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exam 3 Flashcards

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1
Q

OCD and stress

A

it can wax and wane depending on stress levels

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2
Q

do people with OCD know their behavior is unreasonable

A

yes

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3
Q

first line meds for ocd

A

SSRI

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4
Q

what is response prevention theory

A

delay or avoid performing ritual

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5
Q

initial ntervention for compulsions

A

dont stop them, but instead have person identify stressors and involve them in ADLs

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6
Q

schizo is a _______

A

brain illness/brain syndrome

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7
Q

when is schizo dx

A

when someone shows positive ss for 6 months

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8
Q

preservation

A

adhering to a single topic or word

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9
Q

alogia

A

speaking little

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10
Q

anhedonia

A

no joy or pleasure

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11
Q

catatonia

A

immobility

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12
Q

clang associations

A

ideas relating based on sound and rhyming - jill kill

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13
Q

neologisms

A

inventing words

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14
Q

verbigeration

A

repetition of words

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15
Q

stilted language

A

flowery language

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16
Q

echollia

A

copying nurse or others words or actions

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17
Q

schizoaffective disorder

A

psychotic and mood disorder ss

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18
Q

schizophreniform disorder

A

acute reactive psychosis less than 6 months

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19
Q

delusional disorder

A

non bizzare delusions
lasts 1 day to 1 month

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20
Q

what to do if someone is hearing voices

A

are the voices making you do anything

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21
Q

how to deal with innnapropriate client

A

redirect

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22
Q

loss of ego boundaries

A

loss of sense where someone body mind and influence is

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23
Q

3 social implications of schizo

A

isolation, no trust, low self esteem

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24
Q

what to do if someone is delusional

A

clarify but do not agree

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25
Q

interventions for delusions

A

keep stimulation low and say things like” i find that hard to believe” or “I have seen no evidence of that” - presenting reality and voicing doubt

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26
Q

recognize signs of relapse

A
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27
Q

how to dx MDD

A

2 or more weeks of sad mood and 4 other ss

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28
Q

dysthmic disorder

A

MDD but milder

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29
Q

BP 1 vs 2

A

1: one or more manic accompanied with depression
2: hypomania

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30
Q

cyclothymic disorder

A

mood swings but milder

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31
Q

how to treat SAD

A

light therapy

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32
Q

why do people do nonsuicidal self injury

A

avert suicidal thoughts

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33
Q

4 nursing interventions for ECT

A

NPO, no polish, void before, start IV

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34
Q

vegetative signs of depression

A

lethargy, low energy, apathy

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35
Q

lability in mania vs dep

A

mania too fast, dep too slow

36
Q

3 goals of psychotherapy

A

reverse neg thoughts, improve self image, gain competence and self mastery

37
Q

education about diet for pt taking lithium

A

adequate Na and fluids

38
Q

suicide precautions

A

C - current plan -are you having thoughts of suicide?
P- pain - do you have unbearable pain?
R- resource - do you feel you have any resourses?

39
Q

examples of 1,2,3 gen antipsychotics

A

1:zines and haloperidol
2: pines
3: prazole

40
Q

acute dystonic -

A

muscle spasms in deiscrete muscle groups

41
Q

pseudoparkinsonism

A

muscle stiffness, cog wheeling, drooling, slow muscle start

42
Q

akasthisia and tx

A

restlessness - propanolol Beta blocker

43
Q

when to use AIMS

A

tardive dyskinesia (ss like involuntary movemens)

44
Q

neuroleptic malignant syndrome

A

board like rigidity

45
Q

3 meds to treat EPS

A

benadryl, benzotropine, trihexphenidryl (Antihistamines and anticholinergics)

46
Q

MOA of antipsychs

A

blocks dopamine

47
Q

3 TCA meds

A

imipramine
amitriptyline
clomipramine

48
Q

moa of tca

A

block neph reuptake

49
Q

2 ed for TCA

A

reposiiton slowly and works in 4-6 weeks

50
Q

7 SE of TCA

A

ortho hypo, urinary retention, sedation, anticholinergic, wt gain, sweet craving, sex dysfunction, tachycardia

51
Q

which drugs can be lethal in overdose

A

MAOis and TCA

52
Q

SSRI clinical course

A

3-4 days insomnia decreases
5-7 apeitire returns
4-7 energy returns
7-10 mood concentration improve

53
Q

4 interventions for SSRI

A

surgar free bevs or candy
fluids
monitor for hyponatremia
contact HCP if sexual difficulties

54
Q

3 MAOi meds

A

phenelzine
isocarboxacid
tranylcypromine

55
Q

what can happen if someone eats tyramine with MAOI

A

HTN crisis

56
Q

serotonin syndrome occurs when

A

no wash out period between MAOI and SSRI

57
Q

4 atypical antidepressanta

A

venlafaxine SNRI
duloxetine SNRI
buproprion NDRI
tranzodone

58
Q

2 causes of lithium toxicity

A

renal impairemnt and low Na due to diuretics, dehydration or diarrhea

59
Q

intervention and education for pt on lithium

A

monitor blood levels

60
Q

3 anticonvulsants

A

lithium, valpropic acid, lamotrigine

61
Q

AE of lamotrigine

A

stevens johnsons so report rash

62
Q

A client is hospitalized on a psychiatric unit secondary to a suicide attempt. The client has been diagnosed with depression and is consistently depressed. When assessing the client, which finding would alert the nurse that the client’s suicidal risk has increased?

