Chapter 6, 9, and 11 Flashcards
Biological functioning and symptoms of psychiatric disorders
Locating brain structures and their primary functions
Basic mechanism of neuronal transmission
Local and function of neurotransmitters significant to hypotheses regarding major mental disorders.
Role of genetics in the development of psychiatric disorder
Basic utilization of psychoneuroimmunology and chronobiology
Psycho.- examines the relationship among the immune, nervous, and endocrine systems, and our behaviors, thoughts, and feelings
Chrono.- study and measure of time structures or biological rhythm
effective communication strategies for nurse-patient relationships
rapport- respectful, understanding, and trusting (increase the sense of sharing and help lessen patient loneliness)
empathy- the ability to experience, in the present, a situation as another did at some time in the past
(being able to put yourself in the pt shoes, showing compassion and kindness)
empathetic linkages- direct communication of feelings, being aware of personal feelings.
role of professional boundaries- beware of unethical boundaries, sexual relationships, and friendships outside of the nurse-patient role.
Occurrence during the nurse-patient relationship
orientation: the honeymoon phase, first meeting, confidentiality, developing trust, the nurse is responsible for active listening
working: patient begins to identify the problems that need to be worked on, the nurse used non and verbal techniques to help the patient examine problems and support them through the healing process
solution: begins the first day of the relationship, problems solved, the relationship ends, direct patient to community resources and back to life, do not address new problems and can be stressful for patients
Characteristics of a nontherapeutic relationship
the feeling of frustration, struggle to reach common ground, mutual withdrawal, deteriorating relationship–> withholding phase, ignoring phase, and struggling with and making sense phase
Strategies based on the principles of the therapeutic nurse-patient relationship
Motivational interview- engages the patient’s own decision-making by focusing on and reinforcing the client’s own arguments for change, a collaborative process of directed counseling and focused decisions, openness to collaborate with the client’s own expertise, proficiency in client-centered counseling, recognition of key aspects
Target symptoms
measurable, specific symptoms expected to improve with treatment
Side effects (untoward effects)
unwanted effects of medication
Nursing interventions for common side effects assoc. with psychiatric meds.
What is the role of the governmental regulatory process in the approval of medication and the use of other biologic interventions?
Pharmacodynamics of psychiatric meds.
four sites of action: the receptors (selectivity, affinity, and intrinsic activity) the ion channels, the enzymes, and the carrier proteins which uptake the receptors.
Pharmacokinetics of psychiatric meds.
absorption of routes- first: pass effect, and then bioavailability. Distribution- solubility and protein binding
Major classifications of psychiatric meds
- antipsychotic meds.-Indications: schizophrenia; mania; autism; and the symptoms of psychosis, such as hallucinations, delusions, bizarre behavior, disorganized thinking, and agitation. Acute extrapyramidal symptoms (EPS)
Dystonia: acute onset within a few days of initiating therapy, Pseudoparkinsonism: abrupt or sudden onset within the first 30 days of treatment, Akathisia: possibly misdiagnosed as agitation or increased psychotic symptoms, as well as tardive dyskinesia (irreversible) - mood stabilizers- used to treat mood disorders like bipolar, lithium which is the gold standard for treatment, anticonvulsants, atypical antipsychotics, adrenergic blocking agents, calcium channel blockers
- antidepressants- used to treat depression and anxiety disorders, slowly taper off and do not discontinue abruptly, it can take up to several weeks to show effects. Some examples: selective serotonin reuptake inhibitors(SSRI)
Tricyclic Antidepressants (TCA)
Monoamine oxidase inhibitors(MAOI) - antianxiety and sedative-hypnotics- panic and management of alcohol and opioid withdrawal. Examples- Benzodiazepines, Nonbenzodiazepine and Benzodiazepines hypnotics: flurazepam, temazepam, triazolam, quazepam, estazolam
- stimulants- used to treat ADHD
Nursing interventions related to the administration of psychiatric meds.
Potential benefits of somatic treatments
herbal supplements- st. johns wort, for depression, pain, anxiety, insomnia, and premenstrual syndrome, and kava for anxiety reduction
nutrition therapies- iron and folic acid are used for fatigue apathy, tryptophan relates to lowering serotonin levels and increased aggression, melatonin is used for insomnia, DMAE treatment of attention deficit hyperactivity disorders, and Alzheimer’s, lecithin used to improve memory and treat dementia
electroconvulsive therapy- is used for severe depression; mania and schizophrenia when other treatments have failed
light therapy- for phototherapy, Circadian rhythms reset, and seasonal depression
transcranial magnetic stimulation- Alternative to ECT in managing symptoms of depression
vagus nerve stimulation-Adjunct for severe depression in adults unresponsive to four or more adequate antidepressant treatments
