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Mental Health > Final exam > Flashcards

Final exam Flashcards

1
Q

What are the diffrent components of an MSE?

A, B/PA, ATI, M/A, S+T, PD, O/C, M+I, R,J/I, MFT

A
  • appearance
  • behavior/ psychomotor activity
  • attitude towards interviewer
  • mood and affect
  • speech and thought
  • perceptual disturbances
  • orientation and consciousness
  • memory and intelligence
  • reliability, judgement and insight
  • motivation for treatment
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2
Q

What falls under behavior and psychomotor activity?

A
  • excessive or limited body movements
  • eye contact
  • eval excessive or limited eye movement, gestures
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3
Q

What falls under speech and thought?

A

Speech: rate, volume, speed
Ex. Slurring, stuttering

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4
Q

What falls under reliability, judgement and insight?

A
  • Reliability: credibility and trustworthiness
  • Judgement: good or poor
  • Insight: understanding of the situation they are in
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5
Q

What is the HEADSS assesment used for?

A

Psychosocial interview technique that can be used to identify risk factors

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6
Q

What does HEADSSS stand for?

A
  • Home environment (relationship w/ parents + siblings)
  • Education and employment ( school employment)
  • Activities (sports, music, etc.)
  • Drug, alcohol, or tobacco use
  • Sexuality (sexually active or practice safe sex)
  • Suicide risk
  • safety
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7
Q

What is transference?

A

The patient is reminded of a figure in their life which negatively or positively affects care

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8
Q

What is counter transference?

A

When the nurse is reminded of someone in her life which can positively or negatively affect care

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9
Q

What does a decrease GABA level indicate?

A

Increased anxiety

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10
Q

What are examples of monoamine neurotransmitters?

D, NE, S

A

Dopamine
Norepinephrine
Serotonin

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11
Q

What are examples of amino acid neurotransmitters?

G + G

A

glutamate
GABA

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12
Q

What are examples of neuropetides

CRH, E

A
  • Cortico releasing hormone
  • Endorphins
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13
Q

What is the diagnosis is linked to a monoamine neurotransmitters imbalance?

A

Depression and schizophrenia

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14
Q

What is the diagnosis that is linked to a amino acid neurotransmitters imbalance?

A

Schizophrenia and anxiety

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15
Q

What is the diagnosis that is linked to a neuropeptides imbalance?

A
  • PTSD and major depressive (CRH)
  • Stress/ pain ( endorphins)
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16
Q

What is the diagnosis that is linked to acetylcholine imbalance?

A

Alzheimer’s

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17
Q

Why aren’t tricyclic antidepressants the first line of treatment?

A

can be lethal in an OD and causes sedation

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18
Q

What are second generation antipsychotics associated with?

BS, WG, hyperLD

A

Metabolic side effects like
- blood sugar
- weight gain
- hyperlipidimia

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19
Q

What are examples of medications used to treat Alzheimer’s?

Don and Rev

A
  • Donepezil ( aricept)
  • revastigmine ( exelon)
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20
Q

What do typical antipsychotics cause?

EPSE

A

Extrapyramidal side affects like TD, dystonia, and Parkinsonism

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21
Q

What functions as an intermediate step between inpatient and outpatient care?

IOPs and PHPs

A

Intensive outpatient programs and hospitalization programs

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22
Q

What is assertive community treatment?

A

intensive type if case management developed to treat hard to engage community living people w/ serious psych symptoms

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23
Q

what are the six steps of the nursing process?

A, D, O, P, I, E

A
  • assesment
  • diagnosis
  • outcomes
  • planning
  • implementation
  • eval
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24
Q

what are community mental health centers?

A

fed funded that provide service regardless of insurance status

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25
Q

what is assertive community treatment?

A
  • intensive type of case managment to treat hard to engage communities w/ serious and persistent pysch syptoms
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26
Q

how long does it take SSRI’s to start working?

A

4-6 weeks

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27
Q

what are foods that a person taking MAOI’s cant have?

A
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28
Q

what are the theraputic lithium levels?

