Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NRSG 126: Mental Health > [Exam 3] Chapter 17 - Mood Disorders and Suicide > Flashcards

[Exam 3] Chapter 17 - Mood Disorders and Suicide Flashcards

1
Q

When people feel sad ,low, and tired with the desire to stay in bed, episodes are accompanied by what?

A

anergia (lack of energy), exhaustion, agitation, noise intolerance, adn slow thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The feelings of being “on top of the world” also recedes in a few days to what type of mood?

A

Authymic (average effect and activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are mood disorders

A

Affective disorders

Pervcasive laterations in emotions that are manifested by depression or mania or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What self-esteem changes occur in mood disorders?

A

Self-doubt, guild, anad anger alter life activites especially those that involve self-esteem, occupation, and relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What did King Saul, King Nebuchadnezzar, and Moses suffer from?

A

overwhelming grief of heart, unclean spirits, and bitterness of soul, which are all signs of depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What did Abraham Lincoln and Queen Victoria suffer from?

A

recurrent episodes of depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mood disorders are teh most common psychiatric diagnoses associated with what

A

suicide , and depresion is one of the most important risk factors for it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clients with schizophrenia, substance use disorder, antialsocial and borderlien personality disorders are at a increased risk for what

A

suicide and suicide attempts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Categories of Mood Disorders: Primary mood disorders are what?

A

Major depressive disorder and bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Categories of Mood Disorders: Major depresive episode lasts how long?

A

2 Weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Categories of Mood Disorders - Major Depressive Disorder: What does person experience?

A

Depressed mood or loss of pleasure in nearly all activites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Categories of Mood Disorders - Major Depressive Disorder: Symtpoms of those?

A

Changes in eating habits, hypersomnia/insomnia, impaired concentration, inability to dope with daily life, feeling of worthlessness, and thoughts of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Categories of Mood Disorders - Major Depressive Disorder: Symptoms of this causes impairments of what?

A

social, occupational, or other important areas of functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Categories of Mood Disorders - Bipolar Disorder: Diagnosed when?

A

A persons mood fluctuates to extremes of mania or depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Categories of Mood Disorders - Bipolar Disorder: What is mania?

A

Distinct period during which mood is abnormally and persistently elevated, expansive, or irritable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Categories of Mood Disorders - Bipolar Disorder: How long does mania last

A

One week but may be sooner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Categories of Mood Disorders - Bipolar Disorder: manic episodes include what?

A

inflated self-esteem or grandiosity

decreaased sleep

excessive and pressured speech *unrelenting, rapid, often loud talking without pauses)

Flight of ideas

Increased activity

Exessive involvement in please-seeking activites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Categories of Mood Disorders - Bipolar Disorder: Persons mood when manic?

A

Excessively cheerful, enthusiastic, and expansive or the person may be irritiable especially when they are told no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Categories of Mood Disorders - Bipolar Disorder: How will manic person handle problems?

A

Denies any problems and places blame on others for difficulities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Categories of Mood Disorders - Bipolar Disorder: What is hypomania?

A

Period of abnormally and persistently elevated, expansive or orritiable mood and some other milder symptoms of mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Categories of Mood Disorders - Bipolar Disorder: Difference between manic and hypomania episodes?

A

Does not impair the person’s ability to function (can be productive) and there are no psychotic features (delusions and hallucinations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Categories of Mood Disorders - Bipolar Disorder: What is a mixed episode?

A

Often called manic cycling

When the person experiences both mania and depression nearly everyday for 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Categories of Mood Disorders - Bipolar Disorder: What is Bipolar I?

A

One or more manic or mixed episodes usually accompanied by major depressive episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Categories of Mood Disorders - Bipolar Disorder: What is Bipolar II Disorder?

A

One or more major depresive episodes accompanied by at least one hypomanic episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Categories of Mood Disorders - Bipolar Disorder: What do people experience between extreme episodes?

A

May have a depressed mood swing after a manic episode before rreturning to a euthymic mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Related Disorders: What is Persistent Depressive (Dysthymic) Disorder?

A

Chronic, persistent mood disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Related Disorders: What is Persistent Depressive Disorder characterized by?

A

Insomnia, loss of appetite, decreased energy, low self-esteem, difficulty concentrating, and feelings of sadness and hopelessness that are milder than those of depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Related Disorders: What is Disruptive Mood Dysregulation Disorder?

A

Persistent angry or irritable mood, punctuated by severe, recurrent temper outbursts that are not in keeping with the provocation or siutation beginning before 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Related Disorders: What is Cyclothymic Disorder?

A

Characterized by mild mood swings between hypomania and depression without loss of oscial or occupational functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Related Disorders: What is substance-induced depresive or bipolar disorder?

A

Significant disturbance in mood that is a direct physiological consequence of ingested substances such as alcohol, other drugs, or toxin s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Related Disorders: What is seasonal-affective disorder (SAD)

A

Has two subtypes

Winter depression or fall-onset SAD

Spring-onset SAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Related Disorders: What is Winter depression or fall-onset SAD?

