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Nursing Schoom Mental Health Pt 2 > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

How is Zyprexa/Olanzapine utilized

A

rapidly calms agitation. useful in EDs. Produces the most weight. Dont bake pills in half. Can cause skin rash.

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2
Q

Which antipsychotic drugs are used for bipolar disorder as First line

A

Abilify, Lurasidone

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3
Q

What do typical antipsychotics do

A

blocks dopamine leading to reduction in psychotic symptoms. Are prone to EPS such as dyskinesias

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4
Q

What are Side Effects of GHB? (Gamma Hydroxyburtyrate

A

N/V, delusions, depression, vertigo, hallucinations, seizures, LOC, slow HR, Low BP, Amnesia, Coma.

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5
Q

What is a priority action for bipolar I provocately dressed in the mileu

A

discuss inappropriate clothing, puts pt at risk

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6
Q

What category of drug is riperdol

A

dopamine and serotonin antagonist.

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7
Q

Client with Wernicke Korsakoff syndrome and history of alochoism. What is a symptoms nurse should expect?

A

loss of short term and long term memory and the use of confabulation

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8
Q

Dose for Lithium

A

300-1200 mg daily

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9
Q

Clozaril is a lower potency atypical antipyschotic, what needs to be monitored when taking this

A

type II diabetes, WBC count, lowers WBCs

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10
Q

Priority dx for client experiencing cocaine withdrawal?

A

powerlessness

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11
Q

Nursing considerations with pehnothiazines

A

parkinson like symptoms, orthostatic hypotension, avoid strenuous exercise in hot weather, wear suncscreen, no alcohol, dizziness

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12
Q

Client experiencing nausea, vomiting, anorexia from Carbamazepine , what is an appropriate intervention

A

admin next dose with food.

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13
Q

Describe Bipolar I- Mania

A
  • angers easily
  • grandiose
  • can’t sleep
  • unlimited energy
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14
Q

Therapeutic Level for Lithium

A

0.5 - 1.5 mEq/L

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15
Q

How should valproic acid be given (mood stabilizer)

A

two divided doses, 500 - 2000 mg daily. Increases GABA

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16
Q

Parts of the CAGE questionnaite

A
  • have you felt you should cut down
  • have people annoyed you by criticising your drinking
  • have you ever felt guilty about your drinking
  • have you ever had a drink in the morning to steady your nerves?
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17
Q

How are atypical antipsychotics used to MGMT bipolar disorder

A

sedative and mood stabilizing

Olanzapine, Aripiprazole(Abillify), Risperidone

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18
Q

Relapse prevention strategies for substance dependence

A

present information simply, and easily understood terminology

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19
Q

A client with cofnitivie deficitys and alchol abuse. What drug is appropriate for recovery?

A

Naltrexone (Revia), opiate antagonist

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20
Q

What is the medication of choice with Bipolar disorder

A

lithium carbonate. Can be toxic.

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21
Q

What medication would be expected to administer with benzos and obsessive compulsive personality disorder?

A

Clonazepam

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22
Q

How do anticonvulsants work as mood stabilizers

A

enhances effects of GABA and desensitizing the kindling of bipolar disorder.

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23
Q

Topamax Uses

A

Bipolar, mania, migrain headaches, fibromyalgia, schizoaffective

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24
Q

What outcome would you hope to see with a pt with disturbed thought processes

A

The pt can distiguish reality from delusions

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25
Q

What is anhedonia

A

inability to experience pleasure risk for suicide.

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26
Q

Halperidol nursing considerations

A
  • dystonia, muscle tighening
  • akathisia
  • shuffling gait
  • weight gain
  • dry mouth, blurred vision, constipation
  • seizures
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27
Q

What drug has similar effects to Ketamine?

A

PCP “Angel Dust”

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28
Q

Pt complains of muscle pain, swelling and weakness of extremtieis and reddish tinged urine. What lab value should you assess?

A

elevated creatine phosphokinase

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29
Q

A client verbally provokes another patient who is paranoid, what is the priority implementation of the nurse

A

limit setting

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30
Q

waxy flexibility

A

having one’s arms or legs placed in certain position and holding that same position for hours

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31
Q

Common traits of all personality disorders

A
  • Failure to accept consequences of own behavior
  • coipe by altering env’t instead of self
  • lack of insight
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32
Q

Lamictal/Lamotrigine

A
  • Anticonulsant/Mood Stabilizer
  • Good for rapic cyclers
  • Steven Johnson Syndrome
  • Stop medication first sign of rash
  • may change estrogen oral contraceptives
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33
Q

What category drug is Rohypnol- Date Rape Drug

A

Benzodiazepine, like Valium. 10x more potent.

