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Family Concepts II - 2130 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Cognition impairment may signify _______

A

Alzheimer’s disease

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2
Q

A state of well-being in which an individual is able to realize his or her own potential, cope with the normal stresses of life, work productively, and make a contribution to the community is considered ________ ________

A

Mental health

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3
Q

_____ _____ refers to all mental disorders with definable diagnoses manifested in significant dysfunction that may be related to development, biological, or psychological disturbances in mental functioning

A

Mental illness

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4
Q

Emotions may be affected by _____

A

Depression

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5
Q

Behavioral alterations may be apparent with _____

A

Schizophrenia

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6
Q

Projective questions usually start with _______?

A

What if

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7
Q

Presupposition questions usually discuss ______?

A

Future goals

I.e. Suppose you woke up in the morning is a miracle happened and this probably had gone away. What would be different? How would it change your life?

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8
Q

_____ is associated with physical characteristics, such as body movements in past years. Facial expressions, I contact or lack there of, the way someone holds the head, legs, and shoulders, and so on convey a multitude of messages

A

Kinesics

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9
Q

_____ refers to the study of personal space and the significance of physical distance between individuals.

A

Proxemics

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10
Q

_____ distance is 0-18 inches

A

Intimate

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11
Q

_____ distance is 18-40 inches

A

Personal

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12
Q

_____ distance is 4-12 feet

A

Social

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13
Q

_____ distance is 12 or more feet

A

Public

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14
Q

What are the three stages of General adaptation syndrome (GAS)?

A

Alarm,
Resistance/Adaptation,
Exhaustion

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15
Q

_____ is a negative, draining energy that results in anxiety, depression, confusion, helplessness, hopelessness, and fatigue.

A

Distress

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16
Q

_____ is a positive, beneficial energy that motivates and results in feelings of happiness, hopefulness, and purposeful movement.

A

Eutress

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17
Q

For the short term effects of stress related to cortisol and corticoids in the hypothalamus?

A

Fluid loss, increased glucose by gluconeogenesis, decreased inflammation, decreased brain norepinephrine

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18
Q

For the long term (chronic) effects of stress related to cortisol and corticoids in the hypothalamus?

A

Immune system compromise, atherosclerosis, depression, high blood pressure, insulin insensitivity, obesity, high blood lipid, protein breakdown

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19
Q

For the short term effects of stress related to epinephrine and norepinephrine in the central nervous system?

A

Increased heart rate, increased respiration, increased triglycerides, increase platelet aggregation, decreased kidney clearance, increase blood to skeletal muscles, increased muscular tension

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20
Q

For the long term (chronic) effects of stress related to cortisol and corticoids in the hypothalamus?

A

High resting heart rate, heart disease, platelet aggregation, reactive high blood pressure, high cholesterol, high triglycerides, Renal/hepatic problems, glucose intolerance, chronic muscle tension, hyperventilation, digestive problems, chronic anxiety/anger

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21
Q

What are the overall effects of stress on the body?

A

Hypertension, heart disease/heart attack, stroke, atherosclerosis, diabetes, cancer, ulcers, chronic G.I. problems, allergies, autoimmune diseases, arthritis, headaches, reduced immunity, kidney and liver disease

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22
Q

_____ is the progressive deterioration of cognitive functioning and global impairment of intellect with no change in consciousness.

A

Dementia

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23
Q

_____ is the most common type of dementia, accounting for 60% to 80% of all dementias.

A

Alzheimer’s

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24
Q

_____ is memory loss that interferes with one’s activities of daily living.

A

Alzheimer’s

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25
Q

What are the risk factors for Alzheimer’s disease?

A

Cardiovascular disease,
social engagement and diet,
head injury and traumatic brain injury

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26
Q

What are some of the defense mechanisms with Alzheimer’s?

A

Denial,
confabulation,
perseveration,
avoidance of questions

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27
Q

What are the symptoms of Alzheimer’s disease?

