MAJOR DEPRESSION

 REPORTER’S
NELIZA P. ALDANA
JESUS L. ATRERO
MHYLENE MON
BSN-IV
>is a disorder which typically involves 2 or more
weeks of sad mood or lack of interest in life
activities.

>This is the most severe category of depression. In

a major depression, more of the symptoms of
depression are present, and they are usually more
intense or severe.

>A major depression can result from a single

traumatic event in your life, or may develop
slowly as a consequence of numerous personal
disappointments and life problems.
Etiologic:

>A neurotransmitter imbalance that appears to be

caused by a relative deficiency of the
neurotransmitter serotonin ( the new SSRIs add
confirming evidence to this hypothesis)
 Sign and Symptoms:
During the same 2 week period every day five out of nine symptoms
must be present but one and two must be present.
1- depressed mood most of the day, nearly every day, as indicated by
either the patient or observation by others (appears tearful).
2- lose interest in all activities.
3- undesired weight change
4- sleep disturbance (less or more)
5- agitation or retardation
6- fatigue or loss of energy
7- Feeling of worthlessness or guilt
8- cognitive dysfunction
9- strong suicidal ideas , plan or attempt
The symptoms must not related to a medical condition (cancer), loss of
a loved one, drug abuse or medication)
Types Of
\Major Depression
Dysthymic Disorder 
Unspecified Depressi
on
Bipolar Depression
Adjustment Disorder,
with Depression
 Major Depression - This is the most serious
type of depression, in terms of number of
symptoms and severity of symptoms, but
there are significant individual differences in
the symptoms and severity. You do not need
to feel suicidal to have a major depression, and
you do not need to have a history of
hospitalizations either, although both of these
factors are present in some people with major
depression. There is no official diagnosis of
"moderate depression."
 Dysthymic Disorder - This refers to a low to
moderate level of depression that persists
for at least two years, and often longer.
While the symptoms are not as severe as a
major depression, they are more enduring
and resistant to treatment. Some people
with dysthymia develop a major depression
at some time during the course of their
depression.
 Unspecified Depression - This category is used
to help researchers who are studying other
specific types of depression, and do not want
their data confounded with marginal
diagnoses. It includes people with a serious
depression, but not quite severe enough to
have a diagnosis of a major depression. It also
includes people with chronic, moderate
depression, which has not been present long
enough for a diagnosis of a Dysthymic
disorder. (You get the idea!)
 Adjustment Disorder, with Depression -
This category describes depression that
occurs in response to a major life stressor or
crisis.
 Bipolar Depression - This type includes both
high and low mood swings, as well as a
variety of other significant symptoms not
present in other depressions.
GORDON’S FUNCTIONAL HEALTH
PATTERN
 Health Perception and Health Management. Data collection is
focused on the person's perceived level of health and well-being,
and on practices for maintaining health.
 Client habits evaluated as detrimental to health including smoking
and alcohol drinking. Actual or potential problems related to safety
and health management also identified as to poor knowledge on
present medical condition that could be lead to mental problem.
 Nursing Diagnosis: Ineffective health maintenance

 Nutrition and Metabolism Assessment is focused on the pattern

of food and fluid consumption relative to metabolic need.
 Incomplete meal in a day, he usually eats junkfoods and always
skips meal because of lack of appetite.
 Nursing Diagnosis: Imbalanced nutrition: less than body
requirements
 Elimination. Data collection is focused on excretory
patterns (bowel, bladder, skin).
 Stool is soft to watery and feels discomfort in
defecation and urinates only once a day with yellow in
color.
 Nursing Diagnosis: Impaired urinary and bowel
elimination

 Activity and Exercise. Assessment is focused on the

activities of daily living requiring energy
expenditure, including self-care activities, exercise,
and leisure activities.
 Daily activities include bonding with friends. Daily
exercise every morning including stretching, jumping
jack and walking.
 Nursing Diagnosis: activity intolerance
 Cognition and Perception. Assessment is focused
on the ability to comprehend and use information
and on the sensory functions.
 Assessed perception and coordination imbalanced and
delayed response even to simple question and shows
facial expression on more complex questions.
 Nursing Diagnosis: disturbed thought process

 Sleep and Rest. Assessment is focused on the

person's sleep, rest, and relaxation practices.
 Average of 3 hours of sleep at night, he has a difficulty
in sleeping and can’t take a nap at the day. Usually
retire at 2am and awake at 4-5am averagely.
 Nursing Diagnosis: sleep disturbance
 Self-Perception and Self-Concept. Assessment is focused
on the person's attitudes toward self, including identity,
body image, and sense of self-worth.
 Perceived there self as unworthy to live on everyday task
because of depression. They also perceive that it is end of his
world because they can’t solve their problems.

 Nursing Diagnosis: situation low self-esteem

 Most of the patient inside the hospital are lonely because
they thaught that their own family neglect them.

 Roles and Relationships. Assessment is focused on the

person's roles in the world and relationships with others.
 They are always bothered on personal relationship as claimed
as unstable and for not merely for lifetime partnership.
 Nursing Diagnosis: complicated grieving
 
 Sexuality and Reproduction. Assessment is
focused on the person's satisfaction or
dissatisfaction with sexuality patterns and
reproductive functions.
 Partnership claimed to be no pleasurable to him.
 Nursing Diagnosis: ineffective sexuality pattern

 Coping and Stress Tolerance. Assessment is
focused on the person's perception of stress and
on his or her coping strategies.
 He felt that he can’t solve his problem by himself
so he always drinking to copes up instead of
crying.
 Nursing Diagnosis: ineffective coping
mechanism
 Values and Belief. Assessment is focused on the person's
values and beliefs (including spiritual beliefs), or on the
goals that guide his or her choices or decisions.
 Valued and loved his family most. He is a religious person but
can’t manage to go church to attend a mass.
 Nursing Diagnosis: moral and spiritual distress t/t life
changes

 General Evaluation: 
 Client had poor perception of identifiable health condition
and lack knowledge of health agencies assistance. Focus
on what everyday tasks and unfortunate relations with
other sex. Health threats, foreseeable crisis had not been
identified and realized to present health status that might
reoccur in the future. Underprivileged salience in taking
consideration to change personal health habit and
personal undertakings should be the focus of attention.
ANATOMY AND PHYSIOLOGY AND
PATHOPHYSIOLOGY
DRUG STUDY
NURSING CARE PLAN
DISCHARGE PLAN:

1. Strongly encourage the patient to seek out

counselling. Give appropriate referrals
2. If patient is unable to caught himself or is
potentially suicidal, work with other
members of the team as family to
determine discharge options. Patient may
need psychiatric hospitalization or
temporary placement in abroad and care or
convalescent facility.
 3.refer patient for home healthcare for
follow-up on medication compliance and self-
care activities
 4. encourage patient to maintain follow-up
with physicians