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Psych Nursing > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

What is PTSD?

A

Mental disorder characterized by persistent, distressing symptoms lasting longer than 1 month after exposure to an extreme traumatic stressor

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2
Q

Common symptom of PTSD?

A

hypervigilance

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3
Q

What helps with PTSD patients, esp. war vets?

A

1st: Group therapy with those who have suffered the same trauma

  • PET therapy
  • Yoga
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4
Q

What is one of the most important thing for substance abuse to remain sober?

A

peer support groups

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5
Q

Huffing INGESTION symptoms?

A

euphoria, labile effect, impaired judgement, respiratory depression.

Long term: neurotoxicity, parkinsonian syndrome. dizziness

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6
Q

Huffing OVERDOSE can lead to?

A

sudden sniffing death, permanent damage to lungs, liver and renal failure

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7
Q

Huffing interventions?

A

vitals, O2 and ABGs

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8
Q

A patient ingested a drug drug 10 minutes ago, which pt would you be most concerned about? Inhalant or drug taken PO?

A

Inhalant: short term effects are bronchospasms (airway)

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9
Q

Huffing withdrawal symptoms?

A

tremors, hallucinations, sleep disturbances

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10
Q

What defense mechanism do substance abusers usually use?

A

denial

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11
Q

How do you treat alcohol withdrawal?

A
  • Benzodiazepines (Librium and Ativan)
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12
Q

What do you need to have in order to be a candidate for alcohol detox?

A
  1. must not be drunk (havent drank for 12-72 hrs)

2. increased HR & BP

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13
Q

When a person comes into the E.R. drunk - what do we worry about?

A

1st: Safety because of ataxia. “weebles wobble but drunks fall down”
* head trauma = CNS depression —> subdural hematoma
2nd: blood sugar

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14
Q

What do you worry about when someone is on the unit for Detox?

A

1st concern: withdrawal symptoms (seizures, delirium tremors, elevated HR & BP)

2nd concern: hydration & nutrition

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15
Q

Days after they stop drinking - what do we notice in patients on the detox unit?

A

they eat alot!

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16
Q

What is Antabuse (disulfiram)?

A

behavior modification drug

when taken w/ alcohol it makes you feel really sick (vomit, GI upset, etc)
patients wont drink alcohol because of the adverse effects when mixed with Antabuse

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17
Q

What will happen if an alcoholic going through withdrawal is not hospitalized?

A

will seize to death from withdrawal from irritation of the meninges

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18
Q

How to know someone is in withdrawal from alcohol?

A

subjective: seizures and hand tremors
objective: elevated HR and BP

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19
Q

If you just stop drinking alcohol, what are you at risk for? What do we have to do? Why? What does it prevent?

A

@ risk: HYPOGLYCEMIA! (alcohol has alot of sugar)

what to do: give “banana bag” dextrose and thiamine

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20
Q

What will happen if you don’t give banana bag?

A

patient will get disconjugate gaze. their eyes will lose symmetry

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21
Q

What causes disconjugate gaze in an alcoholics?

A

occurs when rapid sugar is given with no thiamine

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22
Q

What does adding thiamine to D10 prevent?

A
  1. disconjugate gaze

2. confabulation (memory loss) due to Kasacoff’s syndrome

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23
Q

What happens if you don’t eat before you drink?

A

there’s no protein to maintain liver causing cirrhosis of liver

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24
Q

When drug addicts lie and say they drink more for more meds, wihat is the solution to this problem?

A

medicate based on “Symptom-Triggered Treatment Plan”

1. need to show obj symptoms (high HR and BP) of withdrawal to get benzos

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25
Q

Patient is admitted for alcoholic overdose but is NOT a candidate for detox. What do you do with the pt?

A

hold pt till they are no longer drunk in order to prevent them from harming themselves

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26
Q

Deadly combinations with alcohol?

A

Barbituates and alcohol (deadlier!!)

Benzos and alcohol

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27
Q

Interventions for alcohol withdrawal?

A

IV hydration and banana bag (thiamine and dextrose)

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28
Q

What med is often used for alcohol abuse?

A
  • Naloxone stops craving for alcohol

- Benzos works for alcohol withdrawal

29
Q

Patient comes in seeking detox and theyre experiencing elevated HR and BP. They are a candidate for detox, should we worry about glucose levels?

A

NO,
b/c they are a candidate for detox it means they stopped drinking awhile ago. They are not intoxicated and glucose is NO longer an issue

30
Q

What primary symptom of alcohol overdose must we worry about?

A

loss of gag reflex

31
Q

Would you provide PO hydration to intoxicated alcoholic?

A

No, because dont want to add volume and gag reflex probs.

32
Q

What are symptoms of mild anxiety?

A
  • “fight or flight” response
  • more focused
  • increased conc.
  • too much mild anxiety can turn into moderate anxiety
33
Q

What are the signs of patient coping with anxiety?

A

patient starts to see and address all things that have been repressed and understand that what they were experiencing is anxiety

34
Q

How would you treat mild, moderate and severe anxiety?

A

MILD: exercise
MODERATE: talk therapy and anxiety
SEVERE/PANIC: benzos short term or PRN (Xanaz and Klonopine)

35
Q

What is secondary gain?

A

exaggerating symptoms for personal gain

36
Q

What is the problem with secondary gain?

