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
A substance use disorder involves repeated use of chemical substances, leading to clinically significant
impairment during a ____-month period
12
anti psychotic medication that:
More expensive Less side effects (overall) Newer meds Weight Gain Target both negative and positive symptoms of schizophrenia
Atypical/2nd Generation
WITHDRAWAL MANIFESTATIONS of ___________
Depression, fatigue, craving, excess sleeping or insomnia, dramatic unpleasant dreams, psychomotor retardation, agitation Not life-threatening, but possible occurrence of suicidal ideation
cocaine
Blessed Dementia scale
This tool provides the nurse with client behavioral information based on an interview with a secondary source, such as a clients family member
Characterized by perfectionism with a focus on orderliness and control to the extent that the individual might not be able to accomplish a given task
Obsessive-Compulsive:
Lack of pleasure or joy The client is indifferent to things that often make others happy, such as
looking at beautiful scenery
Anhedonia
ADVERSE EFFECTS:
GI effects: Nausea, vomiting, and diarrhea
Bradycardia, syncope
Cholinesterase inhibitor medications
Symptomatology:
Clinging behavior, tantrums, crying, screaming, complaints of physical problems, shadowing, specific phobias, & depressed mood
Separation Anxiety Disorder
Alcohol withdrawal delirium can occur ____-____days after cessation of alcohol This is considered a medical
emergency Manifestations include severe disorientation, psychotic manifestations (hallucinations), severe hypertension, cardiac dysrhythmias, and delirium Alcohol withdrawal delirium can progress to death
2 to 3
if on Benzodiazepines and abruplty stop what could happen?
you could have a seizure and die
Characterized by disregard for others with exploitation, lack of empathy, repeated unlawful actions, deceit, and failure to accept personal responsibility: sense of entitlement, manipulative, impulsive, and seductive: nonadherence to traditional morals and values: verbally charming and engaging
Antisocial:
is a subtype of NCD that is neurodegenerative, resulting in the gradual impairment of cognitive function. It is the most common type of major NCD
Alzheimer’s disease (AD)
Clients who have a __________ exhibit one or more of the following common pathological personality characteristics:
Inflexibility/maladaptive responses to stress
Compulsiveness and lack of social restraint
Inability to emotionally connect in social and professional relationships
Tendency to provoke interpersonal conflict
Ability to merge personal boundaries with others
personality disorder
Severe spasm of the tongue, neck, face, and back
facial grimacing
invoulantary upward eye movement
are all symptoms of ________
Acute dystonia
Believes that her thoughts have been removed from her mind by an outside agency
Thought withdrawal:
Feels singled out for harm by others being hunted down by the FBI)
Persecution:
Avoid deny/arguing
Discuss your observation
Assess for command, client needs
are all Therapeutic Guidelines for ___________
Hallucinations
Social withdrawal, lack of emotion, lack of energy, flattened affect, decreased motivation, decreased pleasure in activities
NEGATIVE SYMPTOMS
Narrowed perception, ‘selective inattention’
Can problem solve, defense mechanisms used
Restless, irritable,
Increased physical s/s – pulse, h/a, GI, shaking, GU
is what type of anxiety
Moderate
Focus on 1 detail or many scattered
Cannot problem solve
‘sense of impending doom’ More s/s
“Fight or flight”
is what type of anxiety
Severe
EFFECTS OF INTOXICATION of _________
• Mild toxicity:
dizziness, irritability, tremor, blurred vision
• Severe effects:
hallucinations, seizures, extreme fever, tachycardia, hypertension, chest pain, possible cardiovascular collapse and death
cocaine
The client experiences delusional thinking for at least 1 month Self or interpersonal functioning is not markedly impaired
Delusional disorder
complex neurodevelopmental disorder thought to be of genetic origin with a wide spectrum of behaviors affecting an individual’s ability to communicate and interact with other
Cognitive and language development are typically delayed Characteristic behaviors include inability to maintain eye contact, repetitive actions, and strict observance of routines
more common in boys than girls
Autism spectrum disorder
Methadone substitution, clonidine, buprenorphine, naltrexone, levo-alpha-acetylmethadol
are all meds used for
Opioid withdrawal:
Low blood pressure with possible orthostatic hypotension
Decreased pulse and body temperature
body weight of less than 85% of expected normal
fine, downy hair (lanugo) on the face and back
yellowed skin:
mottled, cool extremities: and poor skin turgor
Dental erosion and caries (if the client is purging)
amenorrhea
constipation
anorexia
Paranoid:
Schizoid:
Schizotypal:
are all ___________ personality disorders
Cluster A (odd or eccentric traits)
Lack of energy
anergia
Restlessness, anxiety, motor agitation, and
fluctuating moods are common Personality change
Some perceptual disturbances can be present,
such as hallucinations and illusion
Change in reality can cause fear, panic, and anger
Can cause vital signs to become unstable requiring
intervention
Should be considered a medical emergency
delerium
Decrease stimuli Reality orientation Assess for SI Calm demeanor Short statements Ensure personal needs met (food, rest etc.) Medication (scheduled or prn) Vital signs
are all nursing interventions for ______
PTSD
