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NUR 356: Mental Health > Exam 3 Study Guide: Q (part 1) > Flashcards

Exam 3 Study Guide: Q (part 1) Flashcards

1
Q

negative symptoms of schizophrenia

A

o anergia
o anhedonia
o aphasia
o ataxia

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2
Q

loss of energy

A

anergia

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3
Q

inability to experience pleasure

A

anhedonia

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4
Q

loss of speech

A

aphasia

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5
Q

loss of fully bodily movements

A

ataxia

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6
Q

o cannot be explained medically and are associated with psychosocial distress
o the individual persistently focuses on the seriousness of the physical symptoms

A

somatic symptoms disorder

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7
Q

S/S of somatic symptom disorder

A

o heightened emotionally
o anxiety
o strong dependency needs
o a preoccupation with symptoms and oneself
o substance abuse issues are common
o an inability to cope (self perception)

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8
Q

nursing interventions for somatic symptom d/o

A

planning and implementation
o relief of discomfort from the physical symptoms
o assistance to determine strategies for coping w/stress other than preoccupation with physical symptoms
o helping client cope with stress

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9
Q

treatments for somatic symptom disorder

A

o individual psychotherapy
o group psychotherapy
o cognitive behavior therapy (CBT) and psychoeducation
o psychopharmacology

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10
Q

what are some interventions for patients with OCD

A

do not stop compulsions unless it is life threatening-compulsions are a way for them to cope with their anxiety

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11
Q

the client has a perceived/believed defect; they will seek to alter this defect through means such as plastics procedures -

most common complaints involve perceived defects in skin, such as wrinkles or scars; the shape or size of the nose; or hair

A

body dysmorphic disorder

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12
Q

what do patients with body dysmorphic disorder seek to remove

A

o wants to cure the imagined defect

o if true defect is present, the person’s concern is unrealistically exaggerated and grossly excessive.
o they will seek to alter this defect through means such as multiple procedures

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13
Q

lacks interest or concern (about their symptom that seem very serious to others)

A

La Belle Indifference

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14
Q

diagnositc critieria for Dissociative Identity Disorder (DID - formerly multiple personality disorder)

A

o existence of two or more personalities in a single individual

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15
Q

S/S of body dysmorphic disorder

A

preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others

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16
Q

“faking symptoms” (an act - not psychological condition)
o people might do it to avoid military service or jury duty
o do it for personal gain or to escape personal responsibility

A

malingering

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17
Q

“faking symptoms”
o conscious, intentional feigning of physical and/or psychological symptoms
o formerly known as Munchausen Syndrome

o mental health condition with no clear cause

A

facticious disorder

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18
Q

side effect so Bupropion

A

the only psychotropic medication that does not have some sexual side effect

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19
Q

what determines the length of time a psychiatric facility can hold a patient

A

determined by state law

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20
Q

what are positive symptoms of schizophrenia

A

o anything created or amplified by schizophrenia

disturbances in thought content, though process manifested in speech, or disturbances in perception

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21
Q

what are negative symptoms of schizophrenia

A

anything taken away or reduced by schizophrenia

disturbances in affect, lack of interest/skills in interpersonal interaction, lack of abstract thinking, waxy flexibility, regression, pacing/rocking, and abnormal eye movements

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22
Q

what are the side effects of SSRIs

A

WOF: increased risk of suicide

o feeling agitated, shaky or anxious
o feeling or being sick
o indigestion
o diarrhea or constipation
o loss of appetite and weight loss
o dizziness
o blurred vision
o dry mouth

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23
Q

what type of therapies will help a client with anxiety

A

o individual psychotherapy
o cognitive behavior therapy
o behavior therapy
o other nonpharmacological treatments (deep breathing exercises, progressive muscle relaxation, guided imagery, mindfulness meditation, and exercise)
o pharmacotherapy (anxiolytics, antidepressants, antihypertensive agents)

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24
Q

what are common coping behaviors of a person with acute anxiety (short term)

A

o socially withdrawn

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25
Q

what are some interventions for a client experiencing a severe panic attack

A

o offer reassurance of safety
o remain calm
o use simple explanations
o administer tranquilizers/medications as ordered

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26
Q

S/S of social anxiety disorder

A

o excessive fear of situations in which a person might do something embarrassing or be evaluated negatively

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27
Q

S/S of general anxiety disorder

A

o chronic
o fatigue
o insomnia
o irritability
o excessive anxiety and worry

o for at least 6 months

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28
Q

S/S of illness anxiety disorder (hypochondriasis)

A

o unrealistic or inaccurate interpretation of physical symptoms or sensations

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29
Q

what is hypertensive crisis

A

o severe increase in blood pressure that can lead to a stroke

o extremely high blood pressure - greater than 180/120
o caused when patients taking MAOI - antidepressant consume foods high in tyramine

