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MentalIllness-Childress > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What is russells sign?

A

nondescript dorsal lesions are caused by repeated contact of the incisors to the skin of the hand that occur during self induced vomiting.

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2
Q

What is known as an unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness?

A

repression (defense mechanism)

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3
Q

what may be seen in a client who has developed conversion disorder due to the stress of recently losing a child?

A

they go blind, deaf, etc.

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4
Q

what are the cues for illness anxiety disorder?

A
  • anxiety that severe illness is present/be acquired
  • anxiety is present > 6 months
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5
Q

what may be a likely practice for a client who has illness anxiety disorder with the belief they have breast cancer?

A

constantly performing breast self-exams

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6
Q

what condition is characterized by the client travelling to a new area and forgetting identity following a traumatic event?

A

dissociative fugue

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7
Q

what condition is characterized by a client having 2 or more distinct personalities, with the switch being precipitated by a stressful event?

A

DID (dissociative identity disorder)

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8
Q

what are the cues for derealization?

A
  • patient feels that outside world is not real
  • experiences feel dream-like
  • objects appear larger/smaller than what they should
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9
Q

what condition is characterized by a feeling that one is observing their own body from a distance?

A

depersonalization

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10
Q

what are some patient teaching points for conversion disorder?

A
  • participate in individual and group therapy
  • attend community support groups
  • utilize prescribed meds
  • stress management
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11
Q

how can unnecessary medical expenses, procedures, treatments, and operations be prevented in those suspected with factitious order?

A

openly discuss speculation about factitious disorder; mention to healthcare team (ati EBP)

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12
Q

what condition is lanugo present in?

A

anorexia nervosa

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13
Q

what eating disorder is characterized by food consumption followed by purging?

A

bulimia nervosa (vomiting or laxatives)

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14
Q

What are some expected clinical findings consistent with a diagnosis of binge eating disorder?

A

obesity with health problems consistent with obesity like HTN and diabetes (elevated a1C)
- abdominal pain

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15
Q

what is likely true of the BMI of those with binge eating disorder?

A

increased (obesity)

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16
Q

why may a client with binge eating disorder experience abdominal pain?

A

larger than normal amounts of food cause gastrointestinal dilation
- may also have: constipation, diarrhea, urgency and feeling of anal blockage

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17
Q

how can we emotionally support a client with bulimia nervosa?

A

encourage independent decision making (ati)

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18
Q

why is prazosin given to patients with PTSD who are experiencing nightmares?

A

prazosin inhibits the brains response to norepinephrine

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19
Q

how does EMDR work?

(eye movement desensitization and reprocessing therapy)

A

it uses stimuli (tapping, eye movements, audio sounds) combined with verbalization of the traumatic event by the client to change how the client processes the trauma

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20
Q

what diagnosis can the nurse expect for a client who gets anxious when attempting to go out alone and must quickly return and hasn’t been able to leave the house for 10 years?

A

agoraphobia

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21
Q

what medication may be provided to a patient who is experiencing PTSD following a traumatic event?

A

paroxetine (SSRI*)

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22
Q

how does trauma effect the hippocampus?

A

decreased volume, which can lead to memory dysregulation/deficits

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23
Q

what are the biological responses to stress?

A

increase HR/BP/RR, sweating, pupil dilation, etc.

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24
Q

what are the assessment findings for binge eating disorder?

A

high BMI (obesity), Hgb A1C 6.5 (elevation)

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25
Q

what type of foods are preferred in those with binge eating disorder?

A

soft, easily digestible and sugary

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26
Q

identify the likely eating disorder:
- amenorrhea
- BMI 15 (low)
- lanugo

A

anorexia nervosa

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27
Q

which condition is consistent with the following assessment findings?
- russells sign
- dental erosion
- parotid enlargement

A

bulimia nervosa

28
Q

what education should be included for a new prescription of fluoxetine for treatment of an eating disorder?

A

do not drive for the first few days after starting the medication

29
Q

what is the hypothalamus responsible for?

A

regulate appetite, blood pressure, and thirst

30
Q

which anatomical brain structure is involved in anorexia nervosa?

A

hypothalamus

31
Q

what are the nursing interventions for anorexia nervosa?

A
  • assess skin turgor
  • sit w/them during meals
  • assess for enlarged parotid glands
  • begin parenteral fluids and electrolytes
  • assess HR and BP
32
Q

why would someone with OCD apply, remove, then reapply makeup?

