Brainscape's Knowledge GenomeTM

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


See full index

Mental Health Nursing > Final Exam > Flashcards

Final Exam Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

What is Dorothea Dix known for?

A
  1. Creation of asylums

2. Moral treatment

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

What is Linda Richards known for?

A
  1. First American psychiatric nurse

2. McLean Hospital; first to train nurses in psych setting

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

Hildegard Peplau’s theory?

A

3 phases: orientation, working, termination

Therapeutic nurse-patient relationship

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

What is Sigmund Freud’s psych theory?

A
  1. All human behavior is caused & explainable
  2. Repressed sexual impulses, desires as motivation for behavior
  3. Id, ego, superego
  4. Behaviors are due to subconscious thoughts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are differences between Id, Ego, and Superego?

A

Id: instinctive, for pleasure, immediate satisfaction, subconscious
Ego: rationality, logicality, reality, conscious
Superego: right & wrong, morality, ideal, sub and conscious

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

Characteristics of Sullivan’s Interpersonal Theories

A
  1. Five life stages
  2. Three develop. cognitive modes:
    - Prototaxic (infancy, childhood)
    - Parataxic (early childhood)
    - Syntaxic (school-aged)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

B.F. Skinner’s Operant Conditioning theory

A
  • All behavior is learned
  • rewards or punishments
  • recurrence of rewarded behavior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clubhouse Treatment Model

A 
4 Rights of Members:
  -place to come to
  -meaningful work
  -meaningful relationships
  -place to return to (lifetime membership) 
Focus on health, not illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Assertive Community Treatment setting (ACT)

(one of the MOST effective!!)

A
  • one of the most effective treatment settings
  • problem-solving orientation
  • direct service instead of referral
  • intense; no time restraints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 “patterns of knowing”

A
  • Empirical (derived from nursing science)
  • Personal (from life experiences)
  • Ethical (from moral nursing knowledge)
  • Aesthetic (from art of nursing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Components of Orientation Phase

A
  • Meeting nurse, client
  • Establishment of roles
  • Discussion of purposes, parameters of future meetings
  • Clarification of expectations
  • Identification of client’s problems
  • Nurse–client confidentiality, duty to warn/self-disclosure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Components of Working Phase

A

•Problem identification: issues or concerns identified by
client; examination of client’s feelings and responses
•Exploitation: examination of feelings and responses;
development of better coping skills, more positive self-
image, behavior change, independence
•Possible transference/counter-transference

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

Components of Termination phase

A

•Begins when client’s problems are resolved
•Ends when relationship is ended
•Deals with feelings of anger or abandonment that may
occur; client may feel termination as impending loss.

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

Nurse-Patient distant zones

A
  • Intimate (0 to 18 inches)
  • Personal (18 to 36 inches)
  • Social (4 to 12 feet)
  • Public (12 to 25 feet)
  • Therapeutic communication: most comfortable when nurse and patient are 3 to 6 feet apart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Catharsis

A
  • To alleviate or increase feelings of anger

- Example: watching a movie knowing that it will make you cry, and you go for the purpose of crying

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

Hwa-Byung Angry Behavior

A
  • Korean; insomnia, depression, somatization in lower abdomen
  • Experienced by middle-aged Korean females
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bouffee delirante

A

-French; short-lived psychosis

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

Amok Anger

A

-Malaysian; rage or vendetta against a person, society, or object

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

Mental illnesses treated with Lithium

A
  • Bipolar
  • Conduct disorders
  • mental retardation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mental illnesses treated with Carbamazepine (anticonvulsant)

A
  • dementia
  • psychosis
  • personality disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mental illnesses treated with atypical antipsychotics (clozapine, risperidone, olanzapine)

A
  • dementia
  • brain injury
  • mental retardation
  • personality disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Interventions for “Triggering” phase of anger

A
  • Approach in nonthreatening, calm manner
  • Convey empathy; listening
  • Encourage verbal expression of feelings
  • Suggest patient go to a quieter area
  • Use PRN medications
  • Suggest physical activity such as walking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Interventions for “Escalation” phase of anger

