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3-Third semester > Exam 3- mental health > Flashcards

Exam 3- mental health Flashcards

1
Q

Anxiety-

feeling of

normal-

provides

A

Feeling of apprehension, uneasiness, or uncertainty resulting from a Real or perceived threat

Normal is healthy for survival

Provides energy needed to do tasks-

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2
Q

how is anxiety Different from fear-

however

A

fear is reaction to specific danger-

however the body will react in similar ways

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3
Q

Mild anxiety-

normal

allows

A

normal experience of everyday living

allows an individual to perceive reality in sharp focus.

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4
Q

physical symptoms Mild anxiety

d
r
i

A

discomfort

restlessness,

irritable

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5
Q

mild anxiety

__ information

what’s more effective

A

Sees, hears, and grasps more information,

problem solving is more effective.

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6
Q

Moderate-

what for information

A

sees , hears, and grasps less information

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7
Q

Moderate anxiety

demonstrates
ability
problem solving

A

demonstrates selective inattention,

ability to think clearly is hampered,

problem solving is not optimal

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8
Q

s/s moderate anxiety

heart
increased x2
p
voice
s

A

pounding heart,

increased hr and rr,

perspiration

, voice tremors

shaking

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9
Q

Mild/moderate level interventions-

help pt
antipate
use non
encourage
avoid closing
ask pt

A

help pt identify anxiety

anticpate anxiety proviking sitautions

use nonverbal language like eye contacnt

encourage pt to talk about feelings

avoid closing off avenues that are important to pt

ask pt to clarify

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10
Q

Mild/moderate level interventions-

help pt
encourage p
help develop
explore b
provide other

A

help pt identify what is onset of anxiety

encourage problem solving

help develop alternative solutions

explore behaviors that have worked in the past

provide other outlets for working off excess energy

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11
Q

Severe-

what’s reduced
may not notice what
what problem solve

A

perceptual field is greatly reduced.

May not notice what’s going on in the environment,

not possible to problem solve///

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12
Q

Severe anxiety s/s
h
n
d
what heart
hyper

A

headache,

nausea,

dizziness,

trembling and pounding heart,

hyperventilation

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13
Q

Panic-
extreme
unable

A

extreme level of anxiety,

unable to process environment,

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14
Q

s/s panic anxiety

p
r
s
s
w
possible
what movements

A

pacing,

running

shouting,

screaming

withdrawal

possible hallucinations,

uncoordinated movements

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15
Q

interventions severe/panic anxiety

maintain
always
minimize
use what statemetns
use what voice
reinforce

A

maintain a calm manner

always remain with person

Mimize enviromntal stimuli

use clear and simple statements

use low pitched voice

reinforce reality

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16
Q

interventions for severe/panic anxiety

listen for
attent to
set
provide
offer
assess need for

A

listen for themes

attend to physical needs

set limits

provideoppurtinnites for ecxercise

offer high calorie foods.

Assess need for meds and seclusion

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17
Q

Defenses against anxiety

adaptive

maladaptive

A

Adaptive- used to lower anxiety and achieve goals in a healthy way- like deep breathing, mediation, walks

Maladaptive-when several defenses are used in unacceptable ways like alcohol, smoking, anger

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18
Q

Altruism

motivaton

A
  • motivation to feel caring and concerns for others
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19
Q

Compensation

counterbalances

A
  • counterbalances perceived deficiencies by emphasizing strengths
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20
Q

Conversion

transforms

A
  • transforms anxiety into a physical symptom- like becoming blind
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21
Q

Denial

escaping

A
  • escaping unpleasant thoughts and feelings by ignoring existence
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22
Q

Displacement

transfer

A
  • transfer of emotions from one person into another person that is not involved in the situation
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23
Q

Dissociation

disruption

A
  • disruption of consciousness, memory or identity of environment
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24
Q

Identification

attributing

A

attributing one groups charactiestics into your own

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25
Q

Intellecualzation

events

A
  • events are analyzed based on cold hard facts instead of using emotions
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26
Q

Projection

unconscious

A
  • unconscious rejection of emotionally unacceptable features and attributing them to others-
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27
Q

Rationalization

justifying

A
  • justifying unreasonable acts by developing explanations that satify the teller
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28
Q

