NUR384 EXAM 3 BluePrint Guide
With Complete Solution
What is depression? - ANSWER Mood characterized by hopelessness,
worthlessness, guilt, loss of interest, fatigue, sleep disturbances, weight
changes, psychomotor changes, difficulty concentrating, and persistent
thoughts of death.
What are the risk factors for depression? - ANSWER Family history, personal
history, female gender, age over 65, neurotransmitter deficiencies.
What are some medical contributors to depression? - ANSWER Cancer,
coronary heart disease, head injuries/trauma, PTSD, personality disorders,
OCD, anxiety disorders, substance-use disorder, thyroid dysfunction.
What are the possible causes of depression? - ANSWER Stressors such as
loss, trauma, hormonal imbalance, or stress. Faulty mood regulation by the
brain, genetic vulnerability, stressful life events, medications, and medical
problems can all interact to bring on depression.
What are the symptoms of Major Depressive Disorder (MDD)? - ANSWER
Persistently depressed mood, long-term loss of pleasure or interest in life,
and other physiological or psychological symptoms.
What is the acute phase of MDD treatment? - ANSWER 6-12 weeks, potential
need for hospitalization, reduction of depressive manifestations, suicide risk
assessment, and implementation of safety precautions.
What is the continuation phase of MDD treatment? - ANSWER 4-9 months,
relapse prevention through education, medication therapy, and
,psychotherapy.
What is the maintenance phase of MDD treatment? - ANSWER Can last for
years, goal is prevention of future depressive episodes.
What is Persistent Depressive Disorder (PDD)? - ANSWER Mild chronic
depression lasting at least 2 years with lesser symptoms than MDD.
What is Seasonal Affective Disorder (SAD)? - ANSWER Form of depression
that occurs seasonally, usually during winter, when there is less daylight
What is the treatment for Seasonal Affective Disorder (SAD)? - ANSWER
Light therapy (1st line)
What is Premenstrual Dysphoric Disorder (PMDD)? - ANSWER Depressive
disorder associated with the luteal phase of the menstrual cycle
What is the prevalence of PMDD? - ANSWER 2-6% of menstruating clients
What are the symptoms of PMDD? - ANSWER Causes problems that can be
severe enough to interfere with the ability of a client to work or interact with
others
What is Substance-Induced Depressive Disorder? - ANSWER Depression that
is associated with the use of, or withdrawal from drugs and alcohol
What are some standardized screening tools for depression? - ANSWER
Hamilton Depression Scale, Beck Depression Inventory, Geriatric Depression
Scale (short form), Zung Self-Rating Depression Scale, Patient Health
Questionnaire
What is the most common medication class used to treat depression? -
ANSWER SSRI (fluoxetine, sertraline, citalopram)
,What is the purpose of SSRI medications? - ANSWER Treatment of
depression and often used in combination with therapy
How do SSRIs function? - ANSWER Inhibit reuptake of serotonin, therefore
increasing serotonin activity
What are some common side effects of SSRIs? - ANSWER Sexual dysfunction,
GI upset, QT prolongation, weight gain, insomnia, agitation, drowsiness,
dizziness, headache, dry mouth, constipation, tremors
What are some severe side effects of SSRIs? - ANSWER Serotonin syndrome
How is serotonin syndrome managed? - ANSWER Stopping all serotonergic
drugs, stabilizing vital signs, sedating with benzodiazepines, administering
cyproheptadine to block serotonin production if symptoms persist
What are some other common medications used to treat depression? -
ANSWER TCAs (amitriptyline), MAOIs (phenelzine), Atypical Antidepressants
(bupropion)
How should TCAs be taken to minimize side effects? - ANSWER Change
positions slowly to minimize orthostatic hypotension, chew sugarless gum,
eat foods high in fiber, and increase fluid intake
What should be avoided when taking MAOIs? - ANSWER Foods high in
tyramine due to risk of HTN crisis
What is the purpose of Atypical Antidepressants? - ANSWER To treat
depression
What are the adverse effects of SNRIs? - ANSWER Nausea, insomnia, weight
gain, diaphoresis, sexual dysfunction
, What are the adverse effects of alternative therapy St. John's Wort? -
ANSWER Contraindicated if taking an SSRI, can lead to serotonin syndrome
What is Electroconvulsive Therapy (ECT) used for? - ANSWER Treatment for
treatment-resistant bipolar, depression, and schizophrenia
What are the pre-ECT workup tests? - ANSWER Chest x-ray, ECG, CBC, BUN,
urinalysis, electrolyte panel
What should be discontinued before ECT? - ANSWER Benzodiazepines
What can a client expect after waking up from ECT? - ANSWER Confusion
What should a client avoid before ECT? - ANSWER Food
What is Transcranial Magnetic Stimulation (TMS) used for? - ANSWER
Stimulate focal areas of the cerebral cortex
What is the contraindication for TMS? - ANSWER Metal plate in the area of
the head being stimulated
How long does a TMS procedure last? - ANSWER About 30 minutes
How long does TMS treatment last? - ANSWER Several times each week for 6
weeks
What can a client experience after TMS? - ANSWER Mild headache
What is Vagal Nerve Stimulation (VNS) used for? - ANSWER
Medication-resistant depression
How is VNS performed? - ANSWER Implanting a vagal nerve stimulator and
programming it to a certain frequency
What are the side effects of VNS? - ANSWER Voice alterations, neck pain,