Exam 2 Flashcards
What are the four domains of personality?
Cognition, affectivity, interpersonal behavior, impulse control
When do personality disorders usually manifest?
Adolescence and adulthood
What three personality disorders are women at risk for?
Paranoid, avoidant, dependent personality disorders.
Men are at higher risk for what type of personality disorder?
Antisocial
When threatened, people with personality disorders do what instead of trying to change their behavior?
They attempt to manipulate their environment
Which theory of personality places importance on nurturing from caregivers in order to foster positive personality traits ?
Psychoanalytic theory
Which theory of personality places importance on genes as well as environmental factors in the development of personality?
Biological theory of personality
Which theory of personality believes that personality develops thru thought and interaction with the environment?
Social learning and cognitive perspective
According to DSM criteria, symptoms must manifest in how many of the four areas of personality?
In two or more
Cluster A disorders are described as what?
“Odd or eccentric”
What three personality disorders fall into Cluster A?
Paranoid, schizoid, and schizotypal
Cluster B disorders are described as what?
Dramatic, emotional or erratic
What four personality disorders fall into Cluster B?
Histrionic, borderline, antisocial and narcissistic
Cluster C personality disorders are described as what?
Anxious or fearful
What three personality disorders are included in Cluster C?
Avoidant, dependent and obsessive-compulsive
Which personality disorder involves a suspiciousness and distrust of others’ motives?
Paranoid personality disorder
Schizoid personalities are characterized primarily by what?
An inability to form close personal relationships
Thought patterns are disturbed in schizoid or schizotypal personality disorder?
In schizotypal personality disorder
Which is more serious, schizoid or schizotypal personality disorder?
Schizotypal personality disorder
Can a schizotypal personality exhibit psychotic breaks?
Yes, when under stress
What personality disorder is irresponsible and aggressive, yet superficially charming?
Antisocial
Which personality disorders shows a disregard for the rights of others as one of its main traits?
Antisocial
Ppl with antisocial PD usually have what kind of temperament as a child?
Aggressive
What might the parents of someone with antisocial PD be like?
May not discipline or otherwise influence their child, and may be sociopaths or alcoholics
Which personality disorder is characterized by intense and chaotic relationships, as well as extreme attitudes regarding others?
Borderline personality
What is the most common personality disorder?
Borderline personality disorder
How long do episodes of emotional instability usually last in borderline PD?
A few hours to a full day
Which PD always seems to be in a state of crisis?
Borderline
Which PD is characterized by attention-seeking, dependent on approval of others, and easily influenced?
Histrionic PD
Which PD is grandiose and self-absorbed, yet has a fragile self esteem?
Narcissistic PD
In narcissistic PD, criticism may result in what?
Rage and humiliation
What is the general mood of someone with narcissistic PD?
Optimistic and carefree
Which PD is characterized by being shy, withdrawn, and afraid to form relationships for fear or being rejected?
Avoidant personality disorder
What is the difference between social phobia and avoidant PD?
Avoidant PD involves avoiding all social situations, while social phobia involves avoiding just select situations
Which personality disorder is characterized by having an intense need to be cared for, and staying in abusive relationships?
Dependent PD
Which PD has a persistent negative attitude and reacts poorly to the normal demands of social and occupational functioning?
Passive-aggressive PD
What are two nursing interventions for Cluster A PD?
Solve the immediate crisis and provide social skills training
For what cluster of PDs is it especially important to try and prevent suicide and self-harm?
Cluster B
What are three nursing interventions for Cluster C PDs?
Enhance social functioning, cognitive restructuring, and assertiveness training
What happens to blood clotting when someone is anxious?
It increases
When is an anxiety disorder diagnosed?
When someone experiences persistent anxiety that cannot be dismissed, and when anxiety interferes with ADLs.
What is the difference between anxiety and fear?
Anxiety is an emotional process, and fear is a cognitive process
At what level does anxiety begin to dull perceptions?
Moderate
At what level of anxiety is one unable to differentiate real from imagined stimuli?
Panic
What is the most common type of psychiatric disorder?
Anxiety disorders
The body’s inability to regulate what two neurotransmitters is likely to lead to anxiety disorders?
Serotonin and GABA
How long can a panic attack last?
5-20 mins (in some cases up to one hour)
What is generalized anxiety disorder characterized by?
Chronic, unrealistic worry for at least 6 months
What is diagnosed when phobias accompany panic attacks?
Panic disorder
In obsessive-compulsive disorder, the pt spends how much time per day on their compulsions?
At least one hour
Acute stress disorder occurs in what time frame after exposure to a trauma?
In the first month
Acute stress disorder resolves in how many days?
2-28 days
How long must symptoms continue for PTSD to be diagnosed?
Greater than one month
After how long is PTSD considered chronic?
After 3 months
What should be kept in mind when using benzodiazepines to treat anxiety disorders?
They should not be discontinued abruptly
Binge eating disorder is diagnosed when compulsive overeating occurs how often and for how long?
Twice a week or more for longer than 6 months
OCD, bulimia and anorexia are associated with excessive levels of which hormone?
Vasopressin
In anorexia, the pt will weigh at least what % less than their expected ideal body weight?
15%
In anorexia/bulimia, the pt should maintain at least what % of their expected body weight as a goal?
At least 80%
When being treated for anorexia/bulimia, it is very important that the pt feel what?
That they are in control of their treatment
Morbid obesity is a BMI of above what?
