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Mental Health > Final: Previous Material > Flashcards

Final: Previous Material Flashcards

1
Q

Defense mechanism: turning to/relying on others for help or support

A

affiliation

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2
Q

Defense mechanism: attributing exaggerated positive qualities to others

A

Idealization

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3
Q

Defense mechanism: transferring a feeling about or a response to one object onto another

A

Displacement

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4
Q

role of dopamine

A

Cognition, motor, and neuroendocrine function

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5
Q

role of norepinephrine

A

Generating and maintaining mood states

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6
Q

role of serotonin

A

Emotions, cognition, sensory perception, and essential biological functions (sleep and appetite)

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7
Q

Role of GABA

A

Control of neuronal excitability through the brain

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8
Q

too much/too little dopamine causes

A

Too much: Schizophrenia
Too little: Parkinsons

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9
Q

too much/too little norepinephrine causes:

A

Anxiety

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10
Q

Too much/too little serotonin causes:

A

Too much: Mania
Too little: Depression & Insomnia

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11
Q

Too much/ Too little GABA causes:

A

Too much: Seizures
Too little: Anxiety

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12
Q

Function: Hippocampus

A

Storing information-emotions attached to memory

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13
Q

Damage to hippocampus causes:

A

Left: verbal memory
Right: recognition and recall of complex visual and auditory patterns

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14
Q

Function of thalamus:

A

Sends sensory information (NOT SMELL) from PNS to CNS (mainly cerebral cortex)

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15
Q

Damage to thalamus causes:

A

Behavioral abnormalities

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16
Q

Hypothalamus function:

A

Regulates basic human activities- sleep, temperature, hunger, sex
Secretes hormones : antidiuretic & oxytocic

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17
Q

Hypothalamus dysfunction causes:

A

Side effects of psychiatric disorders
(temperature regulation, sleep disturbances)

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18
Q

Amygdala function

A

Modulating primitive controls: aggression and sexuality (INCLUDES SMELL)

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19
Q

amygdala dysfunction causes:

A

Impulsive acts of aggression and violence
Over sexual
(Bipolar)

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20
Q

Limbic midbrain nuclei function

A

Chemically reinforce certain behaviors

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21
Q

Limbic midbrain nuclei dysfunction causes:

A

Reinforcement of unhealthy/risky behaviors
Addiction

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22
Q

How to assess suicide

A

CSSRS
□ Do you wish you where dead?
□ Do you have thoughts of killing yourself?
□ Do you have a plan?
□ Do you have the means to complete this plan?
-Have you tried to kill yourself?

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23
Q

Warning signs for suicide (IS PATH WARM)

A

Ideation
Substance use
Purposelessness
Anxiety
Trapped
Hopelessness
Withdrawal
Anger
Recklessness
Mood change

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24
Q

Ranking of lethality of suicide plan/attempt (most lethal to least lethal)

A

Firearms
Drowning
Suffocation/hanging
Poisoning by gas
Jumping
Drug OD
Cutting

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25
Q

Priority suicide interventions

A

Keep patient safe
Reconnecting patient to others and instilling hope
Restoring emotional stability
Reducing suicidal behavior

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26
Q

Communication: suicide

A

Be direct when asking about suicidal ideation/planning (yes/no questions)
Show empathy

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27
Q

Who is most at risk for suicide

A

Adolescents
Adults 35-54
Elderly
Veterans
Substance dependence
Domestic violence
Those w/ legal and administrative stressors Those w/ financial strain

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28
Q

two exception to HIPAA

A

Mandated reporting
Duty to warn

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29
Q

notifying authorities when there is judgement that the patient has harmed any person or is about to injure someone

A

Duty to warn

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30
Q

times when the health care professionals are legally obligated to breach confidentiality and report an instance of abuse/neglect of vulnerable populations
65 and older
18 and younger