A
  • Take control; provide directions in firm, calm voice
  • Direct patient to room or quiet area for time-out
  • Offer medication again
  • Let patient know aggression is unacceptable; nurse or staff will help maintain/regain control
  • If ineffective, obtain help from other staff (show of force)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Interventions for “Crisis” phase of anger

A

-Inform patient that behavior is out of control, and staff
is taking control to provide safety and prevent injury

-Use of restraint or seclusion only if necessary

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

Interventions for “Recovery” phase of anger

A
  • Talk about situation or trigger
  • Help patient relax or sleep
  • Explore alternatives to aggressive behavior
  • Provide documentation of any injuries
  • Debrief staff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Interventions for “post-crisis” phase of anger

A

-Remove patient from any restraint or seclusion to
rejoin milieu.
-Calmly discuss behavior (no lecturing or chastising);
allow patient to return to activities, groups, and so
forth.
-Focus on appropriate expression of feelings, resolution
of problems or conflicts in non-aggressive manner

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

Cycles of abuse/violence

A
  1. Violent episode
  2. Honeymoon phase
  3. Tension building
  4. Violent episode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Elements of PTSD

A 
1. Dreams or intrusive, 
recurrent thoughts of the 
trauma
2. Emotional numbing 
(feeling detached from 
others)
3. Hyper-arousal (being on 
guard, irritable)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

PTSD vs. Acute Stress Disorder

A

PTSD: event occurred >3 months

Acute Stress Disorder: event occurred <3 months

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

PTSD Treatment Options

A
  • Psychotherapy (individual or group)
  • Medications (antidepressants, anxiolytics, sleep aids)
  • Self-help groups
  • Exposure therapy
  • Relaxation techniques
  • Adaptive disclosure
  • Cognitive processing therapy
  • Mental health promotion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

General Adaptation Syndrome

A

Physiological changes the body goes through in response to stress

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

Stages of General Adaptation Syndrome

A

-Alarm reaction stage (preparation for defense)
-Resistance stage (blood shunted to areas needed for
defense)
-Exhaustion stage (stores depleted; emotional
components unresolved)

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

Mild Anxiety

A
  • Special attention
  • Increased sensory stimulation
  • Motivational
  • Anxiety is not bad, but rather a warning sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Moderate Anxiety

A
  • Something definitely wrong
  • Nervousness/agitation
  • Difficulty concentrating
  • Able to be redirected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Severe Anxiety

A
  • Trouble thinking and reasoning
  • Tightened muscles
  • Increased vital signs
  • Restless, irritable, angry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Panic anxiety

A
  • Fight, flight, or freeze response
  • Increased vital signs
  • Dilated pupils
  • Cognitive processes focusing on defense
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How to work with patients with anxiety

A
  • Low, calm, soothing voice
  • Safety during panic level
  • Short-term use of anxiolytics (Benzos: Alprazolam, Diazepam, Lorazapam)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Anxiety experiences for different cultures

A

Asian: often with somatic symptoms; koro

Hispanics: Susto (high anxiety as sadness, agitation,
weight loss, weakness, heart rate changes); due to supernatural spirits or bad air from dangerous places and cemeteries invading body

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

Anxiety Treatment options

A
  1. Medications (anxiolytics; antidepressants)
  2. CBT:
    • Positive reframing (turning negative messages into positive ones)
      - Decatastrophizing (making more realistic appraisal of situation)
    • Assertiveness training (learn to negotiate interpersonal situations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Elder Anxiety

A
  • Phobias (generalized anxiety is most common)
  • Usually have other condition (dementia, physical illness)
  • Treatment: SSRIs (fluoxetine, sertraline)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Obsession vs. Compulsion

A
  • Obsessions = recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses
  • Compulsions = ritualistic or repetitive behaviors that a person carries out continuously in an attempt to decrease anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Self-soothing OCD behaviors

A
  • Excoriation (skin picking)
  • Onychophagia (nail biting)
  • Trichotillomania (hair pulling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Reward-seeking OCD behaviors

A
  • Kleptomania (compulsive stealing)
  • Oniomania (compulsive buying)
  • Hoarding (excessive acquisition)
  • Pyromania (fire setting)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Body identity integrity disorder

