Inflammation / Cognition Flashcards
What is Ambivalence?
mixed feelings or contradictory ideas about something or someone
What is Associative Looseness?
inability to concentrate on a single thought
What is Bizarre Behaviors?
not normal behavior like walking backwards constantly
What is Echolalia?
repeats words spoken to them
What is Echopraxia?
purposeful imitation of movements made by others
What is Flight of Ideas?
someone speaks quickly and rapidly switches between ideas that are not obviously connect.
Ex: I love the sky. My water bottle is cold.
What is Perseveration?
repetition of particular response such as a word, phrase, or gesture
What is Ideas of reference?
false belief that random or irrelevant occurrence’s in the world directly relate to oneself
Ex: the newspaper is telling them that their mom is talking to them
What is Distortion in Perception-bizarre?
What is Alogia?
mumble or respond vaguely
What is Anhedonia?
lack of pleasure or joy
What is Apathy?
lack of motivation, interest or emotional expression
What is Blunted Affect?
reduced ability to express emotions through facial expression, tone of voice, physical movements
What is Catatonia?
person to appear unresponsive to their surroundings and environment which include
- lack of movement
- fast or strange movements
- lack of speech
What is Inattention?
lack of attention
What is Verbigeration?
repeating words, phrases, sentences in a way that is meaningless
ex: dog cat ate car work
What is Flat affect?
lack of facial expression
What is Clang association?
words that rhyme together
ex: bee see me tree
What is Neologism?
made up word
What is Stilted language?
speak in a formal or unnatural way
Ex: mr. wagoner
What is Word Salad?
jumble of words together
ex: bags stain purple vacuum. I no coffee lamp car. bag up me phone
What is Persecutory delusion?
pt. believes a person or group wants to hurt them and firmly believe that it is true.
ex: my neighbor breaks into my house and steals my clothes
What is Grandiose delusion?
pt. believes they are some sort of higher power.
ex: someone believes they are the president or superman.
What is Paranoid Delusion?
fixed false belief that someone is being threatened or mistreated
ex: the FBI is watching them
What is Religious delusion?
fixed belief that is not open to change believes that
- supernatural abilites
- religious mission
- persecuted for religious reasons
- possessed by evil spirit
- cursed by black magic
What is Command hallucination?
auditory hallucination that involve hearing voices that instruct the person to do something
What is Referential delusion?
belief that ordinary events and normal human behavior have hidden meanings that somehow relate to the pt.
ex: believing when a person is bowling their nose they are giving you nonverbal cues
What is visual hallucination?
a perception of something visual that is not actually there
What is auditory hallucination?
hearing voices
What is DSM-5-TR?
a manual use by clinicians and reseachers to diangose and classify mental disorders
(Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision)
What is psychoanalysis?
therapy that helps people understand how their past experiences shape their present and how to deal with those influences
What is transference?
when someone redirects their feelings about one person onto someone else
What is countertransference?
a clinicians lets their own feelings shape the way they interact with or react to their client in therapy
(can be a trigger)
What is free association?
therapeutic technique where the patient shares thoughts, words, and feelings without censoring themselves
What is avolition?
lack of motivation
What is anergia?
lack of energy
What is somatic belief?
believing something about a body part
Ex: bugs are under my skin
What are positive symptoms for schizophrenia?
- disorganized thinking
- hallucinations
- delusions
What are negative symptoms of schizophrenia?
the 6 a’s
What does a person need to have to be diagnosed with schizophrenia?
What is the main goal for inpatient schizophrenia?
to stabilize them on their meds and send them safely back into the world.
What is the nurses priority with a schizophrenia pt.?
safety
What should you ask the patient about if they are schizophrenic?
- If they have any hallucinations and what type
- if they have thoughts of harming themselves or others
What type of environment should you provide a person with schizophrenia?
- decreased stimuli
- headphones/ tv to distract the voices
- calm environment
What is AIMS?
Abnormal involuntary movement scale
What does AIMS screen for?
tool used to monitor involuntary movements and tardive dyskinesia in clients who take antipsychotics
What is the goal of treatment for schizos?
- suppression of acute episodes
- prevention of acute recurrence
- maintenance of highest possible level of functioning
What are first generation antipsychotics for?
- mainly used to control positive symptoms
Who do we give first generation antipsychotics to?
- pt. who use them successfully and can tolerate adverse effects
- concerned about cost of second generation
What is the first level of first generation antipsychotics?
- Low potency
- Low EPS
- High sedation
- High anticholinergic adverse effects
What is the second level of first generation antipsychotics?
- medium potency
- moderate EPS
- moderate sedation
- low anticholinergic adverse affects
What is the third level of first generation antipsychotics?
- High potency
- high EPS
- low sedation
- low anticholinergic adverse affects
What are second generation antipsychotics for?
- first line of treatment
- reliefs both + and - s/s
- fever adverse affects
What are the advantages for second generation antipsychotics?
- improve memory
- fewer or no EPS
- fewer anticholinergic effects
- less relapse
What are third generation antipsychotics used for?
treat both + and - while improving cognitive function
What are the advantages of third generation antipsychotics?
- decreased EPS
- lower risk for weight gain
- lower risk for anticholinergic effects
What are the first generation antipsychotics?
- Haloperidol
- Fluphenazine
- Loxapine
- Thiothixene
- Perphenazine
What are complications of first generation antipsychotics?
