Exam 1 Flashcards
incidence
new number of cases diagnosed in a given timeframe
prevalence
new and chronic cases in a timeframe
spiritual
internal phenomenon, beliefs, values, ideals, purpose
religion
external system that includes beliefs, patterns, symbols
tardive dyskinesia
abnormal body movements
labile affect
affect changes drastically in a short time
normal thought process
logical, linear, goal directed, coherent
circumstantial
providing extra detail that are somewhat related but they never answer question. circle the answer over and over
tangential
eventually answer question but talk about other stories along the way (other stories do have some connection)
flight of ideas
jumping from unrelated topic to unrelated topic
thought blocking
responding to internal stimuli. stop in mid-sentence. may be hearing voices
delusion
false belief about something
obsessions
intrusive thoughts
illusion
misinterpreting external stimuli
insight
ability to identify issue at hand, such as their own mental illness
judgement
ability to ma ke good, safe decisions
conditions to keep someone involuntarily
threat to themselves, threat to others, gravely disabled
completed suicide
person who osuccessfully dies
suicide behavior
any behavior related to suicide such as ideation, self-harm
suicidal ideation
thoughts of taking own life.
active - thoughts of ending your own life
passive - thoughts of dying, not wanting to live anymore
indirect- i want to go to sleep and never wake up
direct - i want to end my own life
suicide intent
what did they want to happen from suicide attempt. do they actually want to die or want attention
Joiners theory of suicide
specific set of circumstances that allow people to be suicidal.
- I am alone
- I am a burden
- I am not afraid to die
major suicide risk factors
major depressive disorder, other mental health disorder, substance abuse, access to lethal means, prior suicide attempts.
populations at risk for suicide
LGBT, youth, American Indians, Alaska Natives, veterans, chronic medial conditions, bereaved by suicide
situational risk factors
stress you are under. family/marital conflict, unemployment, social withdrawal/isolation, medical problems, loss, recent discharge from inpatient unit
warning signs
threatening suicide, seeking means to die, talking or writing about suicide, dramatic mood changes, sudden change in sleep, increased drug use, hopelessness
IS PATH WARM
mnemonic for suicide assessment
Ideation Substance Use Purposelessness Anxiety Trapped feeling Hopelessness Withdrawn Anger Recklessness Mood changes
protective factors
reasons for living, family, spirituality, connectedness, hope for future, engagement with a helper, problem solving skills, availability of physical and mental health care
DICB
Suicidal desire: Factors that make people want death
Intent: Motivation for suicide
Capability: Ability to engage in suicide
Buffer: Factors that protect
cortex
top part of brain, intelligent, “human” part, who we are. higher functioning. 4 different lobes
subcortical/brainstem
bottom part of brain, primitive, automatic, reacts. survival
frontal lobe
intellect, insight, judgment, expression of emotion
parietal lobe
reading, writing, sensory perceptions, maintain attention, process motor activities
temporal lobe
auditory and olfactory senses, emotion, learning and memory
occipital lob
vision and visual memory, integration between vision and other sensory information
prefrontal cortex
front part of frontal lobe. differentiates conflicting thoughts, determines good/bad, same/different, future consequences, social control, impulsivity. Not mature until early to mid 20s
limbic system structures
amygdala, cingulate gyrus, fornix, hippocampus, hypothalamus, olfactory cortex, thalamas
limbic system functions
controls emotions, emotional response, memory storage, hormonal secretions, mood, motivation, pain and pleasure sensations
basal ganglia
impacts complex motor responses
peripheral nervous system
nerves and ganglia outside of CNS, muscles and glands. relay/communication network, brings in sensory info. composed of somatic nervous system and autonomic nervous system (includes sympathetic nervous system and parasympathetic nervous system)
SNS
excitatory, fight or flight. rapidly mobilizes body systems. activates epinephrine and norepinephrine
PSNS
calming, resets autonomic nervous system, rest and digest. slow system. innervates cranial nerves 3, 7, 9, 10
neuroglia
glial cells. support, protect and insulate. do not communicate
neurons
sensory (afferent), motor (efferent) and interneurons. communicate cell to cell via AP/nerve impulse. made up of dendrites, soma and axon
acetylcholine
NT responsible for learning, memory, wakefulness, attention and movement
histamine
NT responsible for allergic responses, gastric acid secretion, modulating CNS transmission, affects wakefulness
serotonin / 5HT
responsible for temp regulation, sleep, appetite, sexual interest, fear, depressive, anxious mood, pain perception
norepinephrine
NT responsible for response to stress, awareness of environment, attention, learning, memory, sleep, arousal.
