ch 8-14 Flashcards
when assessing a patient for suicide, what should a nurse do?
-ask question about past suicidal attempts, plans, and ideas.
-determine their intentions (behavioral,giving away possessions, and verbal cues)
-precipitating stressor, relevant history and life stage iseus
What are the therapeutic factors?
-instillation of hope: by observing other patient gathers hope
-universality:they are not alone
-imparting of info:knowledge is gained
-altruism:helping others w/self image
-corrective recapitulation of primary family group:
-development of socializing techniques
-imitative behavior: role models for others
-interpersonal learning
-group cohesiveness
-catharsis: able to express positive and negative feelings
-existential factors: help others take direction in their life
T or F
therapeutic groups offer psychotherpay
False; that is group therapy
how many types of crises are there?
there are 6 which vary in severity and types of stressors (internal/external)
Class 1: Dispositional crisis
-its an acute response to what stressor
-to an external stressor
-ex:husband beats wife due to baby clothes being expensive
Class 2: Crises of anticipated life transitions
-patient feels ___ about what?
-patient doesnt feel ready for normal life transitions
-ex: bob had baby and picked more hours at work, leaving lesss for studies making him loss scholarship
Class 3: Crises resulting from traumatic stress
Class 4: maturational and developmental crises
-patient can’t master a task that comes with normal life transitions
-ex. norma has trouble with taking care of new born child
Class 5: crises reflecting psychopathology
-crises due to underlying psychological disorders
-personality disorder, anxiety, schizophrenia
Class 6:Psychiatric emergencies
-a patients is unable to functional normally
-patients include people with suicidal ideation, drug overdose, anger
what is the main goal of crisis intervention?
to restore pre-crises functioning and to enhance personal growth
ITS NOT TO CHANGE THEIR PERSONALITY
what should a nurse do when taking care of a person who is having a crisis?
-obtain information about the stressor and who the patient would cope
-help patient using a problem solving process
-set boundaries regarding aggression
-active listening, unconditional acceptance
recovery is characterized by continual ____ and ____
growth and improvement
what are the different models for recovery?
Tidal (focuses on the patients story and encourages them to make own life changes),Wrap (patient makes their own plan), and Psychological recovery
name the acronym for suicidal behavior
IS PATH WARM
-ideation, substance abuse, purposelessness, anger, trapped, hopelessness, withdrawal, anxiety,recklessness, mood
who is more at risk for suicide?
-someone who lost their job vs feeling hopeless
-someone who is doing social isolation vs dramatic changes in mood
-the person feeling hopeless is more at risk
-the person who is experiencing dramatic changes in mood
safety contracts , also known as ___ contract are used when?
in long term situations, where client promises to therapist to contact therapist before attempting suicide
can no suicide contracts be considered primary intervention?
NO; they show little evidence in being effective in reducing suicides
what are key things in helping suicidal people?
-active listening
-instill hope
-dont leave them alone
-remove any item they can use
-DO NOT JUDGE
how to assist survivors of suicide victims?
-encourage to tak to each other
-listen to feelings of guilt
-encourage to talk about individual relationship with person
-help identify new coping strategies and other resources
-this is a disruption in awareness and in cognition which happens over a short period of time
delirium
What disorder experiences these symptoms:
-can’t focus
-rambling speech
-disorientation to time
-vivid dreams
-tremors
-tachycardia, sweating, dilated pupil, high bp
-crying, alls for help
delirium
T or F
Patient with delirium could experience extreme ends of symptoms
ex: either hypervigilant or be in a semi coma
true
T or F
Delirium will be a long term disorder.
False; symptoms can leave within a week
What are some risk factors for delirium?
-people over 65
-people with serious medical/surgical/ neurological conditions
-infections, head trauma, seizures, cardiac surgeries
These meds will cause what?
-ABX, antivirals, antifungals, antihypertensive,analgesics, etc
delirium
differentiate between primary and secondary NCD
Primary: it the major problem that is not caused by another illness
Secondary: is when its caused by another disease
T or F
NCD is always reversible
FALSE; very rare
those that are reversible can be caused by brain tumors, subdural hematomas, CNS infections
How will NCD be noticed in a patient?
-impaired abstract thinking, impulse control, behavior is unhinged
-Hygiene is neglected
-some people can get aphasia
-personality change is common
If a patient forgot a major event like their kids birthday, what stage are they in?
stage 4 moderate cognitive decline
If a person forget to drive a car, what stage are they in?
stage 3 mild cognitive decline
What are some predisposing factors of NCD?
-vascular disease, traumatic brain injury, HIV infection, Parkinson’s, huntington,
what can cause Ad?
-genes, head trauma,
Low dose antipsychotics, melatonin and ramelteon are used to treat what?
delirium
what med is used to treat substance withdrawal
benzos
Cholinesterase inhibitors are used to treat mild to moderate ___
alzheimers
what is used to treat severe alzheimers
donepezil, rivastigmine, galantamine, memantine
which drug is avoided in elderly to treat depression?
tricyclic antidepressants
alcohol intoxication vs withdrawal
-intox: euphoria, depression, slurred speech, unsteady gait, nystagmus, flushed face
-withdrawal: tremors, N/V,tachycardia, high bp, hallucinations
amphetamine intoxication vs withdrawal
-intox: hypervigilance, impaired judgement, pupillary dilation, high bp
-withdrawal:anxiety, fatigue, paranoid, suicidal ideation
Inhalants intoxication vs withdrawal
-intox: apathy, lethargy, depressed reflexes, irritation around eyes
-withdrawal: body aches, N/V, runny nose, poor attention
Opioids intoxication vs withdrawal
-intox:lethargy, pupil constriction, slurred speech , decreased bp and RR
-withdrawal: lacrimation, pupil dilation, fever, insomnia
What is CIWA-Ar?
its a tool used to assess risk of withdrawal from alcohol
Disulfiram is used for what
used to treat people with alcohol misuse
What meds are used for alcohol withdrawal ?
-withdrawal:lorazepam, chlordiazepoxide,oxazepa BENZOS
-even carbamazepine, valproic acid (anticonvulsant)
Chlordiazepoxide (tranquilizer) is used to treat what intoxication?
stimulant
T or F
Acamprosate (Campral) and disulfiram is used to treat opiate intoxication?
False;its used for alcohol abstinence and for opiate intoxication is used for naloxone
T or F
Codependence is when someone depends on other
False: its when a person sacrifices their own needs to fulfill someone else’s to feel in control
