SCF LEVEL 2 EXAM 2 DEPRESSION SOLVED
At what point would you administer MAOIs? - ANSWER-if they were unresponsive to
taking other antidepressant agents
DSM-5 Major Depressive Disorder - ANSWER-At least 1 or 2
1. Depressed mood
2. Anhedonia
- Weight loss/ appetite changes
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- worthlessness or inappropriate guilt
- Diminished ability to think/concentrate
- Recurrent thoughts of death
◦Must not meet other criteria (e.g. mixed episode)
◦Must cause clinically significant distress/impairment in social, occupational or other
functioning
◦Not due to substance or medical condition
How long does imipramine take to work? - ANSWER-2-6 weeks for therapeutic effect
How long does it take for sertraline to work? - ANSWER-up to 4 weeks before full
benefit
Important considerations for the nursing assessment of a patient with depression -
ANSWER-• assess for symptoms of depression and also for history of manic episodes.
- manic episode may imply a bipolar diagnosis
• assess for comorbidities
- rule out possibility of underlying medical condition
(life threatening illness diagnosis may lead to depression)
• certain drugs can complicate depression
- matter of fact questioning
- prescription medications
• assessment of children
- rule out physical illness
- question parents and caregivers
(ex. when did their mood start?
- initial diagnostic evaluation: child psychologist
- useful tools: children's depression inventory 2 & becks depression inventory
• assessment of older adults
, - may be challenging due to POLYPHARMACY
- geriatric depression scale: used w/ cognitive impairments
- cornell depression scale: adults w/ severe cognitive impairments
List risk factors for depression - ANSWER-◦History of abuse, neglect, loss
◦Females
◦Age 65+, teenagers
◦Stressful life events, significant losses
◦Poor social support; being unmarried
- ages 37-49 who are single
◦Dysfunctional family relationships
◦Family or previous personal history of mental illness, substance abuse
◦Poor socioeconomic class
Major Depressive Disorder (MDD) - ANSWER-Change in several aspects of an
individuals emotional state and functioning.
◦2 WEEKS
Single episode or reoccurring
- typically exogenous factor
Severe Cases: may cause catatonic state, psychosis and extreme manifestations
Feelings of:
- sadness
- discouragement
- hopelessness
- increased anger
- somatic complaints (GI upset, headaches)
Nonpharmacologic Therapy for Depression - ANSWER-◦Electroconvulsive therapy
(ECT)
- for severe depression
◦Transcranial magnetic stimulation
- specifically targets areas of the brain relating to mood regulation
◦Alternative or Complementary therapies
- St. John's Wort
At what point would you administer MAOIs? - ANSWER-if they were unresponsive to
taking other antidepressant agents
DSM-5 Major Depressive Disorder - ANSWER-At least 1 or 2
1. Depressed mood
2. Anhedonia
- Weight loss/ appetite changes
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- worthlessness or inappropriate guilt
- Diminished ability to think/concentrate
- Recurrent thoughts of death
◦Must not meet other criteria (e.g. mixed episode)
◦Must cause clinically significant distress/impairment in social, occupational or other
functioning
◦Not due to substance or medical condition
How long does imipramine take to work? - ANSWER-2-6 weeks for therapeutic effect
How long does it take for sertraline to work? - ANSWER-up to 4 weeks before full
benefit
Important considerations for the nursing assessment of a patient with depression -
ANSWER-• assess for symptoms of depression and also for history of manic episodes.
- manic episode may imply a bipolar diagnosis
• assess for comorbidities
- rule out possibility of underlying medical condition
(life threatening illness diagnosis may lead to depression)
• certain drugs can complicate depression
- matter of fact questioning
- prescription medications
• assessment of children
- rule out physical illness
- question parents and caregivers
(ex. when did their mood start?
- initial diagnostic evaluation: child psychologist
- useful tools: children's depression inventory 2 & becks depression inventory
• assessment of older adults
, - may be challenging due to POLYPHARMACY
- geriatric depression scale: used w/ cognitive impairments
- cornell depression scale: adults w/ severe cognitive impairments
List risk factors for depression - ANSWER-◦History of abuse, neglect, loss
◦Females
◦Age 65+, teenagers
◦Stressful life events, significant losses
◦Poor social support; being unmarried
- ages 37-49 who are single
◦Dysfunctional family relationships
◦Family or previous personal history of mental illness, substance abuse
◦Poor socioeconomic class
Major Depressive Disorder (MDD) - ANSWER-Change in several aspects of an
individuals emotional state and functioning.
◦2 WEEKS
Single episode or reoccurring
- typically exogenous factor
Severe Cases: may cause catatonic state, psychosis and extreme manifestations
Feelings of:
- sadness
- discouragement
- hopelessness
- increased anger
- somatic complaints (GI upset, headaches)
Nonpharmacologic Therapy for Depression - ANSWER-◦Electroconvulsive therapy
(ECT)
- for severe depression
◦Transcranial magnetic stimulation
- specifically targets areas of the brain relating to mood regulation
◦Alternative or Complementary therapies
- St. John's Wort
