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Acute Psych > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

Peplau

A

Mother of psych nursing
Created the nursing process
Applied interpersonal theory to nursing practice and nurse-client relationship
Nurses acts s maturing force

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2
Q

Acetylcholine

A

Cholinergic
Location: Autonomic Nervous System
Function: implicated in sleep, arousal, pain perception, modulation & coordination of movement & memory
Implications: Parkinson’s, Huntington’s, Alzheimer’s,increased levels of depression

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3
Q

Norepinephrine

A

Monoamine
Regulation of mood, cognition, perception, cardiovascular function, sleep & arousal
Implications: Increased in mania, anxiety states, schizophrenia, and decreased in depression

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4
Q

Dopamine

A

Monoamine
Reg. Of movements & coordination, emotions, decision making, pleasure & pain reward centers
Implications: decreased levels in depression & Parkinson’s; increased levels in mania & dyregulation in schizophrenia

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5
Q

Serotonin

A

Monoamine
Cognition, sleep, arousal, libido, appetite, mood, aggression, & pain perceptions
High concentrations in GI w nausea w SSRIs
Implications: increased levels in mania and decreased levels in dyregulation anxiety

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6
Q

Gamma-Aminobutyric Acid

GABA

A

Amino Acid
Inhibitory
Widespread in CNS
Interrupts prog of electrical impulse @ synaptic junction, slow down body activity
Implications: decreased level in anxiety, movement disorders & epilepsy

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7
Q

Glutamate

A

Amino Acid
Excitatory
Pyramidal cells in cortex, cerebellum & primary sensory afferent systems
Relays sensory info & reg. Of motor and spinal reflexes
Implications: etiology of certain neurogenic disorder & schizophrenia

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8
Q

Endorphins & Enkephalins

A

Opioid peptides
Location: Hypothalamus, thalamus, lambic structures, midbrain, brain stem, enkephalins founds in GI tract
Pain modulation and Pleasure
Implications: addict tigons, schizophrenia

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9
Q

Id

A

Instinctual drives, immediate gratification, impulsive & irrational

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10
Q

Ego

A

Rational self, develops at 4-6 MO
Experiences the reality of the external world, adapts to it, and responds to it
Role to maintain harmony among external world, the id & superego

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11
Q

Superego

A

The perfection principle

Developers b/w 3-6 yrs, internalize the values and morals set forth by primary caregivers

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12
Q

Oral Stage

A

Birth - 18 MO
Infant feels attach & unable to differentiate self from mothering
4-6 MO, infant starts to view self as separate from mothering fig.
Sense of security & ability to trust others derived from gratification of fulfilling basic needs during this stage

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13
Q

Phallic Stage

A 
3-6 Yrs
Superego development
Sexual ID w parent 
Oedipus complex
Electra complex
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14
Q

Latency Stage

A

6-12 Yrs
Elementary school yrs
Change from egocentricism to more interest in group activities, learning & social w peers
Sexuality is obscure & imperceptible to others
Preference for same-gender relationship, even rejecting members of opposite gender

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15
Q

Anal Stage

A

18MO - 3yrs
Toilet training
Gain independence & control
Stubbornness, stinginess, controlling

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16
Q

Genital Stage

A

13-20 Yrs
Mature of genital organs from reawakening of libidinal drive
Focus on opp gender & prep for mate
Sexual maturity evolves from self-grat. To behaviors deemed accepted by societal norms
Interpersonal relation. Based on genuine pleasure, not child associations.

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17
Q

Compensation

A

Covering up a real or perceived weakness by emphasizing a trait one considers more desirable.

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18
Q

Rationalization

A

Attempting to make or formulate logical reasons to justify unacceptable feelings or behaviors

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19
Q

Denial

A

Refusing to acknowledge the existence of a real situation or feelings associated with it.

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20
Q

Reaction Formation

A

Preventing unacceptable or undesired thoughts or behaviors from being expressed by exaggerations opposite thoughts or types of behaviors

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21
Q

Displacement

A

Transfer of feelings from one target to another that’s considered less threatening or neutral

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22
Q

Regression

A

Retreating is response to stress to an earlier level of development & comfort measures associated w that level of functioning

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23
Q

Repression

A

involuntary blocking of unpleasant feelings and experiences from one’s awareness

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24
Q

Intellectualization

A

An attempt to avoid expressing emotions associated w a stressful situation by using the intellect

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25
Q

Sublimation

A

The diversion of energy of a sexual or other biological impulse from its immediate goal to one of a more acceptable one

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26
Q

Undoing

A

Symbolically negating or canceling out an experience that one finds intolerable

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27
Q

Projection

A

Attributing unacceptable feelings or impulses to another person

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28
Q

Trust v Mistrust

A

Birth-18MO
develop a basic trust in the mothering fig & to gen it to others

Self confidence, optimist, hope for future
Non achievement: emotional dissatisfaction with others, suspiciousness, & difficulties w interpersonal relationships

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29
Q

Autonomy v Shame

A

18MO-3 yrs

Gain self-control & independence w/in environ.
Delay gratification, self confidence in ability to perform
Autonomy achieved when parent encourage & provide opportunity for independent activities

Non achievement: lack of self confidence, lack of pride in ability to perform, feeling of being controlled by others, primary caregiver restriction of independent behavior both physically and verbally.