Above 40
Overweight is considered a BMI of what?
25-30
What differentiates substance abuse from substance dependence?
Substance dependence occurs when there is tolerance to the drug and withdrawal when someone stops using
A healthy liver can metabolize how much alcohol per hour?
About 1 oz
A BAL of what will result in death?
0.5
A BAL of what will result in coma?
0.4
Which condition, related to alcohol dependence, is marked by an inability to learn new info, unsteady gait, and muscle weakness?
Wernicke’s encephalopathy
Which condition, related to alcohol dependence, is marked by gait disturbance, confabulation, disorientation?
Korsakoff’s psychosis
Wernicke’s encephalopathy and Korsakoff’s psychosis are both related to deficiencies of what?
Thyamine
When do early signs of alcohol withdrawal begin?
A few hours after decreasing consumption
How soon after stopping alcohol consumption do withdrawal symptoms peak?
Within 24 to 48 hours
How serious is alcohol withdrawal delirium?
Very serious – it is a medical emergency that can result in death
How long after stopping alcohol consumption does withdrawal delirium start and how long does it last for?
Peaks 2-3 days after stopping and lasts for 2-3 days
A pt who has stopped drinking alcohol 2 days ago exhibits tachycardia, diaphoresis, hallucinations and a fever of 103F. The nurse suspects what?
Alcohol withdrawal delirium
A pt exhibits dry mouth/nose, darting pupils and hyperactivity. The nurse suspects what?
Central nervous system stimulant use (crack, cocaine, or amphetamines)
How long does a crack high last?
5-7 mins
What two main effects on the body does crack/cocaine have?
Anesthetic and stimulant
Rave drugs such as MDMA may lead to failure of what two organs?
Kidneys and heart
What kind of amnesia do date rape drugs produce?
Anterograde amnesia
Date rape drugs produce relaxation of what type of muscles?
Voluntary muscles
What should you do if a nursing coworker is under the influence of drugs on the job?
Document and report to the nursing manager
How does naltrexone work for alcohol abuse?
It works by blocking opiate receptors, which reduces alcohol cravings
How does disulfiram work for alcohol abuse?
It causes unpleasant side effects when combined with alcohol
What is the only med approved to treat pregnant addicts?
Methadone
Before 1950, what were the two main classes of drugs used to treat pysch problems?
Sedatives and amphetamines
In general, how do antidepressants work?
By blocking the reuptake of neurotransmitters
How do antipsychotics work, in general?
Block dopamine and other receptors
In general, how do benzodiazepines work?
By facilitating the transmission of GABA
How long do antidepressants take to work?
Initial relief may be felt in 7 days, but complete relief could take up to several weeks
Antidepressants cause increased risk of suicide in what age groups?
Children and adolescents
How do SNRIs work?
By inhibiting reuptake of seritonin and norepinephrine
What should be verified before starting a pt on an NDRI?
Verify if there is a history of seizure disorder
SSRIs should not be used with what other type of antidepressant?
MAOIs
A client on SSRIs presents with tachycardia, hyperthermia, and N/V. The nurse suspects what?
Serotonin syndrome
What general kind of side effects do tricyclics have?
Anticholinergic (dry mouth, blurred vision, urinary retention)
Tricyclics and SSRIs differ in what important way?
Tricyclics have more serious side effects and a higher lethal potential
Besides anticholinergic effects, what is another common effect of tricyclics?
Sedation
Why can tricyclics not be given to suicidal pts?
Because they can be fatal when used to overdose
How do MAOIs work?
By inhibiting MAO, which is an enzyme that breaks down serotonin and norepinephrine
MAOIs mixed with what may cause hypertensive crisis?
Tyramine-rich foods
MAOIs should never be combined with what other type of med?
SSRIs
Foods such as cheese, chocolate, figs, and beer should be avoided with what type of antidepressant?
MAOIs
A pt on MAOIs presents with tachycardia, lightheadedness, and vomiting. The nurse suspects what?
Hypertensive crisis
What is the therapeutic blood level for lithium?
0.8 to 1.5 meq/L
Thirst, urinary frequency, and hand tremor are side effects of what?
Lithium
Lithium blood levels above what are life-threatening?
Above 2.5 meq/L
If a dose of lithium is missed, the pt should NOT do what with the next dose?
Double it
What is the relationship between salt intake and lithium absorption?
Higher salt intake=lower lithium absorption
What kind of beverages should be avoided with lithium?
Caffeinated beverages
Should anticonvulsants be given with or without food?
With food
Which anticonvulsant may cause a severe, life-threatening skin rash? What should be done if such a rash develops?
Lamotrigine. If rash develops, discontinue immediately
Benzodiazepines are contraindicated in which type of pt?
Those with renal or hepatic impairment, and those who are suicidal
Which medication-related movement disorder causes slow movement and rigidity?
Pseudoparkinsonism
Which medication-related movement disorder causes involuntary muscle spasms?
Dystonia
Which medication-related movement disorder causes an inability to sit still?
Akathisia
How is akathisia treated?
With beta blockers
How is dystonia and psuedoparkinsonism treated?
Anticholinergic meds
What occurs in tardive dyskinesia?
Irregular, repetitive movements such as lip smacking and tongue protrusion
How can tardive dyskinesia be prevented?
By using atypical antipsychotics
What is the most common reason for noncompliance with psych meds?
Side effects
