Exam 1 Flashcards
Antihistamine Action
Antianxiety agent that exerts CNS depressant activity at the subcortical level of the CNS, particularly the limbic system & the reticular formation. They potentate the effects of the powerful inhibitory neurotransmitter, GABA, thereby producing calming effects.
Antihistamine side effects
Antianxiety agent whose side effects include dry mouth, drowsiness, and/or pain at IM sites
Antihistamine Drug names
hydroxyzine, vistaril
sublimation
rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive
isolation
separating a thought or memory from the feeling tone or emotion associated with it
regression
retreating in response to stress to an earlier level of development & the comfort measures associated with that level of functioning
rationalization
attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors
intellectualization
an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, & analysis
identification
an attempt to increase self-worth by acquiring certain attributes & characteristics of an individual one admires
denial
refusing to acknowledge the existence of a real situation or the feelings associated with it
compensation
covering up a real or perceived weakness by emphazing a trait one considers more desirable
undoing
symbolically negating or canceling out an experience that one finds intolerable
reaction formation
preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
introjection
integrating the beliefs and values of another individual into one’s own ego structure
displacement
the transfer of feelings from one target to another that is considered less threatening or that is neutral
suppression
the voluntary blocking of unpleasant feelings and experiences from one’s awareness
repression
involuntarily blocking unpleasant feelins and experiences from one’s awareness
projection
attributing feelings or impulses unacceptable to one’s self to another person
Neurons are composed of…
cell body, axon, dendrites
classes of neurons
afferent, efferent, interneurons
neurotransmitters
allow nerves to communicate with other nerves & surrounding tissues/funcation can be disrupted by systemic chemical changes,disease, and drugs/allow normal behaviors,emotions & cognition when WNL
receptors
are the binding sites for neurotransmitters in the brain/ when activated cause nerve cells to be excited or inhibited/ can be dysfunctional in brain disease states
major categories of neurotransmitters
cholinergics, monoamines, amino acids, neuropeptides
monoamines
norepinephrine, dopamine, serotonin, histamine
acetylcholine
cholinergic responsible for sleep, arousal, pain perception, movement, memory
increased levels= depression
decreased levels= Alzheimer’s, Huntington’s, Parkinson’s
norepinephrine
monoamine responsible for mood, cognition, perception, locomotion, cardiovascular function, sleep, arousal
increased levels= mania, anxiety states, schizophrenia
decreased levels= depression
dopamine
monoamine responsible for movement & coordination, emotion, voluntary judgment, release of prolactin
increased levels= mania, schizophrenia
decreased levels= depression
serotonin
monoamine responsible for sleep, arousal, libido, appetite, mood, aggression, pain perception, coordination, judgment
increased levels= anxiety states
decreased levels= depression
histamine
monoamine responsilbe for wakefulness, pain sensation, inflammatory response
increased levels= associated with wakefulness
decreased levels= depression
GABA
inhibitory amino acid that slows down body acitivity, calming peacemaker in the brain
increased levels= decreases anxiety, reduces stress, increases focus
decreased levels= anxiety disorder, Huntington’s, schizophrenia, epilepsy, hypertension, cardiovascular disease
Glycine
inhibitory amino acid responsible for recurrent inhibition of motor neurons
increased levels= toxic, encephalopathy, hyptonia, lethargy, muscle twitching
decreased levels= spastic motor movements, poorly controlled seizures
excitatory amino acids
glutamate & aspartate
glutamate & aspartate
excitatory amino acids responsible for relay of sensory information in the regulation of various motor & spinal reflexes
increased levels=Huntington’s, temporal lobe epilepsy, spinal cerebellar degeneration
decreased levels= may contribute to developing schizophrenia & psychosis
endorphins & enkephalins
neuropeptides that modulate pain & reduce peristalis
substance P
neuropeptide that regulates pain & processing of inflammation
increased levels= depression, increases anxiety & disrupts sleep
decreased levels= Alzheimer’s, Huntington’s, increased itching in eczema, insensitive to pain
somatostatin
neuropeptide that dependent upon the part of the brain being affected stimulates release of dopamine, serotonin, norepinephrine & acetylcholine OR inhibits the release of norepinephrine, histamine & glutamate. Neuromodulator of serotonin in hypothalamus
hormones of the posterior lobe of the pituitary
vasopressin and oxytocin
hormones of the anterior lobe of the pituitary
growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, prolactin, gonadotropic hormones, melanocyte-stimulating hormone
sleep stages
0-Alpha 1-Beta 2- Theta 3-Delta 4-Delta REM-Beta
neurochemical influences on sleep/wake cycle
serotonin, & L tryptophan, norepinephrine, GABA, actylcholine
genotype
total set of genes in an individual
phenotypes
characteristics that are not only genetic but also may be acquired
neurochemicals that may influence the immune system
growth hormone, testosterone, epinephrine, norepinephrine, serotonin
antidepressants work by
blocking the reuptake of serotonin & norepinephrine