A 
Memory impairment,
Disturbances in executive functioning,
Aphasia (loss of language ability),
Apraxia (loss of purposeful movement),
Agnosia (loss of sensory ability to recognize objects)
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28
Q

What are the three stages of Alzheimer’s disease?

A

Preclinical,
Mild cognitive impairment (MCI) due to Alzheimer’s disease,
Dementia due to Alzheimer’s disease

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29
Q

Contributing factors of delirium?

A

Hypoglycemia, fever, dehydration, hypotension, infection, ever struggle reaction, head injury, change in environment, pain, emotional stress

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30
Q

This neurocognitive disorder presents with altered levels of consciousness

A

Delirium

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31
Q

These neurocognitive disorder’s may also present with sundowning

A

Delirium and dementia

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32
Q

______ can’t present with rapid mood swings, fearfulness, anxiety, suspicious thoughts, aggressiveness, hallucinations and or delusions

A

Delirium

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33
Q

These symptoms may occur in late Alzheimer’s disease

A

Agraphia (inability to read or write),
Hyperorality (The need to taste, chew, and put everything in one’s mouth),
Visual agnosia (Lost ability to recognize familiar objects),
Hypermetamorphosis (manifested by touching everything in sight)

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34
Q

Which medications are aimed at preventing acetylcholine breakdown in Altheimer’s disease patients?

A

Cholinesterase inhibitors

Tacrine hydrochloride, Donepezil, rivastigmine, galantamine, Memantine (Namenda),

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35
Q

This medication treats mild to moderate symptoms of Alzheimer’s disease and improves functioning while slowing the progression of the disease

A

Tacrine (Cognex)

Has significant side effects including elevated liver transaminases levels, gastrointestinal effects, and liver toxicity. As a result it is no longer marketed for used with dementia

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36
Q

What classification of medication is used as first-line treatment for depression

A

Selective serotonin reuptake inhibitors (SSRIs)

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37
Q

This nurse/patient relationship phase involves chart review and preparation for first meeting with patient

A

Pre-orientation phase

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38
Q

This nurse/patient relationship phase can last anywhere from a few meeting or over an extended period of time. Initial interview is conducted, nurses role is clarified, confidentiality is discussed, termination is introduced, and patient problems are discussed with mutually agreed upon goals

A

Orientation phase

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39
Q

This nurse/patient relationship phase is where the relationship is maintained, information is shared, further data is gathered, and the promotion of patient problem-solving skills, self-esteem, and behavioral changes begin

A

Working phase

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40
Q

The inability to identify familiar objects or people is called ____

A

Agnosia

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41
Q

The inability to successfully perform simple tasks is called _____

A

Apraxia

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42
Q

The inability to read or write is called _____

A

Agraphia

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43
Q

I need to taste, Chin, and put everything in one’s mouth is called _____

A

Hyperorality

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44
Q

Forgetting familiar words, the location of every day objects, coming up with the right word or name, trouble remembering names when introduced to new people, difficulty performing tasks in social and work settings, forgetting material that was just read, misplacing things, trouble planning/organizing, are all signs of which stage of Alzheimer’s disease?

A

Mild cognitive Alzheimer’s disease

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45
Q

Impaired ability to perform mental arithmetic, difficulty performing complex tasks such as paying bills, becoming moody or withdrawn, gaps in memory, unable to recall ones address or telephone number, becoming confused about location and day, choosing proper clothing, are all part of what stage of Alzheimer’s disease?

A

Moderate or mid stage Alzheimer’s disease

No assistance with eating are using the toilet is yet required

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46
Q

Personality changes, the need for extensive help with ADLs, loss of awareness of recent experiences and surroundings, I won’t remember names, major changes in sleep patterns, needing assistance toileting, wandering, are all part of which stage of Alzheimer’s disease?

