Exam 1 Flashcards
*What is the purpose of defense mechanisms? Can you define the various defense mechanisms?
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
*Define Anhedonia, anergia, alogia, apraxia, avolititon
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
*How do you describe circumstantial speech, tangential speech, loose associations, clang associations
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
*What are the components of the mental status exam? What items are included under your subjective and objective data?
subjective- what you get from the patients
objective- what you observe about the patients
*What is transference and countertransference?
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
*What techniques are used in psychoanalysis, humanistic, interpersonal, and behavioral therapy?
What is cognitive behavioral therapy?
It uses both cognitive and behavioral therapy. Mainly in anxiety patients.
What is systemic desensitization?
plan to exposure patients to the stressor
What umbrella therapy do these therapies fall under?
Both psychiotherapy
*What is Maslow’s Hierarchy of needs?
A model for understanding the motivation for human behavior
Physiological, safety, love/belonging, self esteem, self actualization
*What is the therapeutic milieu? Why is it important?
Day rooms where the patients interact with each other
What is the nurse’s responsibility in regards to the therapeutic milieu?
keeping an eye so everything stays calm
*What is lithium?
A first lime agent mood and mania stabilizer
As well a first treatment for BPD
*Patient teaching points for lithium
Don’t get dehydrated hence maintain hydration
Avoid antisteroidal meds
NSAIDs
wear the bracelet
*What is a therapeutic lithium level?
0.8-1.4 mEq/L
Why is lithium so hard on the kidneys?
Kidneys are damaged so they have a hard time excreting things
Besides lithium, what other medications from the anticonvulsant family do we commonly use to stabilize an unstable mood?
lamotrigine (rashes)
valporate
*What are the signs and symptoms of serotionin syndrome?
S-shivering
H-Hyperflexia (twitching)
I-increased temp
V- Vital sign instabiltiy
E- encephalopathy (Loss of movement function)
R-restleness
S-Sweating
*What are the signs and symptoms of neuroleptic malignant syndrome?
Fever, muscular rigidity, altered mental status & autonomic dysfunction , lead pipe rigidity , ^ WBC
*What are the differences between first generation antipsychotics and second generation antipsychotics?
1st- only deals with positive symptoms
2nd-fewer side effects, positive and negative symptoms
*What are extrapyramidal side effects? What causes these?
-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
*What are the four different types of EPS?
Parkison
Dystonia
Akithisia
Tardive dyskinesia
What is the relationship between neurotransmitters and mental health symptoms?
When neurotransmitters are not working causes mental health symptoms
How does neurotransmission work? What is the sequence?
Nerves signals fire the messagers, then the messegners connect to the receptors, then the receptors send the information where they need to be
What does the dopamine 2 receptor blockade do in the mesolimbic pathway, and the nigrostriatal dopamine pathway?
Blockaide of the mesolimbic pathway causes no halluations
Nigrostriatal blockaide causes muscle and movement restriction
Why are the MAOIs used infrequently?
Can cause hypertension crisis
What are the dietary restrictions for MAOIs and what happens if they do not adhere to the dietary restrictions?
No fermented foods, preserved meats, wine, aged cheese, tyramine containing food
HTN crisis
*What is priapism and is there a drug in psychiatry that can cause this?
Persistent penile erection
Desyryl (nefazodone & trazodone)
*What is an inhibitory neurotransmitter and what is an excitatory neurotransmitter?
inhibitory- dont wanna send the message
Excitatory-
What are benzodiazepines? What neurotransmitters do they impact?
-benzo- antianxiety and insomnia meds
-impact GABA
*Why are people more likely to get dependent on alprazolam as compared to diazepam?
Alprazolam has short half life which may lead to withdrawal symptoms
What are negative symptoms of schizophrenia? Which dopamine pathway is thought to be responsible?
Auditory hallucinations
Mesocortical pathway
What happens if prolactin levels are elevated?
Infertility
Decrease sex drive
Bone loss
What classes of medications work by preventing/inhibiting the actions of enzymes?
Second genera or atypical antipsychotic (SNRI, SSRI, MAOIs)
Why are tricyclic antidepressants not used more often?
Can be lethal by causing cardiotoxicity, it also has anticholinergic effects
What happens when people overdose on tricyclic antidepressants?
Lethal with cardiotoxic
Which of the antidepressants we discussed in lecture are used in psychiatric to help with sleep?
Trazodone/desyryl
What drugs or substances can cause death if stopped abruptly? Why?
Benzos!!!!!
*Which antianxiety medications do not cause tolerance and dependence?
Buspirone (buspar) and propanolol (indrel)
*Which antianxiety medications do cause tolerance and dependence?
BENZO!!
Diazepam, clonazepam, alprazolam, lorazepam ( all pam + lam)