Reaction formation-

defense

A

defense mechanism that involves behaving in a way that is the opposite of how someone actually feels

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29
Q

Regression

reverting

A
  • reverting to an earlier and more primitive childlike pattern
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30
Q

Repression

unconscious

A
  • unconscious exclusion of unpleasant expeiernces from conscious awareness
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31
Q

Splitting

inability

A
  • inability to integrate positive or negative qualities into image
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32
Q

sublimation

unconscious

A
  • unconscious process of transforming negative impulses into less damaging and productive impulses

like getting angry and going for a run

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33
Q

undoing

person

A
  • person makes up for regrettable acts
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34
Q

Suppresion

delay

A
  • delay addressing a disturbing emotion or feeling
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35
Q

Panic Disorders-

sudden
associated w

have what for reality

feels like what

A

sudden onset of extreme apprehension or fear,

associated with impending doom

have misintepteations of reality,

feel like they are alosing mind or having a heart attack

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36
Q

Separation anxiety

develop

what age in children

A
  • develop inapprorate level of concern when away from significant other

occurs 8 months -2 yrs

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37
Q

Social Anxiety disorder-

A

sever anxiety or fear provoked by exposure to a social or performance situation

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38
Q

Generalized anxiety disorder-

excessive
huge
might also
what’s common

A

excessive worry-

huge amounts of time are spent preparing for situations

might also put things off and avoidance may result in lateness

sleep disrubances are common

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39
Q

Generalized anxiety disorder-

short term goal

A

to state immediate distress and relieve immediate distress

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40
Q

Generalized anxiety disorder

medium trem goal

A

pt will identify precipitants of anciety by specific date

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41
Q

Generalized anxiety disorder

long term is

A

pt will identify strengths and coping skills

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42
Q

Agoraphobia –

excessive

fear of

A

excessive anxiety about being in a place where escape isn’t possible or help might not be available

  • fear of open spaces
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43
Q

OCD

when
they
severe does what

A
  • when obsessive behaviors continue on a daily basis-

they interfere with daily routine

severe takes over the persons entire life

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44
Q

Body Dysmorphic Disorder-

have
will
false

A

have a preoccupation with body parts that they belveie to be ineffective

will check very often

false assumptions about the importance of their appearance

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45
Q

Hoarding Disorder

A

-when trying to get rid of things becomes extremely distressing and hard to get rid of things

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46
Q

Trichotillomania –

A

hair pulling disorder

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47
Q

Excoriation disorder

A

– skin picking disorder

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48
Q

Substance-induced anxiety disorder-

develop when

A

obsessions and compulsions that develop with use if substance within a month of stopping the subtance

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49
Q

phobias examples

A

Acrophobia Heights

Agoraphobia Open spaces

Astraphobia Electrical storms

Claustrophobia Closed spaces

Glossophobia Talking

Hematophobia Blood

Hydrophobia Water

Monophobia Being alone

Mysophobia Germs or dirt

Nyctophobia Darkness

Pyrophobia Fire

Xenophobia Strangers

Zoophobia Animals

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50
Q

Cognitive Therapy-

A

combines cognitive therapy with behavioral therapies,

to reduce anxiety response

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51
Q

Modeling- therapy

someone

A

someone acts as a role model to demonstrate appropriate behavior

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52
Q

Systemic desensitization

pt

A
  • pt is gradually introduced to a. Feared object or experience through a series of steps
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53
Q

Flooding exposes

A

exposes the pt to large amounts of undesirable stimulus

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54
Q

Thought stopping-

negative

A

negative thought or obsession is uninterrupted by staying stop out loud

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55
Q

Response prevention-

used for
doesn’t allow

A

used for compulsive behaviors-

doesn’t allow pt to do obsessive behaviors like keep washing hands over and over again

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56
Q

Relaxation Techniques

A

yoga

guided imagery

therapy

walking

breathing excercises

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57
Q

cognitive reframing

reassessing

A

reassessing situation by replacing beliefs with a more positive outlook

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58
Q

Posttraumatic Stress Disorder (PTSD)

f
avoidance
numbing
difficulty

A

Flashbacks

Avoidance of stimuli

Numbing of responsiveness

Difficulty in interpersonal relationships

59
Q

PTSD

what is hardest thing
can lead to
watch for

A

Trust is hardest thing w thest pts.

