Final exam Flashcards
Therapeutic milieu
Positive and safe physical settings, interactions, and activities that promote recovery.
Abstract thinking
Thinking characterized by the ability to use concepts and to make and understand generalizations, such as of the properties of pattern shared by a variety of specific items or events
Orientation phase
First time nurse and pt. meet. Focuses on building rapport
Working phase
Identifing and exploring issues and emotions
Termination phase
summarizing progress, ending relationship
Countertransference
Nurse responds emotionally to pt. as if they were a significant figure from the past
Transferance
pt. inappropriately displaces patterns of behavior or emotional reactions on person as if they were a significant figure from the past
acting out
(Immature defense) addressing emotional conflicts or stressors by actions rather than reflections of feelings
Splitting
(immature defense) inability to combine the positive and negative aspects of people
Cognitive behavioral therapy (CBT)
seeks to modify negative thoughts that lead to dysfunctional emotions and actions
autocratic leadership
(controls group) does not encourage interaction among members
Free association
Mental process by which one word or image may spontaneously suggest another without any apparent connection
Acetylcholine
Cholinergic neurotransmitters
-increase in depression
-decrease in Alzheimers
Adrenergic
Sympathetic NS “fight of flight”
NT - norepinephrine & epinephrine binds to alpha and beta receptor sites
Antipsychotics
block dopamine
Extrapyramidal symptoms
side effects of antipsychotics
- pseudoparkinsonisms, akathisia, acute dystonic reactions, tardive dyskinesia, neuroleptic malignant syndrome
Monoamine oxidase inhibitors (MAOIs)
Inhibit the enzyme monoamine oxidase from breaking down monoamines (ex. norepinephrine)
- excess tyramine w/ medication cases hypertensive crisis
Neuroleptic Malignant syndrome
Potentially fatal
- Muscle rigidity, tremor, diaphoresis, hypertension, tachycardia, hyperexia, incontinence
NMS treatment
Discontinue medications, transfer to ICU, treat autonomic dysfunction (Diaphoresis, hypertnesion, tachycardia, hyperexia, incontinence)
Norepinephrine
Monoamine
- increased in schizophrenia, mania, anxiety
- decreased in depression
Psuedoparkinsonism
Body destroys ability to move dopamine
- masklike face, stiff & stooped posture, shuffling gait, drooling
- treat w/ diphenhydramine
Akathisia
Inner restlessness, rocking, tapping foot, pacing, cannot fix range of motion
treat
-Treat w/ diphenhydramine
Anticholinergic
Blocks acetylcholine from attaching to receptor
-blocks rest & digest
Antidepressant
Decreased levels of serotonin, norepinephrine, and dopamine
-4-6 weeks of treatment to reach normal levels
Dopamine
Monoamine
-increased in schizophrenia & mania
-decreased in depression
y-aminobutyric acid (GABA)
GABAa and b
-decreases mania, anxiety, and schizophrenia
tardive dyskinesia
Constant movement, tongue thrusting or lip smacking
- discontinue medication
Serotonin syndrome
Side effect of SSRI’s
-high fever, high BP, tachycardia, agiation
-over stimulation of serotonin receptors; common when 2 SSRIs are used together
anergia
lack of energy
Electroconvulsive therapy
3 indications
- drug therapy failed
- pt. is acutely suicidal
- depressed pt is experiencing suicidal symptoms
Major depressive disorder
Emotional, cognitive, & behavioral symptoms that interfere w/ a person’s life
- history of one or more episodes of major depression
Vagus nerve stimulation
Adjunct, long term treatment of pts. w/ treatment-resistant depression
-affects blood flow in the brain
Dysthymia
(persistent depressive disorder)
-functional
-mild-to-moderate depression
-at least 2 yrs of duration
Light therapy
First line of treatment for seasonal affective disorder
-full spectrum wavelength ligth
vegetative signs of depression
somatic changes & alterations in activities necessary to support physical life & growth (sleeping, eating, elimination, sex)
-less likely to be diagnosed
Bipolar I
one or more periods of major depression w/ at least on period of mania
Bipolar II
One more more periods of major depression w/ at least one period of hypomania
Flight of ideas
nearly continuous flow of accelerated speech & abrupt changes among topics usually based on understandable associations or play on words
-“how are you doing kid? Kidding around, I’m going home. Home sweet home. Home is where the heart is”
Anhedonia
lack of pleasure
Echolalia
Mimicking another’s words
Grandiosity
Person’s unrealistic & exaggerated concept of self-worth, importance, worth, & ability
Ideas of reference
