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D-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
Intellecualzation events
- events are analyzed based on cold hard facts instead of using emotions
26
Projection unconscious
- unconscious rejection of emotionally unacceptable features and attributing them to others-
27
Rationalization justifying
- justifying unreasonable acts by developing explanations that satify the teller
28
Reaction formation- defense
defense mechanism that involves behaving in a way that is the opposite of how someone actually feels
29
Regression reverting
- reverting to an earlier and more primitive childlike pattern
30
Repression unconscious
- unconscious exclusion of unpleasant expeiernces from conscious awareness
31
Splitting inability
- inability to integrate positive or negative qualities into image
32
sublimation unconscious
- unconscious process of transforming negative impulses into less damaging and productive impulses like getting angry and going for a run
33
undoing person
- person makes up for regrettable acts
34
Suppresion delay
- delay addressing a disturbing emotion or feeling
35
Panic Disorders- sudden associated w have what for reality feels like what
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
36
Separation anxiety develop what age in children
- develop inapprorate level of concern when away from significant other occurs 8 months -2 yrs
37
Social Anxiety disorder-
sever anxiety or fear provoked by exposure to a social or performance situation
38
Generalized anxiety disorder- excessive huge might also what's common
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
39
Generalized anxiety disorder- short term goal
to state immediate distress and relieve immediate distress
40
Generalized anxiety disorder medium trem goal
pt will identify precipitants of anciety by specific date
41
Generalized anxiety disorder long term is
pt will identify strengths and coping skills
42
Agoraphobia – excessive fear of
excessive anxiety about being in a place where escape isn’t possible or help might not be available - fear of open spaces
43
OCD when they severe does what
- when obsessive behaviors continue on a daily basis- they interfere with daily routine severe takes over the persons entire life
44
Body Dysmorphic Disorder- have will false
have a preoccupation with body parts that they belveie to be ineffective will check very often false assumptions about the importance of their appearance
45
Hoarding Disorder
-when trying to get rid of things becomes extremely distressing and hard to get rid of things
46
Trichotillomania –
hair pulling disorder
47
Excoriation disorder
– skin picking disorder
48
Substance-induced anxiety disorder- develop when
obsessions and compulsions that develop with use if substance within a month of stopping the subtance
49
phobias examples
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
50
Cognitive Therapy-
combines cognitive therapy with behavioral therapies, to reduce anxiety response
51
Modeling- therapy someone
someone acts as a role model to demonstrate appropriate behavior
52
Systemic desensitization pt
- pt is gradually introduced to a. Feared object or experience through a series of steps
53
Flooding exposes
exposes the pt to large amounts of undesirable stimulus
54
Thought stopping- negative
negative thought or obsession is uninterrupted by staying stop out loud
55
Response prevention- used for doesn't allow
used for compulsive behaviors- doesn’t allow pt to do obsessive behaviors like keep washing hands over and over again
56
Relaxation Techniques
yoga guided imagery therapy walking breathing excercises
57
cognitive reframing reassessing
reassessing situation by replacing beliefs with a more positive outlook
58
Posttraumatic Stress Disorder (PTSD) f avoidance numbing difficulty
Flashbacks Avoidance of stimuli Numbing of responsiveness Difficulty in interpersonal relationships
59
PTSD what is hardest thing can lead to watch for
Trust is hardest thing w thest pts. Can lead to abuse of spouses or of chemicals Watch for safety for self /others/thelselves
60
OCD obsessions compulsions interferes with
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
Common obsessions and compulsions losing h unwanted p v c s
Losing control and religious concerns Harm Unwanted sexual thoughts Perfectionism Violence Contamination superstitions
62
Non-Suicidal Self Injury attempts
Deliberate/direct attempts to cause bodily harm that does not result in death
63
non suicidal self injury examples
cutting burning scraping skin biting hittinh skin picking interfering with wound healing
64
non suiocidal self injury prevalence gender biolodigcal factors societal factors
Prevalence- 2 million cases annualy Gender – females Biological Factors-brain disoerders Societal Factors-isolation from others and negative self worth
65
nursing interventions for non suicidal self injuries assess x2 care for establish teaching what watch for
assess how it happened/suicide risk care for wounds establish therapeutic communication teaching coping skills watch for ability to have devices of harm
66
Pt teaching meds do not avoid take no how long
Do not drive or operate heavy machinery. Avoid alcohol or sedating medications. take w food no caffeine takes 2-4 weeks
67
Medications used for anti-anxiety-
Benzodiazepines Antidepressants Tricyclics MAOIs Anticonvulsants Antihistamines Beta Blockers
68
Major Depression Disorder leading interferes w may have not a
leading cause of diasiblity Interferes with social, occupational, causes disability May have delusions and hallucinations Not a result of aging
69
Depression risk factors what gender what childhood what eveents who has it what conditions what use
female adverse childhood stressful events family has it chronic conditions substance use
70
other depressive disorders
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
dominating symptom in children older adults at more risk for what depression
