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220 > eating, anxiety, personality disorders > Flashcards

eating, anxiety, personality disorders Flashcards

1
Q

self-concept

A

the personal perception of self that forms in response to interactions with others and the environment throughout the course of an individual’s lifetime
identity, body image, role performance, self-esteem, self-awareness

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2
Q

anorexia/bulimia s/s

A 
hypotension, bradycardia, hypothermia
lanugo (AN)
acrocyanosis: purple mottled skin on hands and feet
low bone density
muscle weakness
insomnia
refeeding syndrome
cathartic colon with laxative abuse
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3
Q

malnutrition s/s

A 
impaired hepatic function
edema covers muscle wasting
dry, raw, yellow skin
split nails
muscle atrophy
immunodeficiency
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4
Q

bulimia nervosa

A

normal BMI
binge eating behaviors
self-induced vomiting, laxative use, or diuretic use after binge
possible chemical dependency
between binges, they often eat normally or slightly restrict calories
complications of vomiting

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5
Q

complications of vomiting

A 
loss of HCl and K
elevated serum bicarbonate levels
pharyngitis
esophageal tears 
enamel erosion
stomach rupture
aspiration pneumonia
burst blood vessels
cardiomyopathy
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6
Q

eating disorder interventions

A

daily vitals if inpt; temp only at home.
weigh pt consistently
exercise should be monitored
discuss triggers to the binge-purge cycle

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7
Q

eating disorder admission criteria

A 
rapid weight loss of ≥ 30% of body weight in underweight client
inability to gain weight
failure to adhere to treatment contract
severe hypothermia < 89.6
bradycardia at or < 40 bpm
systolic BP at or < 70
hypokalemia < 3 mEq/L 
renal output < 30 cc/hour
EKG changes
suicidal behavior
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8
Q

personality disorders

A

a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving
believed to be 2/2 childhood trauma

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9
Q

personality disorder dx

A

inappropriate response to stress
poor impulse control
difficulties in relating to others
cause others to react with extreme annoyance or irritability
tendency to provoke interpersonal conflict

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10
Q

paranoid personality disorder

A

suspicious of others based on unfounded beliefs that they are out to harm, exploit or deceive them
feel they are always being watched

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11
Q

schizoid personality disorder

A

characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism

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12
Q

schizotypal personality disorder

A

characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking

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13
Q

antisocial personality disorder

A 
(sociopath, psychopath)
an aggressive personality type that disregards the rights of others
repeated unlawful/deceitful actions
above average intelligence
manipulative, no conscience
most violent personality disorder
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14
Q

borderline personality disorder

A

straddle the border between sanity and psychosis

splitting: portrays people as all good or all bad
manipulation
unstable affect, relationships
impulsive
fear of abandonment
self-injury, frequent hospitalizations
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15
Q

narcissistic personality disorder

A

characterized by arrogance, grandiose views of self-importance, the need for constant admiration, and a lack of empathy for others that strains most relationships

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16
Q

histrionic personality disorder

A

characterized by emotional attention-seeking behavior

seductive and flirtatious

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17
Q

avoidant personality disorder

A

characterized by social inhibition and avoidance of all situations & relationships due to extreme fear of rejection; often very anxious in social situations

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18
Q

dependent personality disorder

A

characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends

19
Q

OCD

A

characterized by perfectionism with a focus on orderliness and control to the extent that the individual may not be able to accomplish a given task
type a personality

20
Q

stressor

A

external influence that threatens to disrupt the equilibrium that is needed to maintain homeostasis

21
Q

anxiety

A

a feeling of apprehension that develops when the self or self-concept is threatened

distinct from fear which is a response to an identifiable external threat

22
Q

anxiety psychopathology

A

GABA functions as the body’s natural antianxiety agent by reducing cell excitability
decreases in GABA will increase anxiety

23
Q

generalized anxiety disorder

A

chronic disorder characterized by excessive worry and uncontrollable anxiety
3 of the following must be present:
ADLs provoke anxiety, restlessness, indecision, fatigue, avoidance, poor focus, irritability, muscle tension, sleep disturbance, need for constant reassurance