A

Severe Alzheimer’s disease

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47
Q

_____ is the normal, healthy fluctuations in mood

A

Euthymia

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48
Q

_____ is the lack of interest in normal activities

A

Anhedonia

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49
Q

_____ mania feels wonderful in the beginning but turns scary and dark as it progresses toward loss of control and confusion

A

Euphoric

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50
Q

_____ mania is referred to as mixed state or agitated depression, with depressive symptoms along with mania.

A

Dysphoric

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51
Q

The _____ phase of Bipolar disorder focuses on injury prevention

A

Acute

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52
Q

The _____ phase of bipolar disorder lasts for 4-9 months

A

Continuation

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53
Q

The _____ phase of bipolar disorder focuses on prevention of relapse

A

Maintenance

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54
Q

_____ is the primary medication for Bipolar disorder

A

Lithium

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55
Q

What is the therapeutic level for lithium?

A

0.8 - 1.4 therapeutic

0.6 - 1.2 maintenance blood level
>1.5 is toxic

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56
Q

What are the expected side effects for lithium at therapeutic levels of 0.4 to 1.0?

A 
Fine hand tremor, 
polyuria, 
mild thirst, 
mild nausea, 
general discomfort, 
weight gain
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57
Q

What are the early signs of lithium toxicity?

A 
1.5
Nausea, 
vomiting, 
diarrhea, 
thirst, 
polyuria, 
lethargy, 
slurred speech, 
muscle weakness, 
fine hand tremors
58
Q

What are the signs of advanced lithium toxicity?

A

1.5-2.0

Course hand tremor, 
persistent gastrointestinal upset, 
mental confusion, 
muscle hyperirritability, 
incoordination, 
sedation
59
Q

what are the signs of severe lithium toxicity ?

A 
Ataxia,
Blurred vision,
Clonic movements,
Large output of dilute urine,
Seizures, 
stupor, 
severe hypotension, 
coma
60
Q

What are the two major long-term risks of lithium therapy?

A

Hypothyroidism,

impairment of the kidneys ability to concentrate urine

61
Q

When is lithium therapy contradicted?

A 
Cardiovascular disease,
Brain damage,
Renal disease,
Thyroid disease,
Myasthenia Gravis
62
Q

Which assessment tools are used to screen for depression?

A 
Beck depression inventory,
Hamilton depression scale,
Zing depression scale,
Geriatric depression scale,
Patient health questionnaire (PHQ 2 or 9),
63
Q

The _____ phase of major depression is during weeks 6-12

A

Acute

64
Q

The _____ phase of major depression is during months 4-9

A

Continuation

65
Q

The _____ phase of major depression is greater than 1 year

A

Maintenance

66
Q

A lack of energy is called _____

A

Anergia

67
Q

What are the factors to therapeutic relationships?

A 
Elicit data and understand core problems,
Listening,
Promote patient comfort/safety,
Balancing Control,
Trust and active participation,
Genuineness, empathy, positive regard
68
Q

A lack of feeling, emotion, or interest is called _____

A

Apathy

69
Q

What factors contribute to mental health?

A

Culture,
Resilience,
Ethnicity

70
Q

What is the stage of development (Erikson) for an infant age 0-1 year?

A

Trust vs. Mistrust

Trusting or suspicion and fear

71
Q

What is the stage of development (Erikson) for early childhood age 1-3?

A

Autonomy vs Shame

Self control and adequacy vs Shame and doubt

72
Q

What is the stage of development (Erikson) for an preschool age 3-6?

A

Initiative vs Guilt

Self starter/Independent vs Guilt and inadequacy

73
Q

What is the stage of development (Erikson) for an school age age 6-12?

A

Industry vs Inferiority

Learning how things work and organizing vs Lack of understanding and feeling inferior

74
Q

What is the stage of development (Erikson) for an adolescence age 12-19?

A

Identity vs Confusion

Seeing self as unique person vs Unsure of personal identity

75
Q

What is the stage of development (Erikson) for an early adulthood age 20-25?

