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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
Priority suicide interventions
Keep patient safe Reconnecting patient to others and instilling hope Restoring emotional stability Reducing suicidal behavior
26
Communication: suicide
Be direct when asking about suicidal ideation/planning (yes/no questions) Show empathy
27
Who is most at risk for suicide
Adolescents Adults 35-54 Elderly Veterans Substance dependence Domestic violence Those w/ legal and administrative stressors Those w/ financial strain
28
two exception to HIPAA
Mandated reporting Duty to warn
29
notifying authorities when there is judgement that the patient has harmed any person or is about to injure someone
Duty to warn
30
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
Mandated reporting
31
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)
Voluntary admission
32
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
involuntary admission
33
use of any manual, physical, or mechanical devices or material that when attached to the patients body restricts the patient's movement
physical restraint
34
solitary confinement in a fully protective environment for the purpose of safety or behavioral management
Seclusion
35
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
Least restrictive environment
36
Principles of therapeutic communication
-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
37
3 important Boundaries
-patients should stay out of intimate and personal zone -minimize self-disclosure -hold patients accountable for actions by following rules
38
wear and tear on a persons body and brain resulting from chronic stress
allostatic load
39
when stress becomes chronic, body releases
cortisol
40
Reason for leukopenia / agranulocytosis (Decreased WBCs)
Medication: phenothiazine, clozapine, carbamazepine
41
Reason for "shift to the left" of WBC differentials
Lithium NMS
42
Reason for thrombocytopenia (decreased platelets)
Bacterial infection- NMS
43
reason ALT > AST
Viral and drug induced hepatic dysfunction Sodium valproate
44
reason AST > ALT
Liver disease Post-MI
45
Reason for increased CPK
NMS Repeated intramuscular injections
46
Reason for hypothyroidism (decreased T3)
Medications: lithium and sodium valproate
47
Effects for Hyperthyroidism (increased T3)
Cause mood changes, anxiety, s/s of mania
48
establishes a baseline, provides a snapshot of where the patient is at a moment, and creates a written record
Mental status exam
49
MSE includes:
General observation Orientation Mood and affect Speech Thought process Cognition
50
General observation includes: (MSE)
Initial impression of the patient Patient's appearance Affect Psychomotor activity Overall behavior
51
Orientation includes (MSE)
Date Time Current location Situation
52
prominent, sustained, overall emotions that the person expresses and exhibits
mood
53
person's capacity to vary outward emotional expression; fluctuates with thought content and can be observed in facial expressions, vocal fluctuations, and gestures
affect
54
Types of mood
Euthymic: normal Euphoric: elated Labile: changeable Dysphoric: depressed, disquieted, and restless
55
affect can be described by:
range intensity appropriateness stability
56
Speech analysis (MSE)
what they say how they say it
57
thought process analysis (MSE)
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
Cognition analysis (MSE)
Attention and concentration Abstract reasoning and comprehension Memory- short term, recent, and remote Insight and judgement
59
thoughts about oneself, the world, and the future
Cognitive triad
60
4 types of cognitive distortions
Overgeneralization Personalizing Catastrophizing Selective abstraction
61
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
Overgeneralization
62
Cognitive distortion: I didn't get the job because everyone hates me
Personalizing
63
Cognitive distortion: If I fail this test, I will be a total failure in life
catastrophizing
64
Cognitive distortion: Someone attends a party and afterward focuses on the one awkward look directed her way and ignores the hours of smiles
selective abstraction
65
Responding to distortion: Can't change what happened-> change how you look at it
emotion based reframing
66
Responding to distortion: Didn't do well one time -> change behaviors to make it better next time
problem based reframing
67
Most times you can not change the event but can change another factor within the cycle: (5)
Perception Mood state Feelings Thoughts Beliefs
68
s/s of opiate intoxication
* Euphoria * Sedation * Reduced libido * Memory & concentration difficulties * Analgesia * Constipation Constricted pupils
69
s/s of stimulant intoxication
* Euphoria * Initial CNS stimulation --> CNS depression * Wakefulness * Decreased appetite * Insomnia * Paranoia * Aggressiveness * Dilated pupils Tremors
