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Mental Health > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is the most common drug used for bipolar disorder?

A

lithium

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2
Q

What influences mental health?

A

biologic makeup,
autonomy and independence,
self-esteem,
capacity for growth,
vitality,
ability to find meaning in life,
resilience or hardiness,
sense of belonging, r
reality orientation
coping or stress management abilities

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3
Q

What are some interpersonal factors that can influence mental health?

A

effective communication,
helping others,
intimacy,
maintaining a balance of separateness and connectedness;

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4
Q

What are some social/cultural factors that can influence mental health?

A

sense of community,
access to resources,
intolerance of violence,
support of diversity among people,
mastery of the environment,
positive yet realistic view of the world

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5
Q

What are symptoms of mental health?

A

dissatisfaction with one’s characteristics, abilities, and accomplishments

ineffective or unsatisfying interpersonal relationships

dissatisfaction with one’s place in the world;

ineffective coping with life events

lack of personal growth.

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6
Q

When does ental health become an illness?

A

When is affects the ability to function in society

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7
Q

What factors contribute to mental health?

A

biologic makeup;
anxiety, worries, and fears;
ineffective communication;
excessive dependence or withdrawal from relationships; l
loss of emotional control;
lack of resources;
violence, homelessness, poverty, and discrimination.

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8
Q

What is DSM-5

A

taxonomy used to provide a standard nomenclature of mental disorders,

defines characteristics of disorders and helps distinguish between diagnoses

assist in identifying underlying causes of disorders.

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9
Q

What was a significant contribution to MH treatment in the 1950s?

A

Development of psychotropic drugs such as antipsychotic and antimanic drugs like chlorpromazine and lithium

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10
Q

How many in the US are affected by MH? How many receive treatment? What age group has the highest prevelaence for MH and the lowest percentage of treatment? ADHD affects how many children? What is the leading cause of disability in persons 15-44 in age?

A

44.7 million
19.2 million

18 to 25 age group

3% to 5% of school-aged children

Mental disorders

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11
Q

Who profoundly influenced the psychiatric nursing practice? In what aspects did they focus?

A

Hildegard Peplau and June Mellow,

nurse–client relationship,
anxiety,
nurse therapy
interpersonal nursing theory.

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12
Q

What are the nurse’s areas of concern in MH nursing care?

A

Promotion of optimal mental and physical health and well-being and prevention of mental illness

· Impaired ability to function related to psychiatric, emotional, and

· physiologic distress

· Alterations in thinking, perceiving, and communicating because of psychiatric disorders or mental health problems

· Behaviors and mental states that indicate potential danger to self or others

· Emotional stress related to illness, pain, disability, and loss

· Symptom management, side effects, or toxicities associated with self-administered drugs, psychopharmacologic intervention, and other treatment modalities The barriers to treatment efficacy and recovery posed by alcohol and substance abuse and dependence.

· Self-concept and body image changes, developmental issues, life process changes, and end-of-life issues

· Physical symptoms that occur along with altered psychological status

· Psychological symptoms that occur along with altered physiological status

· Interpersonal, organizational, sociocultural, spiritual, or environmental circumstances or events that have an effect on the mental and emotional well-being of the individual and family or community

· Elements of recovery, including the ability to maintain housing,

· employment, and social support, that help individuals reengage in seeking meaningful lives

· Societal factors such as violence, poverty, and substance abuse

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13
Q

What is the goal of self awareness?

A

to know oneself so that one’s values, attitudes, and beliefs are not projected to the client, interfering with nursing care.

Self-awareness does not mean having to change one’s values or beliefs, unless one desires to do so.

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14
Q

What is the neurobiological/neurochemical theory?

A

purports that, mental illness is a result of neurochemical imbalances in certain areas of the brain

mental illness have strong genetics and heredity connections.

It forms the basis for medication treatment of psychiatric illnesses.

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15
Q

What are neurotransmitters? What do they do? How do they function in the body? Where do they go? What is the theory of neurotransmitters and mental health?

A

chemical substances manufactured in the neuron and aid in transmission of information throughout the body

either excite or stimulate an action (excitatory) or inhibit or stop an action (inhibitory).

They fit into specific receptors on the surface of neurons (dendrites) just like a key fits a lock. These neurotransmitters are released into the synapse of neurons to relay the message to receptors,

they are either transported back to the pre-neurons for storage (reuptake) or metabolized and inactivated by enzymes, primarily Monoamine oxidase (MAO).

Mental illness is believed to have either alteration of the level of these neurotransmitters, low or in excess or dysfunction of these neurotransmitters. Also, low level of receptors or excess receptors can cause mental illness.