A

it effects the pt’s ADLs. they never go back to doing things for themselves

37
Q

How must one deal with a patient who’s been raped?

A
  1. maintain privacy
  2. call 911
  3. collect all evidence (brown paper bag)
  4. maintain chain of custody for evidence
  5. educate on HIV & STD testing
  6. give antibiotics
  7. therapy
38
Q

Sexual assault vs. sexual abuse?

A

sexual assault: performing sexual act with a child

sexual abuse: showing porno to kid, performing acts in front of kid

39
Q

What locations on a child’s body would raise suspicion of abuse?

A

on abdomen

on back

40
Q

What are red flags for suspicion of abuse?

A
  1. bruises on places that typically arent hit in a fall
  2. bruises that req a story
  3. multiple injuries to diff people in household
  4. traveling long distances to receive care
41
Q

What type of burn is indicative of abuse?

A

any type of burn that is well-delineated and symmetrical

ie: cigarette, cigar

42
Q

What type of fracture indicate abuse?

A

spiral fractures = twisting

43
Q

What is the affect/behavior of child who is abused?

A

child is indifferent

not as fearful as a normal child

44
Q

What is an ACS report?

A

someone will stop by and look at the scenario a little bit more because they cant discharge the child till someone sees home and family.

45
Q

Phenelzine

- brand name, drug class, action, contraindicated

A

Brand name: Nardil
Drug class: antidepressant
Action: improved mood in depressed patients
Contraindication: dont give to patient on tyramine diet

46
Q

What is anorexia? Diagnostic criteria? Priority intervention when theyre admitted?

A
  • anorexia: mixture of very low body weight, fear gaining weight,
  • diagnostic criteria: 15% under normal body weight
  • priority intervention: vitals
47
Q

What is anorexia driven by?

A
  1. market that provides the image of beauty

2. family, support and nature where they came from

48
Q

Ways to purge in anorexia?

A
  • vomit after eating (ALKALOSIS)
  • diuretics
  • laxatives (ACIDOSIS)
49
Q

signs and symptoms of anorexia?

A 
bradycardia
hypothermia
dry pale skin
jaundice
brittle nails
amenorrhea
hypo BS
50
Q

As nurses, what must we do to care for anorexia patients?

A
  • watch pt closely
  • watch 40 mins after eating
  • monitor if patient loses 2 lbs in a day
  • monitor diurnal weight changes
51
Q

Why do people binge eat?

A

eating stimulate vagus nerve, makes you feel good

52
Q

What is binge eating used for? What is the cause of bulimia?

A

used to make us feel good

eating too much causes guilt and this causes bulimia

53
Q

What type of patient is more likely to die from the disorder? (anorexia or bulimia)

A

anorexia patient

will die from vit K

54
Q

How many pints in a pound?

A

ONE

55
Q

Types of Opiates

A

Percocet, Vicodin, oxycodone, OxyContin, heroine, Demerol, methadone, DIlaudid, codeine

56
Q

Opiate ingestion symptoms

A

euphoria, reduces pain, shallow respiration, constipation

57
Q

Opiate overdose symptoms

What can quickly reverse opiate overdose?

A

respiratory suppression
respiratory ARREST

Naltrexone/Naloxone (Narcan)
-opioid antagonist

58
Q

Opiate withdrawal symptoms

A

dilated pupils, severe diarrhea, goosebumps, clammy and cold skin, increased HR and BP

59
Q

Where does the phrase “going cold turkey” relate to?

A

pts going through opiate withdrawal and when they get clammy, cold skin with pyeloerection (goosebumps)

60
Q

What is mean to “kick the habit”?

A

with severe opiate withdrawal it causes akathesia and pts kick and move feet alot

61
Q

How to treat opiate withdrawal?

A

Methadone

  • stop from hurting other
  • pts will be much more comfortable

Catapres

  • antiHTN
  • give w/ motrin to reduce pain

Suboxone
- decreases opiate craving

62
Q

Order which patient you would prioritize?

oxycodone w/ dilated pupils, cocaine chest discomfort, weed grandiosity, PCP

A

1st: cocaine chest discomfort
2nd: PCP
3rd: weed
4th: oxycodone

63
Q

What happens in conversion disorder?

A

convert anxiety into a physical manifestation

64
Q

How do you differentiate between somatization and conversion disorders?

A

Somatization: manifestation of psychological distress as physical symptoms

Conversion: severe emotional distress or unconscious conflict is expressed through physical symptoms

65
Q

Patients suffering from conversion disorder goes in for labs and all tests come back negative what night?

A
  1. reinforce to pt that all the tests came back negative

2. talk to them about underlying anxiety issues

66
Q

What is a phobia?

A

irrational fear

67
Q

What is the first phobia that is likely to occur from a panic attack?

A

agoraphobia = fear of and often avoidance of places and situations

68
Q

Treatment of phobias

A
  • CBT
  • Systematic desensitization
  • Flooding
69
Q

systematic desensitization vs. flooding

A

systematic desensitization: 1st week = give PRN, teach relaxation, watch movies with phobia. 2nd week = go to area where phobia takes place, teach relaxation techs. month later = expose pt to phobia

flooding: wrks best like fear factor. contraindicated for pts with cardiac issues

Psych Nursing (10 decks)

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