A

Increases sleep, appetite, and carbohydrate cravings, weight gain, interpersonal conflict, irritabiility, and heaviness in extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Related Disorders: What is spring-onset SAD

A

less common with symptoms of insomnia, weight losos, and poor appetite lasting from late spring or early summer until early fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Related Disorders: How is SAD treated?

A

With light therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Related Disorders: What is Postpartum or maternity blues?

A

Mild, predictable mood disturbance occuring in the first several days after delivery of a baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Related Disorders: Symptoms of postpartum or maternity blues?

A

Labile mood and affect, crying spells, sadness, insomnia and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Related Disorders: Most common complication of pregnanacy?

A

Postpartum depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Related Disorders: When does postpartum depression occur?

A

Within 4 weeks of delivery, consist with symptoms of depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Related Disorders: What is Postpartum Psychosis?

A

Severe and debilitating psychiatric illness with acute onset in days following childbirth?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Related Disorders: Postpartum psychosis signs?

A

Begin with fatigue, sadness, emotional lability, poor memory and confusion

Progress to delusions, hallucinations, poor insight and judgement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Related Disorders: Postpartum psychosis tx?

A

Requires immediate treatment . Women with history of mental illness are at a higher risk for this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Related Disorders: What is premenstrual dysphoric disorder?

A

Severe form of premenstrual syndrome and is defined as recurrent , moderate psychological and physical symptoms that occur during the week before menses and resolving with menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Related Disorders: signs of premenstrual dysphoric disorder?

A

Labile mood, irritability, increased inpersonal conflict, difficulty concentraitng, feeling overwhelmed, and feelings of anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Related Disorders: What is nonsuicidal self-injury?

A

involves deliberate, intentional cutting, burning, scraping, hitting, or intereference with wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Etiology & Genetic Theories: Transmission of major depressision in first degree relatives increases chances by how much?

A

wice at risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Etiology & Genetic Theories: First degree relative with bipolar increases risk ny how much?

A

7x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Etiology & Genetic Theories: There is genetic overlap between early onset bipolar disorder and what?

A

early-onset alcoholism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Etiology & Genetic Theories: Peole with early onset bipolar and early-onset alcoholism have what responses?

A

Rapid rate of mixed/rapid cycling, poorer response to lithium, slower rate of recovery and more hospital admissions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Etiology & Neurochemical Theories: This focuses on what?

A

Serotonin and Norepinephrine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Etiology & Neurochemical Theories: Serotonin has role in what?

A

mood, activity, aggressiveness, irritability, congition, pain, and neuroendocrine process (growth hormone, cortisol, and prolactin levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Etiology & Neurochemical Theories: Deficits of serotonin, precursor tryptophan or metabolite) found in blood of spinal fluid in people with what

A

depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Etiology & Neurochemical Theories: Positron emission tomography demonstrates what in depression?

A

Reduced metabolism in teh prefrontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Etiology & Neurochemical Theories: Norepinephrine levels in depression and mania?

A

Decreased in depression and increased in mania . This energenizes the body to mobilize and inhibits kindling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Etiology & Neurochemical Theories: Wht is kindling?

A

Process by which seizure activity in a specific area of the rain is initially stimulated by reaching a threshold of the cumulative effects of stress, low amount of electric impulse or chemicals like cocaine. Seizures now occur spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Etiology & Neurochemical Theories: What drugs inhibit kindling?

A

anticonvulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Etiology & Neurochemical Theories: What do cholinergic drugs alter?

A

mood, sleep, neuroendorcine functiona dn the electroencephalographic pattern, therefore implicated in depressiona nd mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Etiology & Neuroendocrine Influences: Elevated glucocorticoid activity is associated with what?

A

stress response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Etiology & Neuroendocrine Influences: Postpartum hormone alterations precipitate mood disorders such as what?

A

postpartum depression and psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Etiology & Neuroendocrine Influences: 5-10% of people with depression have thyroid dysfunction, corrected how?

A

with thyroid treatmetn or tx for the mod disorder affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Etiology & Psychodynamic Theories: Self-depreciation of people with depressio becomes self-reproach adn anger turned inward. Feeling abandoned by this loss, how do people feel

A

people are then angry while both loving and hating the lost object

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Etiology & Psychodynamic Theories: When does depression results with the persons ego?

A

When a person is not feeling idea (good and loving, superior or strong)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Etiology & Psychodynamic Theories: How is the ego in depression?

A

Ego is powerless, helpless child victimized by the superego

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Etiology & Psychodynamic Theories: How do most psychoanalytic theoreis of mania view manic episodes?

A

As a degense against underlying depression, with teh ID taking over the ego

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Etiology & Psychodynamic Theories: Children raised by rejecting or unloving parents are prone to feelings of what?

A

inseucirty and loneliness , making them susceptible to depression and helplessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Cultural Considerations: How do children with depression appear?

