over time recurrent: likely to reappear in future subclinical: sadness + 3 symptoms > 10 days (full criteria not met) how is the severity of depression rated? - ANSWER- - Mild: no suicidal thoughts/death wishes - Moderate: some thoughts of death/self-harm - Severe: plan/attempted what other modifiers might be present with diagnosis of MDD? - ANSWER- - With psychotic features: hallucinations, paranoia - In partial remission: some symptoms still present, but full criteria not met; period without any significant symptoms lasting less than 2 months - In full remission: no signs/symptoms >2 months - Unspecified: symptoms vague, hard to tell DSM 5 for bipolar I disorder - ANSWER- depression + mania DSM 5 for bipolar 2 disorder - ANSWER- depression + hypomania what is the #1 predictor of suicide? - ANSWER- Hopelessness and loneliness what are risk factors for suicide? - ANSWER- - Gender: men are more likely to complete suicide - Age: men 45 years +; women 55 years + o Suicide is the 3rd leading cause of death in 15-24-year-olds - Race: Caucasian, Native American, Alaskan native, and immigrants - Divorce - Widows - High-ranking jobs and unemployment - Physicians - MDD most common mental illness associated, schizophrenia, and alcohol use disorder - Past suicide attempt (might be the best indicator) what is the criteria for involuntary commitment? - ANSWER- Danger to self (suicide) Danger to others (homicide) Gravely disabled d/t mental illness (unable to provide food, clothing, shelter) - Courts must have probable case hearing within 96 hours of admission