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30
Q

most serious form of thiamine deficiency in alcoholic patients

A

wernicke’s encephalopathy

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31
Q

syndrome of confusion, loss of recent memory, and confabulation in alcoholic patients

A

korsakoff’s psychosis

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32
Q

a disease in which the body doesn’t have enough vitamin B-1 (thiamine)

A

beriberi

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33
Q

what is the purpose of the COWS scale

A

opioid withdrawal symptoms

34
Q

what is the purpose of the CIWA scale

A

alcohol withdrawal symptoms

35
Q

o high risk condition for those who regularly drink large quantities of alcohol

o reduced level of platelets in the bloodstream

A

thrombocytopenia

36
Q

unhealthy coping mechanisms

o disruption of individual integrity or persistent disequilibrium

A

maladaption

37
Q

how does genetics play a role in a client’s vulnerability to alcoholism

A

o genetics account for 40-60% of person’s vulnerability to alcoholism
o children of alcoholics are 4x more likely to become an alcoholic

38
Q

occurs within 4 - 12 hours of cessation of or reduction in heavy and prolonged alcohol use

A

alcohol withdrawal

39
Q

phase 1 of alcohol withdrawal

A

8 hours;
o anxiety
o insomnia
o nausea
o abdominal pain

40
Q

phase 2 of alcohol withdrawal

A

1 - 3 days
o hypertension
o pyrexia

41
Q

phase 3 of alcohol withdrawal

A

1 week
o hallucination
o fever
o seizure
o agitation

42
Q

on exam:

A

if person starts wandering/goes to a new place and forgets things - dissociative fugue

43
Q

what is dissociative fugue

A

specific subtype of dissociative amnesia

o wandering to places and forgetting autobiographical information
o inability to recall some or all of one’s past
o may be caused by underlying severe psychosocial distress

44
Q

what is conversion d/o

A

a loss of or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism

o it is difficult to diagnose and is unconsciously triggered

45
Q

groups at risk for conversion disorder

A

o lower socioeconomic groups
o rural populations
o less education
o military personnel exposed to combat situations

46
Q

examples of conversion disorder

A

o paralysis
o aphonia
o seizures
o difficulty swallowing
o urinary retention
o blindness
o deafness
o false pregnancy

47
Q

what are the effect of prolonged exposure to stress in the body

A

o leads to decreased immune response and resistance to disease
o psychological stress can affect medical conditions
o exhaustion stage of selye’s general adaptation syndrome

48
Q

what is maladaptive response to stress

A

o when behavior disrupts the integrity of the individual
o maladaptive coping generally increases stress and anxiety, with examples including self-harm, binge eating, and substance abuse

49
Q

what difference is noted in a patient diagnosed with panic disorder compared to someone with GAD?

A

depersonalization - derealization

symptoms:
o anxiety

50
Q

what is the criteria to diagnose someone with a panic attack?

A

at least four of the following symptoms must be present to identify the presence of a panic attack

o palpitations, pounding heart, or accelerated heart rate
o sweating
o trembling or shaking
o sensations of SOB or smothering
o feelings of choking
o chest pain or discomfort
o nausea or abdominal distress
o feeling dizzy, unsteady, lightheaded or faint
o chills or heat sensations
o paresthesias (numbness or tingling sensations)
o derealization (feelings of being detached from oneself)
o fear of losing control or going crazy
o fear of dying

51
Q

what is phobia

A

an irrational fear of specific object or situation resulting in an intense aversion toward the feared stimulus

52
Q

what are indications of risperidone

A

o positive and negative symptoms of schizophrenia
o relief of psychotic manifestations in other disorders such as bipolar

53
Q

what is assessed on an MSE

A

o observations
o mood
o cognition
o perception
o thoughts
o insight
o behavior
o judgement

vital sign monitoring is not included in the actual MSE; it is a separate intervention

54
Q

what manifestation is unique to patients who are bipolar and abusing substances

A

on top of the other manifestations, patient will most likely be malnourished and not maintaining ADLs properly

55
Q

S/S of acute stress disorder

A

o exposure to traumatic events causes anxiety, detachment, and other manifestations about the event

at least 3 days but no longer than 1 month

56
Q

how to manage patients going through benzodiazepine overdose/toxicity

A

o priority nursing intervention: assess level of consciousness since benzo are CNS depressants

o check they are alert and oriented

57
Q

what are important points of eye movement desensitization and reprocessing therapy

A

○ Form of therapy which allows experiences that are causing problems to be “digested” and stored appropriately by the brain.

○ While concentrating on a particular emotion or physical sensation surrounding the traumatic event, the patient is asked to focus his or her eye movements on the therapist’s fingers as the therapist moves them from left to right and back again.