A

Often appear cranky . May have school phobia, hyperactivitty, learning disorders, and failing grades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Cultural Considerations: What may adolescents with depresion do?

A

join gangs, engage in risky behavior, or drop out of school

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Cultural Considerations: What do adults with depression do?

A

substance abuse, eating disorders, compulsive behaviors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Major Depressive Disorder & Onset/Clinical: How long does this last?

A

2 weeks or more of a sad mood or lack of interest with at least four other symptoms of depresion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Major Depressive Disorder & Onset/Clinical: Untreated episode of depression can last how long?

A

Few weeks to months, or even years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Major Depressive Disorder & Psychopharmacology: Categories of antidepressantns include waht?

A

cyclic antidepressants, MAOIs, SSRIs and atypical antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Major Depressive Disorder & Psychopharmacology: What neurotransmitters are decreased here?

A

Norepinephrine and Serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Major Depressive Disorder & Psychopharmacology: Goal of antidepressants neurologic wise?

A

TO increase the efficacy of available neurotransmitters and the absorption by postsynaptic receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Major Depressive Disorder & Psychopharmacology: What is used for a person with acute depression with psychotic features?

A

An antipsychotic is used in combination with an antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Major Depressive Disorder & Psychopharmacology: Evidence is increasing that antidepressant theray should continue for how long?

A

longer than 3-6 months , more ideally 18-24 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Major Depressive Disorder & Psychopharmacology: How should antidepressants be discontinued?/

A

Doage should be tapered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Major Depressive Disorder & Psychopharmacology: Most frequently prescribed category of antidepressants?

A

SSRI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Major Depressive Disorder & Psychopharmacology: What effects to SSRI produce?

A

Few sedating, anticholinergic, and cardiovascular side effects. Makes them safe for older adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Major Depressive Disorder & Psychopharmacology: With SSRIs, how quikcly does insomnia, appetite, energy, and mood,concentration improve?

A

Insomnia: Decreases in 3-4 days

Appetite: Normal in 5-7 days

Energy: Returns in 4-7 days

Mood: 7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Major Depressive Disorder & Psychopharmacology: What effects does FLuxetine (Prozac) produce?

A

Slightly higher rate of mild agtation and weight loss but loss somnolence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Relieve symptoms of what?

A

Hopelessness, helplessness, anhedonia, inappropriate guild, suicidal ideation and daily mood variations . Also panic disorder, OCD, and eatind disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Tricyclic antidepressants have a lag period of what

A

10-14 days before reaching a serum level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: How long to reach full effect?

A

6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Because they have a long serum half life, there is a lag period of what before steady plasma levels are reachd

A

1-4 weeks before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Trycyclic antidepressants are contraindicated in what

A

severe impairment of liver function and in myocardiac infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Cannot be given concurrently with what

A

MAOIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Because of anticholinergic side effects, used cautiously in clients whohave what

A

glaucoma, benign prostatic hypertrophy, urinary retention or obstruction, and diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: Overdosage of this occurs over what time and results in what SE?

A

Several dadys and results in confusion, agitation, hallucinations, hyperpyrexia and increased reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: What population is this not reallt used with?

A

The older adult population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: What may Amoxapine (Asendin) cause?

A

extrapyramidal symptoms, (Tardive Dyskinesia, and NMS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: What to know tolerance wise and what can Amoxapine (Asendin) cause?

A

Tolerance in 1-3 months

Increases appetite and causes weight gain and cravings for sweets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: What risk for Maprotiline (Ludiomil) carry?

A

RF Seizures , severe constipation and urianry retention, stomatitis, and other side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Major Depressive Disorder & Psychopharmacology - Cyclic Antidepressants: What can increase effects of Maprotiline (Ludiomil)?

A

CNS depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: Used when?

A

When client has inadequate response to or side effects from SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: What drugs included here?

A

Venlafaxina (Effexor)

Duloxetine (Cymbalta)

Bupropion (Wellbutrin)

Nefazodone (Serzone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: What does Venlafaxine block?

A

The reuptake of serotonin, norepinephrine, and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: What does Duloxetine block?

A

Both serotonin and norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: What does Bupropion inhibit?

A

reuptake of norepinephrine, dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: Bupropion is marketed as Zyban for what?

A

Smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Major Depressive Disorder & Psychopharmacology - Atypical Antidepressants: What does Nefazodone inhibit?

A

reuptake of serotonin and norepinephrine and has few side effects. Can be used in those with liver and kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: Why are these infrequently used?

A

Because of potentially fatal side effects and interactions with drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: Most serious side effects?

A

Hypertensive crisis, happens when they ingest tyramine-containing foods

102
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: Signs of hypertensive crisis?

A

occipital headache, hypertension, nausea, vomiting, chills, sweating, restlessness, nuchal rigidity, dilated pupils and fever

103
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: What can hypertensive crisis evantually lead to?

A

hyperpyrexia, cerebral hemorrhage and death

104
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: How to tx hypertensive criss?

A

Transisent antihypertensive agents given to dilate blood vessels and decrease vascular resistance

105
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: How long to reach therapeutic level?