A

Feeling alienated from a part of the body to the extent of seeking amputation of the identified body part

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

Ages of people with OCD

A
  • common in kids
  • usually occurs between 18-25

*Rare for it to start after age 50; usually a sign of underlying illness

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

OCD Patient/Family teaching

A
  • Teach family to avoid giving advise.
  • Teach family to avoid trying to “fix the problem.”
  • Teach family to be patient with its own discomfort.
  • Teach family to monitor its own anxiety level.
  • Give family permission to “take a break” from the situation, as needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

OCD Pharmacological Treatment

A

-First line: SSRIs (fluvoxamine, sertraline)
-Second line: SNRI (venlafaxine)
Treatment-resistant OCD:
-second-generation antipsychotics: Risperidone,
Quetiapine, Olanzapine

48
Q

OCD Therapeutic Treatment

A

-Cognitive behavioral therapy (CBT): Treatment focuses on examining the relationships between thoughts, feelings, and behaviors.
-Exposure therapy: deliberately confronting situation and stimuli that one usually
tries to avoid.
-Response prevention: delay or avoid performing the rituals. Learn to tolerate the thoughts and anxiety.

49
Q

OCD Nursing Interventions

A
  • Therapeutic communication
  • Relaxation techniques
  • Behavioral techniques
  • Daily routine completion
  • Diary/log
  • Patient, family education
50
Q

When is Schizophrenia typically diagnosed?

A
  • Late adolescence to early adulthood
  • Men: 15-25
  • Women: 25-35
51
Q

Catatonia

A

Abnormal movement; inability to move

-Ex: staying still, not talking

52
Q

What’s the biggest difference between schizophrenia and schizophreniform disorder?

A

Schizophreniform lasts 1-6 months; Schizophrenia is life-long

53
Q

Positive (hard) vs. Negative (soft) symptoms of Schizophrenia

A

Positive (hard)
■ Delusions, hallucinations;
grossly disorganized thinking,
speech, behavior

Negative (soft)
■ Flat affect, lack of volition,
social withdrawal, or discomfort

54
Q

Pharmacological Treatment for Schizophrenia

A

Conventional antipsychotics (Haloperidol)
– Targeting positive symptoms
– No observable effect on negative symptoms

Atypical antipsychotics (Clozapine)
– Diminish positive symptoms
– Lessen negative symptoms

55
Q

Schizophrenia Medications Neurological Side Effects

A

-EPS
-Acute dystonic reactions
-Akathisia
-Parkinsonism
-Tardive dyskinesia
-Seizures
-Neuroleptic malignant
syndrome

56
Q

Schizophrenia Medication Non-neurological Side Effects

A

– Weight gain, sedation, photosensitivity
– Anticholinergic symptoms (dry mouth, blurred vision,
constipation, urinary retention)
– Orthostatic hypotension
– Agranulocytosis (clozapine)

57
Q

Schizophrenia Psychosocial therapy

A

Individual, group therapies: Supportive, medication management, use of community supports

Social skills training: Cognitive adaptation training, Cognitive enhancement therapy (CET)

Family therapy/education

58
Q

Cluster A personality disorders (odd, eccentric)

A
  • Paranoid (more common in males)
  • Schizoid (more common in males)
  • Schizotypal (slightly more common in males)
59
Q

Cluster B Personality Disorders (dramatic/erratic)

A
  • Antisocial (more common in males)
  • Borderline (more common in females)
  • Histrionic (more common in females
  • Narcissistic (more common in males)
60
Q

Cluster C Personality Disorders (anxious/fearful)

A
  • Avoidant (more common in males)
  • Dependent (more common in females)
  • Obsessive-Compulsive (more common in males)
61
Q

Paranoid Personality Disorder

A
  • Mistrusting and suspicious; Unable to express empathy -Labile mood, angry, hostile
  • See malevolence in others where there is none
  • Use projection, have conflict with authority, paranoia
  • Have problems forming relationships, take everything seriously, very sensitive to how others respond
  • Nurse Intervention: allow to help develop care plan
  • Symptoms: aloof, withdrawn, self protective, hypervigilant
62
Q

Schizoid Personality Disorder

A
  • Detached from social relationship
  • Display little emotion, aloof, indifferent.
  • No leisure or pleasurable activities.
  • Passive/disinterested. Patient not distressed, family is. Have fantasy relationships
  • Intelligent but indecisive, lack goals/direction
  • Loners, lack social skills

-Nurse Intervention: improve community functioning, find suitable housing with little social interaction; Case management important.