Can lead to abuse of spouses or of chemicals

Watch for safety for self /others/thelselves

60
Q

OCD

obsessions

compulsions

interferes with

A

Obsessions - thoughts/images that persist

Compulsions – ritualistic behaviors a person does to reduce anxiety

Interferes with daily life- will always worry about things like doors and lights

61
Q

Common obsessions and compulsions

losing
h
unwanted
p
v
c
s

A

Losing control and religious concerns

Harm

Unwanted sexual thoughts

Perfectionism

Violence

Contamination

superstitions

62
Q

Non-Suicidal Self Injury

attempts

A

Deliberate/direct attempts to cause bodily harm that does not result in death

63
Q

non suicidal self injury examples

A

cutting

burning

scraping skin

biting

hittinh

skin picking

interfering with wound healing

64
Q

non suiocidal self injury

prevalence
gender
biolodigcal factors

societal factors

A

Prevalence- 2 million cases annualy

Gender – females

Biological Factors-brain disoerders

Societal Factors-isolation from others and negative self worth

65
Q

nursing interventions for non suicidal self injuries

assess x2
care for
establish
teaching what
watch for

A

assess how it happened/suicide risk

care for wounds

establish therapeutic communication

teaching coping skills

watch for ability to have devices of harm

66
Q

Pt teaching meds

do not
avoid
take
no
how long

A

Do not drive or operate heavy machinery.

Avoid alcohol or sedating medications.

take w food

no caffeine

takes 2-4 weeks

67
Q

Medications used for anti-anxiety-

A

Benzodiazepines

Antidepressants

Tricyclics
MAOIs
Anticonvulsants
Antihistamines
Beta Blockers

68
Q

Major Depression Disorder

leading
interferes w
may have
not a

A

leading cause of diasiblity

Interferes with social, occupational, causes disability

May have delusions and hallucinations

Not a result of aging

69
Q

Depression risk factors

what gender
what childhood
what eveents
who has it
what conditions
what use

A

female

adverse childhood

stressful events

family has it

chronic conditions

substance use

70
Q

other depressive disorders

A

Substance/Medication-Induced Depressive disorder

Depressive disorder due to another Medical Condition

Premenstrual Dysphoric Disorder

Disruptive Mood Dysregulation Disorder

Depression and the Seasons known as Seasonal affective disorder (SAD)

Depression and Grieving

71
Q

dominating symptom in children

older adults at more risk for what

depression

A

children- irritbility

older adults at risk for not being diagnosed

72
Q

appearance assessment
Major depressive disorders

a
slowed
what posture
what mood
looks
may look/ unable to

A

Affect-how they are on outside

Thought Process- slowed

Poor posture

Mood-Worthlessness

Looks older then they are

May look sad/be unable to cry

73
Q

Major depressive disorders assessment for feelings

g
h
h-what risk
a/I
may experience

A

Guilt

Helplessness-inability to carry out simple tasks- adls

Hopelessness (Suicide Risk!)

Anger/Irritability- may hurt others

May experience delusions/punish themselves for those feelings

74
Q

Major depressive disorders assessment physical behavior

psychomotor
what’s neglected
changes in __habits
changes in __patters
loss of
what’s impaired
may have

A

Psychomotor retardation or agitation

Grooming is neglected

Changes in eating habits

Changes in sleeping patterns

Loss of libido

memory is impaired

may have difficulty in making decisions

75
Q

Major depressive disorders assessment communication/speech

speaks
can become
speaks about

A

Speak slow

Can become mute

speaks about failure

76
Q

Major depressive disorders Interventions

what assessmnet

waht techniques

promotion on what

what management

A

Risk for Suicide Assessment

Counseling and Communication Techniques

Promotion of self-care

Milieu Management

77
Q

subsuicide behaviors

A

anything that hurts them like drugs/ alcohol etc

78
Q

guidelines for communication with severely withdrawn person(catatonic/ vegetative state)

