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Community Mental Health Nursing > HESI Review > Flashcards

HESI Review Flashcards

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1
Q

Milieu Therapy

A

Planned use of people, resources, and activities in the environment to assist in improving interpersonal skills, social functioning, and performing ADLs

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2
Q

Behavior Modification

A

Attempts to change ineffective or maladaptive behavioral patterns

Focuses on consequences of actions rather than peer pressure

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3
Q

Crisis Intervention

A

Directed at the resolution of an immediate crisis

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4
Q

Cognitive Therapy

A

Directed at replacing a client’s irrational beliefs and distorted attitudes

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5
Q

Electroconvulsive Therapy

A

Used with severely depressed clients who fail to respond to antidepressant medications and therapy

Anticholinergic (atropine sulfate) given 30 minutes prior to treatment

Have an emergency cart, suction, and oxygen ready

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6
Q

Displacement

A

Transference of feelings to another person or object

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7
Q

Projection

A

Attributing one’s own thoughts or impulses to another person

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8
Q

Reaction Formation

A

Development of conscious attitudes and behaviors that are the opposite of what is really felt

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9
Q

Repression

A

The involuntary exclusion of painful thoughts or memories

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10
Q

Sublimaiton

A

Substitution of an unacceptable feeling with a more socially accepted one

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11
Q

Suppression

A

Exclusion of feelings and ideas

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12
Q

Mild Anxiety

A

Increased levels of sensory awareness

Allows for logical thoughts

Associated with daily life and motivates learning

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13
Q

Moderate Anxiety

A

Motivates learning with assistance from others

Allows client to be attentive and able to focus, but not at an optimal level

Dulls perceptions of stimuli

Client is restless, has headaches, nausea, diarrhea, tachycardia

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14
Q

Severe Anxiety

A

Stimulates fight-or-flight

Stimuli input becomes disorganized

Impairs concentration and results in selective attention

Verbalization of emotional pain

Tremors, increased motor activity

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15
Q

Panic

A

Causes perceptions to be grossly distorted

Client feels overwhelmed

Anger and aggression

Requires immediate intervention

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16
Q

Generalized Anxiety Disorders

A

Unrealistic, excessive, or persistent anxiety and worry about two or more life circumstances

6 months or longer

Severe anxiety, motor tension, SOB, palpitations, on edge

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17
Q

Panic Disorders and Phobias

A

Discrete periods of intense fear or discomfort that are unexpected

Client recognizes fear is unrealistic but can’t help it

Autonomic hyperactivity, panic attacks, drug/alcohol use to cope

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18
Q

Obsessive-Compulsive Disorders

A

Repetitive thoughts (obsession) or irresistible impulses (compulsion)

Magical thinking, difficulty with interpersonal relationships, safety issues, recurring intrusive thoughts

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19
Q

Antianxiety Drugs

A

Benzodiazepines (epams)

Nonbenzodiazepines (Busipirone, Zolpidem, Ramelteon)

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20
Q

Benzodiazepines

A

Safer than sedative hypnotics

Administer at bedtime

Avoid alcohol

Gradually taper drug therapy

Short-term drug

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21
Q

Antidepressants

A

Tricyclic

MAOIs

SSRIs

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22
Q

Tricyclics

A

Amitryptiline, Desipramine, Imipramine

Anticholinergic effects

Administer at bedtime

Takes 2-6 weeks to achieve therapeutic effects

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23
Q

MAOIs

A

Isocarboxazid, Phenelzine sulfate

Depression, phobias, anxiety

May cause HTN crisis

Must not be used with tricyclics

Avoid tyramine (aged cheese, wine, beer, beef, chicken, chocolate)