WITHDRAWAL MANIFESTATIONS of _______
Abstinence syndrome begins with sweating and rhinorrhea progressing to piloerection (gooseflesh), tremors, and irritability followed by severe weakness, diarrhea, fever, insomnia, pupil dilation, nausea and vomiting, pain in the muscles and bones, and muscle spasms
8-24 hours
Withdrawal is very unpleasant but not life-threatening
opioids
The client can compensate for binge eating through other means, such as excessive exercise and the misuse of laxatives, diuretics, and/or enemas
Nonpurging type
Decrease stimuli Reality orientation Calm demeanor; Firm, short statements Ensure personal needs met (food, rest etc.) Medication (scheduled or prn) Vital signs
are all nursing interventions for _____________
Severe to Panic level of anxiety
with First-generation (conventional) antipsychotic medications
low EPSs, high sedation, and high anticholinergic adverse effects
Low potency:
Clients recurrently eat large quantities of food over a short period of time (binge eating), which can be followed by inappropriate compensatory behaviors, such as self-induced vomiting (purging), to rid the body of
the excess calories
Bulimia nervosa
Psychostimulant drugs (methylphenidate and amphetamine salts) and nonstimulant selective norepinephrine reuptake inhibitor (atomoxetine)
are good for _____
ADHD
The situation is defused for a while after the violent episode The abuser becomes loving, promises to change, and is sorry for the behavior The vulnerable person wants to believe this and hopes for a change Eventually, the cycle begins again
honeymoon phase
age: any age Event: trauma, violence, rape, witness to traumatic event Occupation: nurses, police, military Family history: Repeat exposure
are all risk factors for
PTSD
These antipsychotic agents work mainly by blocking serotonin, and to a lesser degree, dopamine receptors
These medications also block receptors for norepinephrine, histamine, and acetylcholine
Antipsychotics: Second- and third-generation (atypical)
Characterized by emotional attention-seeking behavior, in which the person needs to be the center of attention: often seductive and flirtatious
Histrionic:
Bradykinesia Shuffling gait Drooling Tremors stooped posture rigidity pill rolling moion
are all symptoms of _________
Pseudoparkinsonism
EFFECTS OF INTOXICATION of _________
Slurred speech, impaired memory, pupillary changes
Decreased respirations and level of consciousness, which can cause death
Maladaptive behavioral or psychological changes, including impaired judgment or social functioning
• An antidote, naloxone, available for IV use to relieve effects of overdose
opioids
The client has intellectual deficits with mental abilities such as reasoning, abstract thinking, academic learning,
and learning from prior experience
impaired ability to maintain personal independence and social responsibility, including activities of daily living, social participation, and the need for ongoing support at school
Intellectual developmental disorder
Misconstrues trivial events and attaches personal significance to them, such as believing that others, who are discussing the next meal, are talking about him
• Ideas of reference:
Focus on the feeling
Do not agree/support delusions
Avoid arguing
Matter of fact approach
are all Therapeutic Guidelines for ___________
Delusions
death can occur in alcohol levels greater than ____
0.4% or 400g/dL
puroposeful imitation of movements made by others
echopraxia
Characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism: often uncooperative
Schizoid:
Poverty of thought or speech The client might sit with a visitor but only mumble or respond vaguely to
questions
Alogia
Chewing sugarless gum
Sipping on water
Avoiding hazardous activities
Wearing sunglasses when outdoors
Eating foods high in fiber
Participating in regular exercise
Maintaining fluid intake of 2 to 3 L/day from beverages and food sources
Voiding just before taking medication
are all strategies to decrease _____________
anticholinergic effects
Believes that others’ thoughts are being inserted into his mind
Thought insertion:
Characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends
Dependent:
used to treat depression in patients who have psychotic disorders
paroxetine
Involves the inability of a person to control behaviors requiring sustained attention
Inattention is evidenced by a difficulty in paying attention, listening, and focusing
Hyperactivity is evidenced by fidgeting, an inability to sit still, running and climbing inappropriately, difficulty with playing quietly, and talking excessively
Impulsivity is evidenced by difficulty waiting for turns, constantly interrupting others, and acting without
the consideration of consequence•
Attention deficit hyperactivity disorder
Selective serotonin reuptake inhibitors and antipsychotic medications (risperidone, olanzapine, quetiapine, and aripiprazole)
are good for _______
Autism spectrum disorders:
Believes his actions or thoughts are able to control a situation or affect others, such as wearing a certain hat makes him invisible to others
Magical thinking:
Risperidone Olanzapine Quetiapine Ziprasidone Clozapine Aripiprazole
are all what type of medications
Second-generation/atypical antipsychotics
used to treat positive and negative symptoms
Risperidone Risperdal, Olanzapine (Zyprexa), Ziprasidone, (Geodon), Aripiprazole (Abilify) Quetiapine (Seroquel)
can be used in the treatment of
Conduct Disorder
type of hallucination that:
Seeing persons or things
Visual:
are Benzodiazepines used for short term or long term use?
