NU249/NUR2488- Concept Guides- Exam 2
Mood:
Depression
Define common symptoms- memory difficulties, suicidal, worthlessness,
... [Show More] helplessness,
anhedonia-loss of pleasurable in things they once loved, anergia-lack of energy.. Severe=not
eating or drinking. Given up. High protein, high calorie diet. Around the clock observation,
suicide=1on1.
Beck’s Cognitive Triad (p. 250)
1.A negative, self-deprecating view of self: “I really never do anything well; everyone else
seems smarter.”
2.A pessimistic view of the world: “Once you're down, you can't get up. Look around,
poverty, homelessness, sickness, war, and despair are every place you look.”
3.The belief that negative reinforcement (or no validation for the self) will continue: “It
doesn't matter what you do; nothing ever gets better. I'll be in this stupid job the rest of
my life.”
Risk for suicide- Questions to ask,
Are you feeling suicidal? Do you have a plan? Do you have the means?
High vs low risk (Ch 23)
Nursing Diagnosis (Table 15-2)
Risk for suicide, self mutilation, decisional conflict, impaired memory, acute confusion,
ineffective coping, interrupted family process, risk for impaired parent/infant/child attachment,
ineffective role performance, hopelessness, chronic low self esteem.
Physical Interventions (Table 15-5)
Nutritional interventions (high calorie meals for those not eating), encourage sleep, emphasize
self care measures.
MedicationsClasses:
SSRI- first line! black box warning=increase suicidal ideation. Selexa, fluoxetineProzac. Don’t
start within 14 days of last MAOI dose=serotonin syndrome-hyperactivity, seizures
Citalopram† Celexa Common side effects
include:
Minimal interaction
with other drugs,
minimal weight
Possible initial anxiety
NUR2488 / NUR 2488 / NU 249 Exam 2 Concept / Study Guide (Latest 2021 / 2022): Mental Health Nursing - Rasmussen College
NU249/NUR2488- Concept Guides- Exam 2
•Headache, which
usually dissipates in a few
days
•Nausea, which
usually dissipates in a few
days
•Sleeplessness and/or
drowsiness during day,
which usually dissipates in
a few weeks
•Tremors and/or
dizziness
•Sexual problems:
reduces sexual drive,
problems having and
enjoying sex
•Agitation, feeling
jittery and nervous; rare
serotonin syndrome; rare
activation of suicidal
ideation
gain, sedation
Escitalopram†Lexapr
o
Minimal interaction,
sedation, and weight
gain
Possible initial anxiety
18 yr or older; 12-17 yr
for MDD
Fluoxetine† Prozac Activating
(energizing)
Possible interaction
with other drugs, initial
anxiety
8 yr or older
Fluvoxamine Luvox 8 yr or older for OCD
only
Paroxetine† Paxil Good antianxiety
benefit
Weight gain, interacts
with other meds,
contraindicated in
pregnancy
Sertraline† Zoloft
TCA= amitryptiline, imipramine .anticholinergic effects, get dr attention for urinary retention.
Cardiotoxicity with overdose
Amitriptyline Elavil Common side effects include:
•Dry mouth
•Constipation
•Bladder problems (hard to empty bladder,
weak urine stream, men with enlarged prostat [Show Less]