Professional Documents
Culture Documents
I.
Introduction:
General Definition:
Depression is more than feeling sad. Everyone has days when they are sad, but
depression is a persistent feeling of sadness that disrupts life for the person afflicted and
their loved ones.
III.
A. Neurotransmitters
B. Family History
C. Substance Abuse
D. Presence of Other Psychiatric Disorders E. Environment
F. Other Risk Factors -
IV.
Depressive Disorders:
Bipolar Depression
Substance-Induced Depressive Disorder
Postpartum Depression
Seasonal Affective Disorder
Psychotic Depression
Assessment:
A. Symptoms of Major Depressive Episode Depression presents differently in different individuals. The Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition (DSM-5) uses specific criteria when
formulating a diagnosis. A common mneumonic to help nurses remember the classical
signs and symptoms of major depressive episode is
SIG-E-CAPS
S Sleep disturbances either not sleeping enough or excessive sleep
I Loss of interest in activities that the individual used to find enjoyable (anhedonia)
G Guilt or feeling worthless or helpless
E Low energy or fatigue
C Concentration problems
A Appetite disturbances either eating too much or too little
P Psychomotor retardation or agitation
S Suicidal thoughts or attempts
B. Screening Tools 1.
2.
3.
4.
I. Interventions:
II.
Antidepressant Medication:
D. Others
Class
Medication
Side Effects/Issues
TCAs
Amitriptyline, Doxepin,
Imipramine
MAOIs
Phenelzine,
Tranylcypromine
SSRIs
Citalopram, Escitalopram,
Paroxetine, Fluoxetine,
Sertraline
nausea, diarrhea,
headache, anxiety upon
initiation or dose increase,
sexual dysfunction,
sweating,
sedation/agitation
SNRIs
Venlafaxine, Duloxetine
Others
Mirtazapine, Trazodone,
Bupropion
F. Overview of Medications
1. All take 6-12 weeks for full effect
2. According to available literature all are equally effective
3. Choice based on past response, target symptoms, drug interactions, and cost
4. All have FDA warning for increased suicidality in patients < 24 years of age
VI.
A. Action
B. Nursing Considerations -
VII.
A. Action
B. Nursing Considerations
VIII.
Evaluation:
The patients response to interventions is evaluated based on the attainment of
desired outcomes. The nurse compares the patients clinical symptoms as initially
seen when entering treatment with symptoms exhibited following completion of
the care plan. Input from all healthcare team members as well as the patient and
the patients family members is important.
I.
Introduction:
A person who thinks about suicide often experiences deep sadness and personal
pain. Thoughts of suicide may occur when a person cannot handle the pain they feel
or feel they are not able to cope with the demands of their life. The feel hopeless,
helpless, and trapped. Suicide is often a way of trying to end this pain. Facts about
suicide in the United States:
A. The Joint Commission established in 2015 that a National Patient Safety Goal is
to identify patients at risk for suicide.
B. More than 32,000 people commit suicide each year.
C. One person commits suicide every 16 minutes.
D. Suicide is the 3rd leading cause of death in young people ages 15-24.
E. Males are 4 times more likely to die from suicide than females.
F. Females attempt suicide 3 times more than males.
G. White males commit almost 20% of all suicides.
H. Suicide rates are highest among Americans over the age of 65.
I.
J. Most people who commit suicide suffer from one or more mental illnesses.
II.
F. Those who suffer from chronic illness, chronic debilitation, and chronic pain
congestive heart failure (CHF), stroke, multiple sclerosis (MS), chronic
obstructive lung disease (COPD), seizure disorders, and malignant neoplasms
for example.
G. People who are divorced, widowed, or have never married
H. People who have experienced a major loss
I.
III.
Assessment
Suicide is considered more preventable than any other cause of death. A patients
degree of suicidality can change quickly and unpredictably so assessment for suicide
risk is an ongoing process, not a single event. Information is obtained from both the
patient and those close to the patient.
A. Regard all behaviors and comments about suicide as serious B. A common mneumonic to help nurses remember the classical signs and
symptoms of warning signs for suicide is IS PATH WARM
I Ideation
S- Substance Abuse
P Purposelessness
A Anxiety
T Trapped
H Hopelessness
W Withdrawal
A Anger
R Recklessness
M Mood changes
C. Screening Tools
1.
2.
3.
4.
IV.
Nursing Diagnosis:
First and foremost, the priority nursing diagnosis is Risk for Violence: Self-Directed.
In order to provide interventions for our patients, we must help to keep our patients
free of self-inflicted harm and alive.
V.
Interventions:
Suicide precautions
VI.
Evaluation
Evaluation is an ongoing process that considers the patients progress in attaining
expected outcomes as stated in the inpatient or outpatient plan of care.
CACA
MACARECCARE OF THE PATIENT
WHO IS MANIC