What is Depression | Therapeutic Communication Nursing Full Lecture

now for a big topic on exams depression also called MDD major depressive disorder which is also called clinical depression clients experience a severely depressed mood loss of enjoyment in life low energy and just feel like blah everything is low and slow kind of like Eeyore from Wy the Poo everything is just super slow low energy in a very very sad mood it's thought to be caused from the low levels of happy brain chemicals those neurotransmitters so low serotonin low dopamine and low norepinephrine now the cause of depression is unknown but the risk factors play a big part so in terms of risk factors stressful life event like a trauma a death in a loved one or even a recent job loss all can add stress next is a chronic illness that is debilitating for example Parkinson's disease and even genetics plays a big role So a family history of depression will usually be passed on to the kids and females have it more commonly than males and very lastly substance abuse plays a big role as well like abusing alcohol or drugs so ATI mentions a risk factor for depression stressful life events and Kaplan mentions a client recently become becomes unemployed and the client reports feeling depressed the nurse understands which statement to be true unemployment is a significant potential stressor now in terms of signs and symptoms as well as diagnosis five or more of the following symptoms consistently for 2 weeks are seen in order to make an official diagnosis of MDD again think of eore from win the Pooh low and slow energy mood and even slow movement so number one is a depressed mood clients feel hopeless and empty number two is anadon as mentioned by Hessian ATI so write this down loss of joy and interest in life number three is weight loss typically anorexia but we can also see weight gain but really it's more common for a loss of appetite and rapid weight loss now number four is a big enlex tip here psycho motor retardation so write these down slower speech response time and decreased movement clients will often respond slowly to yes and no questions so again think of eore from Winnie the Pooh very slow response times number five is insomnia or even hypersomnia sleeping too much and number six is fatigue also called energia like a blanket of heavy fatigue clients will not be able to move from their bed for like 3 days or more and they won't eat or shower or groom because of all this fatigue number seven is feelings of worthlessness or even guilt and number eight is difficulty concentrating and lastly a big one is suicidal thoughts that are reoccurring for number nine so be sure to pause your screen and really focus on the the bolded ones here since these are the most tested now hessie had two questions on this so the client states life just doesn't have any joy in it anymore things I did for pleasure aren't fun anhedonia the loss of pleasure in life and question two which complaint regarding sleep would the nurse expect from a client diagnosed with major depression I wake up at 4:00 a.m. and cannot go back to sleep and I feel tired all the time and ATI mentions a nurse is assessing an adolescent who has depression which of the following findings should the nurse expect select all that apply irritability energia or fatigue really and hedonia that loss of pleasure and appetite changes now a little side note for adolescence so adolescence between 10 and the teen years all the way up to 19 huge enlex tips i' be sure to write this down they typically present with angry or aggressive outbursts as well as vandalism and even skipping class and weight loss or weight gain that is sudden or rapid as well as napping during the day or excessive sleepiness during the day and lastly a big one here is low self-esteem known as withdrawal especially from activities that they once loved or were good at so let's say a cheer leader Captain suddenly quits everything and is now a loner at school H huge indication of depression so a top missed enlex question here which of the following pediatric clients should the nurse screen for depression select all that apply a 10-year-old who's taking frequent naps during class time yes the key term There Is frequent naps a 16-year-old who quit the chess team despite being the team captain yes withdrawing from things they were once good at or used to enjoy now a 14-year-old sent home from school due to angry outbursts and skipping class yes remember angry outbursts skipping class and even vandalism are big Key signs and a 17-year-old who suddenly lost 15 lbs in 4 weeks yes once again rapid weight loss now for the types of depression we see d IA which is a long-term persistent depression we see mild symptoms for about 2 years or more seasonal affect disorder happens in the winter due to the lack of vitamin D from the Sun and it's usually treated by the use of light therapy so hessie mentions seasonal affect disorder what appropriate action instruct the patient to be exposed to a light source for 30 to 45 minutes daily and lastly a b one here is pre and postpartum baby blues this occurs either during pregnancy or 4 weeks after pregnancy and it's not to be from hormonal and even lifestyle changes but we cover this in our full video in the maternity course now in terms of treatments let's do a rapid overview then we'll break these down one by one so there are three phases of MDD treatment phase one is the acute phase we see severe clinical signs in 6 to 8 weeks and suicide risk is very high now the goal in this phase one is to have remission of symptoms and restore the function with anti-depressant medications Psychotherapy and even ECT which we'll cover in a moment now phase two is the continuation phase increased ability to function and the goal here is to prevent relapse and number three is the maintenance phase over 6 to 12 months the goal is to prevent reoccurrence and we want the client to return to normal functioning now in terms of Nursing Care the big priority is for suicide risk now the assessments the Key signs to watch for is number one a calmer and more energetic client