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Mental health > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Freud

A

Id
Ego
Superego

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2
Q

Id

A

Pleasure-pain principle

Immediate gratification

Instinctive and primitive mind is dominant

Birth-1 1/2 years

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3
Q

Ego

A

Behaviors

Problem solving skills
Perception
Ability to mediate id impulses

1 1/2-3 years

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4
Q

Superego

A

Perfection principle

Unconscious

Reward and punishment principle

Incorporating moral values, ideals, judgments from right and wrong that are held by parents

3-7 years

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5
Q

Skinner

A

Operant conditioning

Punishment causes behavior to recur again

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6
Q

Erin beck

A

Negative and self critical thinking causes depression

Cognitive behavioral therapies assist to identify negative thought patterns and replace with rational ones (involves hw)

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7
Q

Maslow hierarchy of needs

A
  1. Physiological
  2. Safety
  3. Love and belonging
  4. Self esteem
  5. Self actualization
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8
Q

Dopamine

A

Cognitive
Motivation
Movement

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9
Q

Serotonin

A

Mood
Attention
Body temp

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10
Q

Norepinephrine

A

Mood
Cognition
Perception

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11
Q

GABA

A

Excitement

Anxiety

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12
Q

Orientation phase

A

Assessment

Getting to know patient and their history

Sort of like job orientation

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13
Q

Working phase

A 
Doing work 
Setting goals
Nursing diagnosis 
Nursing intervention
Nursing plan of care
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14
Q

Termination phase

A

Reflect on relationship

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15
Q

Nurse-client relationship/partnership

A

Patient centered

Patient has control over healthcare decisions

Don’t discuss things about yourself

Understanding nurse is safe, reliable, consistent, info is private

Ex. Bipolar patient/ won’t know boundaries

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16
Q

Social relationships

A

Each person gets something out of relationship

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17
Q

Psych RN

A

Cannot medically diagnose

Promote autonomy

Cannot run personal therapy- can group

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18
Q

Advanced practice provider

A

Focused on therapy and medical diagnosis

MH and disease management/ traditional medicine

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19
Q

Developing goal/outcome

A

SMART

Specific e
Measurable 
Attainable
Realistic 
Timely
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20
Q

Mental health

A

Sense of well- being

Ability to adapt to stress

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21
Q

Mental illness

A

Diagnosis

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22
Q

MSE

A

Mental status exam

Physical behavior, nonverbal comm, appearance (weight, BMI), speech, mood and affect, thought content, perception, cognitive ability, insight, judgement

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23
Q

Empathetic

A

Understanding feelings

“I understand your feelings…”

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24
Q

Sympathetic response

A

Feel the feelings

Your experience can relate

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25
Q

Beneficence

A

Act or promoting good to others

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26
Q

Negligence

A

Malpractice

Breeching act resulting in injury

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27
Q

Autonomy

A

Nurse being able to make own decisions

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28
Q

Justice

A

Distributing resources equally

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29
Q

Fidelity

A

Maintaining loyalty to patient

No wrong

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30
Q

Veracity

A

Truthful in documentation, report, speaking truthfully

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31
Q

Patients rights

A

Informed consent

Right to refuse (trtmt, med)

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32
Q

Involuntary admission

A

Right to hold

Can refuse meds and have informed consent

Can’t leave

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33
Q

Duty to warn: inpatient

A

Warn treatment team and staff members

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34
Q

Duty to warn: advanced practice nurse

A

Let victim know they were threatened

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35
Q

HIPAA

A

Health insurance portability and accountability act

Confidentiality

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36
Q

Psychopharmacology

A

Tools for chemical imbalances

NOT a “cure all”

Used to function properly

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37
Q

Social relationship

A

Friendship
Socialization
Environment
Accomplishment

Mutual needs met

Little emphasis on evaluation of interaction

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38
Q

Therapeutic relationship

A

Nurse maximizes their comm skills
Understand human behavior
Personal strengths

Enhance patient growth

Address concerns

Respect patient as partner in decision making

Language straight forward

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39
Q

Clinical competence

A

principles of knowledge for specific situation

Awareness and incorporation of latest knowledge (EBP)

