final exam power points Flashcards
Psychotic disorder in which the individual experiences: Delusions Hallucinations Disorganized speech/behavior Catatonic behavior Negative symptoms
Chronic condition; treatable but not curable
Schizophrenia
is the potentially fatal complication that can occur when fluids, electrolytes, and carbohydrates are introduced to a severely malnourished client
Refeeding syndrome
substane abuse is highest in what age ranges
20-29
Clients who have this disorder exhibit recurrent episodic violent and aggressive behavior with the possibility of
hurting people, property, or animals
Occurs in clients 18 years and older
Includes verbal or physical aggression
Characterized by aggressive overreaction to normal events followed by feelings of shame and regret
Intermittent explosive disorder
Diazepam, carbamazepine clonidine chlordiazepoxide phenobarbital naltrexone
are all meds used for
alcohol withdrawl
block dopamine (D2), acetylcholine, histamine, and norepinephrine receptors in the brain and periphery
Inhibition of psychotic symptoms is believed to be a result of DQ blockade in the brain
First-generation antipsychotic medications
CBC must be checked regularly for the fatal side effect of agranulocytosis with __________
Atypical/2nd Generation
Reminiscence Therapy Structured Routine Cognitive Stimulation Respite Care Caregiver Support
are all therapies for
Dementia
Believes that his body is changing in an unusual way, such as growing a third arm
Somatic delusions:
are classified as either low-. medium-. or high-potency depending on their association with extrapyramidal symptoms (EPSs), level of sedation, and anticholinergic adverse effects
First-generation agents
Cannot focus at all
Cannot problem solve
‘may hallucinate or have delusions’
Cannot learn, irrational, may feel terror
Exhaustion, behavior erratic, impulsive,
Sleeplessness, severe shakes
Requires immediate intervention
is what type of anxiety
Panic
Characterized by arrogance, grandiose views of self-importance, the need for consistent admiration, and a lack of empathy for others that strains most relationships: often sensitive to criticism
Narcissistic:
Autistic Disorder Rett’s Disorder Childhood Disintegrative Disorder Pervasive Developmental Disorder (NOS) Asperger’s Disorder
are all ____________ disorders
Autism Spectrum Disorders
Stop antipsychotic medication
Monitor vital signs
Apply cooling blankets
Administer antipyretics
Increase the clients fluid intake
Administer medication as prescribed to treat arrhythmia
Assist with immediate transfer to an ICU
Administer dantrolene or bromocriptine to induce muscle relaxation
are all interventions for
Neuroleptic Malignant Syndrome
gradual deterioration of function over months or years
Impairments in memory, judgment, speech (aphasia), ability to recognize familiar objects (agnosia), executive functioning (managing daily tasks), and movement (apraxia);
impairments do not change throughout the day
Level of consciousness is usually unchanged
Restlessness and agitation are common; sun downing can occur
Personality change is gradual
Vital signs are stable unless other illness is present
neurocognitive disorder
The client avoids answering questions by repeating phrases or behavior This is another unconscious attempt to maintain self-esteem when memory has failed
Perseveration:
Advise clients to observe for indications of infection (fever, sore throat), and to notify the provider if these
occur these may be signs of _________
Agranulocytosis
No change in LOC Aphasia Apraxia Agnosia Executive Functioning
Dementia
Ask open ended questions
Provide calm presence
Evaluate coping mechanisms
Offer activities & methods to relieve tension→teaching (OCD)
Decrease stimuli
are all nursing interventions for _______
moderate anxiety
Perception that the environment has changed the client believes that objects in her environment are shrinking)
Derealization:
There is no specific laboratory or diagnostic testing to diagnose ______. Definitive diagnosis cannot be made until autopsy Testing is done to rule out other pathologies that could be mistaken for _____
neurocognitive disorder
EFFECTS OF INTOXICATION for _______________
• Increased drowsiness and sedation, agitation, slurred speech, uncoordinated motor activity, nystagmus,
disorientation, nausea, vomiting, Respiratory depression and decreased level of consciousness, which can be fatal
• An antidote, flumazenil, available for IV use for benzodiazepine toxicity
sedatives, hypnotics, anxiolytics
Absence of things that are normally present These manifestations are more difficult to treat successfully
NEGATIVE SYMPTOMS
THERAPEUTIC USES:
Negative and positive symptoms of schizophrenia
spectrum disorders
Psychosis induced by levodopa therapy
Relief of psychotic manifestations in other disorders, such as bipolar disorder
Impulse control disorders
Antipsychotics: Second- and third-generation (atypical)
are used mainly to control positive symptoms of psychotic disorders
First-generation (conventional) antipsychotic medications