this means increased risk for suicide or increased suicide risk so watch for words like sudden abrupt or rapid change in energy so write down these key words any sudden or abrupt rapid change in energy levels typically means a client is more suicidal with more energy to actually do the suicide especially true after starting anti-depressants like ssris clients have more energy to actually follow through with the suicide so ATI mentions major depression and suicidal ideation who is suddenly calmer and more energetic which of the following should the nurse consider the client is suicidal and Saunders a depressed client suddenly begins smiling and Reporting the crisis is over the client says to the nurse I'm finally cured the key intervention is increasing the level of suicide precautions so be sure to write those down and another key assessment to watch for is the client starts giving away possessions that are cherished and valued and look for statements like I can't go on or I don't want want to live so I won't be a problem much longer as stated by hasse and this will all be over soon as stated by Kaplan so when we hear these certain statements by the client we must ask certain questions for suicide risk assessment for example have you had any thoughts of hurting yourself huge enlex tip this one always shows up or do you have a plan to kill yourself or do you want to die the questions should be direct and very blunt not open-ended so very straightforward questions so hessie mentions a man tells the nurse he has no reason to continue living what should the nurse ask him first do you have any plans to end your life right now and Saunders which behavior indicates an adolescent client may be suicidal the client gives away a DVD and a cherished autograph picture of their favorite performer yes giving away cherished items is a huge indicator now for the big enlex tips if the client has a plan to harm themselves number one we do continuous one-on-one observation with the client now this is the number one priority to ensure safety they will be on a 72-hour hold and suicide watch number two is a semi-private room near the nurses station not a private room this decreases isolation and allows rapid access to the client so write this down we always remove harmful objects from the room for example sharp items or even belts ties and glass and inspect the client's personal belongings number two is we supervise the client during meals and always reassess any changes in Suicidal Thoughts a goal statement that we're looking for that shows a client is not currently at risk for suicide is write this down clear plans of the future involving personal goals for family and friends big nlex tip so be sure to write that down so Kaplan mentions a client states I don't want to live anymore I'll find something else to kill myself with which nursing intervention is important to perform next provide direct one-on-one observation to the client as all times and hessie has two questions a client admits to a plan for suicide what is the nurse's priority action provide one-on-one supervision and a second question one week ago a patient attempted suicide which comment by the nurse is most therapeutic I'd like to hear about how you are feeling now yes always reassess now in terms of interventions for depressed clients just in general the goal here is to feel better and less depressed so encourage and invite the client to participate in their own treatment plan and also in activities so Kaplan mentions the client diagnosed with depression which approach by the nurse is best invite the client to join in group activities and Saunders a client with a diagnosis of depression plan of care that includes which intervention a structured program of activities in which the client can participate next is assist with ADLs these clients experience severe fatigue and lack of motivation so a big enlex tip here is help the client get ready especially when they have not left the room for a few days so help them get out of the room and go to the unit and even go to the dining hall or common room next we always spend time with the client a big key term here is to sit with the client and communicate with simple and direct language so Kaplan mentions the client is crying alone in the room the client has refused to eat breakfast or have morning care which intervention by the nurse is best offer to sit with the client and help the client get dressed an ATI had two questions here a newly admitted client who has severe depression sit with the client and offer simple direct information and the second question the client seems more withdrawn and depressed than usual say to the client I would like to spend some time with you and very lastly is re-evaluation is the client getting better for discharge we want the client to have less symptoms and more energy and even more interest in life itself so hessie and ATI mention this in various ways hessie talks about which comment shows Improvement in depression I talked with my family about ways we can celebrate the holidays together an ATI which of the following behaviors indicates a Readiness for discharge verbalization of feeling in control of self and situations now Switching gears to diet remember the big symptom of depression is rapid weight loss or weight gain but typically weight loss is most tested since it's most common so clients lose appetite and refuse to eat so for poor nutritional intake write down these four key points number one we provide small frequent meals number two is high calorie foods and fluids and three stay with the client during meals so that they finish all their meal and number four is we always use weekly weights to track progress all right that wraps it up thank you so much for watching don't forget to take your quiz and download the study guides and also feel free to share the love share with a classmate and even your instructor see you guys in the next videos

Channel: SimpleNursing

Views: 287,055

Keywords: #depression, #mentaldisorder, #clinicaldepression

Id: sUFeuEON9h4

Length: 15min 10sec (910 seconds)

Published: Wed Aug 31 2022