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40
Q

Delaying judgment

A

Avoid transferring own values and beliefs to others

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41
Q

Supervision

A

More experienced clinician or team member overlooks

Essential to develop competence

42
Q

Assessment of children

A

Gather data from variety of sources

Best source of determining feelings is by parents

Can describe behavior, performance, conduct of child

INTERVIEW AND OBSERVATION

position yourself at child’s level

43
Q

Assessment of adolescents

A

Substance abuse and sexual abuse are confidential

Threats of suicide or homicide, use of illegal drugs must be shared with professionals and parents

HEADSSS interview

44
Q

Assessment of older adult

A

Sensory condition
Motor condition
Medical condition

Possible cause of increased anxiety, stress, physical discomfort

Assess mental and emotional needs

45
Q

HEADSSS

A 
Home environment 
Education and employment 
Activities
Drugs, alcohol, tobacco use 
Sexuality 
Suicide risk 
Savagery (violence or abuse)
46
Q

Dopamine and illness

A

Decrease Parkinson’s, depression

Increase schizo and mania

47
Q

Norepinephrine and illness

A

Decrease depression

Increase anxiety

48
Q

Serotonin and illness

A

Decrease depression

Increase anxiety

49
Q

Histamine and illness

A

High levels associated with anxiety and depression

50
Q

Gamma-amino butyric acid (GABA) and illness

A

Decrease anxiety, schizo, mania, Huntington chorea

Increase reduction of anxiety, schizo, mania

51
Q

Glutamate and illness

A

Excitatory signals in CNS

Cognition
Memory
Learning

52
Q

Pharmacokinetic

A

Effects of drugs on plasma concentrations of each other

53
Q

Pharmacodynamic

A

Combined effects of drugs

54
Q

Acetylcholine and illness

A

Increase depression

Decrease Alzheimer’s, Huntington chorea, Parkinson’s

55
Q

Supstance P

A

Regulation of mood and anxiety

Pain management

56
Q

Somatostatin and illness

A

Decrease Alzheimer’s

Increase Huntington

57
Q

Neurotensin and illness

A

Decrease levels of spinal fluid of patients with schizo

58
Q

Monoamines

A

Organic

Neurotransmitters divide into subgroups

Catecholamines

Indolamines

59
Q

Catecholamines

A

Norepinephrine

Epinephrine

Dopamine

60
Q

Indolamines

A

Serotonin

61
Q

Monoamine oxidase (MAO)

A

Enzyme destroys monoamines

62
Q

Monoamine oxidase inhibitors (MOAIs)

A

drugs that increase concentrations of monoamines

Inhibit MAO

63
Q

EMSAM (delegitimization transdermal system)

A

Delivers MAOIs through skin

64
Q

Hypertensive crisis

A 
Patient ingests tyramine found in OTC meds 
Beer
Wine
Aged cheese 
Organ meats
Avacados

RESTRICTION should be maintained 2 weeks after stopping MAOIs

65
Q

Antidepressant drugs

A 
TCAs
SSRIs
SNRIs (serotonin noripenephrine) 
SNDIs (disinhibitors)
NDRIs
SARIs
NRIs
66
Q

TCAs drugs

A

Amitriptyline (elavil)

Nortriptyline (pamelor)

67
Q

TCAs use and SE

A

Increase norepinephrine

SE: anticholinergic, dizziness, hypotension

Taper slowly
6-8 weeks full effect

68
Q

SSRIs drugs

A

Fluoxetine (Prozac)

Sertaline (Zoloft)

Paroxetine (paxil)

69
Q

SSRIs use and SE

A

Increase serotonin

SE: some anticholingeric, nausea, vomiting, serotonin syndrome

Watch for suicidal tendencies

70
Q

SNRIs use and SE

A

Increase serotonin and norepinephrine

SE: few anticholinergic

71
Q

SNDIs use and SE

A

Increase serotonin and norepinephrine

Added to SSRIs to increase effectiveness (augment)

72
Q

NDRIs

A

Norepinephrine dopamine reuptake inhibitors

Bupropion (Wellbutrin)