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16
Q

What is dopamine? What does it do? What happens when it is at high or low levels? What can block this?

A

Neurotransmitter located in the brain stem.

Involved in control of complex movement, motivation, cognition and regulation of emotional responses.

High levels implicated in schizophrenia low levels implicated in Parkinson disease

Antipsychotic medications block dopamine activity.

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17
Q

What is norepinephrine & epinephrine What does it plays a role in? What happens when there are high and low levels?

A

The most prevalent neurotransmitter in nervous system.

Plays role in attention, memory, sleep, wakefulness, and mood.

Excess: anxiety
low levels: memory loss, social withdrawal and depression.

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18
Q

How do high and low levels of serotonin affect brain function? How do antidepressants affect serotonin?

A

Low levels play a major role in anxiety and depression

high levels are implicated in schizophrenia and symptoms such as delusions, and hallucinations

Antidepressants increased serotonin in synaptic gap thus improving mood.

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19
Q

What is GABA? How is GABA affected by benzos?

A

major inhibitory neurotransmitter in the brain

Drugs that increase GABA function such as benzodiazepine are used to treat anxiety and induce sleep.

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20
Q

What happens with histamine and MH meds? What can be the result?

A

Some medications that treat mental illness block histamineà which causes sedation, weight gain and hypotension.

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21
Q

What is the function of acetylcholine? Where is it found? What is the result of a low level?

A

Found in brain, spinal cord and peripheral nervous system at neurotransmitter junction.

It is responsible in signaling muscle to become active

Low level of acetylcholine is implicated in Alzheimer and myasthenia gravis

22
Q

What is glutamate? What can occur with high levels?

A

It is an excitatory amnio acid with neurotoxic effects

high levels Implicated in brain damage caused by stroke, hypoxia, ischemia, hyperglycemia, Alzheimer or Huntington.

23
Q

What is Freud’s levels of awareness?

A

Conscious – material a person is aware of at any one time

· Preconscious – material retrieved rather easily through conscious effort

· Unconscious – repressed memories/ passions / trauma

24
Q

What is Freud’s 3 states of conscious?

A

ID – totally unconscious and impulsive. Source of drives and instincts/ reflexes

Ego – resides in levels of awareness, problem-solving and reality tester, subjective vs objective

Superego – moral component of personality, pride vs guilt, should vs should not

25
Q

What is regression?

A

temporary or long-term reversion of the ego to an earlier stage of development rather than handling unacceptable impulses more adaptively

26
Q

What is supression?

A

Consciously choosing to block ideas or impulses that are undesirable Building for how to manage anger , and why suppressing anger may turn into a maladaptive response later.

27
Q

What is reaction formation?

A

fixation in consciousness of an idea, affect, or desire that is opposite to a feared unconscious impulse

opposite reaction of what the client actually feels

28
Q

What is sublimination?

A

channeling of unacceptable feelings, desires, and impulses – often of a sexual or aggressive nature – into positive, socially approved activit

29
Q

What is repression?

A

Unconscious effort. unpleasure-provoking mental processes, such as morally disagreeable impulses and painful memories, are actively prevented from entering conscious awarenes

30
Q

What is splitting? What is it borderline?

A

immature defense whereby polarized views of self and others arise due to intolerable conflicting emotions. A person employing splitting may idealize someone at one time (seeing the person as “all good”) and devalue them the next (seeing the person as “all bad”).

personality disorder

31
Q

What is dissacosiation?

A

emotionally withdrawn from their healthy sense of self and the world, and this cannot protect against future trauma

32
Q

What is displacement?

A

transferring negative feelings from one person or thing to another

33
Q

Who is Hildegard E Peplau? What was her philosophy? What framework did she establish?

A

American nurse, first published nursing theorist since Florence

· Concerned with process by which nurse helps patient make positive changes in health care status and well being

· Not what we do to the patient, but what we do WITH the patient

· Peplau’s phases of the nurse-patient relationship provide a framework to structure care
1. preorientation
2. orientation
3. working
4. termination phases

34
Q

What are Erikson’s 8 stages of development?

A
  1. Infancy – Basic trust versus mistrust
  2. Toddler – Autonomy versus shame and doubt
  3. Preschool-age – Initiative versus guilt
  4. School-age – Industry versus inferiority
  5. Adolescence – Identity versus identity confusion
  6. Young adulthood – Intimacy versus isolation
  7. Middle age – Generativity versus stagnation
  8. Older adulthood – Integrity versus despair
35
Q

What is a MH crisis?

A

acute, time-limited (usually lasting 4 to 6 weeks) event during which a client experiences an emotional response that cannot be managed with the client’s normal coping mechanisms.