children- irritbility older adults at risk for not being diagnosed
72
appearance assessment Major depressive disorders a slowed what posture what mood looks may look/ unable to
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
Major depressive disorders assessment for feelings g h h-what risk a/I may experience
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
Major depressive disorders assessment physical behavior psychomotor what's neglected changes in __habits changes in __patters loss of what's impaired may have
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
Major depressive disorders assessment communication/speech speaks can become speaks about
Speak slow Can become mute speaks about failure
76
Major depressive disorders Interventions what assessmnet waht techniques promotion on what what management
Risk for Suicide Assessment Counseling and Communication Techniques Promotion of self-care Milieu Management
77
subsuicide behaviors
anything that hurts them like drugs/ alcohol etc
78
guidelines for communication with severely withdrawn person(catatonic/ vegetative state) do what when pt is silent use what words allow listen for avoid
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
Guidelines for counseling people with depression- help pt identify help pt encourage encourage provide
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
SSRI-fluoxetine/ sertraline se a I h / dysfunction hypo
agitation insomnia headache n/v sexual dysfunction hyponatramia
81
SNRI- duloxetine se n mouth reduced s vision
nausea dry mouth reduced appetite sweating blurred vision
82
TCA- amitriptyline, doxepin mouth what gi retention what vision bp cardiac s
dry mouth constipation urinary retention blurred vision hypotension cardiac toxicity sedation
83
MAOI- isocarboxazid, phenelzine se I n a c crisis
insomnia nausea agitation confusion hypertensive crisis
84
foods that interrupt with MAOI veg fruit what meat what fish what dairy what supplements s what sauce
veg-avocado fruit-figs smoked meats dried fish dairy- cheese protein supplemetns soup soy sauce
85
SSRI family teaching may cause no what avoid what tests do not
may cause sexual dysfunction no over the counter drugs avoid alcohol liver/renal tests do not drive or operate machinery
86
serotonin syndrome- SSRI-report immediately increase in skin rapid throat difficulty temp what food unusal what behavior severe
increase in depression skin rash/hives rapid heartbeat sore throat difficulty urinating fever anorexia/ wt loss unusual bleeding hyperactive behavior severe headache
87
adverse reactions to moai bp s changes in muscle retention weight
hypotension sedation changes in cardiac rhythm muscle cramps urinary retention wt gain
88
toxic effects of maoi what crisis severe hr /
hypertensive crisis severe headache tachycardia n/v
89
nutrition Interventions for vegetative state offer encourage include weigh
offer small high calorie foods Encourage family to participate Include pt in deciding meals Weigh pt daily
90
provide encourage encourage provide Sleep Interventions for vegetative state
Provide periods of rest Encourage pt to dress and stay out of bed Encourage relaxation measures Provide decaff coffee and soda
91
Self care deficits encourage when Interventions for vegetative state
Encourage use of toothbrush, washcloth/ adl supplies When appropriate, give step by step reminders
92
monitor offer encourage evaluate Elimination Interventions for vegetative state
Monitor I /0 Offer high fiber foods Encourage intake of fluids Evaluate need for laxatives
93
assess for what in trouble sleeping (what use/ daytime/ normal) always assess for what depression assessment
assess for caffeine use / daytime naps and normal sleep patters always assess for a suicide risk
94
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
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
pt after electrocionsvuslive therapy pt may be what for a few weeks will need
Patient maybe confused afterwards, memory deficits may last a couple weeks Will need someone to drive home
96
internal stimulating therapy's v stimulation d stimulation
Vagus Nerve stimulation Deep Brain stimulation
97
External stimulating therapy r L e E
Repetitive Transcranial magnetic stimulation Light therapy Exercise ECT
98
Bipolar I 1// alternating may be
1 episode of mania alternating with major depression May be psychotic with mania
99
epidemiology bipolar men more likely to
More likely to have legal problems and commit violence
100
women more likely to bipolar
More likely to abuse alcohol, commit suicide, thyroid disorders
101
comobridities bipolar __attacks __ abuse _phobia what illnesses
Panic attacks Alcohol abuse Social phobia chronic illnesses
102
etiology bipolar biological psychological environmental
Biological Genetic predisposition Psychological Stressful events Environmental Upper, socioeconomic status Higher incidence with higher education
103
bipolar assessment moods m I g plans
Mania- unstable- pts feels euphoric/ overjoyed but then….. Irritable transitions quickly into irritation Grandiose plans-more details then necessary
104
Bipolar assessment behavior what's emergency extravagant what life constant what behavior what self esteem how do they dress
Mania = emergency! Extravagant spending, social life , constant activity Risky behavior Inflated self esteem Dress bizzare
105
Thought Process and speech patterns assessment bipolar pressured speech-> circumstantial speech-> tangental speech loose ___ flight __ __ association
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
Thought Content grandiose delusions- is what Persecutory delusions- is what what function assessment bipolar
Grandiose delusions-belief that one is famous/wealthy Persecutory delusions- belief that someone is attempting to harm them Cognition Function
107
Nursing self-assessment Pts can be pts are also
Pts can be very manipulative pts are also very energy consuming
108
Staff-splitting a I p--p bipolar