63
Q

Schizotypal Personality Disorder

A

-Pervasive pattern of social and interpersonal deficits
- Little capacity for close relationships, cognitive/perceptual
distortions, behavioral eccentricities.
-Psychotic episodes when stressed.
-Odd appearance, unkempt, disheveled.
Coherent speech but loose, vague associations; Uses words incorrectly.
-Has restricted emotions. Flat affect or silly and inappropriate.
-Has cognitive distortions; Ideas of
reference (events have special meaning for them).
- Social and close relationships are difficult.

-Nurse Intervention: help develop self-care and social skills, community functioning, daily routine for ADLs, helpthem get involved in the community to decrease discomfort. Use role-play. Find ways around face-to-face interactions

64
Q

Antisocial Personality Disorder

A

-Disregard rights of others.
-Enuresis, sleep walking, acts of cruelty in childhood. Childhood – lying, truancy, sexually promiscuous, cigarette
smoking, substance abuse, illegal activities, erratic, neglectful, harsh or abusive parenting.
-Have a normal appearance, charming. Have false emotions, no empathy, no remorse.
-Narrow, distorted thoughts (view world as cold, hostile)
-Use rationalization.
-Have average to above average IQ. Poor judgment, lack morals/ethics when making decisions

-Nursing Intervention: sign behavioral contract; positive-reinforcement

65
Q

Borderline Personality Disorder

A
  • Pervasive pattern of unstable relationships, marked impulsivity.
  • Most common PD in clinical setting.
  • Suicide, self mutilation common.
  • Very hard to work with
  • dependent/then angry; Act out, manipulate; Reject all offers of help. Labile, unpredictable
  • 50% have childhood abuse

-Nursing Interventions: Focus on safety; no self-harm contract; use distraction & journaling; decatastrophizing

66
Q

Histrionic Personality Disorder

A

-Excessive emotion/attention seeking
-Colorful speech, normal appearance, overdress for situation.
-May be flirtatious, Self absorbed
-Agree with others to get attention; Have to be center of
attention.

-Nursing Intervention: give feedback about dress, behaviors; help with social skills; Use modeling, role play; help identify strengths

67
Q

Narcissistic Personality Disorder

A

-Grandiosity, need admiration
-Arrogant, haughty, lack empathy; Belittle, disparage
others.
-Thought processing is intact but no insight.
-Fragile self-esteem; hypersensitive to criticism.
-Sense of entitlement, expect special treatment; exploit relationships.
-Ambitious, confident – problem working
with others.

-Nursing Interventions: very challenging! Be self aware of
your response. Get their cooperation. Individual psychotherapy is best approach.

68
Q

Avoidant Personality Disorder

A
  • Social discomfort and low self esteem; hypersensitive to negative evaluation.
  • Overly inhibited as children, avoid unfamiliar situations
  • Anxious, fidget, poor eye contact, shy, fearful, socially awkward.
  • Believe inferior, afraid to make mistakes
  • desires social acceptance but fears rejection.

-Intervention: Identify positive traits, self affirmation, positive self talk. Reframing, decatastrophizing. Practice, role play

69
Q

Dependent Personality Disorder

A
  • Need to be cared for
  • Submissive, clingy; Fearful of separation.
  • More common in the youngest child.
  • Seek tx due to anxiety, depression, somatic s/s.
  • Very pessimistic, self-critical. Unrealistic fears of being left alone. Lack decision making, confidence.
  • Will do almost anything to maintain a relationship.
  • Seek another relationship when one ends.

