ch 1 Flashcards
(128 cards)
1
Q
shift from institutional care in hospitals to community care
A
deinstitutionalization
2
Q
DSM is used for
A
describe all mental disorders and outline diagnostic criteria
3
Q
managed care is used to purposely control the balance of
A
expenditure of funds and quality of care
4
Q
a state of overall wellbeing and stability
A
mental health
5
Q
mental illness
A
a behavioral or psychological pattern that causes distress or disability in an individual
6
Q
psychotropic drugs effect
A
mood, behavior and thinking
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
8
Q
3 purposes of DSM
A
- standardized nomenclature is established
- present defining characteristics that differentiate specific diagnosis
- to assist in finding the underlying causes of disorders
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
10
Q
who created the concept of asylums in 1790s
A
William Tuke and philippe pinel
11
Q
who opened 32 state hospitals in the US to offer asylum
A
dorthea dix
12
Q
first drugs to be developed to treat mental illness
A
chlorpromazine (antipsychotic) and lithium (antimanic)
13
Q
supplemental security income
A
mentally ill able to have source of income due to disability
14
Q
__% Americans 18yr+ have a mental illness
A
18.6%
15
Q
mental illness is leading cause of disability 15-44yr in US and Canada T/F
A
true
16
Q
negative side effect of deinstitutionalization
A
revolving door effect
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
18
Q
is funding for community health centers congruent between states
A
no it varies by state and areas depending on funding
19
Q
medicare covers
A
65+ and over
20
Q
medicaid covers
A
people with disabilities
21
Q
mental health parity act
A
eliminated annual and lifetime dollar amounts for mental health care for companies with more than 50 employees
22
Q
first American psychiatric nurse
A
linda richards
23
Q
first psych textbook published when and by who
A
in 1920 by harriet bailey
24
Q
nursing theorist that supported interpersonal relationships with nurse and client
A
peplau
25
nursing theorist that focused on clients psychosocial needs and strengths
june mellow
26
who develops standards of care for nurses
american nurses association
27
intense need to move about, restless movement, cannot remain still
akathisia
28
anticholinergic side effects
cant see
cant pee
cant poop
cant spit
29
neuroleptics
antipsychotic drugs used to treat psychosis
30
anxiolytic drugs
used to treat anxiety
31
black box warning
highlighted box that indicates warning about life threatening side effects
32
depot injection
slow release injectable form of antipsychotic medication for maintenance therapy
33
NT in control of movements, motivation, cognition
dopamine
34
dystonia
extrapyramidal side effect to antipsychotic meds
| acute muscular stiffness, stiff tongue, in severe cases respiratory difficulties and laryngospasm
35
maximal therapeutic effect a drug can reach
efficacy
36
most prevalent NT in CNS
epinephrine and norep
37
epinephrine plays a role in
attention, learning and memory, sleep, and mood regulation
38
extrapyramidal s/s
side effects of antipsychotics
dystonia
pseudoparkinsonism
akathisia
39
snowball effect of when a minor seizure seems to build up into more frequent
kindling process
40
limbic system includes
thalamus
hypothalamus
hippocampus
amygdala
41
mood stabilizing drugs are used for
bipolar
42
possibly fatal reaction to antipsychotic drug
neuroleptic malignant syndrome
43
post injection delirium/sedation syndrome
cluster of s/s from accidental intravascular injection of alanzapine
slurr speech
confusion
altered gait
44
serotonin syndrome
```
caused by combo of serotonin enhancing drugs that will cause
agitation
sweating
fever
tachy
hypotension
hyperreflexia
```
45
most common combo of serotonin drugs that cause serotonin syndrome
MAOI and SSRI
46
tardive dyskinesia
late onset side effect of antipsychotic
| involuntary movements such as lip smacking, tongue protrusion, chewing etc
47
lobe that controls organization, body movement, memories, emotions and moral behavior
frontal lobes
48
abnormalities in the _____ result in schizophrenia, ADHD and dementia
frontal
49
lobe that interprets sensations of taste and touch, assists in spatial organization
parietal
50
center for smell, hearing, memory and emotional expression is interpreted in what lobe
temporal
51
lobe that assists in coordination language, visual interpretation-depth perception
occipital
52
center for coordination or movements and postural adjustments
cerebellum
53
lack of dopamine in cerebellum
parkinsons
54
bottom of brainstem that controls breathing and cardio functions
medulla
55
the pons serves as the ____ pathway
primary motor pathway
56
midbrain connects the pons with cerebellum and controls most of the ____ systems
reticular activating systems and extrapyramidal system
57
extrapyramidal system function
relays info about movement and coordination from brain to spinal cord
58
norep producing area in the brain
locus coeruleus
59
locus coeruleus is associated with
stress, anxiety and impulsive behavior
60
thalamus system regulates
activity, sensation and emotion
61
part of limbic system in control of appetite, temperature control, sex drive and impulsive behavior
hypothalamus
62
part of limbic system associated with memory
hippocampus and amygdala
63
neurotransmission
NT communicate with other neurons
64
MAO function
breaks down NT in synapses when they are not reuptaked
65
dopamine is synthesized by
tyrosine
66
dopamine excess is seen in
schizophrenia
| antipsychotics work to block dopamine receptors
67
excess norep is seen in what disorder
anxiety
68
serotonin is derived from
tryptophan
69
is serotonin excitatory or inhibitory
inhibitory
70
decreased ACH is present in what diseases
alzheimers and myasthemia gravis
71
high glutamate can cause
severe brain damage, seen in strokes, hypoglycemia, hypoxia
72
inhibitory NT that modulates other NT
GABA
| used exp with benzos to reduce anxiety and induce sleep
73
CT vs MRI
CT is multiple Xrays that can visualize soft tissues
| MRI shows more tissue detail and blood flow. used to measure size and thickness
74
PET and SPECT are mainly used for
research, pt performs cognitive functions and is observed.