58
Q

what is AIMS used for

A

side effects of antipsychotics
(abnormal involuntary movements)

59
Q

for patients in the psychiatric unit, which symptoms or indicators need the providers immediate attention after medication

A

o extrapyramidal symptoms
o agranulocytosis (clozaril therapy)
o neuroleptic malignant syndrome
o hormonal changes

60
Q

what is given to prevent or eliminate antipsychotic side effects

A

o anticholinergics (benztropine or benadryl)

61
Q

which types of clients would benefit from group therapy

A

o somatic symptom disorder
o dissociative identity disorder
o schizophrenia
o agoraphobia

62
Q

o fear of the marketplace
o fear of being in open public places, but more specifically, is defined as the fear of being vulnerable and unable to get help or escape the setting

A

agoraphobia

63
Q

treatments of agoraphobia

A

o do not benefit from ECT
o thought stopping (process of suppressing, or pushing away unwanted thoughts - cognitive behavioral)
o flooding (vivo exposure therapy)

64
Q

medications used for alcoholics

A

o disulfram (antabuse)
- - can produce a good deal of discomfort for the individuals

symptoms:
o flushed skin
o throbbing in the head and neck
o respiratory difficulty
o dizziness
o nausea and vomiting
o confusion
o hypotension
o tachycardia

65
Q

what is used to prevent/treat wernicke’s encephalopathy

A

thiamine
vitamin B1

66
Q

which drug does not have sexual side effects

A

bupropion/buspar

67
Q

What are important points with the first 2 phases of schizophrenia?

A

o Phase I-Premorbid Phase

§ Personality and behavior indicators:

· Shy and withdrawn

· Poor peer relationships

· Poor school performance

· Antisocial behavior

§ Current research is focused on the premorbid phase to identify potential biomarkers and at-risk individuals in an effort to prevent transition to illness or provide early intervention.

o Phase II-Prodromal Phase

Person starts showing significant deterioration in function

50 percent have depressive symptoms

Social withdrawal

Cognitive impairment

Obsessive-compulsive behavior

Recognition of the behaviors associated with the prodromal phase provides an opportunity for early intervention with a possibility for improvement in long-term outcomes

This phase can be brief, but most studies indicate that the average length of the prodromal phase is between 2 and 5 years

68
Q

What are important points with the last 2 phases of schizophrenia?

A

o Phase III-Active Psychotic Phase

Psychotic symptoms are typically prominent- hospitalization required

Delusions

Hallucinations

Disorganized speech and behavior

Decreased level of functioning in work, personal relationships, or self-care

o Phase IV-Residual Phase

Active psychotic phase symptoms are either absent or no longer prominent.

Positive symptoms may remain.

Flat affect and impairment in role functioning are common.

Current research indicates that negative symptoms can improve over time; residual impairment often increases with additional episodes of active psychosis

69
Q

what disorder has physical symptoms that suggest medical disease but which have no organic pathology

A

somatic disorder

70
Q

the phase in schizophrenia where patient manifests active positive symptoms

A

phase 3
active phase

71
Q

a client comes in with signs of alcoholism and substance abuse.
as a nurse, you know that genetics accounts for ____% of the client’s vulnerability to alcoholism

A

40-60%

72
Q

this occurs when an individual’s physical or behavioral response to any change in his or her internal or external environment results in disruption of individual integrity or in persistent disequilibrium

A

maladaptation/maladaptive coping skills

73
Q

what type of delusion is this:
“the government is watching everything i do”

A

persecutory delusion

74
Q

what are those that reflect a decrease in normal functions
(functions that have been “taken away”) by the illness?
is it the positive or negative symptom of schizophrenia

A

negative

75
Q

what is fear cued by a specific object or situation in which exposure to the stimulus produces an immediate or intense anxiety response

A

phobia

76
Q

the nurse is educating the parents of a child diagnosed with schizophrenia on how to reply when their child experiences auditory hallucinations.
which is the nurse’s best reply

A

ask what the voices are saying

77
Q

“i havent left my house for six years”
this client is demonstrating a hallmark trait of those that are afraid of other environments and situations that might cause panic or helplessness.
what is this type of disorder?

A

agoraphobia

o experiences fear of being in places or situations from which escape might be difficult or in which help might not be available if panic symptoms should occur

78
Q

this medication will make the client ill with any alcohol exposure to the body orally or otherwise, this medication has many side effects, clients may need to take this medication for months or more

A

disulfram
antabuse

79
Q

clients who have ___________ constantly worry and presents with too much anxiety about the presence of a serious illness even though medical tests do not support this concern

A

illness anxiety disorder

80
Q

warren’s college roommate actively resists going out with friends whenever they invite him.
he says he cant stand to be around other people and confides to warren “they wouldnt like me anyway”
which disorder is warren’s roommate likely suffering from

A

social anxiety

o excessive fear of social situations related to fear that one might do something embarrassing or be evaluated negatively by others

81
Q

positive or negative symptom

hallucinations and paranoia

A

both positive

NUR 356: Mental Health (6 decks)

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