Exam #1 Flashcards
What are the diffrent components of an MSE?
A, B/PA, ATI, M/A, S+T, PD, O/C, M+I, R,J/I, MFT
- appearance
- behavior/ psychomotor activity
- attitude towards interviewer
- mood and affect
- speech and thought
- perceptual disturbances
- orientation and consciousness
- memory and intelligence
- reliability, judgement and insight
- motivation for treatment
What falls under behavior and psychomotor activity?
- excessive or limited body movements
- eye contact
- eval excessive or limited eye movement, gestures
What falls under speech and thought
Speech: rate, volume, speed
Ex. Slurring, stuttering
What falls under reliability, judgement and insight?
Reliability: credibility and trustworthiness
Judgement: good or poor
Insight: understanding of the situation they are in
What is the diathesis stress model and what does it represent?
Stress model that suggests that nature and nurture causes mental health conditions
What is the role of a psychiatric RN?
CC, HT/HM, MT, P, B, IT,
- coordinate care ( advocating for family and pt)
- health teaching and maintenance ( building coping skills)
- oversee mililieu therapy
- pharmacological, biological, and integrative therapies
What is the HEADSS assesment used for?
Psychosocial interview technique that can be used to identify risk factors
What does HEADSSS stand for?
- Home environment (relationship w/ parents + siblings)
- Education and employment ( school employment)
- Activities (sports, music, etc.)
- Drug, alcohol, or tobacco use
- Sexuality (sexually active or practice safe sex)
- Suicide risk
- safety
What is the purpose of a psychiatric mental health nursing assessment?
- build trust w/ pt
- review physical status and baseline vitals
- asses medical conditions that may mimic psych disorders
- asses risk factors
- Preform MSE
- Asses psychosocial status
- identify goals
- document
What are the three levels of psychological awareness?
- consciousness ( currently living)
- preconsciousness ( memories)
- unconsciousness ( repressed memories)
What are the three major personalities?
ID ( @ birth)
EGO (facing reality)
Superego ( moral compass)
What does Peplau define as a professional nurse-patient relationship?
- a nurse who has skills and expertise who wants to alleviate suffering, find solutions to the pt problems, increase QOL
what is the goal of a nurse- patient relationship?
FC, AW/P, HW/R, PSC/I, PE, PH
Facilitate communication, assist pt w/ problem solving, help pt reflect and examine behaviors, promote self care and independence, provide education, promote pt healing
What is the difference between personal and a therapeutic relationship?
- personal relationships initiated for the purpose of friendship, socialization, enjoyment, etc.
- for pt’s growth and healing, focuses on the pt only, the nurses needs are not addressed
What is transference?
The pt is reminded of her deceased mother when she looks at her nurse
The patient is reminded of a figure in their life which negatively or positively affects care
What is counter transference?
The nurse is reminded of her youngest son when engaging with the patient
When the nurse is reminded of someone in her life which can positively or negatively affect care
What is psychoanalytic therapy used for?
Focus on uncovering unconscious conflicts
What is the interpersonal theory?
Daddy/ mommy issues
Emphasizes the importance of early relationships with the primary parenting figure
What is interpersonal therapy?
Focuses on reducing or eliminating psych symptoms by improving interpersonal and social relationships
What are the different kind of behavioral therapies?
M, OC, SD, AT, BF
- modeling
- operant conditioning
- systematic desensitization
- aversion therapy
- biofeedback
What is modeling therapy?
- provides a positive behavior that the pt is supposed to imitate
What is operant conditioning therapy?
The desired behavior is rewarded
What is aversion therapy?
Op. Of operant conditioning
Pairing a neg stimulus with a specific behavior
What is biofeedback?
Used to control the body’s physiological response to stress and anxiety
What is cognitive behavioral therapy?
- patients are taught to challenge their own negative thinking
What is the biological model of mental illness?
Abnormal behavior is the result of a physical problem ( focuses on neuro, chemical, bio, and genetic issues)
what are the diffrent kinds of biological therapies?
- medication and brain stimulation therapies such as ECT
What are the three stages for general adaption syndrome ( GAS)?
AS, RS, ES
- alarm stages: a strong reaction to the presented stressor
- resistance stages: the person adapts to the stressor
- exhaustion: the person doesn’t have the resources or energy to overcome the stressor and it becomes chronic
What are some examples of effective stress reduction interventions?