73
Q

NDRIs use and SE

A

Don’t act on serotonin system

Inhibit nicotin acetylcholine receptors to reduce additive effects

74
Q

SARIs

A

Serotonin antagonist reuptake inhibitors

Trazadone (Desyrel)

75
Q

SARIs

A

Not first choice as antidepressant

Good for insomnia

SE: priapism (prolonged erection)

76
Q

NRIs

A

Selective norepinephrine reuptake inhibitors

Atomoxetine (strattera)

77
Q

NRIs use

A

ADHD when stimulants not tolerated

No significant antidepressant effects

78
Q

Anxiety drugs/ anxiolytics

BENZO

A

Diazepam (Valium)
Clonazepam(klonopin)
Alprazolam (Xanax)

Lorazepam (Ativan) and Xanax reduce anxiety without insomnia

Insomnia: flurazepam (dalmane) and triazolam (halcion)

79
Q

Anti anxiety and hypnotic

NONBENZO

A

Busiprone (buspar)
X-hypnotics
Melatonin receptor agonist

80
Q

Busiporne (buspar)

A

Less potential for dependence

81
Q

Z-hypnotics

A

Short acting sedatives and hypnotic sleep agents

82
Q

Melatonin receptor agonist

A

Ramelteon (rozerem)

Acts similar to melatonin

Regulate circadian rhythms

83
Q

Mood stabilizers meds

A

Lithium (eskalith, lithobid)

Valproate (depakote/ depakene)

Carbamazepine (Tegretol)

Lamotrigine (lamictal)

84
Q

Mania

A

Bipolar disorder

85
Q

Lithium SE

A

Toxicity can include tremor, ataxia, confusion, convulsions, nausea, vomiting

86
Q

Valproate (depakote/depakene)

A

Managed impulsive aggression

87
Q

Carbamazepine (Tegretol)

A

Acute mania

88
Q

Lamotrogine (lamictal)

A

Maintenance therapy

Stevens-Johnson’s

89
Q

Off label mood stabilizers

A

Oxcarbazepine (trileptal)

Gabapentin (neurontin)

Topiramate (topamax)

90
Q

Antipsychotics first generation (FGA)

A

Chloropromazine (thorazine)

Fluphenazine (prolixin)

Haloperidol (haldol)

91
Q

Extrapyramidal side effects

A

Caused from dopamine blocking

Dystonia (muscle stiffness)
Akathisia (restlessness)
Tarditive dyskinesia (TD) -involuntary mvmts (tremors) 
Drug induced Parkinsonism 
Neuroleptic malignant syndrome (NMS)
Ortho hypo
92
Q

Blocking muscarinic cholinergic receptors?

A

Blurred vision

93
Q

Second generation antipsychotics

A

Atypical

Fewer extrapyramidal side effects

Target neg and positive symptoms of schizo

SE: increase weight, BG, triglyceride, insulin resistance

94
Q

Psychiatrist

A

Medical physician

95
Q

Role of psychiatric nurse on inpatient unit

A

Maintain therapeutic milieu

96
Q

Psychoanalytic theory

A

Freud

Unconscious thoughts and psychosexual development

97
Q

Erickson’s stages: adolescence

A

12-20

Identity vs role confusion

Temporary identity diffusion

Integrate all tasks previously

98
Q

Erickson’s stages: young adult

A

20-30

Intimacy vs isolation

Fear of losing identity or relationship

Forming intense long relationships

99
Q

Erickson’s stages: middle adult

A

30-65

Generatively vs self absorption

Achieving goals

100
Q

Goals of therapeutic relationships

A
  1. Facilitate comm of distressing thoughts and feelings
  2. Assist patients with problem solving for ADLs
  3. Help patients examine self defeating behaviors and test alternatives
  4. Promote self care and independence
101
Q

Restraining orders by age

A

4 hrs (18+)

2 hrs (9-17)

1 hr (under 9 years)

Assess every 15-30 min and DOC!

102
Q

Serotonin syndrome

A 
Fever
Agitation
Increased reflexes 
Tremor
Sweating
Dilated pupils 
Diarrhea 
Siezures

Mental health (7 decks)

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