antipsychotics work by
blocking specific neurotransmitter receptors
benzodiazepines facilitate
the transmission of GABA
psychostimulants increase
the release of norepinephrine, serotonin, & dopamine
nucleus acumbens
compulsions, locomotor activity
thalamus
weigh station for incoming sensory signals
hypothalamus
instinctive & appetite systems
brainstem
alerting, stimulus filtering, sleep, autonomic control
stress
the state manifested by a specfic syndrome that consists of all the nonspecifically induced changes within a biologic system
adaption
restoration of homeostasis to the internal environmental system
general adaption syndrome
- alarm reaction stage
- stage of resistance
- stage of exhaustion
precipitating event
a stimulus arising from the internal or external environment & perceived by the individual in a specific manner
primary appraisal
a judgment about the situation in one of the following ways: irrelevant, benign-positive, stress appraisal
seondary appraisal
an assessment of skills, resources, & knowledge that the person possesses to deal with the situation
cognitive appraisal
an individual’s evaluation of the personal significance of an event or occurrence
stress management
the use of coping strategies in the response to stressful situations
adaptive coping strategies…
protect the individual from harm & restore physical and psychological homeostasis
list some adaptive coping strategies
awareness, relaxation, meditation, problem-solving, pets, music, interpersonal communication with caring individual
Who associated mental illness with an irregularity in the interaction among the four humors?
Hippocrates
What four humors did Hippocrates associate with mental illness?
blood, black bile, yellow bile & phlegm
practice of the middle ages where the mentally ill were sent out to sea to search for their lost rationality
ship of fools
1st asylums for the mentally ill were established
in the middle ages in Middle Eastern Islamic countries
1st hospital in America to admit mentally ill
Philadelphia- mid 18th century
father of American psychiatry initiated the 1st humane treatment for mentally ill in the United States
Benjamin Rush
19th century lobbyist successful in establishing state hospitals for the humane treatment of the mentally ill
Dorothea Dix
1st American psychiatric nurse helped establish 1st school of psychiatric nursing 1882
Linda Richards
the successful adaption to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate & congruent with local & cultural norms.
mental health
maladpative responses to stressors from the internal and external enviroment, evidenced by thoughts, feelings, & behaviors that are incongruent with the local & cultural norms & interfere with the individual’s social, occupational, or physical functioning
mental illness
anxiety disorder, somotaform disorders & dissociative disorders
psychoneurotic patterns of behavior
Peplau’s 4 levels of anxiety
mild, moderate, severe, panic
a diffuse apprenhension that is vague in nature and is associated with feelings of uncertainty & helplessness
anxiety
the “normality” of behavior is determined by the culture
cultural relativity
the inability of the general population to understand the motivation behind the behavior
incomrenhensibility
examples of psychoses
schizophrenia, schiozaffective delusional disorders
the subjective state of emotional, physical, & social responses to the loss of a valued entity; loss may be real or perceived
grief
Kubler-Ross Five stages of grief
denial, anger, bargaining, depression, acceptance
anticipatory grief
the experiencing of the grief process before the actual loss occurs
Resolution is delayed by…
guilt for having had a love-hate relationship with the lost entity/ experiencing multiple losses & inability to complete one grieving process before another one begins
Resolution is facilitated by…
anticipatory grieving
length of the grief process is entirely individual, it can last a few weeks to years
resolution
Resolution of the grief response is thought to occur when…
an individual can look back on the relationship with the lost entity & accept both the pleasures & the disappointments of the association
maladaptive grief response
prolonged response/ delayed or inhibited response/ distorted response
clinical disorders & other conditions that may be a focus of clinical attention
Axis I
personality disorders & mental retardation
Axis II
general medical conditions
Axis III
psychosocial & environmental problems
Axis IV
global assessment of functioning rated on the GAF scale, which measures an individual’s psycological, social, and occupational functioning
Axis V
needs at this level on Maslow’s hierarchy are for avoiding harm, maintaining comfort, order, structure, physical safety, freedom from fear & protection
safety & security
basic, fundamental needs on Maslow’s hierarchy include food, water, air, sleep, exercise, elimination, shelter & sexual expression
physiological needs
needs on Maslow’s hierarchy are for giving & receiving affection, companionship, satisfactory interpersonal relationships, and identification with a group
Love & Belonging
Maslow- the individual seeks self-respect & respect from others, works to achieve success & recognition in work, and desires prestige from accomplishments
self-esteem/ esteem of others
Maslow- the individual possesses a feeling of self-fulfillment & the realization of his or her highest potential
self actualization
a collection of individuals whose association is founded on shared commonalities of interest, values, norms or purpose
group
Membership is a group…
is generally by chance, choice or circumstance.
