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ch 1 Flashcards

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1
Q

shift from institutional care in hospitals to community care

A

deinstitutionalization

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2
Q

DSM is used for

A

describe all mental disorders and outline diagnostic criteria

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3
Q

managed care is used to purposely control the balance of

A

expenditure of funds and quality of care

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4
Q

a state of overall wellbeing and stability

A

mental health

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5
Q

mental illness

A

a behavioral or psychological pattern that causes distress or disability in an individual

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6
Q

psychotropic drugs effect

A

mood, behavior and thinking

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7
Q

is mental health considered lack of mental illness

A

no, it is a state of emotional, physical, social and psychological wellness

dynamic and ever changing due to external factors

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8
Q

3 purposes of DSM

A
  1. standardized nomenclature is established
  2. present defining characteristics that differentiate specific diagnosis
  3. to assist in finding the underlying causes of disorders
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9
Q

Aristotle and mental health

A

believed was determined by “humors” or the amounts of blood and bile in the body determined if mental illness was present

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10
Q

who created the concept of asylums in 1790s

A

William Tuke and philippe pinel

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11
Q

who opened 32 state hospitals in the US to offer asylum

A

dorthea dix

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12
Q

first drugs to be developed to treat mental illness

A

chlorpromazine (antipsychotic) and lithium (antimanic)

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13
Q

supplemental security income

A

mentally ill able to have source of income due to disability

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14
Q

__% Americans 18yr+ have a mental illness

A

18.6%

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15
Q

mental illness is leading cause of disability 15-44yr in US and Canada T/F

A

true

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16
Q

negative side effect of deinstitutionalization

A

revolving door effect

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17
Q

do planned hospital stays contribute to the revolving door effect?

A

no-> pt with severe and persistent mental illness may show signs of improvement during an unplanned stay but are not stabilized when released

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18
Q

is funding for community health centers congruent between states

A

no it varies by state and areas depending on funding

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19
Q

medicare covers

A

65+ and over

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20
Q

medicaid covers

A

people with disabilities

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21
Q

mental health parity act

A

eliminated annual and lifetime dollar amounts for mental health care for companies with more than 50 employees

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22
Q

first American psychiatric nurse

A

linda richards

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23
Q

first psych textbook published when and by who

A

in 1920 by harriet bailey

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24
Q

nursing theorist that supported interpersonal relationships with nurse and client

A

peplau

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25
Q

nursing theorist that focused on clients psychosocial needs and strengths

A

june mellow

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26
Q

who develops standards of care for nurses

A

american nurses association

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27
Q

intense need to move about, restless movement, cannot remain still

A

akathisia

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28
Q

anticholinergic side effects

A

cant see
cant pee
cant poop
cant spit

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29
Q

neuroleptics

A

antipsychotic drugs used to treat psychosis

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30
Q

anxiolytic drugs

A

used to treat anxiety

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31
Q

black box warning

A

highlighted box that indicates warning about life threatening side effects

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32
Q

depot injection

A

slow release injectable form of antipsychotic medication for maintenance therapy

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33
Q

NT in control of movements, motivation, cognition

A

dopamine

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34
Q

dystonia

A

extrapyramidal side effect to antipsychotic meds

acute muscular stiffness, stiff tongue, in severe cases respiratory difficulties and laryngospasm

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35
Q

maximal therapeutic effect a drug can reach

A

efficacy

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36
Q

most prevalent NT in CNS

A

epinephrine and norep

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37
Q

epinephrine plays a role in

A

attention, learning and memory, sleep, and mood regulation

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38
Q

extrapyramidal s/s

A

side effects of antipsychotics
dystonia
pseudoparkinsonism
akathisia

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39
Q

snowball effect of when a minor seizure seems to build up into more frequent

A

kindling process

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40
Q

limbic system includes

A

thalamus
hypothalamus
hippocampus
amygdala

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41
Q

mood stabilizing drugs are used for

A

bipolar

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42
Q

possibly fatal reaction to antipsychotic drug

A

neuroleptic malignant syndrome

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43
Q

post injection delirium/sedation syndrome

A

cluster of s/s from accidental intravascular injection of alanzapine
slurr speech
confusion
altered gait

