NUR2459 Mental Health Exam 2

NUR2459 Mental Health Exam 2 Common symptoms of depression (ANS- Anergia, feelings of worthlessness, lack of self esteem, guilt, helplessness, hopelessness, anger and irritability, changes in eating patterns, changes in sleeping patterns, insomnia, hyper insomnia, constipation, decreased libido, chronic pain, lack of concentration and indecisiveness.

Beck's Cognitive Triad (ANS- Believed that people develop depression through psychological predisposition of early life experiences. Even in positive circumstances, Beck believed that depressed people still process things in a negative way. He believed there are three automatic negative thoughts (Becks Cognitive triad).

• A negative, self depreciating view of self.
• A pessimistic view of the world.
• The belief that negative reinforcement will continue.

How Cognitive Behavioral therapy works.(ANS- Changing the way a patient thinks will help relieve depression syndrome.

• Identifying and testing negative cognition.
• Developing alternative thinking patterns.
• Rehearsing new cognitive and behavioral responses.

Risk for suicide- questions to ask (ANS- Ask directly-Are you thinking of or have you been thinking of killing yourself?Ask if the person has a plan- When you think about suicide, do you have a way that you might do this?Determine the lethality of the plan- How detailed is the plan? How lethal is the proposed method? Do they have a gun? 1 / 3

Gather information about risk factors- age, sex, medical problems, unemployment, lives alone.Is there a history of a suicide attempt?Collaborate with other staff involved and come up with a safety plan?Is there anyone that can stay with patient at home?Does this person know the signs of suicidal ideations?

Suicide high risk (ANS- Psychiatric disorder, potentially lethal suicide attempt or persistent ideations with strong intent or suicide rehearsal.-Suicide precautions

Suicide moderate risk (ANS

• Multiple risk factors, suicidal ideations with plan but no intent or behavior. -

Develop crisis plan and give emergency crisis numbers

Suicide low risk (ANS- Modified risk factors, thoughts of death, no plan, no intent or behavior.- Outpatient referral, give emergency crisis numbers.

Nursing Diagnosis for depression (ANS- Risk for suicide Risk for self-mutilation Ineffective coping Hopeless Chronic low self-esteem Impaired social interaction Imbalanced nutrition Constipation Disturbed sleep pattern Spiritual distress Decisional conflict Social isolation Risk for loneliness Self-neglect 2 / 3

Sexual dysfunction

Interventions for depression: Communication

(ANS-

• Help the patient question assumptions and beliefs to reconstruct a healthier and

more hopeful attitude about the future.

2.Help the patient identify cognitive distortions that encourage negative self appraisal: overgeneralization (I have....He always), self-blame (blames self for everything perceived as negative), mind reading (assumes other do not like him without any evidence) discounting of positive attributes ( focuses on the negative).

3.Encourage activities that raise self esteem (problem solving skills, coping skills, assertiveness skills).

• Encourage physical activity- can reduce tension, alleviate depression/anxiety

and improve self concept.

• Encourage formation of supportive relationships- support groups, therapy, peer

support.

• Provide information referrals, when needed, spiritual.

Interventions for depression: Physical-Nutrition/Anorexia

(ANS-

• Offer small, high calorie and high protein snacks and or fluids frequently

throughout the day and evening.

• Encourage family or friends to remain with patient during meals.
• Ask the patient which food or drink she likes- offer choices, involve dietician
• Weigh the patient weekly and observe eating patterns.

Interventions for depression: Physical- Sleep/Insomnia

(ANS-

• Provide periods of rest after activities (fatigue can intensify feelings of

depression)

• Encourage the patient to get up and dressed and to stay out of bed during the

day.

• Encourage the use of relaxation measures in the evening.
• Reduce environmental and physical stimulants in the evening- soft lights, soft

music, quiet activities

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