ANA / ANCC practice Flashcards
The following criteria must be met before commiting someone
- have a diagnosed psychiatric disorder
- they are unaware or unwilling to accept the nature and severity of the disorder
- as a result of the mental disorder, they are harmful to themselves or others
- As a result of the disorder they cannot take care of their basic needs (food, clothing, shelter)
what 2 depression scales are in the public domain that are sensitive and specific for depression
- PHQ-2
- PHQ-9
what is the first step in beginning a systems change project
conduct a system needs assessment
two models that can be used to conduct a quality improvement project
- PDSA
- donabedian model (structure, process, outcome)
Describe donabedian model
- structure - setting where care takes place (includes the availability of equipment, human and material resources)
- Process - the components of care delivered (patient-related processes and organizational aspects)
- outcomes - the effect of healthcare on health status of patients and populations
receptors and basic function of norepineprine
- a1 & a2
- alertness
- focused attention
- orientation
- primes fight or flight
- learning and memory
symptoms of deficiency of norepinephrine
dullness, low energy, depressive effect
symptoms of excess norepinephrine
- anxiety
- hyperalertness
- increased startle
- paranoia
- decreased appetite
Dystonia clinical presentation
- oculogyric crisis -fixed deviation of the eyes in one direction
- protrusion of tongue (thick tongue)
- forced jaw opening
- torticollis
- difficulty speaking
- trismus - restricted opening of mouth
acetylcholine receptors and general function
- nicotinic & muscanaric
- attention
- MEMORY
- thirst
- mood regulation
- REM sleep
- MUSCLE TONE
- sexual behavior
symptoms of acetylcholine deficit
- unihibited
- DECREASED MEMORY
- euphoria
- antisocial actions
- speech decrease
- dry mouth, blurred vision consitpation
symptoms of acetylcholine excess
- overly inhibited
- anxiety
- depression
- somatic complaints, self conciousness
- drooling
- EXTRAPYRAMIDAL MOVEMENTS
Examples of primary prevention
Aimed at decreasing the incidences (new cases) of mental health disorders
* stress management classes graduate students, smoking prevention classes, DARE and Keeping it real curriculum
Secondary prevention
aimed at decreasing the prevalence (# of existing cases) of mental health disorders
* early case finding, screening, prompt and effective treatment - telephone hotlines, crisis intervention, disaster responses
Tertiary prevention
aimed at decreasing the disability and severity of mental illness
* rehabillative services
* avoidance or postponement of complications (day treatment programs, case management for physical, housing or vocational needs, social skills training)
dopamine receptors and general function
- d1 and d2
- thinking
- decision making
- reward-seeking
- fine muscle action
- integrated cognition
symptoms of dopamine excess
mild
* improved creativity, improved ability for abstract thinking, improved executive functioning, improved spaciality
moderate
* disorganized thinking, loose associations, tics, stereotypic behavior
symptoms of dopamine deficit
mild
* poor impulse control, poor spaciality, lack of abstractive thought
Severe
* parkinson’s disease, endocrine alterations, movement disorders
primitive idealization
a defense mechanism that involves viewing people as having superhuman abilities and the capacity to achieve anything
projective identification
the projector splits off aspects of themselves and projects them onto another person. The other person then internalizes the projected qualities and believes they are characterized by them.
clear ego boundaries
sense of individuality
example for a nurse practitioner to promote interprofessional environment
- assign roles for ALL staff members in improving patient outcomes
Patient on stimulants for ADHD develops tic and is worsening, but med is effective. What do you do?
- discontinue and start on a non-stimulant (guanafacine ER) and monitor’s the patient
What process could an NP implement if she is tasked with continually improving the quality of care on an inpatient unit.
PDSA process