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44
Q

serotonin syndrome

A 
caused by combo of serotonin enhancing drugs that will cause
agitation
sweating
fever
tachy
hypotension
hyperreflexia
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45
Q

most common combo of serotonin drugs that cause serotonin syndrome

A

MAOI and SSRI

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46
Q

tardive dyskinesia

A

late onset side effect of antipsychotic

involuntary movements such as lip smacking, tongue protrusion, chewing etc

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47
Q

lobe that controls organization, body movement, memories, emotions and moral behavior

A

frontal lobes

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48
Q

abnormalities in the _____ result in schizophrenia, ADHD and dementia

A

frontal

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49
Q

lobe that interprets sensations of taste and touch, assists in spatial organization

A

parietal

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50
Q

center for smell, hearing, memory and emotional expression is interpreted in what lobe

A

temporal

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51
Q

lobe that assists in coordination language, visual interpretation-depth perception

A

occipital

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52
Q

center for coordination or movements and postural adjustments

A

cerebellum

53
Q

lack of dopamine in cerebellum

A

parkinsons

54
Q

bottom of brainstem that controls breathing and cardio functions

A

medulla

55
Q

the pons serves as the ____ pathway

A

primary motor pathway

56
Q

midbrain connects the pons with cerebellum and controls most of the ____ systems

A

reticular activating systems and extrapyramidal system

57
Q

extrapyramidal system function

A

relays info about movement and coordination from brain to spinal cord

58
Q

norep producing area in the brain

A

locus coeruleus

59
Q

locus coeruleus is associated with

A

stress, anxiety and impulsive behavior

60
Q

thalamus system regulates

A

activity, sensation and emotion

61
Q

part of limbic system in control of appetite, temperature control, sex drive and impulsive behavior

A

hypothalamus

62
Q

part of limbic system associated with memory

A

hippocampus and amygdala

63
Q

neurotransmission

A

NT communicate with other neurons

64
Q

MAO function

A

breaks down NT in synapses when they are not reuptaked

65
Q

dopamine is synthesized by

A

tyrosine

66
Q

dopamine excess is seen in

A

schizophrenia

antipsychotics work to block dopamine receptors

67
Q

excess norep is seen in what disorder

A

anxiety

68
Q

serotonin is derived from

A

tryptophan

69
Q

is serotonin excitatory or inhibitory

A

inhibitory

70
Q

decreased ACH is present in what diseases

A

alzheimers and myasthemia gravis

71
Q

high glutamate can cause

A

severe brain damage, seen in strokes, hypoglycemia, hypoxia

72
Q

inhibitory NT that modulates other NT

A

GABA

used exp with benzos to reduce anxiety and induce sleep

73
Q

CT vs MRI

A

CT is multiple Xrays that can visualize soft tissues

MRI shows more tissue detail and blood flow. used to measure size and thickness

74
Q

PET and SPECT are mainly used for

A

research, pt performs cognitive functions and is observed.

SPECT is single photon and takes shorter time

75
Q

drugs take longer to reach effect and require lower dosages in elderly T/F

A

true

76
Q

how do antipsychotics work

A

block receptors of dopamine

77
Q

antipsychotics main use

A

schizophrenia, acute manic, psychosis

78
Q

is the antipsychotic- clozapine known to have higher or lower instances of extrapyramidal effects

A

lower

79
Q

dopamine stabilizing drug

A

aripiprazole

commonly causes HA, N/V

80
Q

what depot injection has the possibility of causing post injection delirium

A

zyprexa

81
Q

nursing duties after depot injection

A

monitor for 3 hours post for sedation syndrome

82
Q

first gen or second gen antipsychotics more likley to cause EPS

A

first gen

83
Q

when is geodon contraindicated

A

when pt has hx for QT prolongation, recent MI, or uncompensated heart failure

84
Q

dystonia is more likely in what kind of pt

A

first week of tx
under 40
pt receiving haloperidol or thiothixene

85
Q

pt is experiencing severe EPS s/s, what treatment is possible

A

anticholingeric drugs such as benztropine IM or benadryl

86
Q

treatment of EPS s/s of akathisia

A

add a B-blocker, anticholinergic or benzo

87
Q

s/s of neuroleptic malignant syndrome

A 
pt usually confused and mute, usually first two weeks of starting the drug
pale
unstable BP
diaphoresis
high creatine
88
Q

