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Psychiatric > Bipolar, Schizophrenia,Gender > Flashcards

Bipolar, Schizophrenia,Gender Flashcards

1
Q

Why does it hard to diagnose bipolar in children?

A

Because manifestations can mimic ADHD

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2
Q

What is Mania?
Symptoms?

A

Found in Bipolar I

M More energy
A Agitation
N Non-stop talking
I Insomnia and Impulsivity
A Attention

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3
Q

Depressive symptoms

A

Flat
Blunted　鈍い
Tearfulness
Lack of energy
Anhedonia

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4
Q

Bipolar I Disorder

A

At least one full manic episode
at least for a week

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5
Q

Bipolar 2 Disorder

A

At least one episode of hypomania
Persist for at least four days,
One major depressive episode
Never has a full manic episode

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6
Q

Cyclothymic disorder

A

A milder form of bipolar disorder
Many “mood swings,” with hypomania and depressive symptoms that occur frequently

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7
Q

Bipolar disorder
Rapid cycle

A

Four or more mood episodes within 12 months

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8
Q

Priority nursing intervention
Bipolar I: Mania 5

A

Safety and maintaining physical health!!

-Decrease stimulation
-Assess regularly for suicidal thoughts
-High-calorie food and adequate fluid intake
-Promote adequate sleep
-Provide for physical activity

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9
Q

Baseline bloodwork
Valproate or Valproic acid 3

A

CBC (Complete blood count)
Liver function tests
Menstrual cycle history

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10
Q

Baseline bloodwork
Lithium 5

A

Thyroid Functions test
CBC
Electrolytes (lithium=sodium)
Pregnancy test
Renal function

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11
Q

lithium toxicity
For acute mania?
For maintenance?

A

For acute mania: 1.0-1.5
For maintenance: 0.6-1.2

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12
Q

lithium toxicity
Must report! 4

A

-Extreme thirst
-Excessive urination
-Vomiting and diarrhea
-Tremors

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13
Q

lithium
These are just side effects 4
No report!

A

-dry mouth
-thirst
-drowsiness
-weight gain

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14
Q

Risk for lithium toxicity
Pt has a____________ and b_______________.

DO NOT administer who is under a_______ or b___________.
Do not take with e_______take f_______ instead

A

a) Renal failure
Creatinine over 1.3 means BAD kidney
b) Elderly patients
c) dehydration
d) hyponatremia (less than 135)
e) NSAIDs like ibuprofen
f) Tylenol

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15
Q

What is Anhedonia?

A

Loos of pleasure and lack of interest in activities, hobbies and sexual activity

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16
Q

In the initial stages of caring for a client experiencing an acute manic episode, what should the nurse consider to be the priority
nursing diagnosis?

a. Risk for injury related to excessive hyperactivity
b. Disturbed sleep pattern related to manic hyperactivity
c. Imbalanced nutrition, less than body requirements, related to
inadequate intake
d. Situational low self-esteem related to embarrassment secondary to
high-risk behaviors

A

A
maintaining client safety is always a priority

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17
Q

Factors that place a patient at risk for lithium toxicity.

A

Therapeutic window is narrow
For acute mania: 1.0 to 1.5 mEq/L
For maintenance: 0.6-1.2 mEq/L

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18
Q

A nurse is discussing relapse prevention with a client who has bipolar disorder. Which of the following information should the nurse include in the teaching? (select all that apply)
a) Use caffeine in moderation to prevent relapse
b) Difficulty sleeping can indicate a relapse
c) Begin taking your medications as soon as a relapse begins
d) Participating in psychotherapy can help prevent a relapse
e) Anhedonia is a clinical manifestation of a depressive relapse

A

b,d,e

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19
Q

A suicidal client with a history of manic behavior is admitted to the ED.
The client’s diagnosis is documented as Bipolar I disorder current episode depressed. What is the rationale for this diagnosis instead of a diagnosis of major depressive disorder?

a) The physician does not believe that the client is suffering from major
depression
b) The client has experienced a manic episode in the past
c) The client does not exhibit psychotic symptoms
d) There is no history of major depression in the client’s family

A

b

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20
Q

Bipolar 2

A

One or more hypomania episode

Hypomania is less sever episode of mania that last 4 days

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21
Q

A nurse is planning care for a client who had bipolar disorder and is experiencing a manic episode.
Which of the following interventions should the nurse include?

a) Provide flexible client behavior expectation
b) Offer concise explanations
c) Establish consistent limits
d) Disregard client concerns
e) Use firm approach with communication

A

B improve pt’s ability to focus
C decrease the risk for pt’s manipulation
E provide structure and minimize pt inappropriate behavior

a) NOT flexible, established!!

consistent 一貫性のある
manipulation 操作
Disregard 無視

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22
Q

A pt is brought to the ED b a family member who reports the pt stopped taking a mood stabilizer. The pt indicates a manic episode.
What is the priority nursing diagnosis?
a) Imbalanced nutrition: less body requirements related to not eating
b) Risk for injury related to hyperactivity
c) Disturbed sleep pattern related to agitation
d) Ineffective coping related to denial of depression

A

b
Safety is the #1 priority!!

