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Mental Health > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

what is most important thing to ask with person experiencing hallucinations?

A

are they command hallucinations? And what will you do if you follow the commands?

(if telling to harm self or other people → at increased risk → may need hospitalization)

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2
Q 
name the types of hallucinations:
​​-hearing things
-seeing things
-tasting things
-feeling sensations
-smelling things
A 
​​Auditory: hearing things
Visual: seeing things
Gustatory: tasting things
Tactile: feeling sensations
Olfactory: smelling things
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3
Q

psychotic illness is r/t dopamine in which way?

A

excess dopaminergic activity

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4
Q

if person is receiving inpatient tx for OCD, what is your role as RN?

A

observe behavior associated with compulsions

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5
Q

in simple terms what is OCD?

A

obsessive thoughts or behaviors to reduce anxiety

can lead to significant alterations in functionality for person + people around them

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6
Q

describe what negative + positive symptoms are with schizophrenia

+ which one tends to get more severe over time + which one tends to decrease over time?

A

negative: flat affect, etc gets worse over time
positive: added symptoms (clang associations) tends to decrease

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7
Q

chronic stress leads to increased levels of which hormone and ultimately impairments in what?

A

increased CORTISOL → decreased immunity

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8
Q

what is priority goal for SIB?

A

identify triggers + warning signs → can help to prevent

“What happened before? What were you feeling? What can we do next time?”

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9
Q

what is priority intervention for SIB?

A

SAFETY: observation, monitoring, oversight

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10
Q

this disorder is characterized by:

impairments w/ thinking + cognition → major impairments in functionality

A

schizophrenia

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11
Q

what is a hallmark sign of schizophrenia?

A

Flat emotions + flat affect

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12
Q

Flight of ideas, word salad, neologism (making up words), clanging (rhyming), riddled speech, etc are often associated with which psychiatric disorder?

A

schizophrenia

positive symptoms

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13
Q

what substance use is OFTEN seen with schizophrenia?

A

smoking/tobacco

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14
Q

common comorbidities associated with schizophrenia (3)

A

depression, anxiety, SUD

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15
Q

comorbidities associated with schizophrenia are often r/t what?

A

lifestyle of person experiencing schizophrenia, medication SE, risky behavior, stigma, isolation

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16
Q

what is known as a period of time with expansive mood: elevated, irritable, grandiose behavior, racing thoughts, reckless behavior, psychosis

A

mania (r/t bipolar)

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17
Q

therapeutic interactions with person experiencing mania

A
  1. Calm, reassuring tone and presence
  2. Matter of fact approach
  3. Setting boundaries
  4. Do not interrupt them → can make more agitated
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18
Q

episodes of depression lasting > 2 weeks

A

major depressive disorder

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19
Q

persistent symptoms of depression > 3 years (not that common)

A

Dysthymia

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20
Q

name some components of depression (5)

A
  1. feeling down, sad, aggravated
  2. alterations in weight
  3. decreased energy + motivation
  4. problems with concentration or focus
  5. thoughts of suicide

(all cause significant functional impairment)

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21
Q

how should we approach nursing assessment and discharge planning related to suicidal ideation

A

DIRECT language

ex:
Any thoughts of wanting to harm or kill yourself? Or others?
Any thoughts you would be better off dead?
Ask about specific plans, suicide notes, fam hx, impulse control

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22
Q

what is BEST PRACTICE for patient with suicide ideation to keep them safe?

A

safety plan

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23
Q

what are the components/steps of a safety plan? (4)

A
  1. ID thoughts + feelings leading to those thoughts of suicide
  2. What could they do to help themselves?
  3. ID coping skills they can use
  4. Who can I call?
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24
Q

coping skills within a safety plan should be ______ + _______

A

realistic + accessible

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25
Q

re: safety plans, the person you can call if in trouble is ideally a ______, but can be what?

A

ideal: caregiver/parent

can be: another trusted adult (therapist, teacher, etc)

should talk with person to make sure they can fulfill this role

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26
Q

what is the most treated psychiatric disorder in adults ?

A

anxiety disorders

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27
Q

what type of disorder is associated with:

EXTREME anxiety over separation + FEAR → GI symptoms (vomiting)

A

separation anxiety disorder

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28
Q

what type of disorder is associated with:

  • Autonomic dysregulation
  • Can mimic s+s of heart attack, feelings of doom or impending death, can peak within minutes
A

panic disorder

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29
Q

what type of disorder is associated with:

fear when escape may be difficult or embarrassing (elevators, planes, particular rooms)

A

Agoraphobia

30
Q

what type of disorder is associated with:

  • Clear level of anxiety leading to functional impairments
  • Believe other people are judging or scrutinizing you
  • Often aware of the anxiety, but still impaired
A

social anxiety disorder

31
Q

what type of disorder is associated with:

  • Specific concern about illness that leads to decrease in functioning
  • Physiological symptoms: GI, weakness, fatigue, HA
A

somatic disorder

32
Q

what type of disorder is associated with:

  • Chronically worried (about goals, future, children, jobs, etc)
  • Sleep disturbances, restlessness, agitation, irritability
A

generalized anxiety

33
Q

what disorder is associated with:

  • Separation from experience; when level of distress is too much to manage, people may separate out
  • Feeling as if they’re out of control + watching their own experience - statements like “doesn’t feel real”
A

depersonalization disorder

34
Q

what is intervention for depersonalization disorder?