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30
Q

Initiative v Guilt

A

3-6 Yrs
develop a sense of purpose & ability to initiate & direct own activities
Able to exercise restraint & self control
Creativity encouraged

Non achieve: feelings of inadequacy & guilt and sense of defeat

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31
Q

Industry v Inferiority

A

6-12 Yrs
Achieve self confidence by learning, competing, performing successfully, and receiving recognition from significant others & peers
Satisfaction & pleasure in interactions involved w others.
Master reliable work habit, trust & pride in achieve

Non achieve: difficulty interpreting relationships because feelings of inadequacy. Inability to cooperate or compromise, problem solve successfully

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32
Q

Identity v Role Confusion

A

12-20 Yrs
Sense of confidence, emotional stability & view of self esteem as unique individual
Values system, career choice, relationship with both gender
Parents relinquish control

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33
Q

Intimacy v Isolation

A

20-30 Yrs
Form lasting relationships or commitments to person, cause, institution, or creative effort.
Capacity for mutual love & respect b/w people

Non achieve: social isolation; aloneness

34
Q

Generativity v Stagnation/ Self-absorption

A

30-50 Yrs
Achieve life’s goals established for oneself while considering welfare and future generation
Sense of gratification from personal and professional achieve & meaningful contributions to others

Non achieve: lack of concern or welfare of others & total preoccupation w self with dawn, isolated, self-indulgent

35
Q

Ego Integrity v Despair

A

65-Death

Review one’s life & derive meaning from both + & - events while achieving positive sense of self
Self worth/achievement

Non achieve: disgust with how life progressed, want to start over; want 2nd chance

36
Q

“Good Me”

A

Part of personality that develops in response to positive feedback from primary caregiver, a positive response as it becomes incorporated into self-system

37
Q

“Bad Me”

A

Part of personality that develops in response to negative feedback from primary caregiver. Alter behavior in response to negative feelings

38
Q

“Not Me”

A

Part of personality that develops in response to situations that produce intense anxiety in a child, denial of feelings in an effort to relieve anxiety, withdrawal from emotions

39
Q

Symptoms of Manic Episodes

A 
Inflated self-esteem/grandiosity 
decreased need for sleep
Talkative/pressured speech 
Flight of ideas/racing thoughts
Distractibility 
Increase in goal directed activity
Excessive involvement in activities with increased potential for painful consequence
Agitation, irritability, aggression
40
Q

Bipolar Disorder

A

Mood swings from profound depression to extreme euphoria w intervening periods of normalcy
delusions may be present
Onset of symptoms may follow seasonal pattern

41
Q

Hypomanic Episode

A

4 day period of increased, expansive, or irritable mood
episode is change in behavior
Disturbance in mood and change in function are observed by others
Not sever enough to cause marked impairment in function
Not attributed to substances/meds or medical condition

42
Q

Cyclothymic Disorder

A

Chronic, fluctuating mood disturbance of @ least 2 yr duration
Numerous periods of elevated mood (doesn’t meet crit for hypomanic episode)
Numerous period of depressed mood (insuff crit to meet MDD)
Never w/o sump for +2MO

43
Q

Mood

A

Pt’s internal & sustained emotional state

44
Q

Affect

A

Emotional rxn associated with an experience
Expression of mood or what pt’s mood appears to be to the clinician
Congruent/incongruent

45
Q

Abstract Reasoning

A

Ability to shift back & forth b/w general concepts & specific examples
Can pt interpret proverbs
Cultural & educ. limits need to be kept in mind

46
Q

Insight & Judgement

A

Ability to solve prob & make decisions
Knowledge about self
Adaptive / maladaptive use of coping mech.

47
Q

Psychosis

A

Loss of contact w reality

Disorganization of the personality

Deterioration of social function

48
Q

Delusions

A

Fixed false beliefs
Persecutory: ppl out to get them
Referential: everything refers to them
Grandiose: Think they’re God
Somatic: Bodily delusions (think something’s wrong with them)

49
Q

Hallucinations

A

Perception like experiences that occur w/o an external stimulus
Vivid, clear w full force & impact
Occur in sensory: auditory, visual, olfactory, tactile, gustatory

50
Q

Disorganized Thinking

A 
Thought Disorder
Inferred from person's speech
    Loose associations/derailment
    Tangential speech
    Word Salad

Must be severe enough to substantially impair effective communication

51
Q

Negative Symptoms of Psychosis

A 
Diminished emotional expression
Avolition (lack of motivation)
Alogia (inability to speak)
Anhedonia (inability to feel pleasure)
Asociality (lack of motivation in social interactions)
52
Q

Positive Symptoms of Schizophrenia

A 
Hallucinations
Delusions
Illusions
Disorganized Thinking
Bizarre behavior
53
Q