Symptomatology:
Use of physical aggression in the violation of the rights of others
Manifests in home, school, peer relationships, & community
Conduct Disorder
splitting is commonly associated with _______
borderline personality disorder
Meaningless rhyming of words, often forceful, such as, “Oh fox, box, and lox
Clang association:
Aripiprazole
are all what type of medications
Third-generation antipsychotics
Used to treat both positive and negative symptoms while improving cognitive function
Clients who have ______ can have calluses or scars on hand (Russell’s sign)
bulimia
The client has psychotic manifestations that last 1 day to 1 month in duration
Brief psychotic disorder:
Flashbacks of traumatic event High level of anxiety/arousal Numbing of responsiveness Sleep disturbance Mood Concentration Isolation
are all signs and symptoms of
PTSD
Made-up words that have meaning only to the client, such as, “I tranged and flittled
Neologisms:
onset:
anytime before the age of 18
Separation Anxiety Disorder
Believes that she is all powerful and important, like a god
Grandeur:
Believes that her thoughts are heard by others
Thought broadcasting:
acute stress disorder last for_days to _months
anything longer than is considered ______
3 days - 1 month
PTSD
Characterized by distrust and suspiciousness toward others based on unfounded beliefs that others want to harm, exploit, or deceive the person
Paranoid:
is a cognitive-behavioral therapy used for clients who exhibit self-injurious behavior It focuses on gradual behavior changes and provides acceptance and validation for these clients
Dialectical behavior therapy
Nonspecific feeling that a person has lost her identity Self is different or unreal
Depersonalization:
Characterized by instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment: often self-injurious and potentially suicidal: ideas of reference are common: often accompanied by impulsivity
Borderline:
Intoxication
euphoria, impaired judgment, confusion, vital signs
Increased motor activity, SEVERE vasoconstriction leading to MI
Stimulants
WITHDRAWAL MANIFESTATIONS of _________
Craving, depression, fatigue, sleeping
• Not life-threatening
amphetamines
CNS Stimulants: Dextroamphetamine Sulfate (Dexodrine), Desoxyn, Lisdexamphetamine (Vyvanse), Dextroamphetamine (Adderall), Methylphenidate (Ritalin, Concerta), Dexmethylphenidate (Focalin)
Alpha Agonist: Clonidine (Catapres), Guanfacine (Tenex, Intuniv)
Miscellaneous: Amoxitine (Strattera), Buproprion (Wellbutrin)
are all drugs that can be used with
ADHD
This tool will give the nurse information regarding the clients ability to perform self- care, extent of the clients memory loss, mood changes, and the degree of danger to self and/or others
Functional Dementia Scale
type of hallucination that:
Experiencing tastes
Gustatory:
The client can make up stones when questioned about events or activities that she does not remember This can seem like lying, but it is actually an unconscious attempt to save self-esteem and prevent admitting that she does not remember the occasion
Confabulation:
Rapid weight loss or weight loss of greater than 30% of body weight over 6 months
Vital signs demonstrating heart rate less than 40/rnin, systolic blood pressure less than 70 mm Hg
body temperature less than 36.0 C F)
ECG changes
Electrolyte disturbances
Psychiatric criteria: severe depression, suicidal behavior, family crisis, or psychosis
criteria for acute care
demonstrate a persistent pattern of behavior that violates the rights of others or rules and norms of society Categories of conduct disorder include the following:
Aggression to people and animals
Destruction of property
Deceitfulness or theft
Serious violations of rules
Childhood-onset develops before the age of 10, with males being more prevalent Adolescent-onset occurs
after the age of 10 The ratio of males-to-females is equal in the adolescent stage
Conduct disorder (childhood or adolescent onset)
type of hallucination that:
Hearing voices or sounds
Auditory:
Psychiatric disorders, previous attempt Gender Intoxication, substance abuse isolation age Chronic medical illness Access to firearms Hx of trauma, loss
are all risk factors for ____
suicide
4 types of therapies for PTSD
Individual Psychotherapy
CBT
Desensitization Therapy
EMDR
stage of alzheimers where
- Losing ability to converse with others
- Assistance required for ADLs
- Incontinence
Losing awareness of one’s environment
- Progressing difficulty with physical abilities (walking, sitting, and eventually swallowing)
- Eventually losses all ability to move: can develop stupor and coma
- Death frequently related to choking or infection
Severe Alzheimer’s (late stage)
Benzodiazepines
Anticonvulsants
Multivitamin
Thiamine
are all used with
Alcohol Withdrawal
stage of alzheimers where
Memory lapses Losing or misplacing items Difficulty concentrating and organizing Unable to remember material just read Still able to perform ADLs Short-term memory loss noticeable to close relations
Mild Alzheimer’s (early stage)