A
  1. Teach simple grounding techniques: hold chair, point out colors or objects in the room
    * mindfulness*
35
Q

what’s the difference between coping skills + self care? (in regards to psychatric illness)

A

Self care: PREVENTION of emotional dysregulation

Coping skills: something is going on - ways we can manage the situation

36
Q

what are priority interventions with patient experiencing anger + violence? (4)

A
  1. De-escalation (safety)
  2. maintain control + calm (modeling)
  3. acknowledge individuality (“i see you, i hear you”)
  4. remain non-threatening
37
Q

long term intervention for patient experiencing anger + violence

A

teaching patient how to cognitively recognize activation and when to begin using coping strategies → long term learning to reduce or avoid violent behaviors

38
Q

acts or sexual stimuli outside of social norms; required for some to experience desire, arousal + orgasm

A

paraphilia

39
Q

to dx paraphilia, how long do symptoms need to last

40
Q

what is important factor to differentiate when assessing patient with paraphilia?

A

differentiate between victims and active agents

41
Q

what is main assessment piece of paraphilia

A

risk for self harm or harm to others

42
Q

nursing care for patient with sexual dysfunction (4)

A
  1. privacy
  2. note taking to minimum (can make people uncomfortable)
  3. be aware of own bias + judgement
  4. aware of body language
43
Q

ways to provide inclusive care for transgender pts

A
  1. inclusive paperwork
  2. welcome/non discrimination signage
  3. asking pronouns + preferred names
  4. be respectful
  5. if you don’t understand, ask ◡̈
44
Q

what disorder is associated with:

  • significant challenges with being argumentative
  • problems w/ authority figures
  • upset, angry, explosive behavior, low frustration tolerance
  • peer relation and authority figure challenges
  • higher risk for depression and anxiety
A

oppositional defiant disorder (ODD)

45
Q

ODD is often seen with which other disorder?

46
Q

what disorder is associated with:

impairment in social interactions with others

A

autism spectrum disorder

how dr t differentiated between autism and ODD

47
Q

what is most prevalent neuropsychiatric disorder in childhood?

48
Q

ADHD is associated with which 2 NTs?

A

Norepi + dopamine

49
Q

intervention for ADHD

A

behavior management through social skills training classes, role play, etc

50
Q

eating disorder associated with:

  • Fear of being fat or overweight
  • purging + compensatory measures
A

bulimia nervosa

51
Q

eating disorder associated with:

Dental erosion, calloused knuckles, GI symptoms, reflux, petechiae, impulsivity + compulsivity

A

bulimia nervosa

52
Q

eating disorder associated with:

  • Significant consumption of food → leading to significant shame
  • No purging (rather often see weight gain and obesity)
A

binge eating disorder

53
Q

disorder associated with feelings of:

  • altered perception of body
  • fixation on part of body
  • needing a level of repair with body
A

Body dysmorphic disease

54
Q

eating disorders that presents with person as:

A. “normal” weight or a little overweight

B. severely underweight

A

A. normal/a little over: bulimia nervosa

B. severely underweight: anorexia nervosa

55
Q

questions you could ask to assess for bulimia nervosa

A

do you vomit after eating?
Do you exercise excessively after eating?
Do you take laxatives?

56
Q

which eating disorder is associated with the highest risk of suicide?

A

anorexia nervosa

57
Q

s+s you may see with anorexia nervosa

A
  1. extreme weight loss
  2. abnormal hair growth b/c of malnutrition + attempts to keep body warm
  3. F+E imbalances
  4. dysrhythmias
  5. dehydration
  6. amenorrhea
58
Q

interventions for caring for patient with an eating disorder

A
  1. SAFETY - physiological + psychological
  2. non-confrontational + non judgemental
  3. acknowledge ways they try to avoid eating (anorexia nervosa) but without judgement
  4. continue to support their treatment
59
Q

what is tx of choice for alcohol use withdrawal?

A

ChlorDIAZEpoxide (Librium)

long acting benzo

60
Q

CIWA protocol is for what?

COWS screening if for what?

A

CIWA: ETOH withdrawal

COWS: opiate withdrawal

61
Q

someone feels they NEED the substance + have physical symptoms of withdrawal; often w/daily use of a substance

A

dependence

62
Q

need to consume more for same effect (re: substances)

63
Q

hi ◡̈

A

you’re doing great ◡̈

64
Q

what is the preferred medication for pregnant people with SUD?

KNOW

65
Q

what is preferred medication for long standing opioid use tx?

66
Q

things to know for alcohol use withdrawal (3)

A
  1. wean SLOWLY
  2. no cold turkey
  3. keep patient safe - seizure risk
67
Q

primary goals for alcohol use withdrawal (2)

A
  1. SAFETY

2. physiological stabilization

68
Q

MOA of MAT for opioid tx

A

Blocks opioid receptors in brain without producing a “high”

suboxone, methadone, naltrexone

69
Q

ex of MAT for alcohol use tx + their MOA (simple) - (3)

A

Acamprosate (Campral): Reduces withdrawal symptoms
Disulfiram (Antabuse): aversion therapy
Naltrexone: blocks pleasurable effects/cravings

70
Q

what are the 3 stages of change for substance use?

A

precontemplation: not thinking about it; not ready to engage
contemplation: thinking about it; getting information; making plans (good time for motivational interviewing)
action: completely engaging with tx + seeking help

important to understand where someone is in this trajectory

Mental Health (2 decks)

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