-Intervention: help expect grief over loss of
relationship; Help identify strengths, cognitive restructioning; help with simple things (groceries, pay bills). Support, positive feedback

70
Q

Obsessive-Compulsive Personality Disorder

A
  • Preoccupied with perfectionism, mental/personal control, orderliness at expense of flexibility, openness, efficiency.
  • Very formal, serious, no pleasure in life.
  • Constricted emotions and affect
  • Preoccupied with rules, order, lists, schedules.
  • Check/recheck details.
  • Won’t listen to others; problems making decisions.
  • Have low self esteem, harsh, critical, judgmental of
    themselves. Praise/reassurance do not change belief could have done better.
  • Few friends, no social life; Problems working with others.

-Intervention: help them complete projects, be on-time. Work on cognitive restructuring; Encourage to take risks.

71
Q

Bipolar Mania

A

-Distinct period
-Mood is abnormally and persistently elevated, may be grandiose
-Decreased sleep, pressured speech, flight of ideas,
risk taking, excessive pleasure seeking, maybe
delusions.
-1st episode in teens, 20’s, 30’s

72
Q

Major Depressive Disorder

A
  • At least 2 weeks of sadness or anhedonia with at least four other symptoms: hypersomnia or insomnia, feels fatigued, changes in weight, sleep, energy, concentration, self esteem, goals, decision making.
  • May last, weeks, months or years if untreated.
  • Twice as common in women.
  • High incidence in single or divorced people.
73
Q

Major Depressive Disorder Treatment

A

-MAOIs: (Phenelzine) (can be fatal)
-Cyclic antidepressants (Amitriptyline) (can be fatal)
-SSRIs (Fluoxetine, Sertraline) (take 4-6 weeks to work)
-ECT (used when drug therapy fails)
-Psychotherapy is said to be best in combination with
medication

74
Q

Clinical Course of an Alcoholic

A
  • Gets intoxicated for the first time as an adolescent
  • May sip as early as 8 years old
  • Pattern develops in mid 20’s to mid 30’s
  • Blackout
  • Tolerance
  • Tolerance break
  • Abstinence is temporary followed by escalation of alcohol use and crisis; it is a cycle
  • *Babies may be affected prenatally, fetal alcohol syndrome
    • Families are affected sometimes for generations
75
Q

Alcohol Intoxication

A
  • Initial response: relaxation, loss of inhibitions
  • Then: slurred speech, unsteady gait, lack of coordination and judgement; may blackout

•OD may lead to vomiting, unconsciousness, respiratory
distress, aspiration pneumonia, cardiovascular shock and death

76
Q

Alcohol Withdrawal

A
  • Withdrawal 4-12 hours after cessation of drinking
  • Symptoms: coarse hand tremors, sweating, elevated pulse and BP, insomnia, anxiety, N&V.
  • Severe: hallucinations, seizures, DT’s
  • Generally peaks on day 2 and lasts about 5 days-2 weeks
  • Safe withdrawal: use benzos to suppress side effects; use CIWA
77
Q

Benzos (alprazolam, diazepam) & Barbiturates (-barbital)

A
  • Intoxication and withdrawal like alcohol
  • When used as prescribed, cause drowsiness and reduce anxiety
  • Benzos in OD rarely fatal; become confused and lethargic.
  • Treatment: gastric lavage, ingestion of activated charcoal, dialysis for severe symptoms.
  • Barbiturates can be lethal with an OD. Can cause coma, respiratory arrest, cardiac failure, death.
  • Treated in ICU using lavage or dialysis
78
Q

Stimulants (amphetamines; cocaine) Intoxication & Withdrawal

A

Intoxication and overdose
•High or euphoric feeling, hyperactivity, hypervigilance, anger, elevated BP, chest
•Pain, confusion, seizures, coma with overdose

Withdrawal
•Onset within hours to several days
•Primary symptom: marked dysphoria
•“crashing”
•Not treated pharmacologically
79
Q

Opioid Intoxication & Withdrawal

A

Intoxication and overdose
•* procurement ( lots of time and money spent, medical
professionals, divert meds or write their own RX’s.)
•Psychomotor retardation
•Constricted pupils
•Slurred speech, drowsiness
•Naloxone given for overdose

Withdrawal and detoxification
•Initial symptoms: anxiety, restlessness, aching back and
legs, cravings for more opioids
•Later symptoms: N&V, dysphoria, lacrimation, rhinorrhea, sweating, diarrhea, fever, insomnia, significant distress.
-No pharmacological treatment. Drug craving may persist for weeks or months

80
Q

Hallucinogens (mescaline, PCP, ecstasy) Intoxication & withdrawal

A

•Intoxication and Overdose: anxiety, depression, paranoid
ideation, fear of losing one’s mind, potentially dangerous
behavior. Toxic reactions are primarily psychological.