A
  • between 0.8 - 1.2
  • elevated 1.2- 1.4
  • toxic 1.5 and up
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29
Q

What are the diffrent coping skills for stress?

HSH, WLB, SS

A
  • health sustaining habits
  • work life balance
  • social supports
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30
Q

What are the differences between maladaptive and adaptive defense mechanisms?

A
  • positive use of defense mechanism
  • when the defense mechanism is used in excess
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31
Q

What are some examples of effective stress reduction interventions?

DBE, PR, M, PE, CR, J

A
  • deep breathing exercises
  • progressive relaxation
  • meditation
  • physical exercise
  • cognitive reframing ( replacing negative phrase like I will not to I will)
  • journaling
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32
Q

What are the three stages for general adaption syndrome ( GAS)?

AS, RS, ES

A
  • alarm stages: a strong reaction to the presented stressor
  • resistance stages: the person adapts to the stressor
  • exhaustion: the person doesn’t have the resources or energy to overcome the stressor and it becomes chronic
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33
Q

What are the different ethical principles?

B, A, J, F, V, NM

A

Beneficence
autonomy
justice
Fidelity
veracity
nonmaleficence

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34
Q

What is fidelity?

A

Maintaining loyalty and commitment to the pt while doing no wrong

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35
Q

What is veracity?

A

The duty to communicate in truth

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36
Q

what is benefience?

A

the duty to act to benifit the good of others

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37
Q

what is justice?

A

the duty to distribute care and resources equally

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38
Q

When age does the first episode of schizoprenia develop?

A

75% develop between ages 15-25

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39
Q

What are positive symptoms of schizophrenia?

Hallucinations, delusions

A

presence of something that shouldn’t be present

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40
Q

What are the negative symptoms of schizophrenia?

hygiene, anhedonia, BROAD affect

A

syptoms that should be present

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41
Q

What are cognitive symptoms of schizophrenia?

A

impairment in memory, thinking, attention, judgement, problem solving capabilities

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42
Q

What are affective symptoms of schizophrenia?

A

Symptoms that impact the emotional response

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43
Q

Common positive symptoms in schizophrenia?

D, WS, AP, C, IIC, PB

A
  • delusions
  • word salad, rhyming
  • altered perception
  • catatonic
  • impaired impulse control
  • poor boundaries
44
Q

What are common negative symptoms?

4 A’S

A
  • anhedonia: inability to enjoy activities
  • avolition: lack of motivation
  • affective blunting: reduced affect
  • alogia: decreased speech
45
Q

What are common nursing diagnosis for a patient w/ schizophrenia?

A
  • Disturbed sensory perception
  • Altered thought process
  • ineffective coping
  • self care deficit
46
Q

What is the first line of defense to treat schizophrenia?

A

Second generation antipsychotics

47
Q

What is the mechanism of action of second generation antipsychotics?

A

Bind to dopamine receptors in the limbic system and also impact serotonin levels

48
Q

What symptoms does second generation antipsychotic target?

A

Positive and negative

49
Q

What are side effects of taking second generation antipsychotics?

wim

A

weight gain
increased mortality rate in dementia pts
metabolic syndrome

50
Q

What are sone examples of second generation antipsychotics?

C, Q, O, Z, P

A
  • clozapine ( clozaril) * increased risk for infection
  • Quetapine ( seroquel)
  • olanzapine (zyprexa)
  • ziprasidone ( Geodon)
  • paliperidone (in Vega)
51
Q

What is the second line of defense to treat schizophrenia?

A

First generation antipsychotics

52
Q

What symptoms does first generation antipsychotic target?

A

Only positive symptoms

53
Q

What are some examples of first generation antipyschotics?

A

Haloperidol ( Haldol)

54
Q

What are the adverse effects of taking SSRI’s?

A, SD, GIU, SD

A

anxiety/ agitation
sleep disturbances
GI upset
sexual dysfunction

55
Q

What are the severe side effects of taking SSRI’s?

A

serotonin syndrome

56
Q

What are the CM of serotonin syndrome?

IHR+BP+T, D, T, A

A
  • increased HR, BP, and Temp
  • delirium
  • tremors
  • apnea (leads to death)
57
Q

What should the nurse teach a pt who is taking SSRI’s?