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34
Q

schizophrenia and psychosis

A

ALL schizophrenia are psychosis but not all psychosis are schizophrenia

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35
Q

A narcissist states “I do not think that the whole world owes me a living” what defense mechanism is this?

A

denial

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36
Q

A schizotypal personality disorder stated “I envision my future death by fire”, what is appropriate response?

A

I can see you thoughts are bothersome, how can I help?

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37
Q

How is Saphris given and what are SEs

A

Sublingual tablet only, watch for getting bit by pt. Can cause oral numbing, weight gain, EPS like typical antipsychotics.

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38
Q

Client with borderline personality disorder what is the unmet developmental need

A

awareness of separateness of self

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39
Q

Client states “We wanted to take the bus, but the airport took all the traffic”.

A

associative looseness

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40
Q

A client diagnosed with borderline personality disorder requests diazepam (Valium). The physician refuses, the client gets mad and demands to see another physican. What defense mechanisms is the client using?

A

splitting

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41
Q

How should Latuda be given

A

with 350 calories of food. Watch for increase in SI for bipolar, depressed pt. Hyperglycemia

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42
Q

What characteristics is representative of passive aggressive behavior?

A

seeks subtle retribution when feeling others have wronged him or her

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43
Q

what does echopraxia mean

A

repeating movements of another person

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44
Q

Valproic Acid/Depakore

A
  • Anticonvulsant/Mood Stabilizer- First line for Mania, rage, rapid cyclers
  • Liver Problems
  • avoid alcohol
  • taper
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45
Q

What medication is used for maintenance therapy for bipolar disorder?

A

Lamotrigine (Lamictal)

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46
Q

What are other medication used to reduce symptoms of bi polar disorder

A

Valproic Acid (Depakote), Carbamazepine (Tegretol)

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47
Q

What happens as trust in other increases w/ delusions

A

delusions decrease

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48
Q

SE of Rohypnol Date Rape Ddrug

A

drowsiness, headaches, memory loss, dizzy, nightmares, tremors. Can induce aggression and excitability

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49
Q

What is the action behind lithium

A

alters sodium transport across cell membranes, alters metabolism of neurotranmitters

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50
Q

“Then dentist put a filling in my tooth, now receive transmission that control what i think and do:, What is this a symptom of

A

client is experiencing delusion of influence. Believing objects have control of behavior.

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51
Q

Common Atypical antipsychotics

A

seroquel, risperidone, alnzapine, clozapine, aripiprazole, Latuda

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52
Q

What is true about outcomes of nursing interventions for clients experiencing chemcial dependence?

A

should be tailored to the individual’s immediate needs and abilities

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53
Q

Nursing considerations with Lithium

A
  • do not administer with NSAIDS
  • can cause seizures dysrthmia
  • EKG changes
  • fatigue, confusion, Nausea, norexia
  • Hypothyroidism
  • tremors
  • ACE inhibitors may increase serum levels
  • lots of fluids and sodium
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54
Q

Speaking as if words are being forced out quickly

A

pressured speech

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55
Q

What can large doses of ketamin do?

A

vomiting convulsions oxygen starvation to the brain and muscles. 1 gram can cause death. Flashbacks can occur 1 year after use.

56
Q

What medication is commonly used for treatment of EPS

A

Benztropine (Congentin)

57
Q

When do schizophrenia symptoms develop

A

late adolescent or earl adulthood

58
Q

Antisocial personality disorder pt demands to speak with ethics committe at midnight. What is appropriate response?

A

“Let me give you a sleeping pill to help your mind at ease”

expresses empathy

59
Q

DSM V Criteria for avoidant personality disorder

A
  • does not form intimate relationships
  • unwilling to be invovled with people unless certain of being liked
  • views self as socially inpet, unappealing and inferior
60
Q

A client admitted for chest pain r/t cocaine abuse states. “This is nothing but a little indigestion. What is all the fuss about?” What defense mechanism?

A

denial

61
Q

When should Divalproex (Depakote) be taken

A

at bedtime, 500-2000mg mood stabilizer

62
Q

Disorganized schizophrenia looks like

A

regressive, primitive behavior. Poor contact with reality. Flat affect. Personal appeance is neglected and social impairment is extreme.

63
Q

Ectasy (MDMA) Side effects

A

muscle tension, involuntary teeth clenching, nausea, blurred vision, feeling faint, tremors, rapid eye movement. Sweating or chills. Increase HR and BP. Long term use can produce Parkinson’s Syndrome. Damage to brain that are critical to thought and memory

64
Q

A client in active phase of paranoid schizphrenia. What nursing intervention would facilitate other interventions

A

difficulty to establish trust. Make sure staff is consisstent.

