NUR 162 FINAL EXAM 1
- mood/affective disorders
Answer Pervasive alterations in emotions manifested by de- pression, mania, or both
Interference with life; long-term sadness, agitation, or elation
- Etiology of Mood Disorders
Answer Neurotransmitters
Decline in serotonin and norepinephrine
Cognitive
Negative thoughts and rumination (can't let something go) + negative self-talk
Social Skills
Lack of interpersonal skills
- Major Depressive Disorder (MDD)
Answer last at least 2 years
symptoms -depressed mood or loss of pleasure in nearly all activities -changes in eating hypersomnia/insomnia -impaired concentration -inability to cope pessimistic thinking MAOI, SSRIs, atypical
- mania 1 / 4
Answer distinct period during which mood is abnormally and persistently elevated, expansive, or irritable.Typically, this period lasts about 1 week
- S/S of mania
Answer -inflated self-esteem or grandiosity;
-decreased sleep -excessive and pressured speech (unrelenting, rapid, often loud talking without pauses) -flight of ideas (racing, often unconnected, thoughts) -distractibility; increased activity or psychomotor agitation -excessive involvement in pleasure-seeking or risk-taking activities with a high potential for painful consequences.
- Hypomania
Answer period of abnormally and persistently elevated, expansive, or irritable mood and some other milder symptoms of mania.
do not impair the person's ability to function no psychotic features (delusions/hallucinations)
- SSRIs (selective serotonin reuptake inhibitors)
Answer fluoxetine, sertraline, paroxetine, citalopram, escitalopram
blocks reuptake of serotonin Common SE when resolved insomnia decreases in 3 to 4 days, appetite returns to a more normal state in 5 to 7 days, and energy returns in 4
- Fluoxetine /Prozac-SSRI
Answer 2 / 4
Monitor for rash, hives, tremor, insomnia, headache, anxiety, drowsiness, nausea, loss of appetite; avoid alcohol, slightly higher rate of mild agitation
-Monitor for hyponatremia.
- Sertraline (Zoloft) SSRI
Answer SE
Dizziness, sedation, tremor, sexual dysfunction, diarrhea, dry mouth, N/V, diarrhea, headache, insomnia, loss of appetite, and sweating
-avoid alcohol, manic episode (can worsen) -Monitor hyponatremia
- Paroxetine (Paxil) SSRI
Answer SE
Dizziness, sedation, insomnia weakness, fatigue, dry mouth, loss of appetite, N/V, sexual dysfunction, and sweating
-avoid alcohol -Administer with food.
- Citalopram (Celexa) SSRI
Answer SE Drowsiness, insomnia, N/V, weight gain
-Monitor for hyponatremia.-Administer with food.-Administer the dose at 6 p.m. or later.
- Escitalopram (Lexapro) SSRI
Answer Drowsiness, dizziness, weight gain, sexual dys- function, restlessness, dry mouth, headache, 3 / 4
nausea, and diarrhea
-Check orthostatic blood pressure.-Administer with food.
- TCAs (tricyclic antidepressants)
Answer Amitriptyline (Elavil), imipamine, disipramine, nortriptlyine, doxepin
blocks activity of NE and serotonin or increasing sensitivity of postsynaptic receptor site
They relieve symptoms of hopelessness, helplessness, anhedonia, inappropriate guilt, suicidal ideation, and daily mood variations
not for liver impairment or recovery MI cannot be given with MAOIs take4- 6 weeks for full effect but 10-14 days for some effect common SE dry mouth, orthostatic hypotension, tachycardia, insomnia, constipation, weight gain
- Atypical Antidepressants
Answer Used when the client has an inadequate response to or side effects from SSRIs
inhibit reuptake of NE, serotonin and dopamine monitor kidney and liver function bupropion, mirtazapine, duloxetine, venlafaxine,
- Venlafaxine (Effexor)
Answer blocks the reuptake of serotonin, norepinephrine, and dopamine (weakly)
SE Increased blood pressure and pulse, nausea, vomiting, headache, dizziness, drowsiness, dry mouth, and sweating; can alter many lab tests, e.g., AST, ALT, alkaline phosphatase, creatinine, glucose, and electrolytes
- / 4