short term
dry mouth
confusion
constipation
urinary retention
are all symptomes of __________ effects
Anticholinergic Effects
The client has manifestations similar to schizophrenia, but the duration is 1 to 6 months, and social/occupational dysfunction might not be present
Schizophreniform disorder:
Symptomatology:
inability to maintain eye contact; repetitive actions; and strict observance of routines; withdrawal of child into the self and into a fantasy world of his or her creation; marked abnormal impairment of social interaction and communication skills; marked restricted repertoire of activity and interest
Autism Spectrum Disorders
_________________ should be used with caution in clients who have pre-existing asthma or other obstructive pulmonary disorder. Bronchoconstriction can be caused by an increase of acetylcholine
Cholinesterase inhibitors
The client has impairments of personality (self and interpersonal) functioning However, impairment is not as severe as with schizophrenia
Schizotypal personality disorder
Confusion Assessment Method (CAM):
Neelon/Champagne (NEECHAM) Confusion Scale:
is for ________
For delirium
Withdrawal
fatigue, sleep disturbances, ↑ appetite, headache, irritability, muscle pain/stiffness, N/V, anxiety, difficulty concentrating, restlessness,
Stimulants
type of ADHD that: Cant sit still
Predominantly Hyperactive-Impulsive
rapid onset over a a short period of time (hours- days)
Impairments in memory, judgment, ability to focus,
and ability to calculate, Which can fluctuate
throughout the day
Disorientation and confusion often worse at night and early
Level of consciousness is usually altered and can
rapidly fluctuate
delerium
Associative looseness The client might say sentence after sentence, but each sentence can relate to a different topic, and the listener is unable to follow the clients thoughts
Flight of ideas:
metabolic syndrome orthostatic hypotension anticholinergic effects elevated prolactin levels sexual dysfunction mild eps aggitation, dizziness, sedation
are all complications of ________
Antipsychotics: Second- and third-generation (atypical)
This disorder is characterized by a recurrent pattern of the following antisocial behavior:
Negativity Disobedience Defiant behaviors (especially toward authority figures) Stubbornness Argumentativeness Limit testing Unwillingness to compromise Refusal to accept responsibility for misbehavior
Oppositional defiant disorder
Change in LOC
Hallucinations, delusions
Fluctuating symptoms
Medical emergency
Delirium
Cognitive deficits are not related to another mental health
disorder
Advanced age is the biggest risk factor Other causes include
genetics, sedentary lifestyle, metabolic syndrome, and
diabetes
Subtypes of neurocognitive disorder can be related to:
Alzheimer’s disease
Traumatic brain injury
Parkinson’s disease
Other disorders affecting the neurological system
irreversible
neurocognitive disorder
Manifestation of things that are not normally present These are the most easily identified manifestations
POSITIVE SYMPTOMS
what is the treatment for Tardive dyskinesia
there is none
Clients who have this disorder exhibit recurrent temper outbursts that are severe and do not correlate with
situation
Temper outbursts are present three or more times per week and are observable by others, such as parents,
peers, and teachers, in at least by settings, such as home and school
Disruptive mood dysregulation disorder
Brief Interview for Mental Status (BIMS):
Used for clients in ______ care settings
long-term
stage of alzheimers where
Forgetting events of one’s own history
Difficulty performing tasks that require planning and organizing (paying bills, managing money)
Difficulty with complex mental arithmetic
Personality and behavioral change
appearing withdrawn or subdued, especially in social or mentally
challenging situations: compulsive: repetitive actions
Changes in sleep patterns
Can wander and get lost
Can be incontinent
Clinical findings that are noticeable to others
Moderate Alzheimer’s (middle stage)
4 types of medications for anxiety are
Anxiolytics
Antidepressants
SSRI
Sedative-Hypnotic Sleep Agents
Antisocial:
Borderline:
Histrionic:
Narcissistic:
are all ___________ personality disorders
Cluster B (dramatic, emotional, or erratic traits)
The clients disorder meets the criteria for both schizophrenia and depressive or bipolar disorder
Schizoaffective disorder:
Predisposing Factors:
Genetic Factors
Disruptions in Embryonic Development- account for 30% of cases
Pregnancy and Perinatal Factors- account for 10% of cases (fetal malnutrition, viral/other infections, prematurity)
General Medical Conditions Acquired in Infancy or Childhood- 5% of cases
Sociocultural Factors and Other Mental Disorders- 15-20% of cases
Intellectual Disability:
Avoidant:
Dependent:
Obsessive-Compulsive:
are all ___________ personality disorders
Cluster C (anxious or fearful traits; insecurity and inadequacy)
Risperidone (Risperdal)- 5-16/Aripiprazole (Abilify) 6-17
Target: Agitation/deliberate self-injury/Tantrums/Rapid mood swings
can be used to help treat
Autism Spectrum Disorders
Clients who have _______ can have enlargement of the parotid glands
bulimia
with First-generation (conventional) antipsychotic medications
high EPSs, low sedation, and low anticholinergic adverse effects
High potency:
WITHDRAWAL MANIFESTATIONS of __________
Manifestations include abdominal cramping: vomiting: tremors: restlessness and inability to sleep: increased heart rate: transient hallucinations or illusions: anxiety: increased blood pressure, respiratory rate, and temperature: and tonic-colonic seizure.
alcohol
the inability to incorporate positive and negative aspects of oneself or others into a whole image
splitting
Risk factors for ________ include physiological changes, including neurological (Parkinson’s disease,
Huntington’s disease): metabolic (hepatic or renal failure, fluid and electrolyte imbalances, nutritional
deficiencies): and cardiovascular and respiratory diseases: infections (HIV/AIDS): surgery: and substance
use or withdrawal
delirium
: Antipsychotropics
Haloperidol (Haldol)/Pimozide (Orap)- Motor and vocal tics
can be used in the treatment of
Tourette’s
3 main therapies for anxiety disorder are
Individual Psychotherapy
CBT
Desensitization Therapy
Onset:
Childhood <10 years or Adolescence >10 years
Childhood onset is greater in males; Adolescent onset s equal in male/female
Conduct Disorder
Advise the client to avoid over-the-counter medications that contain anticholinergic agents, such as sleep aids and antihistamin
Advise the client to avoid alcohol and other medications that cause CNS depression
Advise the client to avoid hazardous activities, such as driving
Advise the client to avoid concurrent use of levodopa and other direct dopamine receptor agonists
First-generation antipsychotic medications
• Persistent energy intake restriction leading to significantly low body weight in context of age, sex,
developmental path, and physical health
• Fear of gaining weight or becoming fat
Disturbance in self-perceived weight or shape
Anorexia nervosa
The individual drastically restricts food intake and does not binge or purge
Restricting type
Disturbance of consciousness and a change in cognition that develops over a short period of time, reversible
Major Causes:
Substance Induced
Substance Withdrawal
Infection
Delirium
This type of disorder is characterized by excessive anxiety when a child is separated from or anticipating
separation from home or parents The anxiety can develop into a school phobia or phobia of being left alone
Separation anxiety disorder
Is obsessed with religious beliefs
Religiosity:
Progressive deterioration in intellectual functioning, judgment, memory, ability to problem solve, and learning new skills despite being in a state of full alertness Irreversible, gradual onset
Dementia
related to behavior, thought, perception, and speech: Agitation, bizarre behavior, delusions, hallucinations, flight of ideas, loose associations
POSITIVE SYMPTOMS
type of hallucination that:
The voice instructs the client to perform an action, such as to hurt self or others
Command:
EFFECTS OF INTOXICATION of __________
- Impaired judgment, psychomotor agitation, hyper-vigilance, extreme irritability
- Acute cardiovascular effects (tachycardia, elevated blood pressure), which could cause death
amphetamines
onset Between the ages of 8 and no later than adolescence
Comorbidities include: ADHD, Anxiety Disorders, & Mood Disorder
More prevalent in boys than girls before puberty; rates are about equal after puberty
Oppositional Defiant Disorder
Symptomatology:
Inattention: Difficulty paying attention, listening, and focusing
Hyperactivity: Fidgeting, in ability to sit still, running and climbing inappropriately, difficulty playing quietly, and talking excessively
Impulsivity: difficulty waiting for turn, constantly interrupting others, acting without consideration of consequences
ADHD
Selective serotonin reuptake inhibitors (fluoxetine): mood stabilizers (lithium): antipsychotics (clozapine and haloperidol): beta blockers
Intermittent explosive disorder:
Repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated
Physical aggression is common and peer relationships are disturbed
Conduct Disorder
maternal rubella
fragile x syndrome
down syndrome
TB
can be considered influences for
Autism Spectrum Disorders
Characterized by the presence of multiple motor tics and one or more vocal tics, tics can occur simultaneously or at different periods of the illness.