A

Intimacy vs Isolation

Establishing relationships vs Lack of relationships

76
Q

What is the stage of development (Erikson) for an middle adulthood age 35-65?

A

Generativity vs Self-Absorption

Concern for family and others vs Concern for self

77
Q

What is the stage of development (Erikson) for an later years age 65-death?

A

Integrity vs Despair

Feeling fulfilled vs Disappointed with life

78
Q

What attributes to caregiver stress?

A 
Change in roles within the family,
Change in living arrangements,
Financial strain,
Time/energy demands,
Family conflict,
Lack of help
79
Q

What are the physical responses to caregiver stress?

A 
Weakened immune system,
Obesity,
Chronic disease,
Depression/anxiety,
Hypersomnia
80
Q

Signs/symptoms related to caregiver stress

A 
Denial,
Anger,
Social withdrawal, 
Depression,
Exhaustion,
Sleeplessness,
Irritability,
Health problems, 
Anxiety
81
Q

What is the primary role of the caregiver?

A

Assist with ADLs,
Provide emotional and social support,
Manage health care services

82
Q

What are some ways to cope with caregiver stress?

A 
Deep breathing,
Meditation,
Yoga,
Regular exercise,
Music,
Sex,
Maintain social relationships/support,
Eat well,
Adequate sleep
83
Q

What resources would you provide to support caregivers for positive outcomes?

A 
Provide resources (home health),
Seek help from others,
Meals on wheels,
Speak to church,
Government/local assistance
84
Q

Things that contribute to therapeutic communication?

A

Open ended questions,
Reflecting (rewording),
Restating (exact words),
Clarifying (additional questions to clarify)

85
Q

Things that contribute to non-therapeutic communication?

A

Giving advice,
False reassurance,
Asking “why” questions,
Using excessive medical terms

86
Q

What are some signs/symptoms of impaired cognition?

A 
Short-term memory loss,
Confusion,
Poor hygiene,
Poor motor function,
Reappearance of health related symptoms (not taking meds)
87
Q

What are signs and symptoms of depression?

A 
Tired,
Weight loss,
Social isolation,
Irritable,
Frustrated
88
Q

What are signs and symptoms of bipolar disorder (manic phase)?

A

Elevated mood,
Grandiose delusions,
Excessive behavior (spending, sexual partners),
Flight of ideas

89
Q

What are signs and symptoms of bipolar disorder (depressive phase)?

A 
Decreased interest in typically pleasurable activities (Anhedonia),
Fatigue,
Suicidal ideation,
Sadness,
Isolation
90
Q

What are the implications, mechanism of action, adverse effects and nursing considerations for SSRIs?

A

Prozac, Paxil, Zoloft, Lexapro, Celexa

For depression;
Inhibits reuptake of serotonin (making it more available);
Sexual dysfunction, drowsiness, nausea, vomiting, anxiety, sleep disturbance, agitation;
Don’t give with MAOIs, Can cause mania (serotonin syndrome)
Takes 2-4 weeks to become effective, wean off

91
Q

SSRIs typically have a generic name extension of _____ or _____ and becomes effective after ______ (period of time)

A

~ine or ~pram,
2-4 weeks

Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Vilazodome (Vibryd)
Escitalopram (Lexapro), Citalopram (Celexa)

92
Q

Side effects such as; Mania, serotonin syndrome (mental status changes, sweats/fever, tachycardia, seizures, motor skills changes), insomnia, weight gain, and sexual dysfunction are associated with which class of drugs?

A

SSRIs

93
Q

What is the mechanism of action for SSRIs?

A

Serotonin Reuptake Inhibitor

Makes serotonin more available, resulting in elevation of mood

First line Antidepressant

94
Q

SNRIs typically have a generic name extension of _____

A

~ine

Duloxetine (Cymbalta), Venlafaxine (Effexor), Desvenlafaxine (Pristiq)

95
Q

Side effects such as; Headache, Nausea, Insomnia, Diaphoresis, Anticholinergic effects (dry mouth, blurry vision) can occur with which classification of drugs?