A

2-4 weeks

106
Q

Major Depressive Disorder & Psychopharmacology - MAOIs: Lag period?

A

5-6 weeks for washout periods

107
Q

Major Depressive Disorder & Psychopharmacology - DRUG ALERT: What is serotonin syndrome?

A

Occurs when there is an inadequate washout period between taking MAOIS and SSRIs or when MAOIs are combined with meperidine

108
Q

Major Depressive Disorder & Psychopharmacology - DRUG ALERT: Mental State changes in Serotonin Syndrome?

A

Confusion, Agitation

109
Q

Major Depressive Disorder & Psychopharmacology - DRUG ALERT: Neuromuscular Excitment changes in Serotonin Syndrome?

A

Muscle rigidity, weaknes, sluggish pupils, shivering, tremors, myoclinic jerks, collapse and muscle paralysis

110
Q

Major Depressive Disorder & Psychopharmacology - DRUG ALERT: Autonomic abnormalities in serotonin syndrome?

A

hyperthermia, tachycardia, tachypnea, hypersalivation and diaphoresis

111
Q

Major Depressive Disorder & Psychopharmacology - DRUG ALERT: How to decrease risk of overdose of MAOI and cyclic Antidepressant/

A

Depressed or impulsive clients who are taking any antidepressants may need to have refills in limited amounts

112
Q

Major Depressive Disorder & Psychopharmacology - DRUG ALERT: What drugs interact with MAOI

A

Amphetamines

Mepheridine

SSRI

Tricylic Antidepressants

Tyramine

113
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: When is Electroconvulsive therapy used?

A

To treat depression in select groups such as clients who do not respond to antidepressants

114
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: ECT has shown a high degree of efficacy for who?

A

Patients with psychotic features and marked psychomotor disturbances

115
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: How many txs are giving in ECT?

A

Six-15 txs. GEnerally minimum of six treatments are needed. Maximum benfift achieved in 12-15 txs

116
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Steps of performing ECT?

A

Short acting anesthetic given along with muscle relaxant (suxxinycholine). Thus shocked. Believes that this causes brain to correct the chemical imbalance

117
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Unilateral ECT results in what?

A

Less memory loss but more treatments may be needed

118
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Bilateral ECT results in what?

A

More rapid movements but with increased short-term memory loss

119
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Studies report that ECT is as effective as meds for what?

A

Depression

120
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Most effective tx for depressive disorders?

A

Psychotherapy and medication combination

121
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Goals of combined therapy?

A

Symptom remission, psychosocial restorration, prevention of relapse or recurrence, reduced secondayr consequences such as marital discord

122
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Interpersonal therapy focuses on what?

A

Difficulties in relationships such as grief reactions, role disputes and role transitions

123
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Behavior therapy seeks to do what?

A

Increase the frequency of clients positively reinforcing interactions with environment and to decrease negative interactions

124
Q

Major Depressive Disorder & Other Medical Tx and Psychotherapy: Cognitive therapy focuses on what?

A

How person thinks about self, others, and the future and interprets his or her experiences

125
Q

Major Depressive Disorder & History: The nurse asks about behavioral changes, that include what?

A

When they started, what was happened when it began, their duration, and what client has tried to do about them.

126
Q

Major Depressive Disorder & General Appearance/Motor: How do they often look?

A

Sad, ill. Posture slouched with minimal eye contact.

Psuchomotor retardation.

Latency of response seen when clients take up to 30 seconds.

127
Q

Major Depressive Disorder & General Appearance/Motor: Clients here have psychomotor agitation, which is what?

A

increased body movements and thoughts

128
Q

Major Depressive Disorder & Mood/Affect: How will they describe themselves?

A

As hopeless, helpless, down, or anxious . Easily frustrated and can be angry with others . Experience anhehdonia.

129
Q

Major Depressive Disorder & Thought Process/Content: How is their thought process?

A

Slow thinking process, and occurs in slow motion. May not respond verbally to questions. Think negatively and think they will always feel this bad.

Remunate , which is going over same thoughts.

130
Q

Major Depressive Disorder & Sensorium and Intellectual Processes: How are they with sensorium?

A

Some may experience difficulty with orientation.

131
Q

Major Depressive Disorder & Judgement/Insight: Judgement impaired why?

A

Because they cannot use their cognitive abilites to solve problems or make decisions.

132
Q

Major Depressive Disorder & Self-Concept: Self-Esteem here?

A

Reduced. Often think of themselves as good for nothing or just worthless.

133
Q

Major Depressive Disorder & Depression Rating Scales: Self rating depression scales include what?

A

Zung Self-Rating Depression Scale and Beck Depression Inventory

134
Q

Major Depressive Disorder & Depression Rating Scales: What is the Hamilton Rating Scale for Depression?

A

Clinician-rated depression scale used like a clinical interview. Rates teh change of client’s behaviors, such as depressed mood, guilt, suicide and insomnia

135
Q

Major Depressive Disorder & Outcome Identifcation: What are the goals?

