Depression Concept Map

Concept maps
1. Many types, variations, layouts
2. Primary diagnosis
  1. Typically in center of map
  2. Connects to
    1. Contributing factors
    2. Medications
    3. Labwork
    4. Patient education
    5. Nursing diagnoses
      1. Interventions
      2. Evaluations

Nursing Points

General

Nursing diagnosis
1. Ineffective coping
  1. Encourage physical activity
    1. Patient increases activity
  2. Provide patient opportunity to express feelings
    1. Patient continues communication with provider
  3. Encourage cognitive behavorial relaxation
    1. Patient expresses increased coping skills
2. Self-care deficit
  1. Establish short term goals
    1. Patient will successfully complete short term goals
  2. Provide resources (wide grip utensils, straw)
    1. Increased independence by patient
  3. Provide positive reinforcement
    1. Patient exhibits confident
    2. Continued self-care attempts
3. Risk for self-directed violence
  1. Encourage patient to express feelings
    1. Patient identifies alternatives ways to deal with emotions
  2. Arrange crisis counseling – involve family
    1. Patient will identify available resources/support
  3. Implement “no-suicide” contract
    1. Patient does not exhibit self-harm behaviors

Assessment

Contributing factors
1. Family history of mental illness
2. Chronic physical/mental disorders
3. Major life changes
4. Stress
5. Little or no social support
6. Low economic status

Therapeutic Management

Labwork
1. Scales/questionnaires
  1. Used for diagnosis
2. Bloodwork
  1. Rule out other health issues
    1. ie thyroid (hormonal)
    2. Vitamin deficiency
Medications
1. Selective serotonin reuptake inhibitors (SSRIs)
  1. Fluoxetine
    1. 20-80mg oral
  2. Paroxetine
    1. 20-60mg oral
  3. Sertraline
    1. 50-200mg oral
2. Serotonin norepinephrine reuptake inhibitors (SNRIs)
  1. Venlafaxine
    1. 75-375mg oral
  2. Duloxetine
    1. 40-60mg oral

Nursing Concepts

Clinical judgement
Coping
Health promotion
Mood affect

Patient Education

Patient education
1. Report suicidal/homicidal ideations to provider
2. Teach importance of
  1. Proper diet
  2. Exercise
3. Recommend relaxation techniques
4. Recommend speaking with mental health provider

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Transcript

Hey guys! Lets take a look at a concept map for depression.

So in this lesson we will take a look at the components of a concept map including contributing factors, medications, lab work and the significance, patient education, and associated nursing diagnoses with interventions and evaluations!

Ok so here is a basic example of a concept map, guys there are many different variations and this is just one example. First, we start with the primary diagnosis typically in the center of the concept map which leads to nursing diagnoses and interventions and also contributing factors, medications, labwork, and patient education which are associated with the primary diagnosis. Lets jump in! Lets start with contributing factors in this upper corner. Contributing factors for depression may include a family history of mental illness, chronic physical or mental disorders, major life changes or stress, little or no social support, low economic status, being female, and being elderly.

In this next circle right here we might see medications necessary in treating depression. There are quite a few medications and treatments for depression with the most common being antidepressants. Common antidepressants include SSRIs (selective serotonin reuptake inhibitors) including fluoxetine 20-80mg oral , paroxetine 20-60mg oral, sertraline 50-200mg oral which works by affecting the serotonin neurotransmitter by blocking the serotonin transporter from returning serotonin. SNRIs (serotonin-norepinephrine reuptake inhibitors) are also used including venlafaxine 75-375mg oral and duloxetine 40-60mg oral which work by blocking the serotonin and norepinephrine transporters inhibiting reuptake and increasing availability.

Ok additional information included in a concept map is commonly patient education and significant labwork. So in this circle here lets add important patient education information which could be things like report symptoms of severe sadness, suicidal or homicidal ideation to your provider. Also teach the importance of healthy living including proper diet and exercise. Also, encourage the patient to utilize relaxation techniques and the importance of speaking with a provider who specializes in mental health treatment. In this next circle lets place information regarding labwork. For depression, questionnaires or scales are commonly used to aid in the diagnosis while blood tests are used to rule out thyroid or other hormonal issues which could be causing the depressive symptoms.

Finally, in the three circles that are left we will add nursing diagnoses with interventions and evaluations for depression. One possible nursing diagnosis could be ineffective coping with interventions include encouraging physical exercise which reduces acute stress which can be evaluated by an increase in activity by the patient. Provide the patient opportunities to express their feelings and concerns which will be evaluated by the ongoing communication between the patient and the nurse. Finally, encourage the use of cognitive behavioral relaxation as things like guided imagery and music therapy can increase coping which will be evaluated by the patient expressing increased coping after therapy.

Another nursing diagnosis when thinking of depression could be self-care deficit or the inability to complete ADLs like eating, dressing, and bathing. As nurses one intervention might be establishing short term goals which will help to not overwhelm a patient who even the smallest of tasks seems impossible. This intervention could be evaluated by the patient completing short term goals successfully. Another intervention might be providing resources that can aid in independent self-care like wide grip utensils or a straw which will aid in and also be evaluated by increased independence and eagerness of the patient. Finally, providing positive reinforcement for all attempted activities will promote future attempts which will be evaluated by continued confidence and more self-care by the patient.

Ok guys! One last nursing diagnosis for your depression concept map! Risk for self-directed violence is definitely something we as providers might worry about with a patient suffering from depression. Which interventions are appropriate for this diagnosis? First, encourage the client to express feelings of anger, guilt, and sadness which helps the patient to learn alternative ways to deal with overwhelming emotions gaining a sense of control. This intervention is evaluated by the patient identifying alternative ways of dealing with emotions. Next, arrange for crisis counseling and involve the family if possible as patients who are at risk of self-directed violence require a strong support system and resources to diminish feelings of worthlessness, helplessness, and isolation. The patient will be able to identify people and resources available to reach out to. Finally, implement a written” no suicide” contract which will reinforce actions that the patient can take when having these feelings which will be evaluated by the absence of self-harm by the patient.

Ok guys! Here is a look at the completed concept map for depression!

We love you guys! Go out and be your best self today! And as always, Happy Nursing!