- agranulocytosis
- anticholinergic effects
- extrapyramidal adverse effects
What should you teach the pt. about agranulocytosis?
- monitor for fever, sore throat
(signs of infection)
What is the number you should discontinue for WBC on FGA?
below 3,000
What are the anticholinergic effects?
- dry mouth
- blurred vision
- photophobia
- urinary retention
- constipation
- tachycardia
What are some nursing interventions for anticholinergic effects for FGA?
- chewing gum
- sipping on water
- wear sunglasses outdoors
- fiber
What are the extrapyramidal adverse effects?
- acute dystonia
- pseudoparkinsonism
- Akathisia
- tardive dyskinesia
- neuroendocrine effect
- neuroleptic malignant syndrome
- orthostatic hypotension
- sedation
- seizures
- severe dysrhythmias
- sexual dysfunction
- skin effects
- liver impairment
What are second generation antipsychotic drugs?
- clozapine
- risperidone
- olanzapine
What is the most common therapeutic diet for the client with AGN?
low sodium, potassium, and sometimes fluid restriction.
Lower protein- more so with chronic
What is the potential long-term prognosis for AGN?
Most are resolved. In children, 1% and 10% of adults can have CKD
What are the first signs/symptoms of AGN?
Hematuria, oliguria, proteinuria, coughing and SOB, facial puffiness (in the morning)
What are the early signs/symptoms of CGN?
Swelling in the face or ankles, frequent urination, especially at night, foamy or bubbly urine, blood or
protein in the urine, high blood pressure.
What are the signs/symptoms of kidney failure?
n/v, lack of appetite, tired, poor sleep, dry and itchy skin. Nighttime muscle cramps
How can Acute Glomerular Nephritis (AGN) be prevented
Throat cultures and antibiotics – good diet after dx. Good hand hygiene
What is the most important intervention in treating AGN?
Antibiotics
What happens to the kidney in AGN?
Inflammation and clogging of the filtration system
How do you assess fluid excess in the child with AGN?
Daily weights and papilledema/hand swelling can be common as well.
What assessment findings may you expect in urine for glomerulonephritis?
Blood or protein (foamy or bubbly) in the urine. Urine can appear tea colored
How long after strep infection does AGN develop?
2-3 Weeks
Will the client have hypo or hypertension with glomerulonephritis?
Hypertension because retention of fluids
Name five medications that can cause kidney damage:
- Contrast dye
- NSAIDS
- Laxatives
- PPI
- HIV medications
- Cholesterol medications (statins)
- Antibiotics
- Diuretics
Serum
Creatinine range?
0.7-1.2
Serum
Creatinine high or low in glomerulonephritis?
high
Estimated Glomerular Filtration rate (eGFR) normal range?
90-120
Estimated Glomerular Filtration rate (eGFR) high or low in glomerulonephritis?
low
Blood Urea Nitrogen (BUN) normal range?
7-22
Blood Urea Nitrogen (BUN) high or low in glomerulonephritis?
high
Potassium normal range?
3.5-5
Potassium high or low in glomerulonephritis?
high
Urinalysis protein normal range?
more than 150 mg
urinalysis protein high or low in glomerulonephritis?
0.5-4g/ 24 hrs moderate
over 4g in 24 hrs heavy
Urinalysis specific gravity normal range?
1.005-1.030
Urinalysis specific gravity high or low in glomerulonephritis?
1.010
Calcium normal range?
8.4-10.2
Calcium high or low in glomerulonephritis?
low
Phosphorus normal range?
3-5.5
Phosphorus high or low in glomerulonephritis?
high
Identify meningitis manifestations associated with CNS infection in an infant client?
irritability, refusal to eat, fever, seizures, lethargy, rash/petechial- n/v
Identify meningitis manifestations associated with CNS infection in an adult client?
Confusion, Stiff neck/nuchal rigidity, headache, photophobia, fever, rash, drowsy/lethargic. n/v
What is a positive Brudzinski’s sign?
Bend the neck and pain happens in opposite extremities
What is a positive Kernig’s sign?
Flex hips and legs and feel a shooting pain up into your spine
List orders and the rationale that you may expect for a patient who is in a stupor with meningitis?
- Maintain HOB (at least 20 degrees) - mannitol
- seizure precautions
- possible mechanical ventilation
- paralytics (at times)
- fever management (hypothermia - - blanket/protocol)
Nursing interventions for a stable patient with meningitis?
- Maintain droplet and contact (difference- bacterial, highly contagious)
- Administer abx
- Monitor ICP- elevate bed, mannitol
- Maintain temp
- Seizure precautions
- Assess for rash
- Cluster cares
- Prevent injury from immobility (turns every two hours and checking under hypothermia blanket hourly for
breakdown or per facility policy) - Decrease stimuli/lighting
- Assess neurological status- breathing/cranial nerves if indicated.
- Antipyretics
CRP normal range?
less than 1
What are some nursing cares you should provide for the patient who is NPO?
- Good oral hygiene- swabs
- toothbrush with toothpaste
- chlorhexidine wash
- gum (if allowed)
- maintain upright position
- more frequent glucose checks (prednisone)
- residual checks
- mobility (constipation/retention), - - TPN
- Don’t talk about food.
What is acute pancreatitis?
inflammatory process due to activated pancreatic enzymes autodigesting the pancreas ranges from mild to necrotizing hemorrhagic
What is chronic pancreatitis?
Progressive destructive disease of inflammation and fibrosis of the pancreas
