Exam 1

Question 1

*What is the purpose of defense mechanisms? Can you define the various defense mechanisms?

Answer 1

Purpose: a way to manage conflict in response to anxiety to relieve anxiety

Displacement- discharging pent-up feelings, usually of hostility on objects less dangerous than those that initially aroused the emotion
rationalization- justifying one’s failures with socially acceptable reasons instead of the real reasons
reaction formation-transforming anxiety, producing thoughts into their opposites in consciousness
Regression-returning to more primitive levels of behavior
repressions-blocking a threating memory from consciousness
denial-refusing to admit that something unpleasant is happening or that a taboo emotion in being experienced

Question 2

*Define Anhedonia, anergia, alogia, apraxia, avolititon

Answer 2

Anhedonia: inability to experience joy or pleasure in the things that u have used to do
anergia: a continual feeling of tiredness, lack of energy or sleepnes
alogia: speak leas, say fewer words or only speak in response to other (poverty speech- alO = mOuth)
apraxia- unable to perform tasks or movement
Avolition- a total lack of motivation that makes it hard to get anything done

Question 3

*How do you describe circumstantial speech, tangential speech, loose associations, clang associations

Answer 3

circumstantial speech- non-direct thinking/speech (mostly in ADHD)
tangential speech- doesn’t abswer the qns correctly (random,irrevant ideas/topics)
loose associations- lack of connection btn ideas (random jumble of words and phrases) or unrelated
clang associations- grouping of words, with rhythm that are based on similar sounding but don’t have logical reason to be so

Question 4

*What are the components of the mental status exam? What items are included under your subjective and objective data?

Answer 4

subjective- what you get from the patients
objective- what you observe about the patients

Question 5

*What is transference and countertransference?

Answer 5

transference
When client displaces onto the therapist attitudes and feelings that the client originally experienced in other relationships Pt-> RN

countertransference
When the therapist or caregiver displaces onto the client attitude or feelings from his or her past RN->pt

Question 6

*What techniques are used in psychoanalysis, humanistic, interpersonal, and behavioral therapy?

Question 7

What is cognitive behavioral therapy?

Answer 7

It uses both cognitive and behavioral therapy. Mainly in anxiety patients.

Question 8

What is systemic desensitization?

Answer 8

plan to exposure patients to the stressor

Question 9

What umbrella therapy do these therapies fall under?

Answer 9

Both psychiotherapy

Question 10

*What is Maslow’s Hierarchy of needs?

Answer 10

A model for understanding the motivation for human behavior
Physiological, safety, love/belonging, self esteem, self actualization

Question 11

*What is the therapeutic milieu? Why is it important?

Answer 11

Day rooms where the patients interact with each other

Question 12

What is the nurse’s responsibility in regards to the therapeutic milieu?

Answer 12

keeping an eye so everything stays calm

Question 13

*What is lithium?

Answer 13

A first lime agent mood and mania stabilizer
As well a first treatment for BPD

Question 14

*Patient teaching points for lithium

Answer 14

Don’t get dehydrated hence maintain hydration
Avoid antisteroidal meds
NSAIDs
wear the bracelet

Question 15

*What is a therapeutic lithium level?

Answer 15

0.8-1.4 mEq/L

Question 16

Why is lithium so hard on the kidneys?

Answer 16

Kidneys are damaged so they have a hard time excreting things

Question 17

Besides lithium, what other medications from the anticonvulsant family do we commonly use to stabilize an unstable mood?

Answer 17

lamotrigine (rashes)
valporate

Question 18

*What are the signs and symptoms of serotionin syndrome?

Answer 18

S-shivering
H-Hyperflexia (twitching)
I-increased temp
V- Vital sign instabiltiy
E- encephalopathy (Loss of movement function)
R-restleness
S-Sweating

Question 19

*What are the signs and symptoms of neuroleptic malignant syndrome?

Answer 19

Fever, muscular rigidity, altered mental status & autonomic dysfunction , lead pipe rigidity , ^ WBC

Question 20

*What are the differences between first generation antipsychotics and second generation antipsychotics?

Answer 20

1st- only deals with positive symptoms
2nd-fewer side effects, positive and negative symptoms

Question 21

*What are extrapyramidal side effects? What causes these?

Answer 21

-They are caused by dopamine blockaide in the brain
-Acute dystonia- upward eye movement, face is schruged up, muscle spasms
-Akathisia- restless, cant stand still (ADHD)
-Dyskinesia- shuffling gait, pill rolling (parkinsons)
-Tardive dyskinesia- roll tongue, facial schrung, muscle spasm–D2 is blocked for a long time

Question 22

*What are the four different types of EPS?

Answer 22

Parkison
Dystonia
Akithisia
Tardive dyskinesia

Question 23

What is the relationship between neurotransmitters and mental health symptoms?

Answer 23

When neurotransmitters are not working causes mental health symptoms

Question 24

How does neurotransmission work? What is the sequence?

Answer 24

Nerves signals fire the messagers, then the messegners connect to the receptors, then the receptors send the information where they need to be

Question 25

What does the dopamine 2 receptor blockade do in the mesolimbic pathway, and the nigrostriatal dopamine pathway?

Answer 25

Blockaide of the mesolimbic pathway causes no halluations
Nigrostriatal blockaide causes muscle and movement restriction

Question 26

Why are the MAOIs used infrequently?

Answer 26

Can cause hypertension crisis

Question 27

What are the dietary restrictions for MAOIs and what happens if they do not adhere to the dietary restrictions?

Answer 27

No fermented foods, preserved meats, wine, aged cheese, tyramine containing food
HTN crisis

Question 28

*What is priapism and is there a drug in psychiatry that can cause this?

Answer 28

Persistent penile erection
Desyryl (nefazodone & trazodone)

Question 29

*What is an inhibitory neurotransmitter and what is an excitatory neurotransmitter?

Answer 29

inhibitory- dont wanna send the message

Excitatory-

Question 30

What are benzodiazepines? What neurotransmitters do they impact?

Answer 30

-benzo- antianxiety and insomnia meds
-impact GABA

Question 31

*Why are people more likely to get dependent on alprazolam as compared to diazepam?

Answer 31

Alprazolam has short half life which may lead to withdrawal symptoms

Question 32

What are negative symptoms of schizophrenia? Which dopamine pathway is thought to be responsible?

Answer 32

Auditory hallucinations
Mesocortical pathway

Question 33

What happens if prolactin levels are elevated?

Answer 33

Infertility
Decrease sex drive
Bone loss

Question 34

What classes of medications work by preventing/inhibiting the actions of enzymes?

Answer 34

Second genera or atypical antipsychotic (SNRI, SSRI, MAOIs)

Question 35

Why are tricyclic antidepressants not used more often?

Answer 35

Can be lethal by causing cardiotoxicity, it also has anticholinergic effects

Question 36

What happens when people overdose on tricyclic antidepressants?

Answer 36

Lethal with cardiotoxic

Question 37

Which of the antidepressants we discussed in lecture are used in psychiatric to help with sleep?

Answer 37

Trazodone/desyryl

Question 38

What drugs or substances can cause death if stopped abruptly? Why?

Answer 38

Benzos!!!!!

Question 39

*Which antianxiety medications do not cause tolerance and dependence?

Answer 39

Buspirone (buspar) and propanolol (indrel)

Question 40

*Which antianxiety medications do cause tolerance and dependence?

Answer 40

BENZO!!
Diazepam, clonazepam, alprazolam, lorazepam ( all pam + lam)