The client experiences psychosis due to substance intoxication or withdrawal However, the psychotic manifestations are more severe than typically expected
Substance-induced psychotic disorder:
Involuntary movements of the tongue and face, such as lip smacking and tongue fasciculations
Involuntary movements of the arms, legs, and trunk
chewing motion
facial dyskinesia
are all symptoms of ______
Tardive dyskinesia
Common problem associated with hospitalization of
older adult client
Caused secondary to another medical condition,
such as infection, malnutrition, depression,
electrolyte imbalance or substance use
Postoperative causes can include withdrawal from
illegal substances or alcohol, or impaired respiratory
function
Primary step to resolve is to determine the
underlying causa
delerium
type of hallucination that:
Feeling bodily sensations
Tactile:
Behaviors associated with ADHD must be present prior to age ___ and must be present in more than one setting to be diagnosed as ADHD Behaviors associated with ADHD can receive negative attention from adults and peers
12
Inability to sit or stand still
Continual pacing and agitation
restless
are all symptoms of __________
Akathisia
Symptomatology:
Passive-aggressive behavior, tests limits, running away
Begins with opposition toward parents>others over time
Problem is not with them, but with others
Oppositional Defiant Disorder
The abuser has minor episodes of anger and can be verbally abusive and responsible for some minor physical violence The vulnerable person is tense during this stage and tends to accept the blame for what is happening
tension building phase
The client uses self-induced vomiting, laxatives, diuretics, and/or enemas to lose or maintain weight
• Purging
Heightened perception
Can problem solve
Mild tension relieving behaviors
Daily life
is what type of anxiety
mild
Clients recurrently eat large quantities of food over a short period of time without the use of compensatory behaviors associated with bulimia nervosa
At least once per week for 3 months
most common in adults age 46 to 55
Binge eating disorder
Vital signs increased Disorientation Visual/tactile hallucinations Hyper-excitability to lethargy Agitation
are all signs of
Delirium Tremens with alcohol
Obsession part of OCD is ______based
Compulsive piece of OCD is_______ based
thought
behavior
a disorder with onset during the developmental period that includes intellectual/adaptive functioning deficits in conceptual, social, and practical domains.
Intellectual Disability:
Diazepam
Alprazolam
Lorazepam
Clonazepam
are all what type of meds
Benzodiazepines
It is a gross disorganization of the personality, a marked disturbance in reality testing and impairment of interpersonal functioning and relationship to the external world.
Psychosis
The client repeats the words spoken to him
Echolalia:
according to the DSM5 what are the 6 types of psychotic disorders
Brief Psychotic Disorder Schizophreniform Disorder (acute) Schizophrenia Delusional Disorder Schizoaffective Disorder Substance-induced psychotic Disorder
The client exhibits psychotic features such as
impaired reality testing or bizarre behavior (psychotic) or a significant change in motor activity behavior (catatonic) but does not meet criteria for diagnosis with another specific psychotic disorder
Psychotic or catatonic disorder not otherwise specified:
Delirium
Mild neurocognitive disorder (NCO)
Major neurocognitive disorder (commonly known as dementia
are all ____________
Cognitive disorders
Characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations
Schizotypal:
Treatment of acute and chronic psychotic disorders
Schizophrenia spectrum disorders
Bipolar disorder: primarily the manic phase
Tourette disorder
Agitation
Prevention of nausea/vomiting through blocking of dopamine in the chemoreceptor trigger zone of the medulla
First-generation antipsychotic medications
Characterized by social inhibition and avoidance of all situations that require interpersonal contact, despite wanting close relationships, due to extreme fear of rejection: often very anxious in social situations
Avoidant:
with First-generation (conventional) antipsychotic medications
moderate EPSs, moderate sedation, and low anticholinergic adverse effects
Medium potency:
Sudden Hyperthermia Rigidity Mental Status changes Tachycardia, tachypnea, elevated BP diaphoresis drooling coma
Neuroleptic Malignant Syndrome
The client has psychotic thinking or behavior present for at least 6 months Areas of functioning, including school or work, self-care, and interpersonal relationships, are significantly impaired
Schizophrenia:
- Treat with an antiparkinsonian agents such as benztropine
- 1M or IV administration diphenhydramine can also be beneficial
- Stay with the client and monitor the airway until spasms subside (usually 5 to 15 min)
are all nursing considertions for _______
Acute dystonia
decreased response to stimuli and a tendency to remain in an immobile posture.
waxy flexibility
Side Effects:
EPS
Anticholinergic
NMS
Typical Antipsychotics/First Generation
