ati book Flashcards
phase where the NURSE:
Introduce self to the client and state purpose
Set the contract: meeting time, place, frequency, duration, and date of termination
Discuss confidentiality
Build trust by establishing expectations and boundaries
Set goals with the client
Explore the clients ideas, issues, and needs
Explore the meaning of testing behavior
Enforce limits on testing or other inappropriate behavior
orientation
is the expression of psychological stress through physical manifestation.
The physical manifestations of somatic symptom disorder cannot be explained by underlying pathology
spend a significant amount of time worrying about their physical manifestations to the point where it assumes a central role in the clients life and relationship
Somatization
MALADAPTIVE USE:
A person who learns he has a terminal illness focuses on creating a will and financial matters rather than acknowledging his grief
Intellectualization
interactions that occur with ________
Concurrent use with MAO’s can cause severe hypertension.
Concurrent use with antihistamines and other anticholinergic agents can result in additive
anticholinergic effects.
Concurrent use with direct-acting sympathomimetics can result in increased effects of these
medications, because uptake is blocked by TCAs.
Concurrent use with indirect-acting sympathomimetics can result in decreased effect of these medications
Concurrent use with alcohol, benzodiazepines, opioids, and antihistamines can result in additive CNS
depression.
Tricyclic antidepressants
Communication that occurs between two or more people in a small group.
allows the nurse to discuss a change in the clients behavior with the health care team or discuss concerns with clients during a group therapy session
Small-group communication:
Members who take on these roles tend to help maintain the purpose and process of the Group.
For example, the harmonizer attempts to prevent conflict in the group
Maintenance roles:
COMPLICATIONS:
seizures supression of appetite headache drymouth GI distress constipation increased heart rate nausea insomnia restlessness
Atypical antidepressants
A therapist or others serve as role models for a client, who imitates this modeling to improve behavior
help clients improve interpersonal skills
modeling
MALADAPTIVE USE:
A person who dislikes her neighbor tells others what a great neighbor she is
Reaction formation
This examination is used to obtain a baseline assessment of a clients level of consciousness, and for ongoing assessment Eye, verbal, and motor response is evaluated, and a number value based on that response is assigned. The highest value possible is 15, which indicates that the client is awake and responding appropriately
Glasgow Coma Scale
is short term memory losss and confusion normal after and ECT?
yes
these agents, known as serotonin norepinephrine reuptake inhibitors (SNRIs), increase the amount of these neurotransmitters available in the brain for impulse transmission. SNRIs have little effect on other neurotransmitters and receptors
Venlafaxine, duloxefine, desvenlafaxine, levomilnacipran
Atypical antidepressants
These medications block reuptake of norepinephrine and serotonin in the synaptic space, thereby intensifying the effects of these neurotransmitters
THERAPEUTIC USES: Depressive disorders Neuropathic pain Fibromyalgia Anxiety disorders Insomnia Bipolar disorder
Tricyclic antidepressants
level of anxiety that
Slightly reduced perception and processing of information occurs, and selective inattention can occur
Ability to think clearly is hampered, but learning and problem-solving can still occur
concentration difficulties, tiredness, pacing, change in voice pitch, voice tremors, shakiness, and increased heart rate and respiratory rate
somatic manifestations including headaches, backache, urinary urgency and frequency, and insomnia
usually benefits from the direction of others
Moderate
is one in which all members share a certain chosen characteristic, such as diagnosis
or gender
homogeneous group
uses electrical current to induce brief seizure activity while the client is anesthetized
ECT
ADAPTIVE USE:
A student puts off thinking about a fight she had with her friend so she can focus on a test
Suppression
Abdominal pain Back pain Pain in the extremities/joints Menstrual problems or cramps Headaches Chest pain Dizziness Fainting Heart pounding or racing Dyspnea Problems or pain with sexual intercourse Problems with bowel elimination (constipation/diarrhea) Nausea, indigestion, or gas Lethargy
are all most common ___________ symptoms
somatic symptom disorder
•
experiencing a sudden event with little or no time to prepare
Perception of the event as ovemhelrning or life-threatening
Loss or decrease in communication with significant others
Sense of displacement from the familiar
An actual or perceived loss
ARE ALL COMMON ________CHARACTERISTICS
CRISIS
Phenelzine
Isocarboxazid
Tranylcypromine
Selegiline: transdermal patch
are what kind of medictions
Monoamine oxidase inhibitors
This therapy uses various techniques to control pain, tension, and anxiety
A nurse can teach diaphragmatic breathing to a client having a panic attack, or to a female client in labor