do what when pt is silent

use what words

allow

listen for

avoid

A

when the pt is silent - make observations

use simple concrete words

allow time to respond

listen for covert messages

avoid platitudes like things will go up

79
Q

Guidelines for counseling people with depression-

help pt
identify
help pt
encourage
encourage
provide

A

Help pt question underlying assumptions and beliefs

identify what is resulting in negative self impression

Help pt identify coping skills

Encourage exercise

Encourage relationships

Provide referrals

80
Q

SSRI-fluoxetine/ sertraline
se

a
I
h
/
dysfunction
hypo

A

agitation

insomnia

headache

n/v

sexual dysfunction

hyponatramia

81
Q

SNRI- duloxetine
se

n
mouth
reduced
s
vision

A

nausea

dry mouth

reduced appetite

sweating

blurred vision

82
Q

TCA- amitriptyline, doxepin

mouth
what gi
retention
what vision
bp
cardiac
s

A

dry mouth

constipation

urinary retention

blurred vision

hypotension

cardiac toxicity

sedation

83
Q

MAOI- isocarboxazid, phenelzine
se

I
n
a
c
crisis

A

insomnia

nausea

agitation

confusion

hypertensive crisis

84
Q

foods that interrupt with MAOI

veg
fruit
what meat
what fish
what dairy
what supplements
s
what sauce

A

veg-avocado

fruit-figs

smoked meats

dried fish

dairy- cheese

protein supplemetns

soup

soy sauce

85
Q

SSRI family teaching

may cause
no what
avoid
what tests
do not

A

may cause sexual dysfunction

no over the counter drugs

avoid alcohol

liver/renal tests

do not drive or operate machinery

86
Q

serotonin syndrome- SSRI-report immediately

increase in
skin
rapid
throat
difficulty
temp
what food
unusal
what behavior
severe

A

increase in depression

skin rash/hives

rapid heartbeat

sore throat

difficulty urinating

fever

anorexia/ wt loss

unusual bleeding

hyperactive behavior

severe headache

87
Q

adverse reactions to moai

bp
s
changes in
muscle
retention
weight

A

hypotension

sedation

changes in cardiac rhythm

muscle cramps

urinary retention

wt gain

88
Q

toxic effects of maoi

what crisis
severe
hr
/

A

hypertensive crisis

severe headache

tachycardia

n/v

89
Q

nutrition Interventions for vegetative state

offer
encourage
include
weigh

A

offer small high calorie foods

Encourage family to participate

Include pt in deciding meals

Weigh pt daily

90
Q

provide
encourage
encourage
provide

Sleep Interventions for vegetative state

A

Provide periods of rest

Encourage pt to dress and stay out of bed

Encourage relaxation measures

Provide decaff coffee and soda

91
Q

Self care deficits
encourage
when

Interventions for vegetative state

A

Encourage use of toothbrush, washcloth/ adl supplies

When appropriate, give step by step reminders

92
Q

monitor
offer
encourage
evaluate

Elimination Interventions for vegetative state

A

Monitor I /0

Offer high fiber foods

Encourage intake of fluids

Evaluate need for laxatives

93
Q

assess for what in trouble sleeping (what use/ daytime/ normal)

always assess for what

depression assessment

A

assess for caffeine use / daytime naps and normal sleep patters

always assess for a suicide risk

94
Q

Major depressive disorders Treatments

what remission rate
how many per week for how many treatments
uses what
what’s induced
takes how long

Electroconvulsive Therapy

A

70-90% remission rate

2-3 treatments per week for 6-12 treatments (depends on pt)

EEG monitors brain waves and ECG monitors cardiac

Brief seizures are induced

Takes 15 minutes

95
Q

pt after electrocionsvuslive therapy

pt may be
what for a few weeks
will need

A

Patient maybe confused afterwards,

memory deficits may last a couple weeks

Will need someone to drive home

96
Q

internal stimulating therapy’s

v stimulation
d stimulation

A

Vagus Nerve stimulation

Deep Brain stimulation

97
Q

External stimulating therapy

r
L
e
E

A

Repetitive Transcranial magnetic stimulation

Light therapy

Exercise

ECT

98
Q

Bipolar I

1// alternating

may be

A

1 episode of mania alternating with major depression

May be psychotic with mania

99
Q

epidemiology bipolar

men more likely to

A

More likely to have legal problems and commit violence

100
Q

women more likely to

bipolar

A

More likely to abuse alcohol, commit suicide, thyroid disorders

101
Q

comobridities bipolar

__attacks
__ abuse
_phobia
what illnesses

A

Panic attacks

Alcohol abuse

Social phobia

chronic illnesses

102
Q

etiology bipolar

biological
psychological
environmental

A

Biological
Genetic predisposition

Psychological
Stressful events

Environmental
Upper, socioeconomic status
Higher incidence with higher education

103
Q

bipolar assessment
moods

m
I
g plans

A

Mania- unstable- pts feels euphoric/ overjoyed but then…..

