All About Nursing · Hospice & Palliative Care

Mirtazapine – Reading & Reviewing

Mirtazapine (Remeron)

  • Antidepressant with frequent side effect of small weight gain
  • Insufficient data to recommend for ACS (Anorexia/Cachexia Syndrome)
  • It is often given for insomnia and depression
  • It is best to give one pill that can treat several issues and is cost-effective.

All About Nursing · Hospice & Palliative Care

Anxiety, Depression, Caregiver Burnout, Grief, Anger, Frustration in End of Life Care

Anxiety

  • According to the DSM-5, anxiety disorders are those that share features of excessive anxiety and fear with related behavioral disturbances.
  • These disorders differ from normal fear and anxiety in their being excessive and persisting beyond developmentally appropriate periods, typically lasting 6 months or more
  • Types of anxiety:
    1. Separation anxiety – anxiety or fear about separation from an attachment figure
    2. Selective mutism- consistent failure to speak in social situations
    3. Social anxiety – fear or anxiety about social interactions or situations
    4. Panic disorder -recurrent panic attacks
    5. Phobias- fear of a specific object or situation
    6. Generalized anxiety disorder- persistent or excessive anxiety and worry about various domains.
  • Treatment:
    • Nonpharmacological interventions
      1. Establish a trusting relationship
      2. Be aware of any anxiety that you as a nurse may have that may be picked up on
      3. Do not leave a person experiencing an anxiety disorder exacerbation alone
      4. Maintain a calm, nonthreatening, manner-of-fact approach
      5. Keep stimuli minimized
      6. Use simple words and brief messages that are calmly and clearly explained
      7. Discuss the reality of the situation
      8. Include person on decision-making to feel more in control
      9. Encourage exploration of underlying feelings that contribute to irrational fears
      10. Teach and reinforce stress management /relaxation techniques
    • Pharmacological interventions
Continue reading “Anxiety, Depression, Caregiver Burnout, Grief, Anger, Frustration in End of Life Care”
Nursing Continue Education

Bipolar Disorder 躁狂抑郁性精神病 (Reading & Sharing Again)

Bipolar disorder is a complex and challenging brain disorder in which moods range from periods of mania followed by episodes of depression, from sadness to euphoria (Ferri, 2018). Bipolar disorder used to be called manic-depressive because of these two symptoms.

During a manic phase you will usually see a decreased need for sleep, an inflated self-esteem, pressured or fast speech patterns, flight of ideas, racing thoughts, distractibility, risky behaviors or an increase in goal-directed activities (Ferri, 2018). It is possible for individuals to develop delusions or hallucinations during the manic phase (INSA, 2017). Followed by the manic phase will be a depressive episode. During the depressive episode individuals will feel feelings of worthlessness, thoughts of suicide, disinterest in work, family, or friends (INSA, 2017). It is during the depressive phase that most people seek medical assistance.

Unfortunately, the management of the disease has no specific combination of psychosocial and medication regime that works well for everyone’s mood instability. So, therefore, the right combination to manage a particular patient’s mood instability takes time and can change over time due to the patient’s noncompliance with medication and frustration with treatment. However, as with any chronic health condition the bipolar patient has to learn how to be compliant and make lifestyle changes to manage symptoms.

Continue reading “Bipolar Disorder 躁狂抑郁性精神病 (Reading & Sharing Again)”

Nursing Continue Education

Depression 抑郁症 (Reading & Sharing)

Depression is a mental disorder that affects the emotion, cognition, behavior, and physically. Thus, it interferes with the daily life of the patient. One out of 10 adults experience one or more episodes during their lifetime. Common complaints presented to the office are lack of interest in pleasurable activities, insomnia, digestive problems, and unexplained chronic aches and pains. As there are many forms of depression, treatment varies depending on the specific diagnosis. Types of depression may include: major depression, single versus recurrent episode (mild, moderate and severe with or without psychotic features); persistent depressive disorder (dysthymia), postpartum depression, seasonal affective disorder (SAD), bipolar disorder, and premenstrual dysphoric disorder. Most depression is associated with other physical or mental disorders (Cash & Glass, 2017). Although this condition is prevalent in primary care patients, few patients admit to being depressed and present with somatic symptoms such as headaches, back problems, or chronic pain making detection of depression more difficult to diagnose (Williams & Nieuwsma, 2018). This make it imperative that providers must learn to inquire sensitively about depression and how to utilize evidence-based screening tools available.

Continue reading “Depression 抑郁症 (Reading & Sharing)”
Nursing Continue Education

Depression /Reading and Sharing

Depression is the most common psychiatric disorder in the general population and the most common mental health condition seen primary care. Depression is a mental disorder that affects the emotion, cognition, behavior, and physically. Thus, it interferes with the daily life of the patient. 1 out of 10 adults experience one or more episode during their lifetime. Common complaints presented to the office are lack of interest in pleasurable activities, insomnia, digestive problems, and unexplained chronic aches and pains.  As there are many forms of depression, treatment varies depending on the specific diagnosis. Type of depression may include: major depression, single versus recurrent episode (mild, moderate and severe with or without psychotic features); persistent depressive disorder (dysthymia), postpartum depression, seasonal affective disorder (SAD), bipolar disorder, and premenstrual dysphoric disorder. Most depression is associated with other physical or mental disorders (Cash & Glass, 2017).

Continue reading “Depression /Reading and Sharing”