Final Flashcards
Mental status exam tests what 6
appearance, mood, behavior, speech, judgement, cognition
Mini MSE tests 5
orientation, registration, attention, recall, language
Mini cog assessment
3 words to remember
draw clock
repeat three words
When is it depression 4
rapid mental decline, difficulty concentrating, language and motor slow but working, notices or worries about memory problems.
One thing to remember about depression and NCD
CD can be exacerbated by depression. Want to treat this early
What happens in the pre-interaction phase
obtain information and evaluate owns feelings
What happens in the orientation phase?
establish trust, contract for intervention, assess, nursing diagnosis, goals, plan, feelings
what happens in the working phase
promote growth, overcome resistance behaviors, evaluate progress
Two things that come up during the working phase and define them
transference and countertransference
t- patient to you- you look like me dad so…
ct- you to patient I remember when my partner was….
What happens during the termination phase
wrapping it up progress has been made, plan of action established, feelings adressed
Reflection
Refer feelings back to patient to empower the patient to problem solve
Rephrase “I hate my parents” ⇒ “so it sounds like you had a dif time comm w/ your parents?”
all or nothing thinking
I am either a success or a failure
Overgeneralization
This happened one time so it happens all of the time
mental filter or disqualifying the positive
Only seeing the bad
magnification or minimization
Accomplishments are minimized or small events are magnified
Emotional reasoning
concluding that something is real because of an emotional response
personalization
You blame yourself for something you weren’t entirely responsible for, or you blame other people and overlook ways that your own attitudes and behavior might contribute to a problem.
Milieu management 7
health of each individual is realized and encouraged to grow
every interaction = opportunity for therapeutic intervention
each individual owns his/her own environment
each individual owns his/her own behavior
peer pressure = useful/powerful tool
inappropriate behaviors dealt w/ as they occur
restrictions/punishments avoided
Alcohol w/d time frame
4-12 hours after last drink
Anorexia physical signs 6
Hypothermia, bradycardia, hypotension, edema, lanugo, metabolic changes
Delirium Tremens on set plus 4 s/s
Onset 2-3 days after last drink Significant difficulty with attention Disorganized thinking Perceptual disturbances Audio, visual, and/or tactile hallucinations Significant restlessness
Opioid withdrawal s/s 5 and one med
tachycardia, muscle aches, pupillary dilation, abdominal cramping, fever,Loperamide - D
Nicotine and caffine wd s/s
headache and dysphoria (caffeine) or anxiety, irritability, restlessness, decreased heart rate (nicotine)
Signs of Wernicke-Korsakoff Syndrome
Wernicke’s encephalopathy - Most serious form of thiamine deficiency
Impaired ability to walk and talk “wet brain”
Korsakoff’s psychosis
Syndrome of confusion, loss of recent memory, and confabulation(making things up to fill the gaps in our life) in alcoholic patients
seen in conjunction with Wernicke’s
treatment for both CNS disorders is thiamine (Vitamin B1) replacement
What is the difference between ODD and CD
both are persistent patterns of anger but conduct disorder violates the basic rights of others and social rules.
Ages for developing ODD
males 8 before puberty
females after first mens and early teens
Reasons for autism 5
Depakote, anoxia, increase maternal age, gestational diabetes, disruptions in serotonin= enlargement of brain
s/s for autism 6
lack of verbal communication or none, immature or idiosyncratic speech, not responsive to sound or hyper reactive, attachment to things, repetitive behaviors, limited sense of self
What are the interventions for autism 7
Routines, prepare for new experiences, use attachment, one on one, warm connective care givers, positive reinforcement for eye contact, learn names of body parts.
What drugs are used for autisum?
SE 5
Antipsychotics- risperidone and aripiprazoe
drowsy, increased ap, weight gain, neuroleptic malignant syndrome and extrapyramidal symptoms,
s/s of neuroleptic malignant syndrome and why
fever, mm rig, autonomic dysfunction from antipsychotics
What medications are used for tourette’s?
Antipsychotics clonidine and guanfacine
two types of tics
palilalia and echolalia
what are the differences between ocd and tourettes
feelings of incompleteness proceed it no anxiety, repeat behaviors from hyper awareness of sensory and physical awareness.
Emotional abuse
A pattern of behavior on part of whomever that results in serious impairment of persons functioning
Emotional Abuse
vs
Neglect
Inappropriate statements, belittling, rejections
omission of warmth
Predisposing factors of Intellectual development disorder 4
genetics-tays or chromosomal, disruptions in development, illness, environmental exposure.
Adaptive functioning
The persons ability to the requirements of daily living and expectations of their age and culture
interventions for intellectual development
no stereotype, pos and neg reinforcement, identify ability, consistant care givers, habit training
Delirium onset
hours to days
s/s of delirium 9
Acute onset, inattention, disorganized thinking, altered level of conscious, impairment of recent memory, hallucinations, agitation, sleep wake issues, emotional instability
what are the interventions for delirium? 4
confusion assessment method- assess daily better or worse?
orientation to familiar objects, sleep wake cycle, mobility, assistive devices
Def of major or minor nerucog disorder
changes in cognition or memory from previous level of function
major difference between major and minor neurocog d
Help with ADLs
Biggest difference between delirium and neurocog disorder
memory- neuro cog major minor and attention for delirium
s/s of major min neurocog 5
impairment in abstract thinking, judgement. reasoning, rules disregarded, appearance neglected, language may or may not be impaired, personality change.
late s/s of major/min neurocog 6
aphasia, apraxia, dysphagia, irritable mood, cant care for needs, wandering, incontinence
Alzhimers facts 4
common, onset is slow and insidious, deficiency in ace-concentration and memory, memory and judgement before motor,.
what causes alzheimers 6
plaques of beta amyloid fragments and tau protein, head trauma, genetic factors, downs, gen health, age
vascular NCD facts 5
vascular stuff, faster onset than alz, variable course-progession and then stable early motor and cognitive problems
lewy body disease 4
50 and older, 3rd most common ND, lewy body prot part enter brain and impact function of brain cells. it affects movement like parks and memory like alzheimers