A

SNRIs

96
Q

What is the mechanism of action for SNRIs?

A

Inhibits reuptake of serotonin and norepinephrine

Makes serotonin and norepinephrine more available, resulting in elevation in mood

Antidepressant

97
Q

What are the nursing considerations for SSRIs?

A

Evaluate for serotonin syndrome (abdominal pain, diarrhea, sweating, fever, tachycardia, elevated blood pressure, altered mental state, myoclonus, increase motor activity, irritability, hostility, mood change); wean off drug slowly; can cause mania

98
Q

Tricyclic Antidepressants usually have a generic name extension of _____ and become effective in ______ (time period)

A

~ine

Can take 10-14 days to begin working and 4-8 weeks to establish full effects

99
Q

Side effects such as: anticholinergic effects (dry mouth, blurred vision, tachycardia, constipation, urinary retention, esophageal reflux); weight gain; hypotension may present with which classification of drugs?

A

Tricyclic Antidepressants

Third line

100
Q

What are the nursing considerations for Tricyclic Antidepressants?

A

Caution use for elderly (quick accumulation if liver/kidney issues); caution with cardiovascular disorders, BPH, and glaucoma; can cause seizures; not recommended with MAOIs; start with low dose, gradually increase

101
Q

SSRIs, SNRIs, Tricyclics, and MAOIs treat which condition(s)?

A

Depression

102
Q

This class of antidepressant is used only after attempting to use SSRIs and Tricyclics?

A

Atypical antidepressants

Bupropion (Wellbutrin), Mirtazapine (Remeron), Trazadone (Oleptro)

Can also be used for smoking cessation

103
Q

This type of antidepressant has strict dietary requirements (need fresh fruits, meat, and fish: avoid beer, yeast, and cheese) and is used for unconventional depression (characterized by mood reactivity, oversleeping and overeating) as well as panic disorder, social phobia, generalized anxiety disorder, OCD, PTSD, and bulimia

A

MAOIs

104
Q

What is the mechanism of action for MAOIs?

A

Inhibits breakdown of serotonin, norepinephrine, dopamine, and tyramine

Allows more of these neurotransmitters to be present in the body

105
Q

Side effects such as: weight gain, edema, hypertension, muscle twitch/weakness, and sexual dysfunction may present with which drug class?

A

MAOIs

106
Q

What are the nursing considerations for MAOIs?

A

Hypertension crisis (especially with tyramine foods), avoid over the counter drugs

107
Q

_____ is used to treat Bipolar disorder, acute mania, and can be used for depression

A

Lithium

First line drug for bipolar and acute mania

108
Q

What is the mechanism of action for lithium?

A

Alters sodium transport in nerve and muscle cells, inhibits release of norepinephrine and dopamine

109
Q

What are the nursing considerations for lithium?

A

Takes 7-14 days to be therapeutic, need benzodiazepine or antipsychotic in interim

Monitor for toxicity (nausea, vomiting, diarrhea, thirst, polyuria, slurred speech, muscle weakness, hand tremors, G I upset, confusion, incoordination, sedation, ataxia, blurred vision)

Patient must stay hydrated

110
Q

Side effects such as hypothyroidism, kidney nephropathy, polyuria, weight gain and nausea are associated with which drug?

A

Lithium

111
Q

Which drug classification is used for cycling bipolar disorder, schizoeffective disorder, and to reduce impulsivity and aggression?

A

Anticonvulsants

Divalproex (Depakote), Lamotigine (Lamictal), Topiramate (Topomax)

112
Q

What are the nursing considerations for anticonvulsants?