Misinterpreting messages of others giving private meaning
- Seeing nurses talking and assuming thery are plotting your murder
Negative symptoms of Schizo
Affective blunting or flat affect
- lack of motivation, pleasure, and energy
Positive symptoms of schizo
Hallucinations, delusions
- bizarre behavior
- alterations in speech (neologisms, echolalia, clang associations, word salad)
Paranoia
Any intense, or strongly defended irrational suspicion
Hallucination
sensory perceptions for which no external stimulus exists
Delusion
False fixed beliefs that cannot be corrected by reasoning
Acute dystonic reaction
Pt. frozen in pain by acute contractions of tongue, face, neck, back
- emergency treatment of diphehydramine
Thought insertion
belief that thought of others are being inserted into ones mind
Thought broadcastin
belief thoughts can be head by others
thought withdrawl
belief thoughts have been removed from ones head
dystonia
state of abnormal muscle tone resulting in sustained muscle spasm
Alzheimer’s disease
Primary dementia (10-20yrs0
- neurofibrillary tangles and plaques develop in brain
- progressive loss of cognitive function & behavior changes 4 stages: mild, mild-mod, mod-severe, late-end stge
Sundowning
Symptoms and problem behaviors become more pronounced in evening (delirium & dementia
Abuse
habitual use of substance that falls outside of medical necessity or social acceptance
-alter ones mood, emotion, or consciousness
Addiction
compulsive behavior centered on drug use and seeking behavior
-motivated by cravings
- chronic-relapsing brain disorder despite negative consequences to health, mental state, relationships, occupation, finances, & legal issues
Withdrawal
Physiological and psychological s/s associated w/ stopping &/or reducing use of substance
- physical dependens
Alcoholics anonymous
12 step program offering behavioral, cognitive, and dynamic structure needed for recovery
Dual diagnosis
pt. often have substance abuse disorder & psych disorder
- both treated as primary disease
Wernicke-Korsakoff syndrom
Thiamine deficiency
- ataxia, acute confusion, loss of ability to learn/ remember if permanent
Cluster A
- odd/ eccentric disorders
Paranoid
Schizoid
Schizotypal
Paranoid disorder
distrust of others
Responds best to factual information
Schizoid disorder
emotional detachment
loners
Schizotypal disorder
socially inept
Magical thinking
odd speech
may seek help depending on anxiety in social situations
easily overwhelmed
Cluster B
Socially dramatic
antisocial
borderline
narcissistic
histrionic
Antisocial disorder
-highly manipulative to get what they want
violates the rights of others
lack empathy
(SET LIMITS)
Borderline Personality Disorder
instability in relationships
inner emptiness
impulsive acts (self-mutilation, suicide attempts)
fear of abandonment
splitting
Narcissistic
Grandiose
need for admiration, arrogance
entitlement
“all about me”
Histrionic disorder
excessively emotional
provocative & seductive
manipulate others to get attention they crave
Cluster C
Anxious/ fearful
Avoidant
dependent
Obsessive compulsive
Avoidant Disorder
social inhibition
social withdrawal
avoidance
Dependent Disorder
need to be cared for
trouble making decisions
Obsessive-compulsive personality disorder
Perfection/orderliness
keep control of world by organizing it
General anxiety disorder
excessive anxiety and worry for greater than or equal to 6 months
“what if” thoughts
Flooding
Treating phobias
- exposure to disturbing ideas, situations, or conditions until no longer production anxiety
Stress-reducing techniques
relaxation, reframing, sleep, exercise, lower/eliminate caffeine
cycle of violence
continuing cycle of violence alternating w/ periods of safety, hope, & trust
- escalation & deescalation
3 phases
- tension building, serious battering, honeymoon
Tension-building phase
Victim
-feels helpless, compliant, accepts blame, “walks on eggshells”
Abuser
- edgy, minor explosions, verbally abusive, minor hitting or pushing
Serious battering phase
Victim
- tension unbearable, victim may provoke to get over with
-remembers incident, try to cover injury
-most likely to seek help after
Abuser
-may not remember
Honeymoon phase
Abuser
- “undoing” actions, makes promises, buys gifts
Victim
-trusting, hopes for change
- wants to believe promises
Drugs used in rape
GHB, Rohypnol, Ketamine
Crisis
Acute, time-limited phenomenon experienced as an overwhelming reaction to a stressful event in which a person does not have adequate coping skills
-causes a state of disequilibrium
3 types of crisis
Maturational- different stages of growth stressors
situational- personal/ physiological; interpersonal/social
Adventitious: disasters
