Download Guided Lecture Notes, Chapter 1

Guided Lecture Notes, Chapter 20
Learning Objective 1. Describe the prevalence and incidence of mood disorders and
suicide within American society.

Introduce mood disorders as possibly the number one public health problem.
Discuss the difficulty in detecting and treating mood disorders (refer to
PowerPoint Slide 2).

Explain how suicide is a significant risk, therefore having a greater impact on
premature mortality.
Learning Objective 2. Delineate the clinical symptoms and course of mood disorders and
suicidal behavior. (Refer to PowerPoint Slide 6).

Explain the diagnostic criteria for major depressive disorder (refer to PowerPoint
Slide 6 and Table 20.1).

Explain the diagnostic criteria for dysthymic disorder and contrast it with major
depressive disorder (refer to PowerPoint Slide 7).

Discuss the course of major depressive disorder as a progressive, recurrent illness
with episodes occurring more frequently, becoming more severe, and lasting
longer. About 25% of patients experience a recurrence during the first 6 months
after a first episode, and about 50% to 75% have a recurrence within 5 years.

Explain the diagnostic criteria for bipolar disorder (refer to PowerPoint Slide 26
and Table 20.5).

Differentiate between bipolar I and bipolar II disorders (refer to PowerPoint Slide
27).

Explain the following subtypes of bipolar disorders: mixed episode, hypomanic
episode, and cyclothymic disorder (refer to PowerPoint Slide 28).

Explain that bipolar disorder also is a chronic, cyclic disorder.
Learning Objective 3. Analyze the biopsychosocial theories that formulate the education,
practice, and research basis in caring for patients who are diagnosed with a mood
disorder and who exhibit suicidal behavior.

Discuss the genetic patterns, and the potential role of neurobiologic causes in the
development of depressive mood disorders (refer to PowerPoint Slide 12).

Explore the various psychosocial etiologies, such as the conflict between wanting
to be loved and fear of rejection, severe reduction in rewarding activities,
irrational beliefs, losses, maladaptive family interactions, or adverse life events
(refer to PowerPoint Slide 12).

Explore the role of genetics; the relationship between sleep disturbance and
biochemical abnormalities in mood regulation; and sensitization and the related
phenomenon of kindling as possible biologic etiologies of bipolar disorder (refer
to PowerPoint Slide 32).

Explain that from a psychosocial perspective, mania is usually regarded as a
condition that arises from an attempt to overcompensate for depressed feelings
(Refer to PowerPoint Slide 32).
Learning Objective 4. Analyze the human responses to mood disorders.

Discuss common biologic assessment findings for a person with depression,
including the physical, pharmacologic, and neurovegetative symptoms of
depression (refer to PowerPoint Slide 14).

Discuss common psychological assessment findings for a person with depression,
including changes in mood and affect, thought content, cognition and memory,
and any evidence of suicidal behavior (refer to PowerPoint Slide 18).

Explore important assessment areas of social functioning in a depressed person,
focusing on family, relationships, support system, spirituality, education, and
work history (refer to PowerPoint Slide 21).

Discuss common biologic assessment findings for a person with bipolar disorder,
including sleep, eating, and sexual patterns; thyroid function; and a
pharmacologic assessment (refer to PowerPoint Slide 34).

Discuss common psychological assessment findings for a person with bipolar
disorder, including changes in mood, cognition, thought disturbances, coping
skills, and a thorough risk assessment (refer to PowerPoint Slide 41).

Explore important assessment areas of social functioning in bipolar disorder,
focusing on potential cultural views of mental illness, social changes, or any other
changes resulting from the disorder (refer to PowerPoint Slide 44).
Learning Objective 5. Discuss the biopsychosocial nursing clinical reasoning processes
for patients diagnosed with mood disorders and for those who exhibit suicidal behavior.

Discuss that clinical reasoning serves to reduce or control symptoms, improve
occupational and psychosocial functioning, and reduce the likelihood of relapse
(refer to PowerPoint Slides 13 and 33).

Discuss the significance of helping the patient and family learn about lifetime
management of the disorder (refer to PowerPoint Slides 13 and 33).

Emphasize that the priority concern for people with mood disorders is safety due
to self-destructive thoughts and suicidal ideations (refer to PowerPoint Slides 13
and 33).
Learning Objective 6. Formulate nursing diagnoses with strategies, interventions, and
evaluative approaches that address the cultural needs of persons diagnosed with mood
disorders and for those who exhibit suicidal behavior.

During discussion of depressive disorder, list common nursing diagnoses for the
biologic domain (refer to PowerPoint Slide 15), for the psychological domain
(refer to PowerPoint Slide 19), and for the social domain (refer to PowerPoint
Slide 22).

Explain interventions to meet the biologic health needs of a person with
depression, including sleep hygiene, eating well-balanced meals, and healthy
activity and exercise (refer to PowerPoint Slide 16).

Review pharmacologic interventions with antidepressants, discussing actions, side
effects, and drug interactions (refer to PowerPoint Slides 16 and 17).

Discuss the use of ECT and phototherapy for depression (refer to PowerPoint
Slide 17).

Explain therapeutic interventions to meet the psychological health needs of a
person with depression, including cognitive, behavioral, interpersonal, family, and
group therapies (refer to PowerPoint Slide 20).

Explain interventions to meet the social health needs of persons with depression,
including safety in the milieu, support groups, and organizations such as DBSA
and NAMI (refer to PowerPoint Slide 23 and Figure 20.1).

Explain that evaluation of care for a person with depression focuses on helping
the patient to be as independent as possible and to achieve stability, remission,
and recovery from major depression.

During discussion of bipolar disorder, list common nursing diagnoses for the
biologic domain (refer to PowerPoint Slide 35), for the psychological domain
(refer to PowerPoint Slide 42 and Figure 20.2), and for the social domain (refer to
PowerPoint Slide 45).

Explain interventions to meet the biologic health needs of a person with bipolar
disorder, including ensuring enough rest, adequate hydration and nutrition,
performing self-care, and re-establishment of physical well-being (refer to
PowerPoint Slide 36).

Review pharmacologic interventions with mood stabilizers, anticonvulsants,
antidepressants, and antipsychotics, discussing actions, side effects, and drug
interactions (refer to PowerPoint Slides 37-40).

Discuss the limited use of ECT for bipolar disorder (Refer to PowerPoint Slide
40).

Explain interventions to meet the psychological health needs of a person with
bipolar disorder, including cognitive, behavioral, and interpersonal therapies, and
educating on the warning signs and symptoms of relapse and how to cope with
residual symptoms (refer to PowerPoint Slide 43).

Explain interventions to meet the social health needs of a person with bipolar
disorder, including protection in the inpatient setting, use of support groups, and
therapy and education for family members (refer to PowerPoint Slide 46 and
Figure 20.3).

Explain that evaluation of care for a person with bipolar disorder focuses on
stabilization of mood and enhanced quality of life.

Refer to Nursing Care Plan 20.1 and Interdisciplinary Treatment Plan 20.1 during
discussion of Learning Objective 6.