A

attempt to reduce anxiety

33
Q

what action should the nurse take for a client who is having a panic attack?

A

stay with the client and remain quiet
- avoid stimuli (turn off TV, dim lights, etc.)

34
Q

what findings are expected in generalized anxiety disorder?

A
  • restlessness
  • sleep disturbances
    -procrastination in decision making
  • muscle tension
35
Q

what is a statement to make for a client who has severe anxiety?

A

“tell me about how you are feeling right now?”

36
Q

what findings may be seen in a client with PTSD?

A
  • difficulty concentrating on tasks
  • negative self-image
  • recurring nightmares
36
Q

how can PTSD be prevented in nurses who have been involved in a prolonged mass casualty incident?

A
  • take breaks during incident for food/water
  • debrief with others
  • take advantage of counseling
37
Q

what is an indication of derealization?

A

client states furniture is far away and small

38
Q

what should be added to the plan of care for dissociative fugue?

A

work with client on grounding techniques

39
Q

what should be included in assessment of anorexia nervosa (questions to ask)?

A
  • what is your relationship like with your family?
  • describe current eating habits?
  • discuss feelings about appearance?
40
Q

what are expected admission findings for a client with bulimia nervosa?

A
  • hypokalemia
  • slightly elevated body weight
41
Q

what are some risk factors for somatic symptom disorder?

A
  • anxiety disorder
  • childhood trauma
42
Q

what places a client at risk for conversion disorder?

A
  • acute (death of a child 2 months ago)
43
Q

These findings may be seen in illness anxiety disorder:

A
  • obsessive thoughts about disease
  • hx childhood abuse
  • avoidance of providers
  • depressive disorder
44
Q

what should be in the plan of care for conversion disorder?

A
  • encourage them to communicate with others
  • monitor risk of self harm
  • time limit for discussion of manifestations
  • discuss alternate coping mechanisms
45
Q

what is common adverse effect of buspirone?

A

dizziness

46
Q

which neurotransmitters are implicated in anxiety disorder?

A

serotonin, norepinephrine, and gaba

47
Q

Memories can trigger the release of fight or flight hormones. Which structure heightens fear?

A

amygdala

48
Q

which level of anxiety improves awareness and alertness?

A

mild

49
Q

Which level of anxiety is the client unable to focus, concentrate, or comprehend simple commands?

A

panic level

50
Q

Which interventions are appropriate for panic level anxiety?

A
  • stay with them
  • administer lorazepam PRN
  • obtain a paper bag
  • decrease stimuli
51
Q

which eating disorder is characterized by restriction?

A

anorexia nervosa

52
Q

which eating disorder is characterized by binging with compensation?

A

bulimia nervosa

53
Q

which eating disorder is characterized by binging but with NO compensation?

A

binge eating disorder

54
Q

what are some of the potential complications of refeeding syndrome?

A

cardiac dysrhythmia, cardiac collapse, delirium, death

55
Q

what are some electrolyte imbalances that may occur as a result of refeeding syndrome?

A

hypophosphatemia, hypokalemia, hypomagnesemia, hypocalcemia

56
Q

what may be found of the levels of endogenous opioids of those with anorexia nervosa?

A

the levels are increased, which is thought to be associated with denial of hunger

57
Q

why are some patients with anorexia nervosa given naloxone (opioid antagonist)?

A

high levels of endogenous opioids are thought to contribute to denial of hunger, so naloxone is given to promote weight gain

58
Q

what system in prominent in controlling appetite and drives for food?

A

dopamine reward system

59
Q

what are maladaptive reactions to stress?

A

harmful, unhealthy and disrupts the integrity of the individual

60
Q

why are antianxiolytics given for stress?

A

GABA is supposed to stop physical stress, but it may not work as it is supposed to

61
Q

what are some blood dyscrasia manifestations that the nurse should teach the client taking benzodiazepines to report?

A

sore throat, fever, malaise, bruising, and bleeding

62
Q

how long does buspirone take to diminish symptoms in anxiety?

A

2 weeks

63
Q

what is localized dissociative amnesia?

A

can’t recall all incidents associated w/stressful event

64
Q

what is selective dissociative amnesia?

A

can only recall certain incidents for a specific period

65
Q

what is generalized dissociative amnesia?

A

amnesia for his/her identity/total life history

MentalIllness-Childress (8 decks)

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