MENTAL HEALTH 1
The differences between grief and maladaptive grief?
Griefis the normal response to a loss in all totality while maladaptivegrief is a prolonged grief disorder where as a result of an inabilityto express or resolve an earlier grief.
In both books it lists comorbidity of depression with other psychiatric illnesses.
Pickone comorbidity and explain the relationship with depression.
Anexampleof a comorbidity listed by Stuart (2013) is schizophrenia. This is acondition characterized by unusual social behavior and lack ofperception for what is real. This condition is often comorbid withdepression, substance use, anxiety and several other addictions.Patients suffering from this chronic disease usually resisttreatment, and if it remains untreated, it becomes comorbid withother physical and psychological disorders. 3.Review and know the differences between Postpartum blues, post-partumdepression, and post-partum psychosis ,dysthymic disorder, and SAD-seasonal affective disorder. DO not write an answer.
Postpartumblues- also known as maternity blues or baby blues. It is a conditionthat most mothers could experience shortly after childbirth.
Postpartumdepression- is a type of depression common to women and may startduring pregnancy or at any time up to a year after the birth of achild
Postpartumpsychosis-a severe condition of mental illness which develops shortlyafter childbirth.
Dysthymicdisorder- it is a mild type of depression lasting for at least 2years.
SAD-a depression condition related to the changes in seasons. It beginsand ends at about the same times every year.
4.In the ATI book, Under MDD it lists the different phases of treatmentfor this disease. Review the treatment options and especially notethe timetables. Do you agree with this? Explain your answer.
Thefirst phase is the psychiatric management phase. Under this, thevarious options available include establishment and maintaining of atherapeutic alliance which involves collaboration with the patient indecision making. The other option is completing the psychiatricassessment. This is achieved through carrying out a diagnosis toestablish the nature of the depressive disorder. The patient’ssafety need to be evaluated as another option. The risk of suicideneeds to be assessed. The next option is to establish appropriatesettings for the treatment. The other options include evaluating thequality of life, coordinating with other clinicians, monitoring thepatient’s psychiatric status, integrating measurements intopsychiatric management, enhancing treatment adherence and finallyproviding education to the patient and their family. Providingeducation creates awareness about this condition.
Thenext phase is the acute phase. This involves the choice of an initialtreatment modality. The various options available here arepharmacotherapy, other somatic therapies, psychotherapy andanti-depressant medication. In this phase, the adequacy of treatmentresponse should be assessed, and the psychiatrist should put measuresin place to address non-response. The other phase involved in thetreatment of this disease is the continuation phase. This is wherethe patient is monitored for any possible signs of relapse. Patientswith chronic depression cases should proceed to the maintenancephase. This is where maintenance therapy and anti-depressantmedication is conducted. During this phase, patients are monitored atdesignated intervals.
5.Review on pg 100 in ATI- some of the risk factors for MDD and list 3that you found surprising.
Stuart’s(2013), ‘Principlesand Practice of Psychiatric Nursing’ listsseveral risk factors for depression. They are genetics, conflict,alcoholism, serious illnesses, some medications, death or major loss,and abuse. The factors that I found surprising are genetics,alcoholism, and certain medications.6.When assessing a patient for MDD what are some of the subjective datawe look for? Identify what is anergia and anhedonia and anorexia.
Whena patient is being assessed for a major depression disorder, thesubjective data that is searched for includes the feeling of beinginsignificant, lazy speech, somatic complaints, feeling of beingunusual, feeling desperate and likely to commit suicide.
Energiais a condition characterized by a lack of physical activity whileanhedonia is the inability to feel pleasure. Anorexia is an eatingdisorder characterized by low weight.7.What were some of the objective symptoms that you observed inclinical today of patients who were depressed MDD? List at leastfive.
Objectivesymptoms include blocked body movements, slumped sitting position,slow gait, lack of appetite and difficulty in sleeping.8.When working with patients who are depressed- what type of nursingcare interventions did you use or observe others use in clinical thisweek? List at least five.
Nursingcare interventions that were used include:
Assessingclients for clinical symptoms of depression, conceptualizing goalswith the client, providing interventions in depression nursing,communicating emphatically and providing the necessary information.9.Review the antidepressant medications in ATI pg 102. -Nameone of the SSRI meds and what is serotonin syndrome?
Serotoninsyndrome is a type of syndrome that develops due to the use ofcertain serotonergic drugs.
