| Depression | Treatments for depression | Medication side effects | Mental Health Resources | Bonus questions |
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2 weeks or more
How long does signs and symptoms need to last to suspect depression?
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1. Sleep
2. Increased socialization 3. Exercise 4. Meditation
What are the 4 lifestyle changes you can make to treat minor depression?
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Eat tyramine-containing foods (aged cheeses, cured meats like salami, beer, smoked fish, yogurt, tofu, avocado, and soy sauce.
One complication of MAOIs like isocarboxazid (Marplan) and phenelzine (Nardil) is hypertensive crisis; which is triggered when patients do this?
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Call 911 Immediately
What should you do if you or a loved one is experiencing a psychiatric emergency?
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Serotonin syndrome is a complication that occurs when there is an inadequate washout period between taking MAOIs and SSRIs or meperidine. MAOIs have a 2-4 week lag period to reach adequate therapeutic serum level, because of this you need to wait 5-6 weeks after discontinuing MAOI before switching to another antidepressant.
A client taking isocaboxazid (Marplan) and phenelzine (Nardil) discontinued taking these medications 2 weeks ago because of orthostatic hypotension and the tyramine diet restriction and was switched to escitalopram (Lexapro). What should the nurse teach?
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changes in weight, sleep, energy, concentration, decision making, self-esteem, and goals
Name 3 changes that happen in depression.
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1. Selective Serotonin Reuptake Inhibitors
2. Tricyclic Antidepressants 3. Monoamine Oxidase Inhibitors
What are the 3 popular types of antidepressants?
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1. Occipital headache, hypertension, fever, dilated pupils, motor agitation, and nuchal rigidity.
2. Progressing to hyperpyrexia, cerebral hemorrhage, and death.
The symptoms of hypertensive crisis of a MAOI like tranylcypromine (parnate) can present within 20-30 minutes of ingesting tyramine containing foods. How does a hypertensive crisis present as?
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National Suicide Prevention Lifeline
This lifeline provides 24/7, free and confidential initiatives to improve crisis services and advance suicide prevention.
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1. Change in mental status – confusion and agitation
2. Neuromuscular excitement – Muscle rigidity, tremors, and increased hyper reflexivity. 3.Autonomic nervous system abnormalities – hyperthermia / fever, tachycardia, and tachypnea.
What are the 3 main symptoms of serotonin syndrome when MAOIs are combined with SSRIs without adequate washout period?
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Youth, specially 11-17y/o
Which population has been most affected by depression?
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Psychotherapy or CBT
This type of talk therapy is where individuals speak with a trained therapist to uncover unhealthy and negative feelings and behaviors to change them
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Educate the patient that their symptoms of insomnia, decreased appetitite, and decreased energy should improve in a week.
And that there is a "lag period" for antidepressants to work. TCAs can take 1-4 weeks and MAOIs 2-4 weeks to reach therapeutic plasma levels to decrease symptoms of depression.
A patient taking sertraline (Zoloft) for the past 2 days notices they have insomnia, decreased appetite, decreased energy, and their depression is still present. What should the nurse say?
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National Alliance on Mental Illness
NAMI is a free helpline providing support for people and families of those with mental health conditions. What does NAMI stand for?
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Over 8 in 10 people which is over 80%
How many people who took a depression screen have scored with symptoms of moderate to severe depression consistently since the beginning of the pandemic. Over...in ....people
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Electroconvulsive therapy
This type of therapy that involves passing electric currents through a person’s brain under general anesthesia causing a seizure to occur and believed to stimulate brain chemistry to correct chemical imbalance of depression.
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1. Blurred vision
2. Dry mouth 3. Constipation and Urine retention
Name 3 anticholinergic side effects of tricyclic antidepressants
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Clinical Trails
Participation in these studies can help find better ways to prevent, detect, and treat mental health illness.
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Serotonin, Norepinephrine, Dopamine
Depression is associated with abnormal transmission or depletion of which certain neurotransmitters.
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Preprocedure - NPO, voiding, and removing nail polish
Postprocedure - Patient gag reflex assessed and headache treated symptomatically.
How should you prepare a patient for ECT before and after ECT?
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1. Tricyclic antidepressants cause orthostatic hypotension and dizziness. They should get up slowly.
2. Tricyclic antidepressants are also known to cause cardiac dysrhythmias and tachycardia. So the ECG will monitor for abnormalities.
A client is taking desipramine (Norpramin) and nortriptyline (Pamelor) and reports dizziness on standing. The doctor also notified the patient that an ECG was scheduled for the patient. What should the nurse educate the patient on?
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Mental Health Parity and Addiction Equity Act (MHPAEA)
This federal law was passed in 2008 which prevents health insurance providers from imposing less favorable limitations on mental health treatments compared to medical/surgical treatments.
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