function of a group-socialization
the teaching of social norms occurs through groups
function of a group-support
fellow members are available in time of need
function of a group- task completion
groups can assist in endeavors that are beyond the capacity of a single individual
function of a group- camaraderie
individuals receive joy & pleasure from interactions with significant others
function of a group- informational
learning takes place when group members share their knowledge with the others in the group
function of a group- normative
different groups enforce established norms in various ways
function of a group- empowerment
change can be made by groups at times when individuals alone are ineffective
function of a group- governance
large organizations often have leadership that is provided by groups rather than by a singel individual
types of groups
task, teaching, therapeutic, self-help
the way in which group members interact with each other
group process
the topic or issue being discussed in the group
group content
members leave and others join at any time during the existance of the group
open-ended groups
all members join at the time the group is organized & terminate membership at the end of a designated period of time
close-ended groups
instillation of hope
by observing the progress of others in the group with similar problems, a group member garners hope that his/her problems can also be resolved
universality
individuals come to realize that they are not alone in the problems, thoughts, & feelings they are experiencing
imparting of information
group members share their knowledg with each other; leaders of teaching groups also provide information to group members
Altruism
individuals provide assistance & support to each other, thereby helping to create a positive self-image & promote self growth
corrective recapitulation of the primary family group
group members are able to re-experience early family conflicts that remain unresolved
development of socializing techniques
through interaction with & feedback from other members of the group, individuals are able to correct maladaptive social behaviors & learn to develop new social skills
imitative behavior
group members who have mastered a particular psychosocial skill or developmental task serve as valuable role models for others
interpersonal learning
group offers varied opportunities for interacting with other people
group cohesiveness
members develop a sense of belonging that separates the individual (I am) from the group (we are)
catharsis
within the group, members are able to express both positive & negative feelings`
existential factors
the group is able to assist individual members to undertake direction of their own lives & to accept responsiblity for the quality of their existence
leadership style where focus is on the leader, on whom the members are dependent for problem-solving, decision making, & permission to perform
production is high, but morale is low
autocratic leadership
leadership style where focus is on members, who are encouraged to participate fully in problem solving of group issues, including taking action to effect change
production lower, but morale much higher
democratic leadership
leadership style with no focus, goals are undefined & members do as they please
productivity & morale are low
Laissez-faire
a type of group therapy that employs a dramatic approach in which clients become “actors” in life-situation scenarios
psychodrama
3 roles played by members of a group
task roles, maintenance roles, individual (personal) roles
enduring patterns of perceiving, relating to, & thinking about the environment & oneself that are exhibited in a wide range of social and personal contexts
personality traits
inborn personality characteristicis
temperament
Personality disorder occur when…
personality traits become inflexible & maladaptive, causing either significant functional impairment or subjective distress.