Meditation, guided imagery, diaphragmatic breathing, muscle relaxation, and biofeedback
A nurse or other health professional trained in this method uses a sensitive mechanical device to assist the client to gain voluntary control of such autonomic functions as heart rate and blood pressure
Biofeedback
These roles tend to prevent teamwork, because individuals take on roles to promote their own agenda
Examples include the dominator, who tries to control other members, and the recognition seeker, who
boasts about personal achievements
Individual roles
is based on the cognitive model, which focuses on individual thoughts and behaviors to solve
current problems. It treats depression, anxiety, eating disorders, and other issues that can improve by changing a clients attitude toward life experiences
Cognitive therapy
Communication that addresses an individual’s spiritual needs and provides interventions to meet those needs
used when the nurse assists the client with meditation as a means of relaxation
Transpersonal communication:
Emphasizing strengths to make up for weaknesses
Compensation
MALADAPTIVE USE:
A person who is shy works at computer skills to avoid socialization
Compensation
Teaching a client, when negative thoughts or compulsive behaviors arise, to say or shout, ‘stop,” and substitute a positive thought The goal over time is for the client to use the command silently
Thought stopping:
INTERACTIONS
Concurrent use with MAO’s, such as phenelzine, can increase the risk for toxicity.
There is an increased risk of seizures with concurrent use of SSRls.
Atypical antidepressants
Transcrania/ magnetic stimulation is used for pateints with ____
depression
Dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression
Sublimation
phase of major depressive disorder where:
Remission of manifestations
- This phase can last for year
- Prevention of future depressive episodes is the goal of treatment
Maintenance phase:
Communication that occurs within an individual
Intrapersonal communication:
This agent increases the release of serotonin and norepinephrine, thereby increasing the amount of these neurotransmitters available for impulse transmission
Mirtazapine
Monitor for cardiac dysrhythmias, which are an indication of toxicity
Administer at bedtime due to sedation and risk for orthostatic hypotension
Tricyclic antidepressants
Appearance Posture Gait Facial expressions Eye contact Gestures Sounds Territoriality Personal space Silence
things to look at with nonverbal communication
Conscious or unconscious assumption of the characteristics of another individual or group
Identification
type of anxiety that:
A healthy life force that is necessary for survival, normal anxiety motivates people to take action
For example, a potentially violent situation occurs on the mental health unit, and the nurse moves
rapidly to defuse the situation
Normal
the spontaneous, uncensored verbalization of whatever comes to a clients mind
Free association
type of loss that:
Losses normally expected due to the developmental processing of life
Maturational loss:
Tricyclic antidepressants are conrtaindicated in patients with _____________
seizure disorder
ADAPTIVE USE:
An adolescent boy says, “she must already have a boyfriend” when rejected by a girl
Rationalization
enhance the emotional climate of the therapeutic milieu by promoting:
interaction and communication between staff and clients
Decision making skills of clients
A feeling of self-worth among clients
Discussions of common unit objectives, such as encouraging clients to meet treatment goals and plan for discharge
Discussion of issues of concern to all members of the unit, including common problems, future activities,
and the introduction of new clients to the unit
Meetings may be structured so that they are client-led with decisions made by the group as a whole
commuinty meetings
Dealing with anxiety by reaching out to others
Altruism
ADAPTIVE USE:
A young child temporarily wets the bed when she learns that her pet died
Regression
stage of rettribution treatment that:
Work with the provider and client to develop a treatment plan that allows for regular follow-up visits
Stage 4: Negotiating further treatment:
stage of rettribution treatment that:
Use therapeutic communication to acknowledge the lack of a physical cause for the manifestations while allowing the client to maintain self-esteem
Stage 3: Making the link:
is a noninvasive therapy that uses magnetic pulsations to stimulate the cerebral cortex of the brain
Transcrania/ magnetic stimulation
Separation of emotions and logical facts when analyzing or coping with a situation or event
Intellectualization
ADAPTIVE USE:
A man who is trying to quit smoking repeatedly talks to adolescents about the dangers of nicotine
Reaction formation
ADAPTIVE USE
A person who has feelings of anger and hostility toward his work supervisor sublimates those feelings by working out vigorously at the gym during his lunch period
Sublimation
Collaborate with client to identify interventions while in an acute crisis that promote safety
Secondary care
phase of major depressive disorder where:
Increased ability to function