A
  • let the nurse know if you are exp restlessness, tremors
  • dont mix with OTC drugs and other antidepressants
  • kidney and liver testing
  • don’t abruptly stop ( discontinuation syndrome)
58
Q

What are common side effects of taking tricyclic antidepressants?

A
  • anticholinergic side effects
  • sedation
  • hypotension
  • tachycardia
59
Q

What are the side effects of taking MAOI’s?

MAUI IS HAVING TROUBLE FINDING A WOMAN

A

weight gain
sexual dysfunction
cardiac issues

60
Q

What are the potential life threatening side effects of taking MAOI’s?

A

HTN crisis due tp high intake of foods high in tyramine

61
Q

What is the nurses role for ECT?

A
  • educate about procedure
  • pre and post MSE
  • presence during procedure
  • post vitals signs and LOC
62
Q

What should a nurse plan for a patient with SI?

A
  • development of safety plan
  • SI precaution
  • encouraging pt to express feelings
63
Q

What is the nurses role in management of self destructive behaviors?

A
  • asses safety of milieu and limit use of items to self harm
  • closely observe for signs of self harm
  • care for pt w/ wounds and injuries
  • encourage expression of feelings
  • help pt develop pos alt to self harm
64
Q

What are the symptoms of mania?

A
  • elevated mood for 1 week
  • grandiosity
  • days w/o sleep
  • speech is loud, urgent, rapid
  • easily distracted
  • psychomotor agitation
  • labile ( happy one moment, angry the next)
65
Q

What are symptoms of depressive episodes?

A
  • daytime sleepiness
  • excessive eating
  • weight gain
  • leaden paralysis ( feeling you cant move)
  • paranoid thought/ hallucinations
  • irritability
66
Q

What is hypomania?

A

Period of excessive energy w/ expansive mood that is less dramatic than mania ( not accompanied by psychosis)

67
Q

What are the symptoms of hypomania?

A
  • 4 days long
  • not severe enough to warrant hospitalization
  • persistent elevated and irritable mood
  • grandiosity
  • decreased need for sleep
  • easily distracted
  • increased goal directed activity
68
Q

What are the early symptoms of lithium toxicity?

1.5 mEq/L

A

GI upset
sedation
tremors

69
Q

What should the nurse teach the pt about lithium?

A
  • comply with drug therapy to prevent relapse
  • maintain consistent salt and fluid intake ( 1500- 300ml/day)
  • stop taking if dehydration develops from sweating, N/V, diarrhea
  • lithium level mornin blood draw 8-12 hours after last dose
70
Q

how does the nurse deal with the monopolizing group member?

Ned in groups

A

privately or publicly adress them
limit contrubution

71
Q

how does the nurse deal with the disruptive group member?

A
  • listen objectivley and remind them the group is there to support them
  • address anger directly
72
Q

how does the nurse deal with the silent group member?

A
  • allow them extra time to share
  • assign everyone in the group to group
73
Q

what are the disadvantages of theraputic groups?

A
  • some may feel cheated of participation time
  • distruptive group members reduce group effectiveness
  • not all pt’s benefits
74
Q

what are the diffrent types of boundaries?

C, D, R

A

clear
diffuse
rigid

75
Q

What are some ways we can teach our pt’s to reduce the risk for Alzheimer’s?

A
  • staying physically active
  • stop smoking
  • maintain healthy weight
  • drink mod or not at all
  • adequate sleep
  • avoid chronic stress or depression
76
Q

What are the different stages of Alzheimer’s disease?

M, M, S

A

Mild
moderate
severe

77
Q

How is mild Alzheimer’s characterized ?

Stage 1

A

memory lapse occurs but the pt can still function independently

78
Q

How is moderate Alzheimer’s characterized?

Stage 2

A

Symptoms become noticeable and behavior is markedly changed

79
Q

How is severe Alzheimer’s characterized ?

Stage 3

A

May have difficulty w/ communication and needs 24hr care

80
Q

What is the treatment used for Alzheimer’s?