A

Client will not injure themselves

Will indepednetly carry out ADLs

Client will evaluate self-attributes realistically

Will socialize with saff, peers, and family/friends

136
Q

Major Depressive Disorder & Intervention - Providing for Safety: First priority is to determine what?

A

Whether client with depression is suicidal

137
Q

Major Depressive Disorder & Intervention - Providing for Safety: If patient reports suicidial intentions, what happens?

A

Suicide precautions such as removing harmful items and increased supervision.

138
Q

Major Depressive Disorder & Intervention - Promoting Therapeutic Relationship: How can silence be important?

A

Because nurses prescence conveys genuine interest and caring. Silence can conveyr that client sare worthwhile even if they are not listening

139
Q

Major Depressive Disorder & Intervention - Promoting ADLs and Physical Care: How to assess ability to perform ADLS?

A

Nurse asks the client to perform a simple task. If they can’t, nurse breaks it down into smaller segments

140
Q

Major Depressive Disorder & Intervention - Promoting ADLs and Physical Care: What to do if client doesn’t want to do between choosing clothing?

A

Nurse selects clothing and directs them to put it on

141
Q

Major Depressive Disorder & Intervention - Promoting ADLs and Physical Care: When does the nurse help client dress?

A

Only when they cannot perform any of the steps themselves

142
Q

Major Depressive Disorder & Intervention - Promoting ADLs and Physical Care: What should the nurse do with yes-or-no questions?

A

Instead of using these, the nurse should say “It’s time to get up now”.

143
Q

Major Depressive Disorder & Intervention - Therapeutic Communication: It is important for nurse to not fix what?

A

the client’s difficulties or offer cliches.

144
Q

Major Depressive Disorder & Intervention - Therapeutic Communication: As clients improve, nurse can help them rediscover what?

A

More effective coping strategies such as talking to friends, spending leisure time to relax and taking positive steps to deal with stressors.

145
Q

Major Depressive Disorder & Intervention - Family Advice: They should know that treatment outcomes are best when?

A

Psychotherapy and antidepressants are combined.

146
Q

Major Depressive Disorder & Intervention - Family Advice: What does psychotherapy help client do?

A

Explore anger, dependence, guilt, hopelessness, helplessness, object loss and interpersonal isues.

147
Q

Bipolar DisordeR: What is this?

A

Involves extreme mood swings from episodes of mania to episodes of depression.

148
Q

Bipolar DisordeR: How are clients during manic phase?

A

euphoric , grandiose, energetic and sleepless. Have poor judgement and rapid thoughts, actions, and speech

149
Q

Bipolar DisordeR: Diagnoses for this is not made until what

A

person experiences a manic phase

150
Q

Bipolar DisordeR: How long can individual moods last?

A

Weeks or months

151
Q

Bipolar Disorder & Onset/Clinical: First episode occurs when

A

person’s teens, 20s or 30s.

152
Q

Bipolar Disorder & Onset/Clinical: Manic episode typically begin how?

A

Suddenly with rapid escalation of symptoms over a few days and last few weeks to several months

153
Q

Bipolar Disorder & Onset/Clinical: Diagnosis of manic episode require what

A

at least 1 weeks of unusual and incessantly heightened, grandiose, or agitated mood.

154
Q

Bipolar Disorder & Tx - Psychopharmacology: What medications are used?

A

Antimanic agent (Lithium) or anticonvulsant meds used as mood stabilizers

155
Q

Bipolar Disorder & Tx - Psychopharmacology: If client in the acute stage of mania or depression exhibits psychosis, what is given?

A

Antipsychotic agent

156
Q

Bipolar Disorder & Psychopharmacology - Lithium: What is lithium?

A

Salt contained in huhman body.

157
Q

Bipolar Disorder & Psychopharmacology - Lithium: What can lithium treat?

A

Stabilize bipolar disorder by reducing the degree and frequency of cycling or eliminating manic episodes

158
Q

Bipolar Disorder & Psychopharmacology - Lithium: Lithium action peaks when?

A

In 30 minutes to 4 hours in regular forms and in 4-6 hours in slow-release forms

159
Q

Bipolar Disorder & Psychopharmacology - Lithium: Onset of action?

A

5-14 days. Antipsychotics or antidepressants are used during lag period

160
Q

Bipolar Disorder & Psychopharmacology - Lithium: Half life of lithium?

A

20-27 hours

161
Q

Bipolar Disorder & Psychopharmacology - Anticonvulsant Drug: Facts to know about Carbamazepine (Tegretol)?

A

First anticonvulsant found to have mood-stabilizing properties. Agranulocytosis is of great concenr. Need to have drug serum levels checked regularly.

162
Q

Bipolar Disorder & Psychopharmacology - Anticonvulsant Drug: Facts to know about Valporic Acid (Depakote)?

A

Therapeutic levels monitored and ongoing liver function tests performed.

163
Q

Bipolar Disorder & Psychopharmacology - Anticonvulsant Drug: What other drugs are used?

A

Gabapentin (Neurontin, Lamotrigine (Lamictal) and Topiramate (Topamax)

164
Q

Bipolar Disorder & Psychopharmacology - Anticonvulsant Drug: What is Clonzaepam used for?

A

Is an anticonvulsant and benzodiazepine. DEpendence can develop.

165
Q

Bipolar Disorder & Psychopharmacology - Anticonvulsant Drug: What are the Aripiprazole (Abilify), Brexpiprazole (Rexulti) and Cariprazine (Vraylar) drugs?

A

Dopamine system stabilizer antipsychotics meds used as adjuncts to other mood-stabilziing drugs

166
Q

Bipolar Disorder & Psychopharmacology: What class of drugs is most often used to treat bipolar?

A

Second-generation antipsychotic meds in conjunction with mood stabilizers or antidepressants.

167
Q

Bipolar Disorder & Psychopharmacology: Which combination meds are the most effective?

A

Ziprasidone (Geodon) , Lurasidone (Latuda), and Quetiapine (SEroquel).

168
Q

Bipolar Disorder & History: How is this done?

A

Difficult. Client jumps form subject to subject , which makes it difficult for nurse to follow

169
Q

Bipolar & General Appearance/Motor: How do those with mania appear?

A

Psychomotor agitation. Sitting difficult. Can cause injury or exhaustion

170
Q

Bipolar & General Appearance/Motor: What clothes do they wear?

A

Wears clothes that are reflective of elevated mood. Birhg tclothes.

171
Q

Bipolar & General Appearance/Motor: How is the motor here?

A

Pressured speech is the hallmark sign. Talk rapidly without pauses.

172
Q

Bipolar & Mood/Affect: How is the mood?

A

Periods of euphoria, exuberant activity, grandiosity and false sense of well-being . Mood is labile and they alternate between periods of loud laughter and episodes of tears

173
Q

Bipolar & Thought Process/Content: How is thinking?

A

Confused and jumbled with thoughts racing one after another, flught of ideas. Circumstantility and tangentiality also happen.

174
Q

Bipolar & Thought Process/Content: How do they perform activites?

A

Start many projects at one time butdo not finish them. Start activities as they occur in thought processes.

175
Q

Bipolar & Sensorium and Intellectural Processes: What is the problem here?

A

Not oriented to time.

176
Q

Bipolar & Sensorium and Intellectural Processes: How is the intellectual process?

A

Clients claim to have abilities they cannot possses. Also ability to concentrate impaired.

177
Q

Bipolar & Judgement/Insight: How do they judge others?

A

Easily angered and irritated and strike back at what they perceive as censorship.

178
Q

Bipolar & Judgement/Insight: nishgt here?

A

Impulsive and rarely think before acting or speaking. Also limited because they believe they are fine

179
Q

Bipolar & Self-Concept: How is sself-esteem?

A

Exaggerated. They believe they can accomplish anything

180
Q

Bipolar & Roles/Relationships: Clients have great need to socialize but have little what?

A

understanding of their excesive, overpowering and confrontional social interaction

181
Q

Bipolar & Physiological/Self-Care: How do they do with sleep and food?

A

Can do days without sleep or food and not realize they are hungry or tired.

182
Q

Bipolar & Intervention - Providing for Safety: Primary nursign responsibility?

A

Provide a safe environment for clients and others.

183
Q

Bipolar & Intervention - Providing for Safety: What does the nurse assess?

A

Clients directly for suicial ideation and plans of hurting themselves.

184
Q

Bipolar & Intervention - Providing for Safety: What is important for nurse to tell client?

A

That staff members will help them control their behaviors if clients cannot do so alone

185
Q

Bipolar & Intervention - Providing for Safety: What to know about setting limits?

A

Very important to do so because clients do not recognize that they are in others peoples space

186
Q

Bipolar & Intervention - Meeting Physiological Needs: What is the main problem?

A

They get little rest and poor nutrition. Provide a quiet environment for stimulation and provide fingering foods that they can eat while moving.

187
Q

Bipolar & Intervention - Meeting Physiological Needs: What does nurse need to monitor?

A

Food and fluid intake and hours of sleep until clients routinely meet these needs without difficulty

188
Q

Bipolar & Intervention - Providing Therapeutic Communication: How does nurse present information?

A

Using clear, simple sentences when commuicating. Break information into many small segments. Explain purpose of tests .

189
Q

Bipolar & Intervention - Providing Therapeutic Communication: What to do when client speaks rapidly?

A

Keep channels of communication open with clients. “Please speak more slowly. I’m having trouble following you.” Puts the difficulty on the nurse instead of client

190
Q

Bipolar & Intervention - Providing Therapeutic Communication: How does nurse react when speech includes flight of ideas?

A

Nurse asks clients to explain relationships, because the conversation quikcly moves to different subjects

191
Q

Bipolar & Intervention - Promoting Appropriate Behaviors: How can nurses direct their needs for movement?

A

Makes them socially acceptable, large motor activites. Like arranging chairs for a community meeting or walking.

192
Q

Bipolar & Intervention - Promoting Appropriate Behaviors: Problem with those who have few restrictions on themselves?

A

They act out impulsive thoughts, have inflated and grandiose perceptions of their abilities, are demanding, and need immediate gratification

193
Q

Bipolar & Intervention - Promoting Appropriate Behaviors: Problems with clients and sex?

A

Lose sexual inhibitions. They are revealing and engage in unprotected sex with virtual strangers. Will ask everyone for sex and describe sexual acts.

194
Q

Bipolar & Intervention - Managing Medications: How is Lithium handled in body?

A

Reabsorbed by the proximal tubule and excreted in the urine.

195
Q

Bipolar & Intervention - Managing Medications: Maintenance level of Lithium?

A

0.5-1

196
Q

Bipolar & Intervention - Managing Medications: Treatment level of lithium?

A

0.8-1.5

197
Q

Bipolar & Intervention - Managing Medications: Toxic levels of lithium?

A

1.5 or above

198
Q

Bipolar & Intervention - Managing Medications: Symptoms when Lithium is at 1.5-2?

A

N/V, Diarrhea, Reduced Cooridnation, Drowsiness, Slurred Speech

199
Q

Bipolar & Intervention - Managing Medications: Symptoms whn Lithium is 2-3?

A

Ataxia, Agitation, blurrerd vision, tinnitus, giddiness, muscle fasciculation, hyperreflexia, hypertonic muscles

200
Q

Bipolar & Intervention - Managing Medications: Interventions when lithium is at 1.5-2?

A

Without next dose

201
Q

Bipolar & Intervention - Managing Medications: Interventions when lithium is at 2-3?

A

Withhold future doses, call physicial . Gastric lavage may be used.

202
Q

Bipolar & Intervention - Managing Medications: Symptoms when Lithium is 3+?

A

Cardiac arrhythmia, hypotension, peripheral vascular collapse, reduced levels of consciousness.

203
Q

Bipolar & Intervention - Managing Medications: Water and Lithium?

A

SHould drink 2L/day and have usual amount of dietary salt. Too much salt reduces receptor available for lithium

204
Q

Bipolar & Intervention - Managing Medications: Lithium and if too much water ingested?

A

Lithium dilued and lithium level will be low.

205
Q

Bipolar & Intervention - Managing Medications: Lithium and if too little water digested?

A

Increases lithium level and results in toxicity

206
Q

Bipolar & Intervention - Managing Medications: How to monitor fluid balance with lithium?

A

Monitor daily weights and the balance between intake and output and checking for dependent edema.

207
Q

Bipolar & Intervention - Managing Medications: How often are thyroid function tests ordered with lithium?

A

Baseline and every 6 months during tx. In 6-18 months, 1/3 clients taking lithium have increased level of TSH causing anxiety and labile emotions

208
Q

Bipolar & Intervention - Managing Medications: Lithium contraindicated in what peopple?

A

Those with compromised renal function or urinary retnetion and those taking low-salt diets or diuretics

209
Q

Bipolar & Intervention - Providing Fam/Client Education: What is important to teach family memebrs?

A

Education about cause of bipolar, medication managemen, ways to deal with behaviors, and potential problems that manic people can encounter is important

210
Q

Bipolar & Intervention - Providing Fam/Client Education: Education reduces what in family?

A

Guilt, blame, and shame that accompany mental illness. Increases client safety and enlarges the support system for clients.

211
Q

Bipolar & Evaluation: What does this include?

A

Safety issues, comparsion of mood and affect between start of tx and present, and adherence to tx regimen of medication and psychotherapy

212
Q

Suicide: What is this?

A

Intentional act of killing oneself.

213
Q

Suicide: How many suicides happen?

A

45,000 each year. `

214
Q

Suicide: Chonic medical illnesses associated with increased RF suicide include what?

A

Cancer, HIV, diabetes, cerebrovascular accidents and head/spinl cord injury.

215
Q

Suicide: Envionmental factors that increase suicie include what

A

isolation, recent loss, lack of social support, unemployment, critical life events and family history

216
Q

Suicide: behavioral factors that increase risk include what

A

impulsivity, erratic or unexmplained changes

217
Q

Suicide: What is suicidal ideation?

A

Means thinking about killing oneself

218
Q

Suicide: what is active suicidal ideation?

A

when a person thinks about and seeks ways to commit suicide

219
Q

Suicide: what is passive suicidal ideation?

A

when person thinking about wanting to die or wishes or she were dead but has no plans to cause their death

220
Q

Suicide: What does suicide involve?

A

Ambivalence. Its impossible to know if person who drove into telephone pole did this on person

221
Q

Suicide & Assessment: Highest risk period for this?

A

First 2 years after attempt, especially the first 3 months

222
Q

Suicide & Assessment: When are suicides most likely to occur?

A

With natural energy from spring in Apil

Or monday mornings, when people return to work

223
Q

Suicide & Warnings of Suicidal Intent: What must we do as a nurse?