A

Mandated reporting

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31
Q

legal status of a patient who has consented to be admitted to the hospital for treatment
Patient maintains all civil rights and is free to leave at any time (even AMA)

A

Voluntary admission

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32
Q

confined hospitalization of a person without his./her consent, but instead a court order
Person has been judged to be a danger to themselves or others

A

involuntary admission

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33
Q

use of any manual, physical, or mechanical devices or material that when attached to the patients body restricts the patient’s movement

A

physical restraint

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34
Q

solitary confinement in a fully protective environment for the purpose of safety or behavioral management

A

Seclusion

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35
Q

patient has the right to be treated in the least restrictive environment for the exercise of free will
An individual cannot be restricted to an institution when they can be successfully treated in the community

A

Least restrictive environment

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36
Q

Principles of therapeutic communication

A

-patient should be the primary focus
-professional attitude sets the tone
-use self-disclosure cautiously and only when therapeutic
-avoid social relationships
-maintain confidentiality
-use patients intellectual competence to
-determine level of understanding
-use theoretic based interventions
-nonjudgemental attitude
-avoid giving advice
-guide patient to reinterpretation of experiences
-use clarifying statement
-avoid changing the subject unless in patients best interest

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37
Q

3 important Boundaries

A

-patients should stay out of intimate and personal zone
-minimize self-disclosure
-hold patients accountable for actions by following rules

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38
Q

wear and tear on a persons body and brain resulting from chronic stress

A

allostatic load

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39
Q

when stress becomes chronic, body releases

A

cortisol

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40
Q

Reason for leukopenia / agranulocytosis (Decreased WBCs)

A

Medication: phenothiazine, clozapine, carbamazepine

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41
Q

Reason for “shift to the left” of WBC differentials

A

Lithium
NMS

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42
Q

Reason for thrombocytopenia (decreased platelets)

A

Bacterial infection- NMS

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43
Q

reason ALT > AST

A

Viral and drug induced hepatic dysfunction
Sodium valproate

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44
Q

reason AST > ALT

A

Liver disease
Post-MI

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45
Q

Reason for increased CPK

A

NMS
Repeated intramuscular injections

46
Q

Reason for hypothyroidism (decreased T3)

A

Medications: lithium and sodium valproate

47
Q

Effects for Hyperthyroidism (increased T3)

A

Cause mood changes, anxiety, s/s of mania

48
Q

establishes a baseline, provides a snapshot of where the patient is at a moment, and creates a written record

A

Mental status exam

49
Q

MSE includes:

A

General observation
Orientation
Mood and affect
Speech
Thought process
Cognition

50
Q

General observation includes: (MSE)

A

Initial impression of the patient
Patient’s appearance
Affect
Psychomotor activity
Overall behavior

51
Q

Orientation includes (MSE)

A

Date
Time
Current location
Situation

52
Q

prominent, sustained, overall emotions that the person expresses and exhibits

A

mood

53
Q

person’s capacity to vary outward emotional expression; fluctuates with thought content and can be observed in facial expressions, vocal fluctuations, and gestures

A

affect

54
Q

Types of mood

A

Euthymic: normal
Euphoric: elated
Labile: changeable
Dysphoric: depressed, disquieted, and restless

55
Q

affect can be described by:

A

range
intensity
appropriateness
stability

56
Q

Speech analysis (MSE)

A

what they say
how they say it

57
Q

thought process analysis (MSE)

A

Rapid change of ideas
Inability or taking a long time to get to the point
Loose or no connections among ideas or words Rhyming or repetition of words, question, or phrases

58
Q

Cognition analysis (MSE)

A

Attention and concentration
Abstract reasoning and comprehension
Memory- short term, recent, and remote
Insight and judgement

59
Q

thoughts about oneself, the world, and the future

A

Cognitive triad

60
Q

4 types of cognitive distortions

A

Overgeneralization
Personalizing
Catastrophizing
Selective abstraction

61
Q

Cognitive distortion:
After going on a job interview and finding out we didn’t get the job, we conclude we will never get a job

A

Overgeneralization

62
Q

Cognitive distortion:
I didn’t get the job because everyone hates me

A

Personalizing

63
Q

Cognitive distortion:
If I fail this test, I will be a total failure in life

A

catastrophizing

64
Q

Cognitive distortion:
Someone attends a party and afterward focuses on the one awkward look directed her way and ignores the hours of smiles

A

selective abstraction

65
Q

Responding to distortion:
Can’t change what happened-> change how you look at it

A

emotion based reframing

66
Q

Responding to distortion:
Didn’t do well one time -> change behaviors to make it better next time

A

problem based reframing

67
Q

Most times you can not change the event but can change another factor within the cycle: (5)

A

Perception
Mood state
Feelings
Thoughts
Beliefs

68
Q

s/s of opiate intoxication

A
  • Euphoria
  • Sedation
  • Reduced libido
  • Memory & concentration difficulties
  • Analgesia
  • Constipation
    Constricted pupils
69
Q

s/s of stimulant intoxication

A
  • Euphoria
  • Initial CNS stimulation –> CNS depression
  • Wakefulness
  • Decreased appetite
  • Insomnia
  • Paranoia
  • Aggressiveness
  • Dilated pupils
    Tremors
70
Q

s/s of alcohol intoxication

A
  • Sedation
  • Decreased inhibitions
  • Relaxation
  • Decreased coordination
  • Slurred speech
    Nausea
71
Q

s/s of opiate overdose

A
  • Respiratory depression
  • Stupor
    Coma
72
Q

s/s of stimulant overdose

A
  • Cardiac arrhythmias/arrest
  • Elevated or Decreased BP
  • Respiratory depression
  • Chest pain
  • Vomiting
  • Seizures
  • Psychosis
  • Confusion
  • Dyskinesia
  • Dystonia
    Coma
73
Q

s/s of alcohol overdose

A
  • Respiratory distress
    Cardiac arrest
74
Q

s/s of opiate withdrawn

A
  • Abdominal cramps
  • Rhinorrhea
  • Watery eyes
  • Dilated pupils
  • Yawning
  • Goose bumps
  • Diaphoresis
  • Nausea
  • Diarrhea
  • Anorexia
  • Insomnia
    Fever
75
Q

s/s of stimulant withdrawal

A
  • Depression
  • Psychomotor retardation -> agitation
  • Fatigue -> insomnia
  • Severe dysphoria and anxiety
  • Cravings
  • Vivid, unpleasant dreams
    Increased appetite
76
Q

s/s of alcohol withdrawal

A
  • Tremors
  • Seizures
  • Elevated Temp
  • Elevated Pulse
  • Elevated BP
    Delirium tremens
77
Q

priority assessment of alcoholism

A

CIWA

78
Q

CIWA factors being measured and how scale works

A

Nausea/vomiting
Tremors
Sweating
Anxiety
Agitation
Ranked 0-7; not present - severe
total (most severe) = 35

79
Q

how is a CIWA score used

A

determines amount of medication to give

80
Q

CIWA medications and reasons to give

A

Chlordiazepoxide (Librium) and Diazepam = smoother taper off
Lorazepam (Ativan)= better for older adults and those with liver impairment

81
Q

generative brain disorder caused by thaimine deficiency

A

wernicke encephalopathy

82
Q

s/s of wernicke encephalopathy

A

Vision impairment
Ataxia
Hypotension
Confusion
coma

83
Q

heart, vascular, and nervous system problems w/ withdrawal

A

Korsakoff amnestic syndrome

84
Q

s/s Korsakoff amnestic syndrome

A

Amnesia
Confabulation
Attention deficit
Disorientation
Vision impairment

85
Q

Wernicke-Korsakoff syndrome: acute phase vs chronic phase

A

acute: Wernicke
Chronic: Korsakoff

86
Q

Schizophrenia: How it presents

A

Positive symptoms:
* Hallucinations
* Delusions
Negative symptoms
* Flat affect
* Withdrawal
* Ambivalence
* Alogia
Neurocognitive
* Word salad
* Flight of ideas
- Echolalia

87
Q

Schizophrenia: assessment

A

Safety
MSE
ADLS
Comorbidities

88
Q

Schizophrenia: interventions & medications

A

Activities & exercise
Nutritional intervention
Psychosocial intervention
Medication
* 1st gen: Haldol
* 2nd gen: Risperdal, Clozapine
Extrapyramidal dysfunction
* Procyclidine hydrochloride

89
Q

MDD: presentation

A

Change in appetite & sleep
Decreased interest
Flat, blunted affect

90
Q

MDD: assessment

A

CSSRS
MSE
ADLs

91
Q

MDD: interventions & medications

A

Suicide prevention
Therapeutic relationship
CBT
Electroconvulsive therapy
Reframing cognitive distortions
Medications:
* Sertraline
-Phenelzine

92
Q

GAD: presentation

A

Worrying that impairs functioning
Includes symptoms of whole body

93
Q

GAD: assessment

A

CSSRS
MSE
Rule out cardio event

94
Q

GAD: interventions and meds

A

Crisis communication
Problem-based & emotional-based coping
Meds:
* Bupropion
* Lorazepam

95
Q

PTSD: Presentation

A

Intrusive symptoms
Avoidance of persons, places or objects
Hyperarousal
Sleep disturbances

96
Q

PTSD: assessment

A

CSSRS
MSE
Coping mechanisms
ADLs

97
Q

PTSD: Interventions & meds

A

Never touch w/o warning
CBT
Outpatient support
Meds:
* Sertraline
-Lorazepam

98
Q

Bipolar I: presentation

A

Cycling of moods
Mania
* Grandiosity
* Flight of ideas
* Need for sleep disturbance
Depression

99
Q

Bipolar I: assessment

A

ADLs
CSSRS
MSE
Depression

100
Q

Bipolar I: Interventions and meds

A

Prevention of delirious mania
Promote rest
Medication:
* Lithium carbonate
-Divalproex sodium

101
Q

Borderline PD: presentation

A

Pervasive
Instability in relationships
Impulsivity
Self injury, suicidal gesture

102
Q

Borderline PD: Assessment

A

CSSRS
MSE
ADLs
Anticipate manipulation

103
Q

Borderline PD: Interventions

A

Non-emotional responses
Positive attention
Self-harm alternatives

104
Q

Antisocial PD: presentation

A

Pervasive disregard for and Violation of the rights of others
Exploitive
Charismatic
Charming
Lack of accountability

105
Q

antisocial PD: assessment

A

CSSRS
MSE
Avoid manipulation
Anticipate violence

106
Q

Antisocial PD: interventions

A

Hardly ever seen in hospitals bc they will agree to come but wont show
No real treatment

107
Q

Anorexia Nervos: presentation

A

Thin
Lanugo
Rigid, strict, controlled
Hair loss

108
Q

Anorexia Nervos: Assessment

A

CSSRS
MSE
Fluid/electrolyte imbalance
ADLs
Monitor for cardiovascular dysfunction

109
Q

Anorexia Nervosa: interventions

A

Antidepressants
Token Economy
CBT
Monitor meals
CBT

110
Q

Bulimia nervosa: presentation:

A

Normal or overweight
Impulsive
Labile
Reactive
Oral indicators

111
Q

Bulimia Nervos: assessment

A

CSSRS
MSE
Fluid/electrolyte imbalance
ASLs
Monitor for cardio dysfucntion

112
Q

Bulimia Nervosa: interventions

A

Antidepressants
Token Economy
CBT
Monitor meals
CBT

Mental Health (3 decks)

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