Chapter 2 Pt 1 Flashcards
it is important to ask about OTC drug use because NSAIDs can affect lithium how?
decrease lithium excretion thus increasing lithium concentrations (exceptions may be aspirin and suldinac)
what are the important 4 Ps of a psych HPI
psychosocial and environmental conditions:
Predisposing to
Precipitating
Perpetuating
and Protecting against the current episode
what are automatisms
spontaneous involuntary movements that occur during an altered state of consciousness and can range from purposeful to disorganized
a patient laughing when told s/he has a serious illness has what kind of affect?
inappropriate
how can one roughly access a patient’s intellectual functioning
proverb interpretation and vocabulary strategies
proverb good for abstraction
vocabulary good for intellectually capacity
a patient who is laughing one second but crying the next has what kind of affect
liable
a patient who giggles while telling you that he set his house on fire and is facing criminal charges has what kind of affect
inappropriate
when noting appearance of a psych patient one should take special note of what that can help with diagnoses
pupil size (drug intox/withdrawal)
bruises in hidden areas (suspicion for abuse)
needle marks/tracks (drugs)
eroding of tooth enamel (eating disorders)
superficial cuts on arms (self-harm)
what is the difference b/w mood and affect
mood: the emotion that the PATIENT TELLS YOU s/he feels
affect: an ASSESMENT of how the patients MOOD APPEARS TO THE EXAMINER
what are the dimensions of affect
type of affect
quality/range
motility
appropriateness to content
what are the types of affect
euthymic
euphoric
neutral
dysphoric
what are the parameters for quality/range of affect
describes depth and range of the feelings shown flat (none) blunted (shallow) contracted (limited) full (average) intense (more than normal)
what are the parameters of motility of affect
describes how quickly a person appears to shift emotional states
sluggish
supple
labile
what is a patients thought process
how s/he uses language and puts ideas together
describes whether patients thoughts are LOGICAL, MEANINGFUL, and GOAL DIRECTED
what is circumstantiality when describing thought process
when the point of the conversation is eventually reached but with over inclusion of trivial or irrelevant details
what is tangentiality when describing thought process
point of conversation never reached
responses usually in the ballpark
what is loosening of association when describing thought process
no logical connection from one thought to another
what is flight of ideas when describing thought process
thought change abruptly form one idea to another
usually accompanied by rapid/pressured speech
what is neologism when describing thought process
made-up words
what is word salad when describing thought process
incoherent collection of words
what is clang associations when describing thought process
word connections due to phonetics rather than actual meaning
“my car is red, Ive been in bed, it hurts my head”
what is thought blocking when describing thought process
abrupt cessation of communication before the idea is finished
thought content describes what
the types of ideas expressed by the patient
what are examples of thought content disorders
poverty of thought vs overabundance delusions suicidal and homicidal ideation phobias obsessions compulsions