Freud’s 3 components of personality
id, ego, superego
Freud’s Stages of Development of Personality
oral stage (birth-18 months) anal stage (18 months-3 years) phallic stage (3-6 years) latency stage (6-12 years) genital stage (13-20 years)
the study of the biological foundations of cognitive, emotional, & behavioral processes
psychobiology
cerebrum, diencephalon
forebrain
mesencephalon
midbrain
pons, medulla, cerebellum
hindbrain
cerebral cortex
intelligence, judgment & inhibitory control
prefrontal cortex
planning, reasoning, decision making
hippocampus
cognitive learning & memory
amygdala
emotional memory
basal ganglia
reaction time, fine motor control
anthihistamine indications
antianxiety agent that treats anxiety disorders, relief of anxiety, acute alcohol withdrawa, allergic reactions producing puritic or asthmatic conditions, antiematic, reduction of narcotic requirement
antianxiety chemical classes
antihistamines, benzodiazepines
antidepressants chemical classes
tricyclics, SSRIs, MAOIs
barbiturates - contraindications
hypersensitivity, severe renal, hepatic, cardiac or respiratory disease; history of OD drug or alcohol abuse; porphyria, intra-arterial or subcutaneous administrations/use cautiously in elderly & debilitated, depressed or suicidal clients, children, pregnancy or lactation
Heterocyclics- drug names
Antidepressants named
Bupropion, Marpotiline, Mirtazapine, Trazodone
Nonselective reuptake inhibitors -drug names
antidepressants named
Nefazodone, Venlafaxine
Monoamine Oxidase Inhibitors-drug names
anitdepressants named
Isocarbozazid, Phenelzine, Tranylcypromine
MAOIs - side effects
antidepressants that can cause dizziness, headache, orthostatic hypertension, contstipation, nausea, edema, sexual dysfunction, weight gain, disturbance of circadian rhthym, insomnia, hypertensive crisis
MAOIs- actions
antidepressants that inhibit the enzyme MAO, resulting in an increase in the concentration of endogenous epinephrine, norepinephrine, & serotonin in storage sites throughout the nervous system
MAOIs - indications
antidepressants used to treat depression
SSRIs- drug names
antidepressants named
Citalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline
SSRIs - side effects
headache, insomnia, nervousness, sweating, anxiety, dizziness, nausea, sexual dysfunction, somnolence & dry mouth
barbiturates - action
depresses CNS; interferes with transmission through the reticular formation which is concerned with arousal; action on neurotransmitters is not well defined; all levels of CNS depression can occur from mild sedation to hypnosis to coma to death
SSRIs - actions
antidepressants that selectively inhibit the CNS neuronal uptake of serotonin, thus potentiating its activity
SSRIs - indications
antidepressants used to treat depression, OCD, Bulima Nervousa, & panic disorders. Unlabeld uses include alcoholism, anorexia nervosa, ADHD, PMS, migraine headaches, & obesity
Tricyclics - drug names
antidepressant drugs named
Amitriptyline, Clomipramine, Doxepin, Desipramine, Imipramine, Nortriptyline, Protriptyline, Trimipramine
Tricyclics -side effects
antidepressants that can cause drowsiness, dry mouth, orthostatic hyptension, tachycardia, constipation urinary retention, blood dyscrasias, nausea, vomiting, and photosensitivity
Tricyclics - indications
antidepressants used to treat major depression, dysthymic drug overdose, depression associated with bipolar drug overdose & anxiety, childhood enuersis & OCD, investigatory uses include ADHD, Panic disorders, chronic pain & alcoholism
Tricyclics - action
antidepressants that inhibit the reuptake of norepinephrine or serotonin at the presynaptic neurons
Benzodiazepines- indications
antianxiety agents used to treat anxiety disorders, anxiety symptoms, acute alcohol withdrawal, skeletal muscle spasms, convulsive disorders & status epilepticus, preop sedation
Benzodiazepines - action
antianxienty agents thought to potentiate the effects of GABA, a powerful inhibitory neurotransmitter, thereby producing a calming effect/ effect may involve the spinal cord, brain stem, cerebellum, limbic system & cortical areas
Benzodiazepines - drug names
antianxiety agents named
Alprazolam, Clonazepam, Chloridiazepoxide, Clorazepate, Diazepa, Lorazepam, Oxazepam
Benzodiazepines - side effects
antianxiety agents can cause drowsiness, dizziness, ataxia, lethargy, hypotension, tolerance, physical and psychological dependence
antipsychotics - chemical classes
phenothiazines, benzisoxazole, butyrophenone
antipsychotic - side effects
anticholinergic, dry mouth, blurred vision, constipation, urinary retention, nausea, GI upset, skin rashes, sedation, orthostatic hypotension, photosensitivity, reduction of seizure threshold, agranulocytosis, salivtion, EPS, tardive dyskinesia, neuroleptic malignant syndrome, weight gain, decreased libido, retrograde ejaculation, amenorrhea, gynecomastia
Phenothiazines - indications
antipsychotic used to treat acute & chronic psychoses, mania, recurrent psychotic symptoms in dementia, as an antiemmetic, intractable hiccups, control of tics and vocal utterances
Phenothiazines- action
antipsychotic agent thought to work by blocking post-synaptic dopamine receptors in the basal ganglia, hyothalamus, limbic system, brain stem & medulla. Also demonstrates affinity for cholinergic, alpha 1- adrenergic & histamine receptors. May also be related to inhibition of dopamine mediated transmission of neural impulses at the synapse.