A

Never ignore any hint of suicidal ideation regardless of how trivial or subtle it seems

224
Q

Suicide & Warnings of Suicidal Intent: How does nurse repsond to “I just want to go to sleep and not think anymore”

A

“Specifically just how are you planning to sleep and not think anymore?

225
Q

Suicide & Warnings of Suicidal Intent: Nurses response to “I want it to eb all over”

A

“What is it you specifically want to be over?”

226
Q

Suicide & Warnings of Suicidal Intent: Nurse response to “IT will just be the end of the story”

A

“Are you planning to end your life”

227
Q

Suicide & Warnings of Suicidal Intent: Nurses response to “You have been a good friend”

A

“You sound as if you are saying goodbye. Are you?”

228
Q

Suicide & Warnings of Suicidal Intent: Nurses response to “If there is any need for anyone to know this, my will and insurance appers are in the top drawer of my dresser”

A

“I appreciate your trust. However, I think there is an important message you are giving me. Are you thinking of ending your life”?

229
Q

Suicide & Risky Behaviors: What kind of risky behaviors may an individual perform?

A

Speeding in blinding rainstorm or when intoxicated .Carrires a high risk of harm to clients and innocent bystanders

230
Q

Suicide & DRUG ALERT & ANTIDEPRESSANTS: Why may they have a continued or increased risk for suicide?

A

They may experience an increase in energy from the antidepressant but remain depressed. May make them more likely to act on suicidal ideas.

231
Q

Suicide & Lethality Assessment: What questions are asked if clients admit to having a death wisk or suicidal thoughts?

A

Does the client have a plan?

Are the means availble to carry out the plan?

If client carries out the plan, is it likely ot be lethal?

Has client made preparations for death?

232
Q

Suicide & Internvetion & Using an Authoritaive role: What role does nurse use?

A

This authoritative role to keep client safe. Nurse lets client know that their safety is the primary concern and takes precendence over othere needs or wishes.

233
Q

Suicide & Internvetion & Providing Safe Environment: What objects may staff remove from patient?

A

Sharp objects, shoelaces, belts, lighters, matches, pencils, pens and even clothing

234
Q

Suicide & Internvetion & Providing Safe Environment: How often are patients chekced on if lethality low?

A

Every 10 minutes

235
Q

Suicide & Internvetion & Providing Safe Environment: What is done is high lethality possible?

A

Clients observed on a one-on-one supervision. Client in direct sight and no more than 2-3 feet away.

236
Q

Suicide & Internvetion & Providing Safe Environment: What are no-suicide or no-self-harm contracts?

A

/Clients agree to keep themselves safe and notify staff at their first impulse to harm themselves.

237
Q

Suicide & Internvetion & Creating a support system list: What support system list will eb created?

A

Mental health clinics, hotlines, psychiatric emergency evaluations services, student health services, church groups and self-help groups

238
Q

Suicide & Internvetion & Nurses Response: How must nurse respond to this?

A

Must indicate unconditional positive regard not for the act for but the person adn their desperation . Must convey belief that person can be helped and can grow and change

239
Q

Suicide & Lethal and Ethical Considerations: Who is Dr. Jack Kevorikian?

A

A doctor who participated in numerous assited suicides. They are lobbying for changes in laws that would allow health care profesionals and family members to assit with suicide attempts

240
Q

Suicide & Community-Based Care: What changes may individuals notice first?

A

Difficulty eating and sleeping, thinking, complaints of being tired all the time, sadnes, and agitation.

241
Q

Suicide & Community-Based Care: People with depressionc an be treated successfully in the community by who?

A

pschiatrists, psychiatric advanced practice nurses , and primary care physicians.

242
Q

Suicide & Community-Based Care: People with bipolar disorder should be referred to who?

A

Psychiatrist or psychiatric advanced practice nurse.

243
Q

Mental Health Disorderes and Mental Health Promotion: What do programs that use an education approach focus on?

A

Increasing self-esteem and reducing loneliness and hopelessness

244
Q

Mental Health Disorderes and Mental Health Promotion: Efforts to improve primary care tx of depression have built upon a chornic illness care model that includes what

A

improved screening and diagnosis in primary care settings, use of evidence-based protocols for tx and patient self-management

245
Q

Antidepressants: Which have fewest side effects?

A

SSRIs

246
Q

Antidepressants: Which are oldest and have longer lag period before reaching adequate serum level?

A

Tricryclic Antidepressants, are chespest

247
Q

Antidepressants: MAOIS used least why

A

because clients are at ris k for hyptertensive crisis if they ingest tyramine-rich foods an fluids while taking these drugs.

248
Q

People with bipolar disorder cycle between what

A

mania, normalcy and depression.

249
Q

Lithium is how effects?

A

75% of clients, but has a narrow range of safety.

250
Q

Conducting a suicide lethality assessments involves determinign what??

A

the degree to which the person has planned his or her death including time, method, tools, place, person to find the body, reason and funeral plans

NRSG 126: Mental Health (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions