NSG 350 Mental Health Nursing Exam 2 Study Guide

Mental Health Nursing Exam 2 Study Guide Chapters 18-20, 23, 26, 35-37 Be Familiar with the following:  Differentiate between depression and bipolar disorders ( ex MDD, SAD, dysthymia) o MDD  Presence of auditory ...

Mental Health Nursing Exam 2 Study Guide Chapters 18-20, 23, 26, 35-37 Be Familiar with the following:  Differentiate between depression and bipolar disorders ( ex MDD, SAD, dysthymia) o MDD  Presence of auditory hallucinations-voices telling the client he/she is sinful  Presence of delusions-client thins that he/she has a fatal disease o Postpartum depression-begins within 4 weeks of childbirth o May include delusions  This may put the newborn infant at high risk of being harmed by the mother  Seasonal Affective Disorder (SAD)-that could last over 2 years  Occurs during winter  Possibly treated with light therapy  Dysthymic Disorder  A milder form of depression that usually has an early onset (childhood or adolescence  Last 2 years in length for adults  1 year in children  Pharmacological treatment for mood disorders and antidepressants. Class of antidepressants and side effects, nursing considerations, contraindications & precautions. Understand mood disorder pharmacological treatments, side effects, nursing considerations. o Psychopharmacology  Tricyclic Antidepressants o Amitriptyline (Elavil) o Clomipramine (Anafranil) o Doxepin (Sinequan) o Imipramine (Tofranil) o Trimipramine (Surmontil) o Nortriptyline (Pamelor) o Amoxapine (Asendin) Action is to block the reuptake of norepinephrine and serotonin in the synaptic space Uses  Depressive disorders  Fibromyalgia  Neuropathic Pain  Anxiety Disorders  Insomnia Side Effects o Orthostatic hypotension o Anticholinergic effets (can’t see, can’t pee, can’t spit, can’t poop) o Sedation o Toxicity resulting in cholinergic blockade and cardia toxicity evidenced by o Dysrhythmias 2 Mental Health Nursing Exam 2 Study Guide Chapters 18-20, 23, 26, 35-37 o Mental confusion o Agitation which are followed by  Seizures  Coma  Possible death Contraindications  Coronary artery disease  Liver disorders  Respiratory disorders  Angle closure glaucoma  Diabetes  Kidney disorders  Hyperthyroidism  BPH Selective Serotonin Reuptake Inhibitors Drugs  Fluoxetine (Prozac)  Citalopram (Celexa)  Escitalopram (Lexapro)  Paroxetine (Paxil)  Sertraline (Zoloft)  Vilazodone (Viibryd) Action  SSRI’s block the reuptake of the neurotransmitter serotonin in the synaptic space o Intensifies the effects of serotonin Uses  Major depression  OCD  Bulimia Nervosa  Premenstrual Dysphoric Disorders  Panic Disorders  PTSD Side Effects  Sexual dysfunction: o Anorgasmia o Impotence o Decreased libido  May need another med with fewer SE (Wellbutrin)  CNS stimulation: o Inability to sleep o Agitation o Anxiety-take medication in the AM 3 Mental Health Nursing Exam 2 Study Guide Chapters 18-20, 23, 26, 35-37 o Occurrence of weight loss early in therapy that may cause weight gain with long term treatment o Withdrawal syndrome: Antidepressant discontinuation syndrome: FINISH  Flu-like symptoms  Insomnia  Nausea  Imbalance  Sensory disturbances  Hyperarousal (anxiety/agitation) Contraindications  Fluoxetine (Prozac) is a pregnancy risk category C  Fluoxetine (Prozac) and Paroxetine (Paxil):  May increase the risk of birth defects-Other SSRI’s should be used  Late in pregnancy, use of SSRI’s may:  Increase the risk of withdrawal symptoms or pulmonary hypertension in the newborn.  Concurrent use with MAOI’s, TCA’s and St. Johns Wort o Increases the risk of serotonin syndrome o Concurrent use with warfarin (Coumadin) o Monoamine Oxidase Inhibitors  These medications block MAO in the brain  Increasing the amount of norepinephrine, dopamine, and serotonin available for transmission of impulses  An increased amount of these neurotransmitters at nerve endings intensifies the responses and relieves depression  Used to treat:  Depression  Bulimia nervosa  Drugs for treatment  MAOIs to treat de