Irritable transitions quickly into irritation

Grandiose plans-more details then necessary

104
Q

Bipolar assessment behavior

what’s emergency
extravagant
what life
constant
what behavior
what self esteem
how do they dress

A

Mania = emergency!

Extravagant spending,

social life

, constant activity

Risky behavior

Inflated self esteem

Dress bizzare

105
Q

Thought Process and speech patterns assessment bipolar

pressured speech->
circumstantial speech->
tangental speech
loose ___
flight __
__ association

A

Pressured speech-sense of urgency when talking

Circumstantial speech-adds unnecessary information

Tangential speech-lose point and never goes back to original topic

Loose associations-lack of connection between ideas

Flight of ideas- change ideas fast

Clang associations –words that rhyme

106
Q

Thought Content

grandiose delusions- is what
Persecutory delusions- is what
what function

assessment bipolar

A

Grandiose delusions-belief that one is famous/wealthy

Persecutory delusions- belief that someone is attempting to harm them

Cognition Function

107
Q

Nursing self-assessment

Pts can be

pts are also

A

Pts can be very manipulative

pts are also very energy consuming

108
Q

Staff-splitting
a
I
p–p

bipolar

A

Anger

Isolation

Power-plays

109
Q

bipolar assessment

if
need for p
need for h
status
knowledge

A

assess if danger to self/others

need for protection from behaviors like spending money

assess need for hospitalization

medical status

family knowledge

110
Q

interventions bipolar

set
c
c
what is key

A

Set limits

Collaboration- work as a team

Communication

Consistency is key for these pts

111
Q

acute phase bipolar

what
what is priority

A

injury prevention

priority- medical stabilization and safety// I and o, sleep and rest, self control of thoughts, no self harm

112
Q

continuation phase bipolar

what
what is priority

A

relapse prevention

What is the priority? Educate them and families, med compliance, knowledge of disease, s/s of relapse, support groups

113
Q

maintenance phase bipolar

what
what is priority

A

Relapse prevention

Lessen severity and duration of future episodes

114
Q

Pt and family teaching bipolar

what causes relapse
what is critical to stability
what is important
what is helpful
keep what accessible

A

Use of alcohol, drugs caffeine can cause a relapse

Good sleep is critical to stability

Coping strategies are important for dealing with life

Group therapy is helpful

Keep phone numbers is easily accessible place

115
Q

lithium bipolar indications

what ideas
m
a
what behavior

A

flight of ideas

manipulation

anxiety

self injurious behavior

116
Q

early signs of toxicity

1.5-2.0

s/s
what uspet
hand
c

intervention-what x2 med

A

gi upset

hand tremor

confusion

intervention- withheld med and revelate med

117
Q

advanced signs of lithium toxicity

2.0-2.5

s/s
vision
urine
c
g

interventions- x2

A

blurred vision

large amounts of urine

coma

giddiness

intervention- stop drug potential bowel irrigation

118
Q

severe lithium toxicity
>2.5

s/s
c
o
d

intervention-above + d

A

convulsions

oliguria-producing no urine

death

intervention- above+ dialysis

119
Q

takes how long to be effective

checked how often
then checked how often

lithium bipolar
maintenance

A

takes 7-14 days to be effective

checked every 2-3 days until levels are reached,

then checked every 3-6 months

120
Q

lithium bipolar

contraindications

A

pts with cardiovascular disease, brain damage, renal disease, pregnancy

121
Q

atypical antipshyotocs

what effects
mood
help prevent

A

Sedative effects

Mood stabilizing

Help prevent mania relapse

122
Q

Lithium teaching

monitor what
maintain
maintain what electrolyte
be screened for

A

Monitor levels closely

Maintain consistent fluid levels

Maintain consistent sodium levels

Be screened for organ diseases before taking

123
Q

Lithium teaching

take w
may what
give
how get off
want

A

Take with meals

May gain wt

Give referral

Taper doses gradually

Want adherence to plan

124
Q

communication interventions for mania

use what approach
use what explanations
be what
identify expectations how
act on what
redirect what