70
s/s of alcohol intoxication
* Sedation * Decreased inhibitions * Relaxation * Decreased coordination * Slurred speech Nausea
71
s/s of opiate overdose
* Respiratory depression * Stupor Coma
72
s/s of stimulant overdose
* Cardiac arrhythmias/arrest * Elevated or Decreased BP * Respiratory depression * Chest pain * Vomiting * Seizures * Psychosis * Confusion * Dyskinesia * Dystonia Coma
73
s/s of alcohol overdose
* Respiratory distress Cardiac arrest
74
s/s of opiate withdrawn
* Abdominal cramps * Rhinorrhea * Watery eyes * Dilated pupils * Yawning * Goose bumps * Diaphoresis * Nausea * Diarrhea * Anorexia * Insomnia Fever
75
s/s of stimulant withdrawal
* Depression * Psychomotor retardation -> agitation * Fatigue -> insomnia * Severe dysphoria and anxiety * Cravings * Vivid, unpleasant dreams Increased appetite
76
s/s of alcohol withdrawal
* Tremors * Seizures * Elevated Temp * Elevated Pulse * Elevated BP Delirium tremens
77
priority assessment of alcoholism
CIWA
78
CIWA factors being measured and how scale works
Nausea/vomiting Tremors Sweating Anxiety Agitation Ranked 0-7; not present - severe total (most severe) = 35
79
how is a CIWA score used
determines amount of medication to give
80
CIWA medications and reasons to give
Chlordiazepoxide (Librium) and Diazepam = smoother taper off Lorazepam (Ativan)= better for older adults and those with liver impairment
81
generative brain disorder caused by thaimine deficiency
wernicke encephalopathy
82
s/s of wernicke encephalopathy
Vision impairment Ataxia Hypotension Confusion coma
83
heart, vascular, and nervous system problems w/ withdrawal
Korsakoff amnestic syndrome
84
s/s Korsakoff amnestic syndrome
Amnesia Confabulation Attention deficit Disorientation Vision impairment
85
Wernicke-Korsakoff syndrome: acute phase vs chronic phase
acute: Wernicke Chronic: Korsakoff
86
Schizophrenia: How it presents
Positive symptoms: * Hallucinations * Delusions Negative symptoms * Flat affect * Withdrawal * Ambivalence * Alogia Neurocognitive * Word salad * Flight of ideas - Echolalia
87
Schizophrenia: assessment
Safety MSE ADLS Comorbidities
88
Schizophrenia: interventions & medications
Activities & exercise Nutritional intervention Psychosocial intervention Medication * 1st gen: Haldol * 2nd gen: Risperdal, Clozapine Extrapyramidal dysfunction * Procyclidine hydrochloride
89
MDD: presentation
Change in appetite & sleep Decreased interest Flat, blunted affect
90
MDD: assessment
CSSRS MSE ADLs
91
MDD: interventions & medications
Suicide prevention Therapeutic relationship CBT Electroconvulsive therapy Reframing cognitive distortions Medications: * Sertraline -Phenelzine
92
GAD: presentation
Worrying that impairs functioning Includes symptoms of whole body
93
GAD: assessment
CSSRS MSE Rule out cardio event
94
GAD: interventions and meds
Crisis communication Problem-based & emotional-based coping Meds: * Bupropion * Lorazepam
95
PTSD: Presentation
Intrusive symptoms Avoidance of persons, places or objects Hyperarousal Sleep disturbances
96
PTSD: assessment
CSSRS MSE Coping mechanisms ADLs
97
PTSD: Interventions & meds
Never touch w/o warning CBT Outpatient support Meds: * Sertraline -Lorazepam
98
Bipolar I: presentation
Cycling of moods Mania * Grandiosity * Flight of ideas * Need for sleep disturbance Depression
99
Bipolar I: assessment
ADLs CSSRS MSE Depression
100
Bipolar I: Interventions and meds
Prevention of delirious mania Promote rest Medication: * Lithium carbonate -Divalproex sodium
101
Borderline PD: presentation
Pervasive Instability in relationships Impulsivity Self injury, suicidal gesture
102
Borderline PD: Assessment
CSSRS MSE ADLs Anticipate manipulation
103
Borderline PD: Interventions
Non-emotional responses Positive attention Self-harm alternatives
104
Antisocial PD: presentation
Pervasive disregard for and Violation of the rights of others Exploitive Charismatic Charming Lack of accountability
105
antisocial PD: assessment
CSSRS MSE Avoid manipulation Anticipate violence
106
Antisocial PD: interventions
Hardly ever seen in hospitals bc they will agree to come but wont show No real treatment
107
Anorexia Nervos: presentation
Thin Lanugo Rigid, strict, controlled Hair loss
108
Anorexia Nervos: Assessment
CSSRS MSE Fluid/electrolyte imbalance ADLs Monitor for cardiovascular dysfunction
109
Anorexia Nervosa: interventions
Antidepressants Token Economy CBT Monitor meals CBT
110
Bulimia nervosa: presentation:
Normal or overweight Impulsive Labile Reactive Oral indicators
111
Bulimia Nervos: assessment
CSSRS MSE Fluid/electrolyte imbalance ASLs Monitor for cardio dysfucntion
112
Bulimia Nervosa: interventions
Antidepressants Token Economy CBT Monitor meals CBT

Mental Health (3 decks)

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