Phenothiazine - drug names
Antipsychotic agents named
Fluphenazine, Mesoridazine, Perphenazine, Prochlorperazine, Promazine, Thioridazine, Trifluuoperazine, Triflupromazine
Benzisoxazole - indications
Antipsychotic agents used to manage manifestations of psychotic drug overdose
Benzisoxazole - actions
Antipsychotic agent that exerts antagonistic effects on dopamine type 2, serotonin type 2, alpha 1 & alpha 2 adrenergic & H1 histaminergic receptors.
Benzisoxasole - drug name
Antipsychotic agent named
Risperidone
Butyrophenone - indications
Antipsychotic agent used in the management of manifestations of psychotic drug overdose, psychotic symptoms in dementia in elderly, control of hyperactivity & severe behavior in children
Butyrophenone - actions
Antipsychotic agents that block postsynaptic dopamine receptors in the hypothalamus, limbic system, and reticular formation, demonstrates for cholinergic, alpha 1-adrenergic & histaminic receptors
Butyrophenone- drug name
antipsychotic agent named
Haloperidol
Phase of group development
- leader/members work together to establish rules & goals for group
- leader promotes trust & ensures that rules do not interfere with goal achievement
- members are superficial & overly polite/ trust not established
Inital Phase of group development
Phase of group development
- productive work towards completion of the task is undertaken
- leader role diminishes & becomes facilitator
- trust established between members, cohesiveness exists
- conflict manged by group members themselves
Middle/ Working phase of group development
Phase of group development
- a sense of loss, precipitating the grief process that may be experienced by member
- leader encourages members to discuss feelings of loss & reminisce about accomplishments of the group
- feelings of abandonment & grief for previous losses may be triggered for members
Final/ Termination phase of group development
Peplau’s Nursing Model stages of personality development
stage 1- learn to count on others
stage 2- learn to delay gratification
stage 3- identifying oneself
stage 4-developing skills in participation
Peplau’s Nursing Model of Development - Roles
resource person, counselor, teacher, leader, technical support, surrogate
Kohlberg’s Levels of Moral development
preconventional level (4-10 years) conventional level (10-13 years & into adulthood) post conventional level (from adolescence on)
Piaget’s Stages of Cognitive Development
sensorimotor (birth - 2 years)
peroperational (2-6 years)
concrete operations (6-12 years)
formal operations (12-15+ years)
Erikson’s Theory of Psychosocial development stages
trust vs mistrust (birth-18 months) autonomy vs shame/doubt (18 mo- 3 years) initiative vs guilt (3-6 years) industry vs inferiority (6-12 years) identity vs role confusion (12-20 years) intimacy vs isolation (20-30 years) generativity vs stagnation (30-65 years) ego integrity vs despair (65 years - death)
Mahler’s Theory of Object Relations Stages
phase I: autism (birth-1 month)
phase II: symbiosis (1-5 months)
phase III: separation-individuation (5-36 months)
Mahler’s phase III subphases
differentiation (5-10 months)
practicing (10-16 months)
rapprochement (16-24 months)
consolidation (24-36 months)
Sullivan’s Interpersonal Theory Major Concepts
anxiety, satisfaction of needs, interpersonal security, self-esteem.
Sullivan’s Interpersonal Theory Stages of Development
infancy (birth -18 months) childhood (18 months to 6 years) juvenile (6-9 years) preadolescence (9-12 years) early adolescence (12-14 years) late adolescence (14-21 years )
