CHP 29: PSYCH EMERGENCIES Flashcards
overt vs covert behaviors
overt: open and generally understood by surrounding people
covert: hidden meanings or intentions understood only by person displaying the behavior
delusions vs hallucinations
delusions: false beliefs
hallucinations: sensory perceptions not founded on objective reality
behavioral vs psychiatric emergencies
behavioral: person’s behavior is interfering with activities of daily living
psychiatric: behavior threatens person’s health/safety or another person’s health/safety
definition of serious mental illness
diagnosis of psychiatric disorder with serious functional impairment
4 categories of causes for abnormal behavior
- biologic or organic
- person’s environment
- acute injury/illness
- substance-related
2 ways people cope with environmental caused behavior
find ways to alter the situation or alleviate discomfort by escaping from stress
what is affect
outward expression of a person’s inner feelings such as happy, sad, angry
what are stereotyped movements
repetition of movements that do not seem to serve any useful purpose
what are compulsions
repetitive actions that are carried out to relieve the anxiety of obsessive thoughts
what is the pressure of speech
pouring out of words liked water escaping under pressure
what are neologisms
words invented by patients
what is echolalia
patient echoes words they hear
what is mutism
patient does not speak at all
what is flight of ideas
accelerated thinking in which mind skips very rapid from one thought to the next
what is perseveration
repetition of same idea over and over again
what circumstantial thinking
inclusion of many irrelevant details
what is inappropriate affect
emotion out of sync with situation
what is flat affect
absence of emotion
what is confabulation
inventing experiences to fill gaps in memory
what is catatonic
lacking expression or movement, appearing rigid
what is labile
rapidly shifting among different emotional states
what mnemonic is used for mental status exam
COASTMAP - consciousness, orientation, activity, speech, thought, memory, affect and mood, perception
in what patients may scars be found and why
self-mutilation in patients with borderline personality disorder
what is hobble tie
tying feet together
what patients do you have to be cautious in giving droperidol and haloperidol to
suspected electrolyte imbalances, cardiac abnormalities, and pt’s taking drugs that affect QT interval
antipsychotic to use for pediatrics
haloperidol
what is loosening of associations
logical connection between one idea and the next becomes obscure
what is thought broadcasting
belief that thoughts are broadcast aloud and can be heard by others
what is thought insertion
belief that thoughts are being thrust into the patient’s mind by another person
what is thought withdrawal
belief that thoughts are being removed
what does delirium present with
disorientation, hallucinations, or delusions
three types of delirium
hyperactive - periods of agitation and restlessness
hypoactive - inactivity usually associated with CNS depressants, fever, or liver/kidney failure
mixed delirium - hyperactive and hypoactive delirium
what does dementia present with
chronic that produces deficits in memory, abstract thinking, and judgement
what is excited delirium and its S/S
potentially fatal state of extreme agitation and delirium
acute onset of agitation, aggressiveness, high pain tolerance, psychotic behavior, bizarre behavior, noncompliance with police and EMS, profuse sweating, incoherent speech, superhuman strength, hyperactivity, respiratory arrest and death
what is bipolar mood disorder
patients who alternate between mania and depression
what is manic behavior
“elated, on top of the world”, tangential thinking, flight of ideas, delusions of grandeur
what are delusions of grandeur
inflated belief about one’s own fame, wealth, power, or intelligence
what is tangential thinking
skipping rapidly from one topic to another
what determines chronic depression
S/S of depression for most days over at least two years
what mnemonic is used for depression
GAS PIPES - guilt, abnormal appetite, sleep disturbance, paying attention, interest decrease, psychomotor abnormalities, energy low, suicidal thoughts
symptoms of schizophrenia
delusions, hallucinations, apathy, mutism, flat affect, lack of interest in pleasure, erratic speech, overly emotional responses, extreme motor behavior
what are neurotic disorders
collection of psychiatric disorders without psychotic symptoms and lacking intense psychopathology of other mood disorders
how is generalized anxiety disorder diagnosed
symptoms present more days than not for at least 6 months and hard to control
what is a simple phobia
focuses all anxieties on one class of objects or situations like spiders or heights
what is agoraphobia
fear of going into public places
S/S of panic disorders
palpitations, sweating, chest discomfort, paresthesia, hyperventilation
substance use, intoxication, use disorder, dependence
use: moderate amounts (social drinker)
intoxication: use of substance that results in impaired thinking and motor function
use disorder: disrupts activities of daily living
dependence: addiction to a substance
side effects of eating disorders
electrolyte imbalances, cardiac conditions, seizures, renal failure, erosion of dental enamel, salivary gland enlargement
what is a somatoform disorder
people overly concerned with their physical health and appearance to where it dominates their life
what is hypochondriasis
patients have extreme fear that they may have serious disease
what is another name for factitious disorder and what is it
Munchausen syndrome - person intentionally produces or feigns physical/psychological S/S. pt wishes to be sick to gain attention or avoid legal responsibilities
what is Munchausen syndrome by proxy
parent or caregiver intentionally makes child sick to get attention or pity
what are impulse control disorders
lack ability to resist temptation or can’t avoid acting on a drive - pyromania, pathologic gambling, kleptomania
what are personality disorders
way of thinking/behaving that deviates from cultural expectations causing distress or problems functioning - usually another psych illness is also present
how do antidepressants work
alter levels of neurotransmitters (serotonin, norepi, dopamine) in autonomic nervous system
what is an acute dystonic reaction and what is the treatment
side effect from antipsychotic agents causing muscle spasms of neck, face, and back - IV Benadryl 25-50mg
antipsychotic meds can have effects similar to what drug like what
atropine-like (anticholinergic)
dry mouth, blurred vision, urinary retention, cardiac dysrhythmias
when are amphetamines prescribed
attention-deficit disorder with hyperactivity
3 main effects post war
musculoskeletal ailments, mental disorders, illnesses
4 categories of symptoms of PTSD
intrusive thoughts, avoiding reminders, negative thoughts/feelings, arousal/reactive symptoms