A

use firm and calm approach- come with me)

use short/ concise explanations

be consistent

identify expectations in simple , concrete terms

act on legitmaiate complains

redirect energy into more appropriate channels

125
Q

safe milieu interventions for mania

maintain
provide what activities
provide what periods
redirect what
store

A

maintain low level of stimuli

provide structured activites

provide frequent rest periods

redirect aggressive behavior

store valuables until rational behavior continues

126
Q

nutrition interventions bipolar

montior
offer what drinks
offer what foods
remind pt

A

montior I/o

offer high calorie protein drinks

offer finger foods

remind pt to eat

127
Q

sleep interventions bipolar

encourage
keep pt in what area
do what at nights

A

encourage frequent rest periods

keep patient in low stimualtion area

night- warm baths and soothing music

128
Q

hygiene/elimination bipolar

encoaurage
step
offer what food/drink

A

encourage approiarte clothes

step by step reminders

offer fluids/high fiber foods

129
Q

suicide
feelings of
p
h
h

A

pain, hopelessness and helplessness.

130
Q

what Ages

waht gender

what social support

what diagnosis

what medical illness

what abuse-

suicide assessment

A

Age over 60 or adolescents

gender males

social support - single or divorced or widowed

diagnosiso depression or scizo

medical illness0 chronic

abuse- substances

131
Q

Evaluation suicide

contracts
verbalizes f
verbalizes desire
verbalizes absence
demonstates
involved

A

contracts no self harm

verbalizes feelings openly

verbalizes desire to live

verbalizes absence of suicidal ideation

demonstrates hope

involved in daily life

132
Q

Assess for what in suicide-

m
t
a
c

A

method,

timing,

availability,

chance of rescue.

133
Q

limit what
c
close
e s

suicide interventions

A

limit access to means

contract with client

close observation

emotional support

134
Q

involve who

watch

continuously

suicide assessment

A

involve family and friends

watch for cues

Continuously reassess and revise plan as needed

135
Q

warning factors -immediate risk of suicide

talks
expresses
increased
dramatic
what behavior

cues- suicide

A

Talks about death

Expresses no reason of living

Increased substance use
Withdrawal

Dramatic mood changes

Reckless behavior

136
Q

Risk factors-more likely to consider

previous
use of
what disorder
access
hx
what illness

cues- suicide

A

Previous attempts

Substance use

Mood disorder

Access to lethal means

Hx of abuse

Chronic illness

137
Q

Protective factors-makes it less likely that they commit

effective
strong
m
contact
problem

cues- suicide

A

Effective mental healthcare

Strong connections to family

Marriage

Contact w providers

Problem solving skills

138
Q

Difference between overt and covert

A

Overt is like I cant take it anymore

Covert is like everything will be fine soon

139
Q

Preventing suicide

implement
promote
report
reduce
provide

A

Implement research designed to prevent suicide

promote wellness

Report high risk of suicide

Reduce access to lethal means

Provide care

140
Q

nursing repsosbilities for 1-1 observation

how often per day
how often chart
ensure meal has no
when sleeping
observe for

A

24 hrs a day-dont let them out of sight

chart every 15 minutes

ensure meal has no glass/metal

when sleeping hands needs to be in veiw

observe for pt to swallow all meds

141
Q

1 thing you always need to do and always need to assess for

A

RISK for suicide assessment

142
Q

environmental guidelines for suicidal behavior

use what/ count
use what in shower
electrical cord length
do what to rooms
search visitors for what
search pt when

A

use plastic utensils /count them

breakaway shower rods and nozzles

electrical cord minimal length

lock all other rooms

143
Q

why search pt if they are allowed to leave

why search visitors

A

search for harmful objects if allowed to leave

visitors can accidenelty bring in a gift or have items that may harm pt- like nail file, vase, shoelaces

3-Third semester (19 decks)

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