65
Q

DSM VI Borderline personality disorder

A
  • avoid real or imagined abandonment
  • recurrent suicidal and self mutilating behaviors
  • feelings of emptiness
66
Q

interventions for aggressive behavior

A
  • identify feelings of frustration
  • encourage discussion
  • identify precipitating events
  • describe consequences
  • previous coping mech
67
Q

What is a priority action for pt with pressured speech and increased levels of anziety

A

vital signs. Physican complications can occur due to pyschological symptoms

68
Q

Antisocial personality disorer pt is smoking in a non smoking area. what do you do?

A

Confront the client about the behavior. Must be done in a timely manner

69
Q

Early alocholic phase s.sx

A

amnesia occurs during or immediately after period of drinking

70
Q

Flight of ideas

A

constant flow fo speech in which client jumps from one topic to another in rapid succession

71
Q

What intake do you need when monitoring pt on lithium

A

dietary sodium and fluid (2-3 L/day)

72
Q

Alcoholic client with ineffective health maintenance. What is a longterm goal

A

the client will exhibit reduced medical complications r/t alcoholism within 6 months

73
Q

Common Typical Antipsychotics

A

Haloperidol, Perphenazine

74
Q

What drug helps client control cravings for alcohol

A

Naltrexone (ReVia)

75
Q

How are antianxiety agents used to MGMT bipolar disorder

A

managing psychomotor agitation characteristics of mania

avoid if pt has substance abuse

76
Q

A client with nursing dx of disturbed thought processes has an expected outcome of recognizing delusional thinking. What should the nurse implement?

A

appreciate that the client has experienced disturbing delusional thinking. Shows empathy

77
Q

Types of delusions

A

grandiose persecutaory

78
Q

What is a longer acting medium potency Atypical antipsychotic?

A

zypreza/olanzapine. Injectable form

79
Q

What sort of state the Ketamine put the user in?

A

dissasociative

80
Q

Why does pt receive Lorazepam for high CIWA score?

A

detterent therapy that helps to motivate clients to maintain alcohol abstinence

81
Q

Manipulative behavior

A
  • set clear limits
  • communicate expectations
  • clear about consequences
  • discuss behavior in non judgmental way
  • gather staff to provide an escort to take pt to room
82
Q

What kind of effects does Ketamine/PCP have?

A

numbness, loss of coordination, muscle rigidity, aggresssive, slurred speech/blocked speach. Blank Stare, exaggerated speech.Does not depress CNS. Relieves pain, may cause user to hurt themselves. Intensifies colors/sounds

83
Q

Assessment for Schizophrenia physical characteristics

A

unkempt appearnce, body image distortions, hyponatremia, somatic complaince, poor sleep

84
Q

Lamotrigine (Mood stabilizer), mode of action

A

inhibits release of glutamate and excitatory neurotransmitter. Dose 100-200 mg daily

85
Q

What type of approach is attaching consequences to adaptive and maladaptive behavior

A

behavioral therapy approach

86
Q

What are antipsychotic drugs predominatnlty

A

dopamine antagonists. Treat positive symptoms of schizphrenia

87
Q

What does echolalia mean

A

repeating speech of another person

88
Q

Which medication has the highest potential for client to experience serious side effects?

A

Clozapine. Life threatening agranulocytosis.

89
Q

A client with borderline personality disorder has disturbed personal identiy. What is an appropriate nursing intervention?

A

help the client identify values and beliefs.

fixation from early developmental level

90
Q

a client diagnosed with substance dependence states, “My wife causes me to abuse meth. She uses and expects me to. What defense mechanism?

A

projection

91
Q

Medications commonly used for bipolar affective disorder

A

Depakote (Anticonvulsant), Verapamil (Caclium Channel Blocker), Olanzapine

92
Q

Positive prognosis after being diagnosed with schizophrenia

A

diagnosed at ate 35, female whose s/sx began after rape, family with hx of mood disorder

93
Q

What is the purpose of delusions

A

establish identity and self esteem

94
Q

What does Gamma Hydroxybutyrate (GHB) do?

A

relaxant, causing loss of muscle tone and reduced inhibitions

95
Q

What symptom of schizoid personality disorder is a high risk for schizophrenia

A

limited range of emotional experience and expression. Do not enjoy close relationships

96
Q

A client with antisocial personality disorder states “my kids are busy at home they don’t miss me or even know i’m gone”. Which nursing dx is applicative

A

ineffective denial

97
Q

what is catatonic excitement

A

moving excitedly with no environmental stimuli present

98
Q

Olfactory hallucinations

A

smeeling things that do not exist

99
Q

What is an appropriate nursing intervention for a pt risk for injury r/t extreme hyperactivity

A

use prn antipsychotic meds. Need to sedate the pt quickly. A mood stabilizer can be given concurrently for maintenance therapy.