Anger Isolation Power-plays
109
bipolar assessment if need for p need for h status knowledge
assess if danger to self/others need for protection from behaviors like spending money assess need for hospitalization medical status family knowledge
110
interventions bipolar set c c what is key
Set limits Collaboration- work as a team Communication Consistency is key for these pts
111
acute phase bipolar what what is priority
injury prevention priority- medical stabilization and safety// I and o, sleep and rest, self control of thoughts, no self harm
112
continuation phase bipolar what what is priority
relapse prevention What is the priority? Educate them and families, med compliance, knowledge of disease, s/s of relapse, support groups
113
maintenance phase bipolar what what is priority
Relapse prevention Lessen severity and duration of future episodes
114
Pt and family teaching bipolar what causes relapse what is critical to stability what is important what is helpful keep what accessible
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
lithium bipolar indications what ideas m a what behavior
flight of ideas manipulation anxiety self injurious behavior
116
early signs of toxicity 1.5-2.0 s/s what uspet hand c intervention-what x2 med
gi upset hand tremor confusion intervention- withheld med and revelate med
117
advanced signs of lithium toxicity 2.0-2.5 s/s vision urine c g interventions- x2
blurred vision large amounts of urine coma giddiness intervention- stop drug potential bowel irrigation
118
severe lithium toxicity >2.5 s/s c o d intervention-above + d
convulsions oliguria-producing no urine death intervention- above+ dialysis
119
takes how long to be effective checked how often then checked how often lithium bipolar maintenance
takes 7-14 days to be effective checked every 2-3 days until levels are reached, then checked every 3-6 months
120
lithium bipolar contraindications
pts with cardiovascular disease, brain damage, renal disease, pregnancy
121
atypical antipshyotocs what effects mood help prevent
Sedative effects Mood stabilizing Help prevent mania relapse
122
Lithium teaching monitor what maintain maintain what electrolyte be screened for
Monitor levels closely Maintain consistent fluid levels Maintain consistent sodium levels Be screened for organ diseases before taking
123
Lithium teaching take w may what give how get off want
Take with meals May gain wt Give referral Taper doses gradually Want adherence to plan
124
communication interventions for mania use what approach use what explanations be what identify expectations how act on what redirect what
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
safe milieu interventions for mania maintain provide what activities provide what periods redirect what store
maintain low level of stimuli provide structured activites provide frequent rest periods redirect aggressive behavior store valuables until rational behavior continues
126
nutrition interventions bipolar montior offer what drinks offer what foods remind pt
montior I/o offer high calorie protein drinks offer finger foods remind pt to eat
127
sleep interventions bipolar encourage keep pt in what area do what at nights
encourage frequent rest periods keep patient in low stimualtion area night- warm baths and soothing music
128
hygiene/elimination bipolar encoaurage step offer what food/drink
encourage approiarte clothes step by step reminders offer fluids/high fiber foods
129
suicide feelings of p h h
pain, hopelessness and helplessness.
130
what Ages waht gender what social support what diagnosis what medical illness what abuse- suicide assessment
Age over 60 or adolescents gender males social support - single or divorced or widowed diagnosiso depression or scizo medical illness0 chronic abuse- substances
131
Evaluation suicide contracts verbalizes f verbalizes desire verbalizes absence demonstates involved
contracts no self harm verbalizes feelings openly verbalizes desire to live verbalizes absence of suicidal ideation demonstrates hope involved in daily life
132
Assess for what in suicide- m t a c
method, timing, availability, chance of rescue.
133
limit what c close e s suicide interventions
limit access to means contract with client close observation emotional support
134
involve who watch continuously suicide assessment
involve family and friends watch for cues Continuously reassess and revise plan as needed
135
warning factors -immediate risk of suicide talks expresses increased dramatic what behavior cues- suicide
Talks about death Expresses no reason of living Increased substance use Withdrawal Dramatic mood changes Reckless behavior
136
Risk factors-more likely to consider previous use of what disorder access hx what illness cues- suicide
Previous attempts Substance use Mood disorder Access to lethal means Hx of abuse Chronic illness
137
Protective factors-makes it less likely that they commit effective strong m contact problem cues- suicide
Effective mental healthcare Strong connections to family Marriage Contact w providers Problem solving skills
138
Difference between overt and covert
Overt is like I cant take it anymore Covert is like everything will be fine soon
139
Preventing suicide implement promote report reduce provide
Implement research designed to prevent suicide promote wellness Report high risk of suicide Reduce access to lethal means Provide care
140
nursing repsosbilities for 1-1 observation how often per day how often chart ensure meal has no when sleeping observe for
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
1 thing you always need to do and always need to assess for
RISK for suicide assessment
142
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
use plastic utensils /count them breakaway shower rods and nozzles electrical cord minimal length lock all other rooms
143
why search pt if they are allowed to leave why search visitors
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

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