Final Exam Flashcards
What is trichtillomania?
Hair pulling disorder
Ex: pulling hair from scalp, eyebrows, or other areas of the body
Treatment: antidepressants
What is mutism?
The inability or willingness to speak
Can happen due to a traumatic event
*Selective Mutism is only talking in certain situations.
Phobia?
The intense fear of a specific item or situation
How do you know someone with anorexia is getting better
Gaining weight
No compulsive actions
Vitals return to normal
Absence of cognitive distortions
They are eating something
observe patient while eating and 1-3 hrs after
Borderline personality disorder: What to do if they get angry?
Low stimuli
Separate from the room
Change of scenery
Want to prevent self mutilation & self harm
- these ppl are often self injurious & suicidal
What is the purpose of the SANE nurse
Sexual assault nurse examiner
-Trust & security
They also provide compassion
Main symptoms for someone clinically depressed ?
Anedonia- loss of pleasure in things they used to love doing
The theory of Freud what is meant under “id”
Pleasure motivated
Instant gratification
Impulsivity
Devil
This is where sexual desire, jealousy, greed, and self preservation come from
What does behavior therapy focus on ?
Change maladaptive behaviors
Examples of maladaptive behaviors: avoidance, withdrawal (avoiding stressful situations)
How would you describe Milieu Therapy?
Low stimuli
Structured
safe - no hazards or weapons, & having supervision
Increase self esteem
Decrease isolation
Warning signs of suicide
Giving away possessions
More energy but still having depressive episodes
Sudden change in mood
What kinds of food to ignore when taking methylphenidate?
Stimulants
Ex: caffeine, coffee, tea, cola, energy drinks
Medications for anorexia
Olanzepine
Fluoxetine
Which medications to avoid with anorexia
laxatives and diuretics
Symptoms of depression?
Loss of appetite
Flat affect
Loss of energy
Insomnia or hypersomnia
No motivation
low self esteem
irritable
somatic pains
How to prevent a relapse?
Try to identify what the clients triggers are
This is in regards to relapse of schizophrenia, eating disorders, substance abuse, etc.
What is reactive attachment disorder?
Doesn’t respond to comfort or seek comfort
- does not show response when given comfort
This can be due to emotional neglect or abuse at a certain age
Medications for paraphilia (abnormal sexual desires)
Naltrexone [normally to prevent relapse into alcohol or drug abuse
Antidepressants
- Lithium
- SSRIs
Mood stabilizers
- Valproate, valproate acid, divalproex, depakote, carbamazepine, lamotrigine
2nd Gen antipsychotics
- Risperidone
- olanzepine
- clozapine
What is a poor coping skill?
Drinking alcohol
Someone refusing medication, what do you do first?
-assess identify the reasons why they don’t want the medication
-Then document
Who would be placed on an involuntary legal hold?
Someone who is a harm to themselves or others
Greatly disabled
Someone panicking, how would you communicate
Short, simple commands
If someone looks sad, not answering questions, and makes no eye contact then what are you concerned about?
Worried if they are going through some type of abuse
If taking care of a child who needs to care for younger siblings that are not going to school.
We can consider this as neglect
When can you breach confidentiality
-When someone has been threatened
-STDs (since they are a threat to infect someone else)
Why does someone act on an impulse with an impulse control disorder?
-achieving relief
-they get a sense of pleasure
Medications to treat ADHD
Methylphenidate
Amphetamine salts
Lisadexafetamine
Atomoxetine
Bupropion
If someone wants to end their life what do you want to ask ?
Ask what their plan is
Best therapy for depression
Cognitive behavioral therapy
If someone is inattentive, impulsive, hyperactive; what class of meds are best
CNS stimulants
If someone is having delusions & hallucinations what meds are best?
Antipsychotics
Examples:
Labs that indicate sexual abuse
STI
Children:
Bruising
Swelling and bleeding in genital area
Hard time sitting
Signs of emotional abuse
Harsh criticism
*Low self esteem
Humiliation
*Rationalizing for abuser
If a suicidal person is being discharged how to know if they are safe
- They have a safety plan
knowing they have resources outside
Ability to reach out
Someone having auditory hallucinations
Ask what they are saying
Beware of command hallucinations
How long does it take for antidepressants to start working
Few weeks 2-4 weeks
What antipsychotics give extrapyramidal symptoms
First gen antipsychotics
Chlorpromazine
Loxapine
Fluphenazine
Haloperidol
What disorder has a hard time following directions, disorganized, and hard time at work.
ADHD
- starts in adolescence
Specific meds for major depression
SSRIs
— Citalopram
— Escitalopram
— Fluoxetine
— Paroxetine
SNRIs
*– Venlafaxine
– Desvenlafaxine
– Duloxetine
– Levomalinacipran *
TCAs
*— Amitriptyline
— Doxepine
— Imapramine
— Nortriptyline *
MAOIs
— Phenelzine
— Isocarboxazid
— Tranylcypromine
— Selegiline
What does attending mean for our patients
Being there for patient
The intensity of presence
Most common mental illness
Anxiety
Alcohol intolerance- how is it seen ?
No affect with high BAC level > 0.08
Interventions for Alzheimer’s disease
Remind them to do ADLs
Short instructions in step by step
- break activity into short time frames
Encouraging
Keep consistent daily routine
Minimize need for decision making to avoid frustration
Pavlov- Behavioral theory
Conditioning: dog example
B.F skinner - behavioral theory
Behaviors are learned through both positive or negative reinforcement
Aversion therapy
Punishment through pain
Ex: pedophile with electrodes on his penis
Peplau- Interpersonal theory
Nurse-patient relationship influences patient outcomes
Neglect signs
Underweight
Poor hygiene
School problems
Stealing food
Early or late to school
Psychosomatic complaints
* Headache
* backpain
* muscle pain
* stomach pain
Cycle of violence
Honeymoon phase
Tension-building phase
Serious battering phase
(Can then go back to honeymoon phase)
Honeymoon phase
Abuser: Loving behavior, regretful, sorry, makes promises to change
Victim: trusting, hoping for change, wants to believe partners promises
Tension-building phase
Abuser: edgy, has minor explosions, may become verbally abusive, minor hitting, and other incidents
Victim: Feels tense and afraid, walking on eggshells, feels helpless, and blames themself
Serious battering phase
Abuser: serious battering incident
Victim: may cover up injury (wear turtleneck) or may look for help. The victim may provoke an incident to get it over it
Why do people stay when being abused?
Being afraid of being murdered
Lack of exposure to violence
Dependence for financial need
Interventions for Intimate partner violence (IPV)
Assess in nonthreatening manner
Do they have a safe place?
Remind them that it is not their fault
Who’s at higher risk for elder abuse
Those with psychiatric illnesses
Women
80+
*Abuser usually son or nephew *
Sexual violence
Completed or attempted penetration of a victim
Even just talking about it
Unwanted sexual contact
act of violence, power and hate
93% of perpetrators are someone they know
Vulnerable individuals for sexual violence
Women
Ages 16-19 higher rate
Higher risk —> history of sexual violence
Ethnicity: Native Americans, Alaskan
Sexual violence-Young adults
Afraid to report
Cannot remember incident clearly
Interventions for violent patient
Always make sure you have access to an exit
Let patient yell, listen attentively
Set clear limits
“What will help now”
Distraction
Leave room ‘
Psychopharmacology for anger, agression, and violence
Fast acting: Olanzepine, chlorpromazine
Other: haloperidol and diphenhydramine