36
Q

What are characteristics of crisis?

A

Experiencing a sudden event with little or no time to prepare

§ Perception of the event as overwhelming or life-threatening

§ Loss or decrease in communication with significant others

§ Sense of displacement from the familiar

§ An actual or perceived loss

37
Q

What are nursing interventions for crisis?

A

The initial task of the nurse is to promote a sense of safety for the client and protect the client by assessing the client’s potential for suicide or homicide.

v Assist with admission to an inpatient facility, as needed for clients who have suicidal or homicidal thoughts.

v Prioritize interventions to address the client’s physical needs first.

38
Q

What are the primary, secondary and tertiary care in psychotherapeutic interventions?

A

v Primary care: Collaborate with client to identify potential problems; instruct on coping mechanisms; and assist in lifestyle changes.

v Secondary care: Collaborate with client to identify interventions while in an acute crisis that promote safety.

v Tertiary care: Collaborate with client to provide support during recovery from a severe crisis that include outpatient clinics, rehabilitation centers, crisis stabilization centers, short-term residential services, and workshops

39
Q

What are goals of acute care?

A

§ Prevent harm of self or others (Safety and support)

§ Stabilize mental health crises

§ Return of clients with severe illness to community care

40
Q

What is the nurse’s role of acute care?

A

Management of unit (client and therapeutic milieu aka environment)

§ Safe med admin

§ Implementation of tx plans

§ Documentation

§ Managing crisis

§ Transition to community health facilities

§ Reintegration and outpatient collaboration

41
Q

What is EPS? S/S?

A

Extrapyramidal Side Effects. Extrapyramidal symptoms (EPSs), serious neurologic symptoms

acute dystonia, pseudoparkinsonism, and akathisia.

42
Q

What occurs with acute dystonia?

A

acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing, and, in severe cases, laryngospasm and respiratory difficulties

43
Q

What is akathesia?

A

restless or anxious and agitated, often with a rigid posture or gait and a lack of spontaneous gestures. This feeling of internal restlessness

44
Q

What is NMS? S?S

A

Neuroleptic Malignant Syndrome. Neuroleptic malignant syndrome (NMS) is a potentially fatal idiosyncratic reaction to an antipsychotic (or neuroleptic) drug. The major symptoms of NMS are rigidity; high fever; autonomic instability such as unstable blood pressure, diaphoresis, and pallor; delirium; and elevated levels of enzymes, particularly creatine phosphokinase. Clients with NMS are usually confused and often mute; they may fluctuate from agitation to stupor.

45
Q

What are anticholinergic Side Effects?

A

orthostatic hypotension, dry mouth, constipation, urinary hesitance or retention, blurred near vision, dry eyes, photophobia, nasal congestion, and decreased memory.

46
Q

What treats bipolar disorder? What is the most common? What other type of drug class can treat bipolar?

A

Mood-stabilizing drugs

Lithium is the most established mood stabilizer;

some anticonvulsant drugs, particularly carbamazepine (Tegretol) and valproic acid (Depakote, Depakene), are effective mood stabilizers. Other anticonvulsants, such as gabapentin (Neurontin), topiramate (Topamax), oxcarbazepine (Trileptal), and lamotrigine (Lamictal), are also used for mood stabilization.

47
Q

What is a therapeutic community or milieu? What is the role of the therapist?

A

goal of treatment as the establishment of satisfying interpersonal relationships.

The therapist provides a corrective interpersonal relationship for the client.

participant observer for the therapist’s role, meaning that the therapist both participates in and observes the progress of the relationship.

48
Q

What is milieu therapy?

A

involves clients’ interactions with one another, including practicing interpersonal relationship skills, giving one another feedback about behavior, and working cooperatively as a group to solve day-to-day problems.

49
Q

What is anosognosia?

A

the inability to recognize one’s illness due to the illness itself

50
Q

what is ACT?

A

Assertive Community Treatment (ACT)

§ Working with multidisciplinary team for comprehensive services

§ At least one member available 24 hours for crisis care

§ Treating pt in own environment

51
Q

What is denotative/connotative communication?

A

Denotative/connotative meaning

· When communicating, participants must share meanings.

· Words that have multiple meanings can cause miscommunication if they are interpreted differently.

52
Q

What are characteristics of a therapeutic nurse‐client relationship?

·

A

purposeful and goal-directed.

· Well‐defined with clear boundaries.

· Structured to meet the client’s needs.

· Characterized by an interpersonal process that is safe, confidential, reliable, and consistent.

Mental Health (4 decks)

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