Substance Abuse and Abuse Q 52
Which of the following would best indicate to the nurse that a depressed client is improving?
A. Reduced levels of anxiety
B. Changes in vegetative signs
C. Compliance with medications
D. Requests to talk to the nurse
Correct Answer: B. Changes in vegetative signs
Vegetative signs such as insomnia, anorexia, psychomotor retardation, constipation, diminished libido, and poor concentration are biological responses to depression. Improvement in these signs indicates a lifting of the depression. Give step-by-step reminders such as “Brush the teeth “Clean the outer surfaces of your upper teeth, then your lower teeth. . .”Encourage the client to get up and dress and to stay out of bed during the day. Minimizing sleep during the day increases the likelihood of sleep at night. Encourage small, high-calorie, and high-protein snacks and fluids frequently throughout the day and evening if weight loss is noted.
Option A: Reduced levels of anxiety do not indicate an improvement in depressive symptoms. Eventually involve the client in group activities (e.g., group discussions, art therapy, dance therapy). Socialization minimizes feelings of isolation. Genuine regard for others can increase feelings of self-worth.
Option C: Compliance with medications does not indicate improvement in depression. Help the client identify negative thinking/thoughts. Teach the client to reframe and/or refute negative thoughts. Negative ruminations add to feelings of hopelessness and are part of a depressed person’s faulty thought processes. Intervening in this process helps in a healthier and more useful outlook in life.
Option D: Requests to talk to the nurse vary. Requests may show trust in the nurse but are not a sign that depression has diminished. Initially, provide activities that require minimal concentration (e.g., drawing, playing simple board games). Depressed people lack concentration and memory. Activities that have no “right or wrong” or “winner or loser” minimizes opportunities for the client to put himself/herself down. Eventually maximize the client’s contacts with others (first one other, then two others, etc.).