-Nameone of the TCA meds and what is what is a side effect of this med?
sideeffects of this medication are constipation, dizziness, and vomiting.
-Nameone of the MAOI`s meds and what is hypertensive crisis? and whatfoods should be avoided and why?
Hypertensivecrisis is a condition that refers to a severe increase in the bloodpressure and maylead to cases of stroke.
Thefoods to avoid include cheese, liver, yoghurt, and salami. This isbecause these foods are high in tyramine levels that are not safewith MAOIdrugs.-Nameone of the atypical antidepressants and explain any conditions to beaware of.
Not safe to people with heartdisease because these medicationsare linked to heart rhythm problems.
Anothercondition to be aware of is seizures and eating disorders.
10.Treatment options for MDD patients
Serotonin-norepinephrinereuptake inhibitors (SNRIs)
Selectiveserotonin reuptake inhibitors (SSRIs)
Norepinephrine-dopaminereuptake inhibitors (NDRIs)
List three behaviors associated with Bipolar disorder and briefly explain. p 108 ATI
Behaviorsassociated with bipolar disorder include: being socially isolated,being disinterested in activities one used to enjoy and euphoria.These behaviors arise due to extremechanges in mood ranging from deep depression to mania.
Review the various bipolar disorders and be ready to discuss them. No written ans bipolar 1 disorder, bipolar 11 disorders, cyclothymic disorder and other specified and unspecified bipolar disorders.
List some of the comorbidities with Bipolar disorder.
Anxiety,substance use, hyperactivity disorder, personality disorder, andcardiovascular diseases.
Under the list of clinical manifestations ATI pg 110- list any of these that you are not familiar with or need more information especially regarding sleep and circadian rhythms disruption. Bring your questions to class.
Sleepwalking and hypersomnia
Review Table 18-3 and list anything that surprises you or did not know as it relates to Mood disorders.
Itcan be substance or alcohol induced.
List several nursing interventions that are useful with bipolar patients who are exhibiting manic behavior versus hypomanic behavior.
Keepingthe patient under observance every 15 minutes, making them feelworthwhile, engaging the patient in cognitive-behavioral therapy,recommending group therapy to the patient.
Several medications work well with Bipolar patients. Name some of them and one effect and one side effect.
Themedications include mood stabilizers, antidepressants,antipsychotics, and psychotherapy. Common side effects includetrembling, drowsiness, nausea, diarrhea, and vomiting.
List 2-3 items to teach the client and family regarding depression or bipolar disorder.
Theclient needs to be sensitized on the causes, symptoms, treatment ofdepression or bipolar disorder.
Review direct and indirect self-destructive behavior. no written answer needed.
Directself-destructive behavior- this is a suicidal activity of any formlike suicidal threats, gestures, attempts or the act itself where thevictim is fully aware that death is the desired outcome.
Indirectself-destructive behavior- life threatening behavior often repeatedunconsciously but without the intention of death.
Is self-injurious behavior a sign that the person is suicidal?
Self-injuriousbehavior may be an indication that the individual is suicidal as itclearly shows his mental state is not stable.
Review and define the different suicidal behaviors on pg 326 in the textbook.
Thesuicidal behavior includes drug overdose and hanging.
Review the risk factors in ATI pg 284-5- List several that you are unfamiliar with.
Accessto guns, break-ups, and history of suicides in the family.The one I am unfamiliar with is an outbreak in suicides in acommunity.
Review the nursing care list on ATI pg 286. Identify which section you are most comfortable with and why.
Ammore comfortable with the individual care plans section since thisplan is more hands on and specific.
Review the list of medications that can be used to prevent suicide. Why do you think that these type of medications work so well? Review the material on neurotransmitters and what is happening physiologically with this type of patients.
Suicidalpeople should receive immediate treatment in case of an attempt. Theyshould stay in the hospital to reduce the risk of future attempts.Therapy is highly recommended.
Suicidalthoughts in patients are caused by changes in chemicals in the braincalled neurotransmitters like serotonin. In suicidal patients,serotonin is found in decreased levels.
Discuss some of your thoughts about working with a patient who is suicidal or has tried to commit suicide in the past. Would it be hard?
Workingwith a suicidal patient entails being understanding to theirsituation. You need to engage them both physically and mentally. Itis a little difficult, but it requires patience.
Stuart,G. (2013). Principles and Practice of Psychiatric Nursing (10th ed.)St. Louis, MO: Elsevier