dopamine
NT responsible for motor movement, learning, memory, judgment, insight, pleasure, motivation
glutamate
amino acid NT. excitatory
GABA
amino acid NT. inhibitory
euthymic
normal mood
SSRI’s
selective serotonin reuptake inhibitors. ASE - serotonin syndrome
SNRI’s
serotonin norepinephrine reuptake inhibitors
NDRI’s
norepinephrine dopamine reuptake inhibitors. Wellbutrin
TCA’s
tricyclic antidepressants. for sleep, pain, migraine. lethal in overdoses
MAOI’s
monoamine oxidase inhibitors. inhibit enzymes (monoamine oxidase) that breakdown NT’s, many drug interactions, requires tyramine restricted diet.h
serotonin syndrome
fever, sweating, increased HR and BP, hyperreflexia. mental status changes, agitation, shivering, N/D, pain. caused by opioids, antidepressants (esp 2 of same class), CNS stimulants and triptans, OTC herbal supplements
Food with tyramine
aged cheese, avocado, figs, yeast extracts, deli meat, liver, beer/wine, fermented food
EPS / extrapyramidal symptoms
dystonia, pseudoparkinsonism, akathisia
dystonia
abnormal muscle movements
akathisia
restlessness, pacing, rocking, anxiousness
neuroleptic malignant syndrome / NMS
caused by antipsychotics. medical emergency. occurs suddenly after dose increase or new med. labile HTN, increased HR/RR, fever, diaphoresis, drooling, increased muscle tone, decreased LOC. elevated WBC, CK
second generation
EPS reduced because these drugs do not bind as tight to D2 receptors. monitor wt, cholesterol and BG. can cause DM2
mood stabilizers
stabilize mood in bipolar and anticonvulsants/antiepileptics. reduce threshold of AP and reduce glutamate. lithium, valproic acid, carbamazepine, lamotrigine
benzodiazepines
only for short term use. less than 2 weeks. lorazepam, clonazepam, alprzaloam
transference
patient projecting past on to health professional. can be good or bad. (pt treating me as her son)
countertransference
professional projecting feelings on to patient
boundary crossing
self disclose when you shouldn’t, calling pt from home. crosses boundary of nurse-patient relationship
boundary violation
crosses boundary of nurse-patient relationship and causes patient harm. ex. sex
empathy
ability to understand how another person is feeling
sympathy
feeling sorry
Hildegard Peplau
Mother of psychiatric nursing. Theorist who said we should attempt to understand patient’s story and their feelings. Being empathetic is the healing part for the patient
genuine
when your verbal and nonverbal communication is congruent
DSM-V
criteria used to diagnose/classify mental health disorders. used worldwide. helps people be on the same page.
unconditioned positive regard
regardless of patient’s situation, you are empathetic and treat them with respect. being nonjudgmental
beneficience
ethical principle that addresses the idea that a nurse’s actions should promote good. Doing good is thought of as doing what is best for the patient.
paternalism
action limiting a person’s or group’s liberty or autonomy which is intended to promote their own good.
justice
Fair and equal treatment of patients
fidelity
being dedicated to patients and faithful in the performance of his/her duties
anxiolytics
antidepressants, benzodiazepines, buspirone
psychosocial assessment
subjective patient perceptions, chief complaint, hx of violent behaviors, substance use, legal, family history, past psychiatric history, stressors and coping methods, social background, support system, spiritual beliefs, religious, cultural
rambling
scrambled, not staying on topic. similar to flight of ideas
illogical
no logical connection
loose associations
ideas loosely associated with each other. ex. the picture has a headache.
mesocortical pathway
thinking, planning, reasoning
mesolimbic pathway
schizophrenic s/s
nigrostriatal pathway
movement
tuberoinfundibular
maintain prolactin level