24
Q

panic disorder

A

repeated episodes of full-blown panic; sudden onset of fear associated with feelings of impending doom
palpitations, chest pain, SOB, chills or hot flashes, emotionally painful

25
Q

agoraphobia

A

intense fear of being in places or situations where help might not be available & escape might be difficult or embarrassing; most limiting & debilitating of all the phobias
being alone outside the home, using public transportation, being out in open spaces, being in an enclosed space, being in a crowd

26
Q

obsessive compulsive disorder

A

obsessions: thoughts, impulses or images that persist & cannot be dismissed from the mind
compulsions:ritualistic behaviors an individual feels driven to perform to reduce anxiety caused by the obsession
obsessions and compulsions usually occur together
together they are called a ritual
tx: antidepressants

27
Q

PTSD

A

occurs in people who have experienced a highly traumatic event, witnessed a traumatic event or been repeatedly exposed to stories about a traumatic event
feelings of fear, helplessness or horror
flashbacks
difficulty with interpersonal, social, or occupational relationships
hypervigilance and irritability
exposure to reminders of the event can exacerbate symptoms

28
Q

anxiety disorder assessment

A

caffeine and sugar intake
skin assessment especially for broken areas on those patients who are obsessive-compulsive because many rituals revolve around bathing
perception of events: if the patient perceives the event as stressful that is all that matters
coping patterns may include overuse of medication or substance abuse
ritualistic activity is often increased by anxiety

29
Q

relaxation techniques

A 
deep breathing exercises
progressive relaxation
meditation
mental imagery
calming music
expression of feelings
30
Q

medication for anxiety disorders

A 
benzodiazepines increase GABA [GABA up, anxiety down]
chlordiazepoxide (Librium)
diazepam (Valium
alprazolam (Xanax)
lorazepam (Ativan)
midazolam (Versed)
clonazepam (Klonopin)
31
Q

diazepam (valium)

A

anxiolytic, anticonvulsant, muscle relaxant
benzodiazepine
caution with opioids, other benzodiazepines, hypnotics, muscle relaxants
avoid with pregnancy, lactation, myasthenia gravis, sleep apnea

32
Q

diazepam adverse effects

A 
respiratory depression
dizziness
lethargy
hangover
constipation
addiction
33
Q

benzodiazepine antidote

A

flumanezil

34
Q

alprazolam (xanax)

A

increases GABA in the CNS
caution with CNS depressants, valproate, oral contraceptives, valerian
avoid with pregnancy, lactation, angle-closure glaucoma

35
Q

alprazolam (xanax) adverse effects

A 
dizziness
drowsiness 
lethargy
physical dependence
psychological dependence
tolerance
36
Q

buspirone (buspar)

A

anxiolytic, also treats sleep disorders
binds to serotonin & dopamine receptors in brain
caution in hepatic or renal impairment.
avoid use with MAOIs, alcohol, grapefruit, valerian

37
Q

buspirone (buspar)

A 
headache
N/V
dizziness
chest congestion
insomnia
fatigue
blurred vision
tinnitus
palpitations
38
Q

CBT anxiety techniques

A

looking at the situation another way (positive reframing)
trying not to blow the situation out of proportion (decatastrophizing)
snapping a rubber band to stop themselves from dwelling on the negative (thought stopping)

39
Q

anxiety levels

A

mild: can be productive, senses sharp, automatic responses
moderate: agitation, focus on root of anxiety, easily redirected
severe: inability to function, ritualistic behavior, tachycardia, diaphoresis, chest pain
panic: distorted perception, cannot process environmental stimuli, possibly suicidal, cannot communicate verbally

40
Q

transference

A

occurs when the client unconsciously projects to the health professional feeling toward another person who has been significant to the client’s personal life

41
Q

countertransference

A

the tendency of health professionals to displace on to a client, feelings related to another person in the healthcare worker’s personal or professional life

42
Q

voluntary admission

A

the client or client’s guardian seeks admission to a mental health facility in order to obtain treatment
right to refuse tx and meds
right to leave AMA

43
Q

involuntary admission

A

the client enters the mental health facility against their will for a period of time
the rationale for commitment is always danger to self or others
cannot leave AMA
can still refuse meds, but can be overruled with input from two doctors

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