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The client is being admitted to the inpatient psychiatric unit with a diagnosis of major depression. During the initial nursing assessment, the nurse anticipates that the client will acknowledge which of the following? Select all that apply.

1. Suicidal thoughts or plans of suicide over at least the past 2 weeks
2. History of one depressive episode within the past 2 years
3. Loss of appetite for approximately 3 days
4. Loss of interest in previously enjoyed activities
5. Presence of hallucinations for at least 3 days


The nurse should understand that in order for a client to be diagnosed with major depression, DSM-IV-TR specifies that symptoms consistent with at least 5 of 9 criteria must have been present for at least 2 weeks. Suicidal ideations and plans are included in one criterion (option 1). The nurse should keep in mind that the presence of suicidal ideations alone would not support the diagnosis of major depression. Another criterion for major depression involves markedly diminished interest or pleasure in all, or almost all, activities (option 4). Option 2 is incorrect because major depressive symptoms represent a more recent change in functioning, not a single episode within 2 years. While persons with major depression often have changes in weight and appetite (option 3), the relevant DSM- IV-TR criterion for major depression does not involve a 3-day period. It also allows for either increases or decreases in appetite to have occurred. Hallucinations (option 5) may occur in psychotic levels of major depression, but they are not part of the diagnostic criteria in DSM-IV-TR. Compare and contrast usual presenting symptoms and DSM-IV-TR criteria for dysthymia and major depression.


Member since: April 2011
(Boynton Beach,FL) Original question source

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Topics: Mental Health, Nursing Process: Assessment

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