Mood disorders

Question 1

what are 2 parts of bipolar disorder?

Answer 1

depression and mania

Question 2

in order to avoid lithium toxicity, the client must maintain adequate___ and ___ intake

Answer 2

sodium and water

Question 3

what are the most important interventions for a manic episode?

Answer 3

1- keep the person safe. remove hazardous objects from the place

2- give them a private room if possible (limit group activities)

3- reduce environmental stimuli

4- provide high calorie finger foods (since thy won’t sit still)

5- avoid competitive games

6- provide gross motor movements like walking

Question 4

in depression, patients may experience

____ which is when the person feels better at a certain time of the day

or

_____ when a person has persistent thoughts about and discussion of a particular subject

Answer 4

diurnal variation

ruminatiom

Question 5

intervention for depression after a manic episode

Answer 5

• assess for suicidal or homicidal ideation
• keep patient and everyone safe
• NEVER leave the client alone for a long time
• give them easy games to play so they can build self confidence/esteem
• offer them small, high calorie, high protein snacks during the day
• spend time with the client before bedtime

Question 6

this treatment is used when antidepressants/ medications don’t work for severely depressed clients, or bipolar clients who are in manic phase for too long and not respond to treatment.

Answer 6

ECT

Question 7

What happens in the ECT?

Answer 7

an electrical current is delivered through electrodes attached to the temples that cause a brief seizure within the brain.

you’ll see subtle outward movements of hands, feet, or toe because the client is pre-medicated with a muscle relaxant

Question 8

which clients cannot get an ECT?

Answer 8

• recent MI
• Brain lesion/tumor
• any client with abnormality to the brain

Question 9

with voluntary client to get ECT, an informed consent must be signed by the client. what about the involuntary client?

Answer 9

informed consent must be obtained by the next of kin…. in some states, by the court.

Question 10

what are some important things to tell the client before an ECT?

Answer 10

• NPO after midnight or at least 4 hours before procedure
• pee before
• no hairpins, contact lenses, or dentures during the procedure

Question 11

what must you do during the ECT?

Answer 11

• continual vital signs monitoring (BP, O2 ETC)
• 1st give a short acting anesthetic and then the muscle relaxant
• they get 100% o2 via positive pressure
• an airway or bite-block is placed so they can’t bite their tongue

Question 12

what do you do after the ECT?

Answer 12

• continual V.S
• Client can leave PACU when o2 is %90 or >, VS is stable, and mental status is good
• Assess the gag reflex before giving fluids, or anything to swallow

Question 13

major side effects of ECT?

Answer 13

• MAJOR= short term memory loss, confusion, disorientation
• memory deficits may occur but it usually recovers completely. it may take some people like 6 months to get it back fully

Question 14

T OR F?

YOU MUST MONITOR BOTH DEPRESSED AND CLIENT WHO JUST STARTED TAKING AN ANTIDEPRESSANT FOR SUICIDE

Answer 14

T

Question 15

What happens when a depressed client or client who just started taking antidepressant now have much energy?

Answer 15

they can be at risk for suicide because they now have the energy to do it

Question 16

what is chlordiazepoxide?

Answer 16

Librium= helps with alcohol withdrawal symptoms… benzodiazepine

Question 17

Dissulirum is?

Answer 17

antabuse= used to sensitize alcoholic patient to alcohol. they will get sick if they ingest any alcohol

No alcohol must be consumed for at least 12 hours before taking the 1st dose.

Question 18

After dissulfirum has been DC,d how long does the patient have to wait before drinking again?

Answer 18

14 days… or else, they’ll get sick.

they should avoid all alcohol containing substances.

Question 19

when does a client start experiencing alcohol withdrawal symptoms?

Answer 19

a few hours and peaks at 2-3 days/ 48 to 72 hours.

Question 20

This is a medical emergency around 2-3 days during alcohol withdrawal

Answer 20

withdrawal delirium

everything increases/ they get fever and hallucinations and delusions

Question 21

with CNS depressants, what are the interventions for an overdose?

awake versus comatose

Answer 21

awake= give activated charcoal

comatose= maintain airway patentcy, gastric lavage with activated charcoal, and initiate seizure precautions

Question 22

What is the antidote for benzodiazepine?

Answer 22

Flumazenil (Romazicon)

Question 23

T OR F?

Benzodiazepines can be used to treat alcohol withdrawal

Answer 23

t! they’re both depressants

Question 24

T OR F?

Abrupt withdrawal of substance abused like a CNS depressant can lead to death

Answer 24

T!

Question 25

Alcohol, benzodiazepines, and barbiturates (barbital) are all____

Answer 25

CNS depressants

Question 26

Amphetamines like ritalin, cocaine, and crack are all____

Answer 26

CNS stimulants

Question 27

withdrawal of CNS stimulants are treated with ____ because___

Answer 27

antidepressants because after their "manic" episode, they feel really depressed after. It's an opposite effect of feeling "stimulated"

Question 28

``` opium heroin morphine sulfate codeine sulfate methadone hydromorphone oxycodone hydrocodone fentanyl ``` are all

Answer 28

opioids= pain killers CNS depressant

Question 29

Naloxone is the antidote for___

Answer 29

Opioid overdose

Question 30

Lysergic acid diethylamid (LSD), mescaline, psilocybin (mushrooms), and phencyclidine (PCP) are all___-

Answer 30

Hallucinogens

Question 31

antianxiety meds are used to treat

Answer 31

hallucinogens