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24
Q

SSRIs

A

Fluoxetine, Sertraline, Citalopram

Depression, anxiety, panic disorder, aggression, anorexia, OCD

Effective 2-4 weeks after treatment is initiated

Wait at least 14 days between discontinuing MAOI and starting Fluoxetine

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25
Q

Traumatic and Stressor Related Disorders

A

Anxiety level is proportional to perceived degree of threat

Shock, anger, panic, denial

Self-destructive behavior

Visible reminders of trauma

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26
Q

Antipsychotic Drugs

A

Phenothiazines

Nonphenothiazines

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27
Q

Phenothiazines

A

Chlorpromazine

Extrapyramidal symtpoms

May cause drowsiness, weightgain, photosensitivity

Used to control hallucinations, delusions, bizarre behavior

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28
Q

Nonphenothiazines

A

Haloperidol

Controls psychotic behavior with less sedation

Severe extrapyramidal symptoms

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29
Q

Somatic Symptom Disorder

A

Long history of health visits to HCPs for multiple somatic complaints

Most frequently pain, palpitations, or dizziness

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30
Q

Factitious Disorder

A

Deliberate exaggeration of symptoms for self gains

31
Q

Munchausen Syndrome

A

Severe and chronic form of factitious disorder that may result in severe self-harm that requires treatment at the hospital

32
Q

Factitious Disorder by Proxy

A

Occurs when a person foists deliberate fabricated symptoms onto another person

33
Q

Munchausen Syndrome by Proxy

A

Occurs when a caregiver causes a child to require treatment for an injury stimulated by them

34
Q

Malingering

A

Occurs when a client creates complaints for secondary gain (to obtain a disability check)

35
Q

Dissociative Amnesia

A

Sudden temporary inability to recall extensive personal events

Occurs after traumatic event

Most common dissociative disorder

36
Q

Dissociative Identity Disorder

A

Person assumes two or mote identities simultaneously

Emerges during stress

37
Q

Depersonalization Disorder

A

Characterized by temporary loss of one’s reality and the ability to feel and express emotions

Expresses detachment with regard to surroundings

38
Q

Schizotypal Personality

A

Has interpersonal deficits

Has eccentricities and odd beliefs

Is socially isolated

39
Q

Antisocial Personality

A

Shows aggressive acting-out behavior pattern without remorse

Clever and manipulative

Lacks social conscience; immature and impulsive

40
Q

Borderline Personality

A

Has disturbances regarding self-image

Shows impulsive, self-damaging behavior, makes suicidal gestures

Overly dependent

Self-critical, demanding, whiny, manipulative, argumentative, verbally abusive

41
Q

Narcissistic Personality

A

Perceives self as all-powerful and important, is critical of others, arrogant

Needs attention and admiration

Exploits others, lacks empathy

42
Q

Avoidant Personality

A

Socially inhibited, feels inadequate

Hypersensitive to negative criticism/rejection

Longs for relationships

43
Q

Dependent Personality

A

Has unreasonable wishes/wants, expresses needs in a demanding manner while professing independence

Passive and does not accept responsibility

Low self-esteem

44
Q

Obsessive-Compulsive Personality

A

Attempts to control self through the control of others or the environment

Shows inattention to new facts or viewpoints

Perfectionist, cold and rigid towards others

Preoccupied with efficiency and productivity

45
Q

Anorexia Nervosa

A

Distorted body image and intense fear of becoming obese drive excessive dieting and exercise

46
Q

Bulimia Nervosa

A

Eating disorder characterized by eating excessive amounts of food followed by self-induced purging

47
Q

Mild Depression

A

Feelings of sadness

Difficulty concentrating and performing activities

48
Q

Moderate Depression

A

Feelings of helplessness and powerlessness

Decreased energy

Sleep pattern disturbances

Appetite and weight changes

Slowed speech, thought, movement

Rumination on negative feelings

49
Q

Severe Depression

A

Feelings of hopelessness, worthlessness, guilt, shame

Despair, flat affect, indecisiveness, suicidal thoughts

50
Q

Nursing Interventions for Depression

A

Directly ask about self-harm

Do not give the client a choice about participating in activities

Observe for sudden elevation in mood (may indicate increased risk for suicide)

