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This document discusses mood disorders including depression and bipolar disorder. It defines the diagnostic criteria for major depression which includes 9 clinical signs such as depressed mood and loss of interest. It also describes different subtypes of depression including dysthymic disorder. For bipolar disorder, it discusses the extreme mood swings between mania and depression and subtypes such as bipolar I and II. Finally, it outlines nursing diagnoses and interventions for these disorders focusing on safety, socialization, nutrition, and psychopharmacology.
This document discusses mood disorders including depression and bipolar disorder. It defines the diagnostic criteria for major depression which includes 9 clinical signs such as depressed mood and loss of interest. It also describes different subtypes of depression including dysthymic disorder. For bipolar disorder, it discusses the extreme mood swings between mania and depression and subtypes such as bipolar I and II. Finally, it outlines nursing diagnoses and interventions for these disorders focusing on safety, socialization, nutrition, and psychopharmacology.
This document discusses mood disorders including depression and bipolar disorder. It defines the diagnostic criteria for major depression which includes 9 clinical signs such as depressed mood and loss of interest. It also describes different subtypes of depression including dysthymic disorder. For bipolar disorder, it discusses the extreme mood swings between mania and depression and subtypes such as bipolar I and II. Finally, it outlines nursing diagnoses and interventions for these disorders focusing on safety, socialization, nutrition, and psychopharmacology.
Pervasive alteration in emotion that are manifested E- ating disturbance (overeating/under eating) by Depression (lost of interest in pleasure) and P- hysical signs (agitation or retardation) Mania (exalted feeling, over activity) R- eccurent thought of death E- xcessive feeling of unworthiness (DSM-IV-TR) 2 CATEGORIES OF AFFECTIVE S- leep disturbance (insomnia/hypersomnia) DISORDER S- adness/ dysphoria E- nergy diminished I. Depressive/Unipolar Disorder D- iminished pleasure (anhedonia)
Persistent sad or depressed mood loss of interest on SUBTYPE of DEPRESSION
things that were once pleasurable and disturbance in I. Major Depression sleep, appetite, energy and concentration. - presence of 5 criteria for depression, Increase incidence in Women than Man prime symptoms are depressed mood Cause: and loss of interest Medical/Biological Theory - last for at least 2 wks - high familial genetic pattern (70% - occurs in late 20’s identical twin, 15% siblings and 7% * with psychotic symptoms grandparent aunts and uncle) * Melancholic type (agitated occurs after - disregulation of NorEpinephrine and 40y/o but before 60 y/o), morning serotonin depression - low level of Tryptophan precursor for * Seasonal pattern (3 years pattern onset serotonin II. Dysthymic Disorder Psychodynamic Theory - milder than major depression - disturbance in early mother-child - duration at least (2 yrs. For adult and 1 relationship, weak ego strong Superego yr. for children and adolescent) Cognitive Behavioral Theory - presence of 2 or more criteria. - reinforcement theory result of impaired - absence of Psychotic features cognition III. DDNOS - learned helplessness, individual belief of - last for 2 days or 2 weeks lack of control - cognitive triad, negative belief to NURSING DIAGNOSIS AND INPLEMENTATIONS SELF,WORLD and FUTURE * Potential for Injury directed to Self - assess for the signs of suicide DIAGNOSTIC CRITERIA (9 clinical signs) - risk factor for SUICIDE S- ex more female attempt more male commit * Self Esteem Disturbance U- nsuccessful previous attempts - focus on the strengths and accomplishments I- dentification with family member - teach assertive techniques C- hronic * Social Isolation I- llness - spend time to client D- epression/dependent personality - then proceed to group activity A- ge (18 -25 y/o and 40 above / Alcoholics) * Powerlessness L- ethality of previous attempt - take as much responsibility as possible for own self care C- aucasians and native Americans - identify areas that she can control L- iving alone/ No spouse or nagging spouse - verbalize areas in life that cannot control A- cts through Gun’s and explosive next is * Altered Nutrition Less tan Body requirement hanging and poison -high protein and carbohydrate in diet F- inancial problems/ unemployed - increase fluid consumption - common expressions of Suicidal individual - weight daily Cry for help Escape - serve small frequent feeding Heroic Manipulation Martyrdom Rebirth PSYCHOPHARMACOLOGY Redemption Relief of pain SSR’I Retaliatory Reunion TCA’S Loss of self esteem MAOI’S - secure rooms (windows lock, break proof glass II. BIPOLAR/ MANIC DEPRESSIVE DISORDER and mirror use plastic ware) Extreme mood swing from Mania to depression - NO cords and sharps Cause: - frequent observation/ unscheduled rounds Genetic 1st degree family members - staff communication one on one Neurobiological (increase NE) - develop therapeutic relationship Psychological (poor mother and child relationship) - written contract SUBTYPES - restraint as order I. BIPOLAR I - medication as ordered - Manic episodes – persistent elevated mood for * Dysfunctional Grieving a duration of 1 week and 3 out of the - encourage verbalization of thoughts and following signs (grandiosity, insomnia, feelings verbosity, flight of ideas, distractability, - develop trusting relationship agitation and excessive involvement - assist patient to discharge Pent –up anger into pleasurable activities ) through purge motor activity - Major Depression (alternating) II. BIPOLAR II. - Hypomanic – period of elevated irritable mood lasting for 4 days, it is Less Severe and manifesting 3 or more signs - Depressive Disorder III. CYCLOTHYMIC - hypomanic episode dispersed with periods of depressed mood - No evidence of true major depression and manic - alternating moods swing - last for 2 years NURSING DIAGNOSIS WITH IMPLEMENTATIONS * High Risk for violence directed to self and others - redirect negative feelings into a socially acceptable manners - encourage brief contact with patient - conduct suicide assessment - seclude, restraint if necessary - provide frequent “quiet time out” * Impaired social Interaction - set limit on behavior - provide meaningful interactions * Altered Nutrition - increase calories, vitamin in diet, provide finger foods and fruits - encourage non-competitive solitary play