A

The client’s behavior makes a marked switch from irritability to calmness

63
Q

A client with bipolar disorder is experiencing a major depressive episode. Which would the nurse expect to assess? Select all that apply.

a.
Flight of ideas

b.
Obsessive rumination

c.
Hypersomnia

d.
Excessive shopping sprees

e.
Difficulty concentrating

A

bce

64
Q

A client with bipolar disorder is experiencing acute mania. The client is unable to sit still, moving from place to place. Medication therapy has been prescribed but not yet initiated. Which would the nurse include in the plan of care to meet the client’s physical needs?

A

high energy snacks

65
Q

A client has just been diagnosed with a major depressive disorder following recent problems with the client’s mood, work performance, and sleep quality. When planning this client’s care, the nurse should anticipate what interventions? Select all that apply.

a.
Administration of an monoamine oxidase inhibitor (MAOI)

b.
Administration of a selective serotonin reuptake inhibitor (SSRI)

c.
Repetitive transcranial magnetic stimulation (rTMS)

d.
Cognitive therapy

e.
Phototherapy

A

bd

66
Q

A client receiving lithium therapy has a plasma blood concentration of 2.2 mEq/L. Which would the nurse expect to assess?

A

slurred speech

67
Q

A 42-year-old client with major depression is in an inpatient psychiatric hospital. The client has been taking phenelzine for depression. The therapist writes an order to discontinue the phenelzine and begin fluoxetine. Which action by the nurse is indicated?

A

call hcp for washout period

68
Q

A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine. After educating the client on this medication, the nurse determines that the education was successful when the client states what?

A

ill notify if i get a rash

69
Q

An inappropriately dressed client has not slept for 3 days and has been making excessive long-distance phone calls. When the client can be heard singing loudly in the examining room, the nurse makes initial plans to focus on what?

A

food fluid and rest

70
Q

The nurse is preparing to discharge a client from the inpatient facility where the client was treated following an unsuccessful suicide attempt. The priority assessment for the nurse to make is to assess whether or not the client can do what?

A

Identify a person to whom he or she can turn to for help after discharge

71
Q

A client is admitted to the unit in an acute manic episode. The client has had three major depressive episodes in the past 10 years and two other hospitalizations for mania. Which disorders would reflect the client’s symptom profile?

A

BP 1

72
Q

A client who has a recent diagnosis of bipolar I disorder is scheduled to begin therapy with lithium. Which instruction should the nurse provide to this client?

A

“Avoid exercise at the hottest times of the day.”

73
Q

education for ECT

A

“Some people experience mild confusion after ECT. Generally it clears in a few days, though it may take longer.”

74
Q

A nurse is providing psycho-education to a client who has been admitted to the inpatient mental health unit for a manic episode. In order to ensure the teaching is effective, the nurse must first determine which regarding the client?

A

Ability to concentrate and process the information

75
Q

A client with bipolar disorder has been taking lithium, and today the client’s serum lithium level is 1.8 mEq/L. What effects would the nurse expect to see?

A

nausea, diarrhea, confusion

76
Q

The nurse knows that the most dangerous time period following a previous suicide attempt is what?

A

first 3 mo

77
Q

A client’s depression is being treated in the community with phenelzine. The client has presented to the clinic stating, “I had a few beers and I’m feeling absolutely miserable.” What is the nurse’s best action?

A

BP

78
Q

A client who has just been prescribed lithium for bipolar disorder is being given education from the nurse about this medication. Which is important for the nurse to include in teaching?

A

the higher the Na the lower the lithium

79
Q

A nurse is assessing a client and suspects obsessive-compulsive disorder .The nurse understands that to rule a behavior as obsessive-compulsive disorder (OCD), the obsession or compulsion must meet which criteria?

A

They take up more than 1 hour/day and cause stress to the client.

80
Q

The nurse is teaching relaxation techniques to a client with obsessive-compulsive disorder (OCD). When does the nurse teach relaxation techniques to the client?

A

when low anxiety

81
Q

The nurse is evaluating the plan of care for a client with schizophrenia. Which observation best suggests that the plan has been effective?

A

The client has resumed employment and attends social functions.

82
Q

When teaching a class of nursing students about brief psychotic disorder, the instructor explains that the episode lasts for at least 1 day but less than which time frame?

A

1 month

83
Q

A client with schizophrenia has returned to the clinic because of an increase in symptoms. The client reports the client stopped taking the medication because the client did not like the side effects. The nurse educates the client about managing uncomfortable side effects. Which is included in the teaching plan? Select all that apply.

a.
Use stool softeners as needed

b.
Decrease the amount of daily fluid intake

c.
Spend at least 30 minutes outside in the sun daily

d.
Suck on hard sugar-free candy as desired

e.
Maintain a balanced calorie-controlled diet

A

ade

84
Q

A client with schizophrenia is prescribed clozapine. The nurse would monitor the client closely for specific signs of which of the following?

A

infection

85
Q

education for clozapine

A

WBC count every week for 6 mo

psych class (5 decks)

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