100
Q

Deescalation techniques

A
  • Large personal space
  • non aggressive posture
  • calm approach
  • determine client’s need
  • don’t argue
  • problem solving
101
Q

Gustatory

A

experiencing tast in the absence of stimuli

102
Q

Hallucination interventions

A
  • ask about hallucination
  • do not react as if it were real
  • decrease stimuli
  • do not negate experience
  • engage through a concrete activity
  • avoid touching client
  • monitor for anxiety/agitation (hallucinations could be icnreasing
103
Q

Why should a pt pacing the halls be a priority

A

most at risk for assaultive behavior due to hyperactivity

104
Q

What is confabulation

A

fillin in memory gap with detailed fantasy

105
Q

Mixture of words and phrases that has no meaning

A

word salad

106
Q

Describe schizophrenia

A

disordered throught processes, disrupted interpersonal relationship. Disturbances in affect, mood, behavior and thought processes.

107
Q

Cuation for women taking antipsychotic medications

A

amenorrhea can occur but ovulation still occurs. Risk for pregnancy

108
Q

What is a priority nursing dx for alcohol withdrawal

A

risk for injury

109
Q

What may have a good prognosis on schizphreniform disorder?

A

confusion and perplexity, good premorbid social and occupational functioning, absence of blunted or flat affect, onset of psychotic symptoms within 4 weeks of noticeable behavioral change.

110
Q

How should Carbamazepine (Tegretol) Mood Stabilizer be given

A

2 divided doses, inhibits release of glutamate, an excitatory neurotransmitter.

400-1200 mg daily

111
Q

Oscarbazepine

A
  • Anticonvulsant Bipolar
  • Birth control pills may not work
  • taper
112
Q

Looseness of association

A

haphazard, illogical and confused thinking. Interrupted connections (Mostly schizophrenic)

113
Q

Topamax

A
  • Anticonvulsant/Mood Stabilizer
  • May alter liver enzymes
  • No Alcohol
  • Taper
  • Decrease hormonal contraceptives
  • May feel groggy
114
Q

What do atypical antipsychotics do

A

block dpamine, boost serotonine. Less prone to EPS, but have metabolic side effects

115
Q

When would a schizophrenic pt benefit from group therapy

A

diagnosed in an outpatient clinic

116
Q

What classification of drugs shares similar featurs with alchol overdose and withdrawal

A

anxiolytics

117
Q

Thought Blocking

A

sudden cessation of a thought in the middle of a sentence. Unable to continue the train of thought.

118
Q

Abnormal thought processs: circumstantiality

A

pt gets caught up in countless details and explanations

119
Q

What is catatonic posturing in schizo client

A

holding bizarre postsures for long periods of time

120
Q

What symptoms might you expect of pt lithium level is 2.6 mEq/L

A

excessive output of dilute urine, tremors and muscular irritability

121
Q

When alcohol is consumed, what percentage is absorbed immediately into the blood stream?

A

20% through the stomach wall

122
Q

Medication combination for auditory hallucination and bipolar I

A

riperidone for auditory hallucination and Lamitrigine mood stabilizer for bipolar I

123
Q

Abnormal thought processs: confabulation

A

filling a memory gap with detailed fantasy belived by the teller, maintains self esteem

124
Q

Lithium is to mania as clozapine is to

A

psychosis

125
Q

Crucial phase of drinking pattern?

A

client lost family, job, driver’s license

126
Q

Carbazepine

A
  • Anticonvulsant/Mood stabilizer
  • Steven Johnson syndrome
  • Taper
  • decrease oral contraceptives
  • avoid alcohol
  • no grapefruit juice
127
Q

Overcompliance

A

deny responsibility for any action by doing only what another person instructs exactly

128
Q

Describe Bipolar II- Depression

A
  • affects appetite
  • easily fatigued
  • can’t make decisions
  • lack of energy
  • no self confidence
129
Q

Neologisims

A

makes up words that have meaning only for the individual. Part of a delusional system

130
Q

A client insists that grandmother has come back to life as a pet kitten through reincarnation. Which personality disorder?

A

Schizotypal personality disorder

131
Q

What is the process of delusions

A
  • denial
  • projection
  • rationalization
132
Q

Can a true alcoholic go on benzos?

A

No never

133
Q

what co morbidity can alcoholic have

A

ADHD

134
Q

Assessment for alcohol

A

how much, what type, how long

135
Q

Treatment for Alcohol withdrawal

A
  • Folic Acid
  • Thiamine
  • Antacid prn
  • Ecotrin for headache and pain (safest for kidneys
  • need to have platelets
  • pepsid
  • lactulose for liver
136
Q

What drug is used to reverse effects of benzos

A

flumezenil

137
Q

What can overdose of inhalants cause

A

damage to nervous system and death

Nursing Schoom Mental Health Pt 2 (1 decks)

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