23
Q

A nurse is caring for a client who has bipolar disorder. which is the priority nursing action?
a) Set consistent limits for expected client behavior
b) Administer prescribed medications as schedule
c) Provide the client with step-by-step instructions during hygiene activities
d) Monitored the client for escalating behavior

A

d for safety

Safety is #1!!!
a) b) c) Not priority for safety

24
Q

A nurse is teaching about ETC.
Which following statements indicate newly nurse understanding?
a) ECT is the recommended initial treatment for bipolar
b) ECT is contraindicated for client who have suicidal ideation
c) ETC is effective for client who are experiencing sever mania

A

b

25
Q

Gender dysphoria
diagnosed

A

Not diagnosed unless symptoms of
Distress with gender identity
Depression related to desire to be opposite gender

26
Q

Gender is?

A

one’s sense of oneself as either a man, woman, or other gendered.

27
Q

Sex?

A

A person’s sex is male or female assigned at birth based

28
Q

Transvestism?

A

to dress in the clothing of the opposite sex
異性の服装をすることで性的満足を得ること

29
Q

Gender dysphoria?

A

mismatch between their biological sex and their gender identity

性同一性障害
自身の生まれ持った肉体的性別と精神的性別に不一致、違和感を覚えること

30
Q

What is the outcome who have gender dysphoria?

A

Verbalizes positive self-esteem (accepts themselves)
Verbalizes and demonstrates comfort with gender identity.

31
Q

Sexual dysfunction

A

A problem that prevents you from wanting or enjoying sexual activity
heart disease or other medical conditions
drug use
alcohol use

32
Q

Gender dysphoria
Nursing diagnosis

A

-Impaired social interaction related to socially and culturally nonconforming behaviors
-Low self-esteem related to rejection by peers and/or family members.

33
Q

Schizophrenia
Positive symptoms

A

Add!
Hallucinations
Delusions
Alterations in Speech
Bizarre behavior(Extremely odd)

34
Q

Schizophrenia
Negative symptoms

A

Subtract!
Anhedonia　無快感症
Alogia　失語
Anergia　abnormal lack of energy
Anxiety and avoiding social interaction

35
Q

Delusions

A

a belief that is clearly false
an abnormality in the affected person’s content of thought

36
Q

Persecutory delusions

A

the most common type
believe someone or something is spying on, or to harm
“the FBI has bugged my room and intends to kill me.”

37
Q

Grandiose delusions

A

sense of self-worth, power, knowledge, or identity
“claims to be president of the United States, when they clearly are not”

38
Q

Somatic delusion

A

something wrong with part or all of their bod
“the doctor says I’m not pregnant, but I know I am”

39
Q

Nihilistic delusion

A

having lost one’s own internal organs or even not existing entirely as a human being

40
Q

Erotomania delusion

A

believes that another person, usually of higher status, is in love with him
Famous people are often the subjects

41
Q

Jealous delusion

A

belief that their spouse (or sexual partner) is being unfaithful

42
Q

Delusion of reference

A

un-related occurrences in the external world have a special significance for the person who is being diagnosed
“Someone is trying to get a massage to me through the this magazine, I must break the code.”

43
Q

Word salad

A

Group of words put together in a random fashion
-ex: “Most forward action grows life double plays circle uniform.”

44
Q

Clang associations

A

Words by sound and rhythm
- “oh, fox, box, and lox”

45
Q

Loose associations

A

Shift of ideas from one unrelated topic to another (the individual is unaware that topics are unrelated)
-We wanted to take the bus, but the airport took all the traffic. During is the ticket when you want to get somewhere. We have all it in our pocket.

46
Q

Nursing intervention
Hallucination

A

Avoid touching clients w/out warning them
Acceptance of the voice, but make sure to tell the reality

47
Q

Symptoms of tardive dyskinesia

A

Stick out the tongue without trying
Blink the eyes fast
Involuntary movement of face, lips, and tongue

48
Q

What the rationale for using the Assessment of Involuntary Movements Scale (AIMS)?

A

Monitor involuntary movements and tardive dyskinesia in clients who take antipsychotic meds
Because early detection is the key!!

49
Q

Signs and symptoms
Neuroleptic malignant syndrome (NMS)

A

hyperpyrexia
tachycardia
tachypnea
Muscle rigidity (stiffness).
Altered mental status
High blood pressure or low blood pressure.
life-threatening emergency associated with the use of antipsychotic agents
Excessive sweating.

50
Q

bound duty to warn

A

Protection of a third party
Imminent serious physical harm or death to a clearly identified or identifiable victim

51
Q

What to do under bound duty to warn

A

If pt is expressing the intent to harm someone, the nurse has the duty and right to warn the person w/out fear of consequences for breaching provider-patient confidentiality

52
Q

Thought insertion

A

believes that others’ thoughts are being inserted into their mind (type of delusion)
They can differentiate that the thought is not their thought

53
Q

Magical thinking

A

Psychiatric (21 decks)

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