- Treatment is generally 4 to g months in duration
- Relapse prevention through education, medication therapy, and psychotherapy is the goal of treatment
Continuation phase:
selectively block reuptake of the monoamine neurotransmitter serotonin in the synaptic space, thereby intensifying the effects of serotonin
• First line treatment for depression
Selective serotonin reuptake inhibitors
This therapy is the planned, progressive, or graduated exposure to anxiety-provoking stimuli in real-life
situations, or by imagining events that cause anxiety During exposure, the client uses relaxation techniques to suppress anxiety response
Systematic desensitization
a short period of _____ may occur after ECT
hypertension
is the way the group behaves during sessions, and, over time, it provides structure for the group
Group norm
A form of depression that occurs seasonally, usually during the winter, when there is less daylight Light therapy is the first-line treatment
Seasonal affective disorder
MALADAPTIVE USE:
A person experiences deafness after his partner tells him she wants a divorce
Conversion
Sudden use of childlike or primitive behaviors that do not correlate with the person’s current developmental level
Regression
type of anxiety that
This level of anxiety is precipitated by an imminent loss or change that threatens one’s sense of security
Acute (state)
Flat, blunted, labile affect
Tearfulness, crying
Lack of energy
Anhedonia: loss of pleasure and lack of interest in activities, hobbies, sexual activity
Physical reports of discomfort/pain
Difficulty concentrating, focusing, problem-solving
Self-destructive behavior, including suicidal ideation
Decrease in personal hygiene
Loss or increase in appetite and/or sleep, disturbed sleep
Psychomotor retardation or agitatio
are all_________ characteristics
depressive characteristics of bipolar disorder
Misinterprets physical manifestations as evidence of a serious disease process. Illness anxiety disorder,
previously known as hypochondriasis, can lead to obsessive thoughts and fears about illness
Physical manifestations can be minimal or absent
illness anxiety disorder
assists clients in addressing specific problem. It can improve interpersonal relationships, communication, role-relationship, and bereavement
Interpersonal psychotherapy
Members are often consistent, the focus of the group is on growth, external influences are limited, and the leader can allow members an opportunity in determining the group’s direction
Outpatient setting:
are based on clients’ level of functioning and personal needs, such as adverse effects of medication
Psychoeducational
type of crisis that:
Often unanticipated loss or change experienced in everyday, often unanticipated, life events
Situational/ external:
is characterized by scheduled sessions with a mental health provider to address specific mental health concerns, such as depression
Individual therapy
Pretending the truth is not reality to manage the anxiety of acknowledging what is real
Denial
sexual dysfunction anxiety, aggitation, insomnia weight changes serotonin syndrome withdrawal syndrome hyponatremia rash sleepiness, faintness, lightheadedness GI bleed
are all complications of ___________ meds
Selective serotonin reuptake inhibitors
is an acute, time-limited (usually lasting 4 to 6 weeks) event during which a client experiences an
emotional response that cannot be managed with the clients normal coping mechanism
A crisis
MALADAPTIVE USE:
A young adult explains he had to drive home from a party after drinking alcohol because he had to feed his dog
Rationalization
Members can vary on a daily basis, and the focus of the group is on relief.
Unit activities will directly impact the group, and the leader must provide a higher level of structure
Acute mental health setting:
phase of major depressive disorder where:
Severe clinical findings of depression
- Treatment is generally 6 to 12 weeks in duration
- Potential need for hospitalization
- Reduction of depressive manifestations is the goal of treatment
- Assess suicide risk, and implement safety precautions or one-to-one observation as needed
Acute phase:
A single episode or recurrent episodes of unipolar depression resulting in a significant change in a clients normal functioning (social, occupational, self-care) accompanied by at least five of the following specific clinical findings, which must occur almost every day for a minimum of 2 weeks, and last most of the day:
Depressed mood Difficulty sleeping or excessive sleeping Indecisiveness Decreased ability to concentrate Suicidal ideation Increase or decrease in motor activity inability to feel pleasure Increase or decrease in weight of more than 5% of total body weight over 1 month
Major depressive disorder
assists clients to identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self-talk
Cognitive reframing
type of loss that:
Any loss of a valued person or item
Actual loss:
ADAPTIVE USE:
An adolescent who is physically unable to play contact sports excels in academic competitions
Compensation
type of loss that:
Part of the cycle of life: anticipated, but can still be intensely felt
Necessary loss:
