Final: New info Flashcards by Kalyn21Blessing .

S/S: Borderline PD

Unstable interpersonal relationships
Unstable self image
Unstable affect
Impaired problem solving
Self-harm behaviors

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S/S Antisocial PD

Pervasive pattern of disregard for and violation of the rights of others occurring since age 15

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Risk factors: Borderline PD

Sexual/physical abuse
Parental divorce
Illness
Parental psychopathology

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Risk Factors: Antisocial PD

Males w/:
Alcohol use disorders
Released from prison
Released from rehab
Adverse socioeconomic/sociocultural
Violent family life as child

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Comorbidities: Borderline PD

Major Depressive disorder
Eating Disorder
Anxiety disorder
Substance use disorder

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Comorbidities: Antisocial PD

Mood disorder
Anxiety disorder
Other personality disorders
Alcohol/Drug abuse (not diagnosable if only occurs w/ substance use)

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Priority Nursing intervention: Borderline PD

Don’t give unnecessary attention- positive reinforcement
DBT
MBT
Safety
Medications: SAFE doses (likely to try and OD)
-Mood stabilizers
-Atypical antipsychotics
-Antidepressants

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Priority nursing interventions: Antisocial PD

Typically not seen in for treatment
Protect other patients from harm
Identify dysfunctional thinking patterns and develop new problem-solving behaviors
Anger control
Milieu interventions

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Priority nursing assessment: Borderline PD

CSSRS
Head to toe- cutting/self harm
MSE

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Priority nursing assessment: Antisocial PD

CIWA (if indicated)
MSE

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Improve patients’ capacity to accurately understand others’ actions and develop self-awareness skills through therapeutic relationship

Mentalization-based therapy (MBT)

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Providing structured environment w/ rules that are consistently enforced

Milieu interventions

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restriction of intake. Leading to significantly low body weight

Anorexia

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Severity of anorexia by BMI

Mild BMI >17
Moderate BMI 16-16.9
Severe BMI 15-15.9
Extreme BMI <15

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2 Remission statuses of anorexia

Partial remission: Patient is no longer underweight but still restricts or binges/purges
Full remission: Criteria no longer applies

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2 types of anorexia

Restrictive: dieting, fasting, and/or excessive exercising
Binge-eating/purging type: binge eating followed by purging (vomiting, laxative, diuretics, enemas)

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rapid, episodic, impulsive, and uncontrollable ingestion of large amount of food during a short period of time followed by purging

Bulimia

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Complications of starvation to weight loss:
Musculoskeletal

Loss of muscle mass
Loss of fat
osteoporosis

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Complications of starvation to weight loss:
Gastro

Delayed gastric emptying
Bloating
Constipation
Abdominal pain
Gas diarrhea

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Complications of starvation to weight loss:
Cardiac

Bradycardia
Hypotension
Loss of cardiac muscle
Small heart
Cardiac arrhythmias
Prolonged QT interval
Ventricular tachycardia
Sudden death

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Complications of starvation to weight loss:
Metabolic

Hypothyroidism
Hypoglycemia
Decreased insulin sensitivity

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Complications of starvation to weight loss:
Reproductive

Amenorrhea
Irregular periods
Low FSH and LH

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Complications of starvation to weight loss:
Dermatologic

Dry, cracking skin
Brittle nails
Lanugo
Edema
Acrocyanosis
Thinning hair

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Complications of starvation to weight loss:
Hematologic

Leukopenia
Anemia
Thrombocytopenia
Hypercholesterolemia
Hypercarotenemia

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Complications of starvation to weight loss: Neuropsychiatric

Abnormal taste sensation Apathetic depression Mild organic mental symptoms Sleep disturbances fatigue

Starvation to weightless cause complications in these areas

Neuropsychiatric Hematologic Dermatologic Reproductive Gastrointestinal Cardiac Metabolic Musculoskeletal

Complications related to purging: Metabolic

Electrolyte abnormalities Hypokalemia Hypochloremic alkalosis Hypomagnesemia Increase BUN

Complications related to purging: Cardiac

Ipecac cardiomyopathy arrhythmias

Complications related to purging: Gastro

Salivary gland and pancreatic inflammation/enlargement Esophageal/gastric erosion and rupture Dysfunctional bowel w/ dilation Superior mesenteric artery syndrome

Complications related to purging: Neuropsychiatric

Seizures Mild neuropathies Fatigue Weakness Mild organic mental symptoms

Complications related to purging: Dental

Erosion of dental enamel (perimylolysis) (particularly frontal teeth Decreased decay

Eating disorder criteria for hospitalization: medical

Acute weight loss <85% below ideal Heart rate near 40 bpm Temp <36.1 Blood pressure <80/50 Hypokalemia Hypophosphatemia Hypomagnesemia Poor motivation to recover

Eating disorder criteria for hospitalization: Psychiatric

Risk for suicide Severe depression Failure to comply w/ treatment Inadequate response to treatment at another level of care

Supporting disclosure of sexual assault/ violence: children

Explain that you have to tell someone Do not promise to keep it a secret Never make assumptions about how the person feels about the abuser Support them through the healing process Details are not needed

Supporting disclosure of sexual assault/ violence: adults

Support them in any way possible Talk about collecting evidence, even if they don't want to use it now Let them know you believe them and are grateful they told you Let them know they are brave

Indicators of sexual violence: Physical

Bruising/bleeding/redness/rashes/bumps/scrapes/scabs/tears Especially around the genitals UTIs STIs/HIV Pregnancy Abnormal discharge Difficulty walking/standing Fear of physical contact Destructive coping mechanisms

Indicators of sexual violence: Behavioral

Withdrawal Disclosing Advanced sexual knowledge for age Indiscriminate sexual behavior Running away Abusing others Regression Over compliance Excessive nightmares Truancy/dropping out Substance abuse Sudden fear of situations/people

Indicators of human trafficing

New technology Tattoos More cash Change in demeanor/behavior Change in wardrobe/appearance Missing school Older friends or BF/GF

Barriers to disclosure

Scared no one will believe them Scared they will get hurt Don’t want to hurt loved ones

Power and control wheel Making her ask for money Giving her an allowance Taking her money Not letting her know about or have access to family income Preventing her from getting or keeping a job

Economic abuse

Power and control wheel Treating her like a servant Making all the big decisions Acting like the "master of the castle" Being the one to define men's and women's roles

Male privilege

Power and control wheel Making her feel guilty about the children Using the children to relay messages Using visitation to harass her Threatening to take the child away

Using children

Power and control wheel Minimizing, denying, and blamingMaking light of the abuse and not taking her concerns about it seriously Saying the abuse didn't happen Shift responsibility for abusive behavior Saying she caused it

Minimizing, denying, and blaming

Power and control wheel Controlling what she does, who she sees, talks to, what she reads, where she goes Limiting her outside involvement Using jealousy to justify actions

Using isolation

Power and control wheel Putting her down Making her feel bad about herself Calling her names Making her feel guilty Making her think she's crazy Playing mind games Humiliating her

Emotional abuse

Power and control wheel Making her afraid by using looks, actions, and gestures Smashing things Destroying her property Abusing pets Displaying weapons

Using intimidation

Power and control wheel Making and/or carrying out threats to do something to hurt her Threatening to leave her, commit suicide, report her to welfare Making her drop charges Making her do illegal things

Using coercion and threats

Indicators of child abuse

Don't want to go to someone's house Don't want to play a certain game anymore Describe the situation happening to a friend or a toy Journal or draw about abuse Want to tell you a BIG secret Saw something on a movie multiple stages of bruising explained bruising, cuts, broken bones

Indicators of elderly abuse

Multiple stages of bruising explained bruising, cuts, broken bones HIV/STDs vaginal bleeding New onset confusion, anxiety, depression

persistent pattern of inattention, hyperactivity, and impulsiveness

ADHD

S/S ADHD

Restless Busy Distractible Unable to take turns Disruptive Hypofocus

Non-pharmacological treatment of ADHD

Diet change Sleep Routien

Pharmacological treatment of ADHD

Methylphenidate

Techniques for data collection w/ child

Use simple vocabulary and short sentences tailored to child's developmental and cognitive levels No leading questions Child understands the question Tailor questions on individual basis Watch tone and face for personal bias Speak slowly and quietly Learn about child's current interests

emotional bond formed between child and their parental figured at an early age; attaining and retaining interpersonal connection to a significant person, beginning at birth

attachment

attachment type: inconsistent parenting style; anxious when separated "I want to be extremely emotionally close with others but they abandoned me"

anxious attachment

Attachment type: Individuals believe that they are unworthy of love due to severe childhood trauma, emotional neglect, or abuse "I have trust issues and maintain distance from others"

Fearful avoidant attachment

Attachment type: Formed when a parent fails to mee their child's needs emotionally "It is very important that I feel independent and self-sufficient"

Dismissive/avoidant attachment

Attachment type: Emotional bond that is formed when a parent constantly response to their child's every need and ensured that the child feels secure, understood, and calm "I don't worry about being abandoned or about someone getting too close to me"

Secure Attachment

person's characteristic intensity, activity level, rhythmicity, adaptability, energy expenditure, and mood

Temperament

Temperament type: positive mood, regular patterns of eating and sleeping, positive approach to new situation, low emotional intensity

Easy temperament

Temperament type: Irregular sleep and eating patterns, negative response to new stimuli, slow adaption, negative mood, and high emotional intensity

Difficult temperament

Temperament type: negative, mildly emotional response to new situation that is expressed with intensity and initially slow adaptation but evolves into a positive response

Slow-to-warm