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Example Case: Depressive Disorders (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:00 So, let's think about a person who might have a manic episode, all right.

    00:09 And we see this person acting very hyperactive, restless, totally disorganized.

    00:16 And this person goes into the dining room.

    00:19 And it's here with us in a psychiatric unit, and we see that patient start to throw food around, picks up dishes, starts breaking dishes, starts verbally screaming at the staff, starts yelling at the other patients that are in the room.

    00:41 One of the nurses gets up and escorts the patient out of the dining room and takes the patient back to the room.

    00:51 Why would this be the proper response of any staff member upon seeing someone who is going to be becoming abusive and erratic? So your answers are to prevent other patients from observing this behavior or thinking that the patient's behavior poses a substantial injury to others and self.

    01:22 Maybe you want to protect the patient's biological integrity until the medication takes effect or reinforced limit setting, making sure that the patient learns how to follow the unit rules.

    01:39 Which intervention would be the best intervention for that? Remember, safety, safety, safety, safety! You always want to be able to remove a patient that is a danger to themselves, a danger to others, and put them in an area where they are safe, and which keeps everyone else safe as well.

    02:04 When a person is having the violent outbursts, it is not that moment that you are enforcing limit setting.

    02:11 You are practicing safe practice to bring that patient out of the room where that patient might hurt themselves or someone else.

    02:22 So here's one of the kinds of questions that you might find in licensing exam.

    02:28 Which mood disorder is characterized by the patient feeling depressed most of the day for a 2-year period? Now remember, it's 2 years that's what's going to stick in your head.

    02:43 Depression for 2 years, most everyday.

    02:49 So would it be dysthymia, cyclothymia, melancholic disorder or seasonal affective disorder? We always say go for the worst one and eliminate it.

    03:01 So we know that it's not seasonal affective because seasonal affective would actually be something that comes with seasons and not persistent for 2 years.

    03:12 So that leaves us with melancholic, cyclothymic and dysthymia.

    03:18 Well melancholia, we have not ever spoken about a melancholic disorder.

    03:25 And the reason is, melancholia is a symptom of depression.

    03:30 It is not in and of itself a disorder, so we'll get rid of that one as well.

    03:35 Which leaves us with cyclothymia and dysthymia.

    03:39 And we know cyclothymia is an alteration between high and low moods so we can get rid of that one.

    03:46 Dysthymia is when we have a patient who is feeling sad, almost every day for a period of 2 years or more.

    03:56 So if you chose dysthymia, you got it.


    About the Lecture

    The lecture Example Case: Depressive Disorders (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Mood Disorders: Major Depressive and Bipolar Disorders (Nursing).


    Included Quiz Questions

    1. Remove the client from the common room and direct them to an area clear of other clients
    2. Tell the client to apologize to the other clients
    3. Have the client sit in the corner of the common room until they have calmed down
    4. Have the client sit in the common room while the nurse grabs a sedative medication
    1. The client who endorses a 2-year history of depressive symptoms occurring most days
    2. The client who endorses a 4-year history of depressive symptoms occurring during the winter months
    3. The client who endorses a 2-month history of depressive symptoms occurring most days
    4. The client who endorses a 5-year history of depressive symptoms lasting around two weeks at a time followed by periods of euthymia

    Author of lecture Example Case: Depressive Disorders (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN


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