Negative Symptoms of Schizophrenia

A 
Flat Affect
Anhedonia 
Avolition 
Social isolation
Diminished self care
54
Q

Waxy flexibility

A

Person maintains the body position into which they are placed (catalepsy)

55
Q

Posturing

A

Strange, fixed & bizarre bodily positions (catatonic posturing)

56
Q

Anergia

A

Lack of energy

57
Q

Side Effects of Typical Antipsychotics

A 
EPS: Extra Pyramidal Side Effects 
   Cog wheeling 
   Dystonia 
   Akathesia 
   Tardive dyskinesia 
   Parkinsonianism

Neuroleptic Malignant Syndrome
Orthodontic hypotension

58
Q

Tardiness Dyskinesia

A

Syndrome characterized by abnorm involuntary movements of pt’s face, mouth, trunk or limbs

Monitor symptoms with AIMS scale

59
Q

Vascular Dementia

A

Secondary to CV disease
Fluctuating pattern of prog
R/t interruption of vascular flow
Mult sm. strokes

60
Q

Picks Disease

A

Frontotemporal NCD

Language, behavioral and motor subtypes

61
Q

Lewy Body Dementia

A

Dementia accompanied by delirium, visual hallucinations, & Parkinsonism.

Symptoms: syncope, falls, sleep disorder & depression

Amyloid plaques, deficiencies in dopamine & acetylcholine

62
Q

Pseudo dementia

A

Can be reversed w appropriate treatment

not caused by organic disease

63
Q

Kubler-Ross Stages of Grief

A 
I. Denial 
II. Anger
III. Bargaining
IV. Depression
V. Acceptance
64
Q

John Boulby Stages of Grief

A

I. Numbness/Protest
II. Disequilibrium
III. Disorganization & despair
IV. Reorganization

65
Q

George Engel Stages of Grief

A 
I. Shock & disbelief 
II. Developing awareness
III. restitution 
IV. Result ion of loss
V. Recovery
66
Q

Tasks to be Reconciled

William Worden

A

I. Accepting reality of the loss
II. Processing pain of grief
III. Adjusting to world w/o lost entity
IV. Finding an enduring connection w lost entity in midst of embarking on new life

67
Q

Anticipatory Grief

A

Experiencing feelings/emotions associated w normal grief before loss occurs

Becomes more intense as loss becomes more imminent

Defense mechanism

68
Q

Delayed/Inhibited Grief

A

A sense of Grief

Fixed in denial

69
Q

Distorted (exaggerated) Grief Response

A

Symptoms exaggerated
Dysfunc in managing ADLs
Fixed in anger phase; depression may result

70
Q

Chronic/prolonged Grieving

A

Disabling behavior that prevents bereaved from ADLs

71
Q

Major Depressive Disorder

A

Depressed mood/loss of interest in activities for @ least 2 wks
Evidence of impaired social & occupational function
No hist of manic behavior
Symptoms not attributed do to substance/medical condition
Decrease/increase in weight (significantly)
Insomnia/hyperinsomnia
Psychomotor agitation
SSRI,SNRI

72
Q

Side effects of SSRIs and SNRIs

A 
Headache 
Nausea 
Insomnia/anxiety
Weight gain/loss
Sexual dysfunction 
Serotonin syndrome
73
Q

Serotonin Syndrome

A

Most commonly drug-drug interaction
Symptoms: diarrhea, restlessness, agitation, hyperreflexia, autonomic instability, myoclonus, seizures, delirium, coma, status epileptius, cardiovascular collapse

Fix by remove agent; meds to block serotonin receptors

74
Q

Autism Spectrum Disorder

A 
Wide range of impairment in 2 domains
   Social communication
   Restricted & repetitive behavior 
Onset first 3 yr life
Seizure disorder common co-morbidity
75
Q

ADHD

A

Persistent pattern of inattention &/or hyperactivity-impulsivity that interferes w func or development

Types:
Hyperactive-impulse
Inattentive
Combined

76
Q

Stimulant Side Effects

A 
Restlessness
Overstimulation 
Insomnia 
Anorexia 
Tolerance
Dependence
77
Q

Clozapine (Clozaril)

A

1st effective antipsychotic w decrease EPS
Associated w risk of agranulocytosis & risk for myocarditis
Monitor WBC closely
Used for severely ill pt who fail to respond to standard treatment

78
Q

Lamotrigine (Lamictil)

A

Anticonvulsant

Side effects: Steven Johnson’s Syndrome

79
Q

Lithium

A

Mood stabilizer

Acute mania: 1.0-1.5 mEq/L
Maintenance: 0.6-1.2 mEq/L

Side effect: drowsiness, dry mouth/ thirst, GI upset, hand tremor, polyuria, dehydration, weight gain, acne, lithium toxicity

80
Q

Valproic Acid (Depakote)

A

Anticonvulsant

Side effects: sedation, weight gain, hepatotoxicity w liver fail, pancreatitis, prolonged bleed time

81
Q

Carbamazepine (Tegretol)

A

Anticonvulsant

Side effects: Steven Johnson syndrome, aplastic anemia, hyponatremia

Acute Psych (1 decks)

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