•Withdrawal and detoxification: no withdrawal symptoms.
-craving for the drug, flashbacks may persist for a few months up to 5 years.

81
Q

Which type of diagnosis presents a big challenge to health care professionals?

A 
Dual Diagnosis (mental illness + drug/alcohol addiction)
Ex: Bipolar patient with alcoholism
82
Q

Intermittent Explosive Disorder

A

•Episode of angry, explosive, impulsive, aggressive behavior that lasts less than 30 minutes
•More common in males
•Expressed response is out of proportion to the situation
•!!!!Typically feel embarrassed and remorseful for their behavior!!!!
•May have another psychiatric disorder (ADHD, substance
abuse, anxiety, depression, etc.)

83
Q

Intermittent Explosive Disorder Treatment

A
  • Meds: SSRIs (fluoxetine), mood stabilizers (lithium)
  • CBT, anger management, relaxation techniques, avoidance of substances
  • A combination for the best outcome
84
Q

Oppositional Defiant Disorder (ODD)

A

•Pattern of behavior that is defiant, uncooperative, hostile
toward persons in positions of power, especially parents
•Behaviors are more intense than those seen in unaffected
peers
•Problems with social, academic and work situations.
•More often in males; increased risk of conduct disorder

85
Q

ODD Treatment

A
  • Focus is on parents! Parents report difficulty in managing the aggressive behaviors and balancing interaction with multiple providers/agencies.
  • Child’s behaviors are learned and reinforced in the home so parents are the focus to develop behavioral interventions.
  • Work with parents to identify the most problematic behaviors, target change in those, ignore the other maladaptive responses.
  • Reward positive behaviors with praise and reinforcers, be consistent! Try token economy, individual psychotherapy
  • No meds to treat unless comorbid condition
86
Q

Conduct Disorder

A

•A pattern of behavior that violates societal rules, norms,
rights of others
•Children express aggression toward others, animals, deceit, deception, destruction of others’ property
•!!!!!Do not express remorse or guilt about the behavior!!!!!
•Poorer outcome if diagnosed before age of 10
-Usually males before age 10, both males and females after age 10.

87
Q

Degrees of Impaired Conduct (Conduct Disorders)

A
  • Mild: minor shoplifting, breaking curfew, lying
  • Moderate: increasingly problematic behaviors including vandalism, substance abuse, sexual behaviors, verbal bullying
  • Severe: physical aggression, cruelty to peers and animals, forced sexual acts, parole violation
88
Q

Conduct Disorder: Internalizing Behaviors

A
  • Loner
  • Sulks
  • Won’t talk
  • Shy
  • Secretive
  • Somatic complaints – N/V, fatigue
  • Guilty
  • Crying
  • Feels unworthy and unloved
89
Q

Conduct Disorder: External Behaviors

A
  • Lying
  • Cheating at school
  • Swearing
  • Truancy
  • Vandalism
  • Bragging
  • Setting fire
  • Inappropriate attention-seeking
  • Arguing
  • Angry outbursts
90
Q

Conduct Disorder Interventions

A
  • Safety! Protect others.
  • Behavioral contracting
  • Can use a written contract but all staff must be consistent in applying the contract.
  • Time-out
  • Develop a daily schedule.
  • Journaling
  • Role-modeling
  • Parents must be assisted to develop appropriate social skills, problem solving and appropriate ways of expression and limit-setting
91
Q

Delirium

A

Syndrome involving disturbance of consciousness with change in cognition

92
Q

Delirium Etiology

A

Usually from identifiable physiologic, metabolic, cerebral disturbance or disease or from drug intoxication or withdrawal