Encourage discussion of feelings

Sit in silence if client in nontalkative

51
Q

Suicide Precautions

A

Previous suicide attempt

History of family suicide

Giving away possessions

Depressed –> happy

52
Q

Evaluation of Suicidal Intent

A

Identify the method (the more lethal the method, the higher the probability that attempt is imminent)

Determine availability of method chosen

53
Q

Mild Mania

A

Feeling of being on a high

Feelings of well-being

Minor alterations in habits

54
Q

Moderate Mania

A

Grandiosity, talkativeness, pressured speech, impulsiveness, excessive spending, bizarre dress/grooming

55
Q

Severe Mania

A

Extreme hyperactivity, flight of ideas, nonstop activity, talkativenss, easily distracted

Delusions of grandeur or persecution

56
Q

Mood-Stabilizing Drugs

A

Lithium carbonate

Anticonvulsant Mood Stabilizers

57
Q

Lithium Carbonate

A

Used for bipolar disorders

Assess electrolytes (Na+)

Keep salt usage consistent

Do not use with diuretics

58
Q

Anticonvulsant Mood Stabilizers

A

Valproic Acid, Carbamazepine, Lamotrigine

59
Q

Key Symptoms of Schizophrenia

A 
Delusions
Hallucinations
Disorganized speech
Disorganized behavior
Negative symptoms
60
Q

Catatonia

A

Stupor (decrease reaction to environment)

Rigidity (maintenance of a posture against efforts to be moved)

Posturing (waxy flexibility)

Negativism (resistance to instructions)

Excitement (severely agitated)

61
Q

Schizophrenia

A

Characterized by thought disturbance, altered affect, withdrawal from reality, regressive behavior, difficulty with communication, and impaired interpersonal relationships

62
Q

Alcohol Withdrawal Symptoms

A

Begin 4-6 hours after drinking, peaks in 48-72 hours

Delirium tremens may appear 12-36 hours after last drink

Tachycardia, tachypnea, diaphoresis, hand tremors, insomnia, NV, paranoia, grand mal seizures, hallucinations

63
Q

Disulfiram

A

Treatment of alcoholism; aversion therapy

Causes NV, hypotension, headaches, rapid pulse and respirations, flushed face, confusion, chest pain, weakness

64
Q

Opiate Withdrawal Symptoms

A

Dilated pupils, anxiety, diaphoresis, depression, fatigue, insomnia, tachycardia

65
Q

Opiate Overdose Symptoms

A

Constricted pupils, respiratory depression, unconsciousness leading to coma, death

66
Q

Antianxiety Drug Withdrawal Symptoms

A

Tremors, agitation, anxiety, abdominal cramps, NV, grand mal seizures

67
Q

Antianxiety Drug Overdose Symptoms

A

Drowsiness, confusion, hypotension, convulsion, shock, coma, death

68
Q

Delirium

A

Occurs in response to a specific stressor (infection, drug reaction, substance intoxication, electrolyte imbalance, head trauma)

Reversible if it is recognized by its sudden onset

Treatment is correction of causative disorder

69
Q

Dementia

A

Cognitive impairments characterized by gradual, progressive onset; irreversible

Aphasia, apraxia, agnosia

70
Q

Attention Deficit Hyperactivity Disorder (ADD/ADHD)

A

Disruptive behavior, excessive talking, underachievement, failure to follow instructions

71
Q

Autism Spectrum Disorder

A

Causes problems in social skills, communication, repetitive behaviors and routines, emotional attachment

72
Q

Conduct Disorder

A

Characterized by callous and unemotional interpersonal relationships

Significant impairment in social, educational, or occupational functioning

Physical fighting, running away, lying, stealing, animal cruelty, truancy, vandalism, alcohol/drugs

73
Q

Oppositional Defiant Disorder

A

Characterized by behavior that causes significant problems at school, work, or home

Argumentativeness, blaming others, defying rules, obscene language, resentfulness, vindictiveness

Community Mental Health Nursing (4 decks)

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