FINAL Exam Flashcards

1
Q

Renal, thyroid, blood, Community, endocrine:

A
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2
Q

Review restraints/involuntary commitment

A

-Involuntary Emergency Admission (IEA): a person who is a harm to themselves or others, or shows a self-care deficit. Will be admitted for 72 hours (tops per state). Needs 2 approvals from physicians/psychiatrist.
-Restraint checked q 15 minutes. Offer water. Need constantly reapproved restraint order from physician.

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3
Q

Graves disease, diabetes mellitus, adenoma, anemia, neutropenia, thrombocytopenia, thyroid medication, IBS,

A

Graves disease: hyperthyroidism. Bulging eyes, High BP
DM: sugar level unregulated. Hyper and hypoglycemia. Tx of hyper with insulin, hypo with crackers.

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4
Q

Transference and Countertransference

A

-Transference: when a person projects someone they know onto you; positive or negative.
-Countertransference: the we project someone from our life onto our patient.

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5
Q

How do you assess for hallucinations.

A

-You don’t ask if they’re hallucinating, you ask if they’re hearing or seeing things that others can’t see.

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6
Q

Review Stages of Alzheimer’s, and differences between delirium and dementia and medications ( NMDA and Cholinesterase medications

A

AD
-Stage 1: mild short memory loss, loosing things
-Stage 2: repeating things, loss of short and long term memory, regression. Un orientated to place, time, and situation.
-Unable to speak, complete ADLS. Un orientated to person, place, and time. Swallow risk.

Dementia: an acute loss of neurocognitive function related to an underlying cause. 50% of hospital patients experience this.
-Irritability, or agitation
-Poor recall
-Moments of lucidity*

Meds:
NMDA - memantine

Cholinesterase medications: donezpezil, galantine,

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7
Q

Know ranges of Gabapentin
and Olanzapine

A

100 mg TID – 1200 mg TID
2.5 mg – 20 mg

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8
Q

Which personality disorder is the most manipulative? What is splitting

A

Most manipulative is Bipolar Personality Disorder.
Splitting is when you either hate or love someone. It can also be pitting two people against each other.

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9
Q

Review antidepressants and suicide risk, do the all or just SSRI’s

A

4 highlights of antidepressants: 1) High suicidal risk for 18-24 yo in beginning of tx 2) DON’T mix MAOIs and other depressants 3) Side Effects! Sexual dysfunction, wt changes 4) ???

Classes
-SSRIs: fluoxetine, paroxetine
Serotonin syndrome

-SNRI: duloxetine

-TCA: amitriptyline, imipramine
Anticholinergic effects

-MAOI: phenyline
Hypertensive crisis

-Atypical: bupropion/Wellbutrin

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10
Q

Anorexia

A

Anorexia: abnormal restraint on diet, through exercising, food restriction, enema/vomiting.

D- When a person restricts their diet through purging, dieting, exercising, diuretics. Low BMI (below 18.5). At risk of
E- Family hx. A r w/ substance abuse, depression/anxiety
A- At risk for electrolyte imbalance and cardiac issues. Assess for irregular pulse, hypotension, jaundice. Look at knuckles for marks from throwing up.
T- Slowly. Don’t feed them a bunch at once; they’ll get re-feeding syndrome. One-on-one observation during eating to make sure they’re not hiding food or making themselves puke. Doing desensitization to food. Deep breathing. Introduce them to larger portions at a time. Educate on disorder
H- There’s a chemical reason behind this. Come from where they are.

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11
Q

What are the stages of violence

A

-3 stages 1) Tension phase 2) Acute battering phase 3) Honeymoon phase

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12
Q

Review Lithium/ when to draw a Lithium level.
Therapeutic level
Know Lithium toxicity, need maintain fluid balance

A

Take test 8-12 hours after the last dose.
Therapeutic range: 0.6-08 or 0.6-1.0
Lithium toxicity: fever and confusions.

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13
Q

Antipsychotic side effects for 1st and 2nd generation. Remember conventional antipsychotics are 1st generation.

A

Antipsychs:
First Gen: Haloperidol. Chlorpromazine. Tx positive effects.
-Akasthia, muscle tremors, dystonia tardive

Second Gen: Clozapine, duloxetine
-Metabolic syndrome

Third Gen: Abilify. Subset of second Gen.

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14
Q

Propranolol (beta blockers). Used for

A

(Test) anxiety

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15
Q

Alcohol and nutritional needs

A

Alcohol abuse: typically malnourished from running on liquid calories. B1, 12 deficiency
-Tx: water

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16
Q

acute mania

A

-Treated with olanzepine, then lithium
-Prodromal phase: treated with medications and potentially restraints.

17
Q

Positive and negative symptoms of schizophrenia

A

Schizophrenia

Positive Symptoms
Thought: thought blocking, insertion, deletion, and magical thinking.

Speech
-Clang associations
-Associative looseness***:
-Echolia: like myth abt Echo
-Neologism: make new words
-Tangential speech:, or “tangents”. Person keeps digressing from original topic.
-Pressured speech
-Cognitive retardation: slow speech
-Flight of ideas: jump from one thought to another. Like flight pit stops.

Behavior !!
-Catatonia
-Motor retardation: slow movement
-Posturing, gesturing: faces and posture that don’t match situation.
-Echopraxia: copy person’s movements.
-Motor agitation: increased response to external stimuli, irritability
-Stereotyped behaviors: antsy, pacing
-Impaired impulse control
-Negativism: resistance to requests.
-Boundary impairment: everything near person is theirs.

Perception
-Hallucination
-Delusion
-Derealization
-Depersonalization: out of body experience

Negative Symptoms
-Apraxia: lack of purposeful movement
-Alogia: lack of speech
-Ahedonia: lacks pleasure from life. “Hed” will to live.
-Avolition: volition, decision. Can’t make decisions
- Asociality
-Affective blunting. **Beware! depression w negative affect.
-Apathy

18
Q

ADHD

A

Meds
Stimulants: methylphenidate/Ritalin and amphentime salts/Adderall
Non-stimulants: clonidine and guanfacine.
SNRI: atomoxetine
Atypical antidepressants

19
Q

Rape Trauma syndrome stages

A

Rape trauma syndrome:
1. Acute phase: may be expressive, mute, or disorientated.
2. Outward adjustment phase: goes on with life while coping with trauma. May: suppress, minimize, dramatization, explanation, flight
3. The resolution phase

20
Q

Review DID (dissociative identity disorder)

A

D - DID: when a person has two or more personalities that don’t know about one another.
E - Typically due to severe trauma.
A - May have varying affects, intonation at times. May have gaps in memory.
T - psychotherapy, counseling
H -

21
Q

Medications for Alcohol and Opioids

A

Meds for Alcohol
-Disulfiram: makes you feel gross when you drink.
-Acamprosate: decreasing craving

Opioids
-Methadone: controlled substitute
-Suboxone: treats withdrawal and substitutes dependence.
-Sublocade: substitute.

Both
-Naltrexone: suppresses reward of behavior

22
Q

detox CIWA and COWS

A

CIWA, or clinical institution withdrawal assessment; for alcohol withdrawal
-Scale of 0 to 15+. 8-10 mild symptoms, 10-15 moderate, 15+ BAD.

COWS, or clinical opioid withdrawal scale: for opioid withdrawal
-Scored 5 to 36, 36 being the worst.

23
Q

Review anticonvulsant medications

A

-gabapentin
indications: idk