tx for neuroleptic malignant syndrome

A

stop immediately

89
Q

tool used to assess for tardive dyskinesia

A

abnormal involuntary movement tool

90
Q

increased prolactin levels when n antipsychotic drugs causes

A

weight gain
breast enlargement
decreased libido

91
Q

weight gain is most commonly seen with what antipsychotic

A

clozapine and olanzapine

92
Q

what 3 antipsychotics may lengthen the QT interval and lead to life threatening effects

A

droperidol
thioridazine
mesoridazine

93
Q

clozapine’s deadly side effect nurses must watch for

A

agranulocytosis

94
Q

pt misses an antipsychotic med

A

can take it if its within 3-4hours-> omit if not

95
Q

antidepressants act on what 2 NT

A

norep and serotonin

96
Q

life threatening possible side effects of taking MAOI

A

HTN crisis if pt ingests tryamine
many drug interactions
lethal if OD

97
Q

first choice for depression

A

SSRI

98
Q

drugs effective fro OCD

A

SSRI and clomipramine

99
Q

MAOI’s commonly prescribed for pt who is highly suicidal

A

no

100
Q

most established mood stabilizer

A

lithium

101
Q

serious side effect of lamotrigine

A

serious rashes, higher risk in younger children

102
Q

signs of lithium toxicity

A

severe diarrhea, vomiting, drowsiness, muscle weakness

103
Q

most effective drug class for anxiety

A

benzo’s

-> never discontinue abruptly!

104
Q

where do amphetamines act on the cell

A

presynaptic terminals

105
Q

client teaching for stimulants

A

take after meals

no caffeine, sugar

106
Q

why is disulfiram used

A

produced negative side effects when ingested with alcohol

107
Q

why is disulfiram used

A

produces negative side effects when ingested with alcohol

108
Q

extrapyramidal system is controlled where

A

midbrain

109
Q

a drug induced movement disorder would be induced where

A

D2 receptors in midbrain

110
Q

4 functions of dopamine

A

complex movements, motivation, cognition, regulation of emotional response

111
Q

schizophrenia has high/low dopamine

A

high

antipsychotics block receptors

112
Q

is norep increased or decreased in anxiety disorder

A

increased

113
Q

what meds function to increase the function of gaba

A

benzo

114
Q

what meds function to increase the function of gaba

A

benzo

115
Q

tardative dyskinesia is most likely seen with what kind of antipsychotics

A

conventional/first gen

116
Q

weight gain is most common side effect with what kind of antipsychotics

A

second gen:
clozapine
olanzapine

117
Q

what to do if suspect neuroleptic malignant syndrome (side effect of antipsychotics)

A

stop meds!

118
Q

what antipsychotic can cause deadly agranulocytosis

A

clozapine

119
Q

what antidepressants cause anticholingeric side effects

A

TCA

120
Q

what antidepressants cause anticholingeric side effects

A

TCA

121
Q

when should TCA’s be given

A

at night

122
Q

examples of mood stabilizaera

A 
valpronic acid
carbamazepine
gabapentin
topiramate
oxcarbazepine
lamotrigine
123
Q

how are valpronic acid and topiramate known to work for mood stabilization

A

increase GABA

124
Q

what two anticonvulsants are thought to stop the kindling process

A

valpronic acid and carbamazepine

125
Q

lithium side effects

A

Nausea
diarrhea
anorexia
fine hand tremor

126
Q

lithium severe side effects

A

severe diarehha and vomitting, weakness

= toxicity (over 3)

127
Q

when must blood tests be taken when on lithium

A

within 12 hours of last dose

128
Q

biggest side effect with benzos

A

physical dependence

psych test 1 (1 decks)

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