A

Can cause life threatening rash (Lamictal), watch liver/platelets, watch drug levels

113
Q

This classification of drugs typically has the extension ~ole or ~pine

A

Second generation antipsychotics

Aripiprazole (Abilify), Quetiapine (Seroquel), Risperidone (Risperdal)

114
Q

Side effects such as: seizures, muscle restlessness, priapism, sedation, nausea, vomiting, weight gain, dry mouth, cough and rash are common is which drug classification

A

Antipsychotics

115
Q

What drug classification is typically used for schizophrenia?

A

Antipsychotics

116
Q

What are the nursing considerations for antipsychotics ?

A

Watch kidney/liver function,

Hematologic profile

117
Q

Which drug classification has the extension ~pam or ~lam?

A

Antianxiety medications

Clonazepam (Klonopin), Lorazepam (Ativan), Alprazalam (Xanax)

118
Q

What is the mechanism of action for Antianxiety medication?

A

Enhances GABA (inhibitory), tranquilizes the central nervous system

119
Q

What are the side effects for anti-anxiety medications?

A

Sedation, CNS depression, psychosis, neuro changes

120
Q

Which drug classification is used to treat acute mania, psychomotor withdrawal, and anxiety

A

Anti-anxiety medications

121
Q

What are the nursing considerations for anti-anxiety medication

A

High abuse potential/tolerance

122
Q

What are the 4 As of Alzheimer’s ?

A

Amnesia (memory)
Aphasia (speech)
Apraxia (purposeful movement)
Agnosia (object recognition)

123
Q

Which part of the brain is linked with emotion?

A

Amygdala

124
Q

Which part of the brain is linked to memory?

A

Hippocampus

125
Q

Which part of the brain controls functions such as sleep/rest, temperature, aggression, libido?

A

Hypothalamus

126
Q

Which part of the brain is the message cortex with motor/sensory fibers?

A

Thalamus

127
Q

This neurotransmitter is responsible for regulating body temperature, sleep, mood, appetite and pain. Related disorders include depression, impulsive behavior and aggressiveness?

A

Serotonin

128
Q

This neurotransmitter is responsible for regulating attentiveness, emotions, sleeping, dreaming, learning, and fight/flight response. Related disorders include depression and bipolar disorder?

A

Norepinephrine

129
Q

This neurotransmitter is responsible for regulating movement, posture, mood and dependency. Related disorders include Parkinson’s, chemical dependency, and self injury?

A

Dopamine

130
Q

This neurotransmitter is responsible for regulating muscle contraction, wakefulness, attentiveness, anger, aggression, sexuality, and thirst. Related disorders include Alzheimer’s and certain neurological disorders?

A

Acetylcholine

131
Q

This neurotransmitter is responsible for regulating the excitatory response associated with learning and memory. Related disorders include Alzheimer’s, memory, ETOH withdrawal?

A

Glutamate

132
Q

This neurotransmitter is responsible for regulating inhibitory response related to anxiety, cortical, vision and motor. Related disorders include epilepsy and neuropathic pain?

A

GABA

133
Q

Who developed the theory that notes transference and counter-transference?

A

Freud

134
Q

Who developed the theory relating to the 8 stages of development?

A

Erikson

135
Q

Who developed the theory relating to interpersonal processes and social framework, helping clients gain insight into their disorders?

A

Sullivan

136
Q

Who is considered the “Mother of psychiatric nursing” that developed nurse/patient relationships as a foundation?

A

Peplau

137
Q

Who developed the theory related to conditioning and reinforcement and behavior theory?

A

Skinner

138
Q

Who developed the theory relating to rational/emotive behavior therapy and CBT?

A

Ellis, Beck, Maslow

139
Q

_____ are errors in perception of sensory stimuli. The stimulus is a real object misinterpreted as something else

A

Illusions

140
Q

_____ are false sensory stimuli. They see something that isn’t there.

A

Hallucinations

141
Q

_____ is thinking or believing something that isn’t true (people can see you through the walls)

A

Delusions

Family Concepts II - 2130 (3 decks)

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