Onset can be as early as 2 years, but commonly 6-7 years
More common in boys than girls
Can be lifelong, but usually diminish in adolescence and adulthood (can disappear all together in early adulthood in some cases)
Tourette’s Disorder
anti psychotic medication that:
Less expensive More side effects Older meds Violence/aggression Target positive symptoms of schizophrenia
Typical/1st Generation
3 medications given to patients with Dementia
Donepezil
Memantine
Haldoperidol
type of ADHD that: Inability to focus
Predominantly Inattentive
These medications are contraindicated in clients who are in a coma or have Parkinson’s disease, liver damage, or severe hypotension
First-generation antipsychotic medications
opposition in ages : 10-11 months, 18-36 months, & adolescence is
Normal opposition
Symptomatology:
Motor tics – Head, torso, upper/lower limbs
Simple – blinking, neck jerking, shoulder shrugging, or facial grimacing
Complex – squatting, hopping, skipping, tapping, or retracing steps
Vocal Tics – Various words of sounds
Simple – squeaks, grunts, barks, sniffs, snorts, or coughts
Complex – Obscenities
Tourette’s Disorder
Disulfiram
Acamprosate
Naltrexone
SSRIs
are all used with
Alcohol Abuse Disorder
4 types of medications for PTSD
Anxiolytics
Antidepressants
SSRI
Sedative-Hypnotic Sleep Agents
Effects of excess of _________
Slurred speech, nystagmus, memory impairment, altered judgment, decreased motor skills, decreased level of consciousness (which can include stupor or coma), respiratory arrest, peripheral collapse, and death (with large doses)
Chronic use:
Direct cardiovascular damage, liver damage (ranging from fatty liver to cirrhosis), erosive gastritis and gastrointestinal bleeding, acute pancreatitis, sexual dysfunction
alcohol
GAD Panic Disorder Phobias Obsessive Compulsive Disorder Social Anxiety Disorder
are all types of _________
anxiery disorders
The tension becomes too much to bear, and serious abuse takes place The vulnerable person can try to cover up the injury or try to get help
acute battering phase
Persistent pattern of angry mood and defiant behavior must be present for at least six months and be exhibited in interaction with at least one person that is not a sibling
Angry/Irritable Mood
Argumentative/Defiant Behavior
Vindictiveness
Oppositional Defiant Disorder
type of hallucination that:
Smelling odors
Olfactory:
Persistent pattern of angry mood and defiant behavior
Interferes with social , educational , occupational, or other important areas of functioning
Oppositional Defiant Disorder
donepezil, rivastigmine, and galantamine
are all __________
In some clients, these medications improve the ability to perform self-care and slow cognitive deterioration of
Alzheimer’s disease in the mild to moderate stages
Cholinesterase inhibitor medications
Haloperidol
Loxapine
Chlorpromazine
Fluphenazine
are all what type of medications
First-generation/conventional antipsychotics
mainly used to treat positive symptoms
Lack of motivation in activities and hygiene For example, the client completes an assigned task, such as making his bed, but is unable to start the next common chore without prompting
Avolition:
WITHDRAWAL MANIFESTATIONS for __________
Anxiety, insomnia, diaphoresis, hypertension, possible psychotic reactions, hand tremors, nausea, vomiting, hallucinations or illusions, psychomotor agitation, and possible seizure activity
sedatives, hypnotics, anxiolytics
Words jumbled together with little meaning or significance to the listener, such as, “Hip hooray, the flip is cast and wide-sprinting in the forest
Word salad:
