EXAM #2 Review Flashcards
What is mental health and what is mental illness
Mental health: ability to cope, do daily activities of life, and contribute to society.
Mental illness: Lack of resilience (inability to cope). Unable to do basic function of life.
If you are looking for symptoms for a specific diagnosis what manual do you look at?
The DSM-5. or the NANDA-1
What speicific reason can a person be hospitalized for mental illness
The person must be at risk of hurting oneself or others. Or they are unable to do ADLs.
What are the three phases of therapeutic communication and when do you know terminate of the relationship is effective?
1) Orientation phase: introduce. Set boundaries. Establish trust. Assessment made.
2) Working phase: nurse assumes role to help client. Encourages expression of feelings.
3) Termination phase: when agreed goal is met, patient is discharged. Promote indolence. Coping methods placed.
What are good coping skills and what can you teach your client to decrease stress and better cope with events?
Coping skills: biofeedback, guided imagery, relaxation techniques, meditation and mindfulness.
Techniques: journaling, exercise, humor, cognitive reframing.
What is stress, what is anxiety, and what happens to the body when someone becomes anxious; fight or flight.
Stress: fight or flight response. (Hans Selye) GAS 1) Alarm phase 2) Resistance/adaptation phase 3) Exhaustion phase.
Anxiety: dread from perceived threat.
What techniques would you provide to your patient to decrease anxiety and what types of medications to decrease anxiety?
(see above for techniques)
Anxiolytics:
-Benzodiazepines, or -pam and -lams
Xanax, or alprazolam
Klonopin, or clonazepam
Valium, or diazepam
Ativan, or lorazepam
-Barbiturates
Phenobarbital
-Buspirone
What are neurotransmitters and how do they work
-Acetylcholine: Body maintenance. Slows HR, smooth muscle, excitatory function. Low in Alzheimers.
-Dopamine: reward system. Modulates mood, posture, movement, wakefulness. Low in Parkinson’s, high in Schizophrenia.
-Serotonin: a monoamine transmitter. Modulatory. Affects cognition, emotion, metabolism, mood, sleep/wake. Low in Depression.
-GABA: inhibits excitatory activity. Fine tunes thoughts (worse w exhaustion).
-Glutamine: a free amino acid. Activates neurons.
What is depression/ a mood disorder. What meds are used to treat this. What do we think is cause of depression, low serotonin in the brain
Depression: feeling of helplessness. Lasts for 2 years in adults and 2 year in children.
Meds: SSRIs, SNRIs, TCAs, and MOAIs (see notebook)
Mood Disorders: psychological disorders that affect a person’s mood or affect, aka feelings.
What type of medication is fluoxetine and paroxetine
-fluoxetine, or Prozac: SSRI (see notebook)
-paroxetine, or Paxil: SSRI (^^)
TCA antidepressants and low blood pressure
Amitriptyline: “Amy trips on things”, or orthostatic hypotension. Slow position changes.
Imipramine: “Inhibits my peeing” drys stuff out. Cholinergic effects - dry eye, constipation, dry cough.
What does autonomy mean?
Autonomy is our independence. Our ability to accept or deny care, request information, and choose our plan of care.
Stages of anxiety: mild, mod, severe, and panic
Mild: everyday anxiety. encourages us to be productive.
Mod: clouds our judgement. Impaired thinking.
Severe: can’t focus on environment. Somatic symptoms.
Panic: yelling, shouting, screaming. Loss of reality.
Circadian rhythm and effects on sleep and mood
Circadian rhythm: 1. Relaxed wakefulness (Alpha) 2. Stage N1 (Theta waves) 2. Stage N (sleep spindles) 3. Stage 3 (delta waves) or Deep sleep, 4. REM or dreaming sleep.
- Poor sleep leads to insomnia, anxiety, poorer daily function, accident prone.
Transference and counter transference
Transference: when pt project image of person from their life onto nurse.
Countertransference: when nurse project image of person from their life onto pt.
Bipolar; difference between bipolar I and II. Which is worse? What is dysthymic and cyclothymic?
Bipolar I: pt has 1 or more hyper-mania episodes. This one’s worse and more common in men.
Bipolar II: pt has 1 or more hypomanic or depressive episodes. More common in women.
Dysthymic: chronic depression.
Cyclothymic: mild or mod depression for 2+ years. May rapidly cycle.
If a person is manic what behaviors might you see? (Types of speech)
Speech patterns:
-Pressured speech: speak quickly
-Circumstantial speech:
-Tangential speech:
-Loose associations:
-Flight or ideas:
-Clang associations
Thought process
-Gradniose dellussions
-Persecutory delusions, “someone’s out to get them”
Other:
-Manipulative, demanding. Agitation and mood swings.
Lithium: mood stability; the importance of water/fluid levels if a person is placed on med (like diuretic) that diesis water. What happens?
Lithium: has narrow therapeutic range. Over 1.5 TOXIC. Fluids keep person from becoming toxic. No diuretics or concentration of lithium could increase.
Tx for manic episode
Lithium and then olanzepine (antipsychotic)
Aversion therapy
Associating a bad beware with a bad sensation, or undesirable stimulus. Ex. Pinching self when thinking about smoking. (aka, conditioning self)