DBE, PR, M, PE, CR, J
- deep breathing exercises
- progressive relaxation
- meditation
- physical exercise
- cognitive reframing ( replacing negative phrase like I will not to I will)
- journaling
What are the differences between maladaptive and adaptive defense mechanisms?
- positive use of defense mechanism
- when the defense mechanism is used in excess
What are the health conditions that can occur with chronic stress?
- increase in mental health diagnosis
- increased respiratory and cardiac illnesses
- suppression of the immune system
What are the diffrent coping skills for stress?
HSH, WLB, SS
- health sustaining habits
- work life balance
- social supports
What are the diffrent types of crisis?
MC, SC, AC
- maturational crisis
- situational crisis
- adventitious crisis
What is maturational crisis?
- when a person reaches a new dev stage of life and hasn’t developed new coping skills
What is situational crisis?
Divorce, job loss
- unanticipated events that are external
What is an adventitious crisis?
Natural disasters, school shootings
A unplanned event
What are the diffrent phases of crisis?
- confronted by conflict causes an increase in anxiety
- functioning becomes disorganized
- problem solving fails s anxiety increases to severe or panic level
- if coping remains ineffective anxeity manifests into depression, violent behavior, SI/ attempts
What are the 4 phases of disaster response?
M, P, R, REC
- mitigation
- preparedness
- response
- recovery
What are examples of monoamine neurotransmitters?
D, NE, S
- Dopamine
- Norepinephrine
- Serotonin
What are examples of amino acid neurotransmitters?
- glutamate
- GABA
What are examples of neuropetides
CRH, E
Cortico releasing hormone
Endorphins
What is the diagnosis is linked to a monoamine neurotransmitters imbalance?
Depression and schizophrenia
What is the diagnosis that is linked to a amino acid neurotransmitters imbalance?
Schizophrenia and anxiety
What is the diagnosis that is linked to a neuropeptides imbalance?
PTSD and major depressive (CRH)
Stress/ pain ( endorphins)
What is the diagnosis that is linked to acetylcholine imbalance?
Alzheimer’s
What is the difference between an agonist and an antagonist?
- agnostic mimics the effects of neurotransmitters
- antagonist block neurotransmitters
What does a decrease GABA level indicate?
Increased anxiety
What antianxiety medication is highly addictive?
Benzos
What is an SSRI?
Blocks
- blocks the reputable of serotonin and makes neurotransmitters more available
What are SNRI’s?
They increase both serotonin and norepinephrine
Why aren’t tricyclic antidepressants the first line of treatment?
- can be lethal in an OD and causes sedation
What are examples of benzo’s?
Pam is with Val, Klon, xan, and Ati
- diazepam ( Valium)
- clonazepam (klonopin)
- alprazolam (Xanax)
- lorazepam ( Ativan)
What are examples of SSRI’s?
What lay lay takes
- fluoxtentine Prozac
- sertraline Zoloft
- citalopram Celexa
- escitalopram lexapro
What are examples of SNRI’s?
Cymbals
Duloxetine ( cymbalta)
What are second generation antipsychotics associated with?
BS, WG, hyperLD
Metabolic side effects
What is assertive community treatment?
- intensive type if case management developed to treat hard to engage community living people w/ serious psych symptoms
What functions as an intermediate step between inpatient and outpatient care?
IOPs and PHPs
Intensive outpatient programs and hospitalization programs
What are the different ethical principles?
B, A, J, F, V, NM
- Beneficence
- autonomy
- justice
- Fidelity
- veracity
- nonmaleficence
What is fidelity?
Maintaining loyalty and commitment to the pt while doing no wrong
What is veracity?
The duty to communicate in truth
What are examples of medications used to treat Alzheimer’s?
Don and Rev
- Donepezil ( aricept)
- revastigmine ( exelon)
What are the short acting sedative hypnotic sleep agents?
Logic: “ and the haters that love gonna pop an..”
- zolpidem ( ambien )
- zaleplon ( Sonata)
- eszopiclone (Lunesta)
What are examples of orexin receptor agonist?
S, L (-exant)
- suvorexant (Blesomra)
- lemborexant (Davigo)
What are examples of atypical antipsychotics?
S, Z, G, A, L
(Seroquel) quetapine
(Zyprexa) Olanzapine
(Geodon) Ziprasidone
(Latuda) Lurasidone
(Abilify) apripirazole
What do typical antipsychotics cause?
EPSE
Extrapyramidal side affects like TD, dystonia, and Parkinsonism