| SPECT is single photon and takes shorter time
75
drugs take longer to reach effect and require lower dosages in elderly T/F
true
76
how do antipsychotics work
block receptors of dopamine
77
antipsychotics main use
schizophrenia, acute manic, psychosis
78
is the antipsychotic- clozapine known to have higher or lower instances of extrapyramidal effects
lower
79
dopamine stabilizing drug
aripiprazole
| commonly causes HA, N/V
80
what depot injection has the possibility of causing post injection delirium
zyprexa
81
nursing duties after depot injection
monitor for 3 hours post for sedation syndrome
82
first gen or second gen antipsychotics more likley to cause EPS
first gen
83
when is geodon contraindicated
when pt has hx for QT prolongation, recent MI, or uncompensated heart failure
84
dystonia is more likely in what kind of pt
first week of tx
under 40
pt receiving haloperidol or thiothixene
85
pt is experiencing severe EPS s/s, what treatment is possible
anticholingeric drugs such as benztropine IM or benadryl
86
treatment of EPS s/s of akathisia
add a B-blocker, anticholinergic or benzo
87
s/s of neuroleptic malignant syndrome
```
pt usually confused and mute, usually first two weeks of starting the drug
pale
unstable BP
diaphoresis
high creatine
```
88
tx for neuroleptic malignant syndrome
stop immediately
89
tool used to assess for tardive dyskinesia
abnormal involuntary movement tool
90
increased prolactin levels when n antipsychotic drugs causes
weight gain
breast enlargement
decreased libido
91
weight gain is most commonly seen with what antipsychotic
clozapine and olanzapine
92
what 3 antipsychotics may lengthen the QT interval and lead to life threatening effects
droperidol
thioridazine
mesoridazine
93
clozapine's deadly side effect nurses must watch for
agranulocytosis
94
pt misses an antipsychotic med
can take it if its within 3-4hours-> omit if not
95
antidepressants act on what 2 NT
norep and serotonin
96
life threatening possible side effects of taking MAOI
HTN crisis if pt ingests tryamine
many drug interactions
lethal if OD
97
first choice for depression
SSRI
98
drugs effective fro OCD
SSRI and clomipramine
99
MAOI's commonly prescribed for pt who is highly suicidal
no
100
most established mood stabilizer
lithium
101
serious side effect of lamotrigine
serious rashes, higher risk in younger children
102
signs of lithium toxicity
severe diarrhea, vomiting, drowsiness, muscle weakness
103
most effective drug class for anxiety
benzo's
| -> never discontinue abruptly!
104
where do amphetamines act on the cell
presynaptic terminals
105
client teaching for stimulants
take after meals
| no caffeine, sugar
106
why is disulfiram used
produced negative side effects when ingested with alcohol
107
why is disulfiram used
produces negative side effects when ingested with alcohol
108
extrapyramidal system is controlled where
midbrain
109
a drug induced movement disorder would be induced where
D2 receptors in midbrain
110
4 functions of dopamine
complex movements, motivation, cognition, regulation of emotional response
111
schizophrenia has high/low dopamine
high
| antipsychotics block receptors
112
is norep increased or decreased in anxiety disorder
increased
113
what meds function to increase the function of gaba
benzo
114
what meds function to increase the function of gaba
benzo
115
tardative dyskinesia is most likely seen with what kind of antipsychotics
conventional/first gen
116
weight gain is most common side effect with what kind of antipsychotics
second gen:
clozapine
olanzapine
117
what to do if suspect neuroleptic malignant syndrome (side effect of antipsychotics)
stop meds!
118
what antipsychotic can cause deadly agranulocytosis
clozapine
119
what antidepressants cause anticholingeric side effects
TCA
120
what antidepressants cause anticholingeric side effects
TCA
121
when should TCA's be given
at night
122
examples of mood stabilizaera
```
valpronic acid
carbamazepine
gabapentin
topiramate
oxcarbazepine
lamotrigine
```
123
how are valpronic acid and topiramate known to work for mood stabilization
increase GABA
124
what two anticonvulsants are thought to stop the kindling process
valpronic acid and carbamazepine
125
lithium side effects
Nausea
diarrhea
anorexia
fine hand tremor
126
lithium severe side effects
severe diarehha and vomitting, weakness
| = toxicity (over 3)
127
when must blood tests be taken when on lithium
within 12 hours of last dose
128
biggest side effect with benzos
physical dependence