93
Q

Delirium Treatment

A
  • Sedation

- Identifying underlying cause

94
Q

Delirium Nursing Interventions

A

-Promoting patient safety
-Managing patient’s confusion: orienting cues; speaking in
low, clear voice; avoiding sensory overload
-Promoting sleep, proper nutrition

95
Q

Dementia

A 
Multiple cognitive deficits; primarily memory plus any of the 
following:
-Aphasia (echolalia, palilalia)
-Apraxia
-Agnosia
-Disturbance in executive function
96
Q

Dementia Stages

A

Mild – forgetful, loses things

Moderate – Confusion, memory loss, complex tasks can be performed; Still recognizes familiar people

Severe – Personality and behavioral changes; Forgets
important people, help with ADLs.

97
Q

Dementia Treatment

A

-Underlying cause
-Usually progressive
-Medications for degenerative dementia: cholinesterase
inhibitors

Symptomatic treatment for behaviors

  • Antidepressants
  • Anti-psychotics
  • Mood stabilizers
98
Q

Korsakoff’s Syndrome

A

Disturbance in memory due to long-term use of alcohol

99
Q

Autism

A
  • 5 times more prevalent in boys​
  • USUALLY identified between 18 months and 3 years​
  • Persistent difficulties in communication and socialization​
  • Restricted interests and patterns of behavior​
  • Little eye contact, few facial expressions​
  • Don’t relate well to parents or peers​
  • Hand flapping, head banging, body twisting​
  • Late developers have speech, then lose it, then develop the other traits
100
Q

Autism Treatment

A
  • Reduce behavioral symptoms, short term inpatient for severe cases​
  • Reduce Symptoms: Haloperidol, Risperidone, Aripiprazole, Clonidine
  • No medicine specifically for Autism
101
Q

Somatization

A

Transference of mental experiences and states into bodily symptoms

102
Q

Somatic Symptom Illness Treatment

A
  • SSRIs (fluoxetine, sertraline, paroxetine​)
  • Pain clinic​
  • Avoid narcotics; use NSAID’s (Ibuprofen)
  • Group therapy
103
Q

Night Eating Syndrome

A
  • Morning anorexia, evening hyperphagia
  • Eat half of their daily calories after dinner and awake at least once at night for a snack.
  • Often obese with failed loss weight plan
104
Q

Anorexia Medications

A
  • Amitriptyline​
  • Antihistamine cyproheptadine​
  • Olanzapine​
  • Fluoxetine
105
Q

Erik Erikson’s Developmental Theory

A
  • 8 stages of psychosocial development

- Achievements of life’s virtues

106
Q

What are the 4 stages of Jean Piaget’s developmental theory?

A
  1. Sensorimotor (newborn-2 years old)
  2. Preoperational (toddler: 2-7)
  3. Concrete (7-11)
  4. Formal (adolescence-adulthood)
107
Q

Abraham Maslow’s humanistic theory

A

-Hierarchy of needs
-Basic physiologic, safety and security, love and
belonging, esteem, self-actualization

108
Q

Carl Rogers’ Humanistic Theory

A

-Client-centered therapy (focus on client’s role)

-Unconditional positive regard, genuineness,
empathetic understanding

109
Q

Which theorist believed in classical conditioning?

A

Ivan Pavlov

110
Q

What is the goal of the existential theory?

A

To return the person to their authentic sense of self

-Theorists: Frankl & Ellis

111
Q

Maturational Crisis

A
  • when a person is unable to cope with the natural process of development
  • Ex: time of transition (birth of first child; retirement)
112
Q

Situational Crisis

A
  • an unexpected event that is usually beyond the individual’s control
  • Ex: natural disaster, loss of job, assault
113
Q

Adventitious Crisis

A
  • events of disaster

- Ex: flood, fire, earthquake, pandemic, war

114
Q

What is concrete thinking?

A

Literal; thinking about the physical word

Example: Thinking that the phrase “It’s raining cats and dogs” means that it really is literally raining cats and dogs.

115
Q

What medications slow down the progression of Alzheimers?

A 
Memantine
Rivastigmine
Galantamine
Donepezil
           (How to remember: Memories Really Going Down)

Mental Health Nursing (2 decks)

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