A

cholinesterase inhibitor which doesn’t cure but helps delay or prevent symptoms from becoming worse

81
Q

What are some possible intervention for a pt experiencing Alzheimer’s?

A

transportation
suppor groups
home health services

82
Q

How is cluster A personality disorders characterized by?

A

odd
eccentric

83
Q

What personality disorders fall under cluster A?

PSS.. do you know the government is watching us??

A

Paranoia PD
Schizoid
schizotypical

84
Q

How is cluster B personality disorders characterized by?

A

dramatic
emotional
erratic

85
Q

What personality disorders fall under cluster B?

BANH

A

borderline
narcissistic
antisocial
histrionic

86
Q

How is cluster C personality disorders characterized by?

A

fearful
anxious

87
Q

What PD’s fall under cluster C?

A

avoidant
dependent
obsessive compulsive

88
Q

What are the clinical manifestations of cluster B borderline personality disorder?

A

instability ( moods, relationships)
impulsive
distorted self image/ identity
labile
splitting
separation anxiety
self harm

89
Q

What are some nursing interventions of cluster B borderline personality disorder?

A
  • therapeutic relationship is essential
  • monitor for manipulation and splitting
  • monitor for self harm behaviors
90
Q

What are some treatments for cluster B borderline personality disorder?

A

DBT
antidepressants and mood stabilizers

91
Q

What are the clinical manifestations of antisocial personality disorder?

A

disregards the right of others and frequently violates
deceitful, manipulative, and hostile when they can’t manipulate the person
no remorse / guilt
criminal misconduct and substance misuse are common

92
Q

What are some nursing interventions for cluster b antisocial PD?

A
  • direct and clear language to avoid manipulation
  • monitor for violence
  • usually not hospitalized
93
Q

What are some treatment options for cluster b antisocial PD?

A

mood stabilizers
antidepressants
benzodiazepines
therapy

94
Q

What are the clinical manifestations of cluster B narcissistic PD?

A
  • feelings of entitlement
  • exaggerated belief in ones importance
  • lack of empathy
  • poor self esteem and hypersensitive to criticism
95
Q

What are some nursing intervention for a person with cluster b narcissist PD?

A
  • remain neutral
  • model healthy communication/ empathy
  • do not engage in power struggles
96
Q

What are treatment options for a person with cluster b narcissist PD?

A

CBT
group therapy
lithium
antidepressants

97
Q

What are the clinical manifestations of cluster C dependent PD?

A

overwhelming need to be cared for
submissive and clingy behavior
intensive fear of separation

98
Q

What are some nursing interventions used for Cluster C dependent PD?

A
  • identify stressor
  • teach assertiveness training
  • beware of countertransference
99
Q

What are some treatment options used for Cluster C dependent PD?

A

CBT
antidepressants
anti anxiety

100
Q

How is mild anxiety characterized?

A
  • they are able to perceive what’s happening around them
  • restlessness, irritability, psychomotor agitation
    ( foot tapping, fidgeting)
101
Q

How is moderate anxiety characterized?

A
  • decreased perception and grasp less information, and has selective attention
  • thinking is impaired but learning can still occur
  • increased RR/ HR, GI problems, tremors, and headache
102
Q

How is severe anxiety characterized?

A
  • very low perception, unable to learn or problem solve
  • nausea, dizziness, confusion, hyperventilation, impending doom
103
Q

How is panic anxiety characterized?

A

complete loss of touch of reality
screaming, shouting, social withdrawal, or hallucinations

104
Q

What is the most lethal substance to have a pt withdrawal on?

A

Alcohol then benzo’s

105
Q

What is conduct disorder?

A
  • rights of others are violated and societal normal or rules are disregarded
  • if left untreated it will develop into antisocial personality disorder
106
Q

What are the common side effects of taking stimulants?

WL/A, WT, HTN, IS, T, I

A

weight loss
anorexia
worsen tics/ tremors
HTN
impaired sleep
tachycardia

107
Q

opiate widthdrawl S + S

A
  • increased respirations
  • N/V
  • dilated pupils

Mental Health (4 decks)

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