Little Bits and Bobs 2

Question 1

Thyroid stimulating hormone (TSH)

Answer 1

Higher levels suggest hypothyroidism, or an underactive thyroid, while lower levels indicate hyperthyroidism, or an overactive thyroid

Question 2

Fitness assessment

Answer 2

Assessment regarding clients ability to stand trial
If unfit, treatment services provided to allow the person a chance to recover and become fit to stand trial
If unfit, trial is postponed until the client is found to be Fit to Stand Trial
If unfit, person will have a disposition hearing

Question 3

Responsibility assessment

Answer 3

Not Criminally Responsible :
The accused suffered from a mental disorder when they committed the criminal act or made the omission that formed the basis of the offence they were charged with by the judge or jury
At the time of the offence were unable to distinguish right from wrong

Question 4

Possible dispositions:

Answer 4

1. Detention in custody in a Hospital
2. Discharge (subject to Review Board’s conditions) to community placement
3. Absolute discharge (Review Board has no further involvement)

Question 5

Neuroleptic Malignant Syndrome

Answer 5

Extrapyramidal side effects (muscle rigidity)
Increased body temperature (diaphoresis)
Change in consciousness (delirium, confusion, coma)
Fluctuating BP, Tachycardia, decrease respirations
Elevated CK and myoglobin (causes damage to the liver and kidneys)
Tremor
Progresses over days to weeks if untreated

Question 6

TIPP

Answer 6

temperature,
intense exercise,
paced breathing,
paired muscle relaxation (tighten/relax)
for DBT

Question 6

Trauma:

Answer 6

Anything that overwhelms a persons’ capacity to cope

Question 7

Crisis:

Answer 7

very tempory state. 4-6 weeks of intense disequilibrium

Question 8

rhabdomyolysis

Answer 8

occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death.

post restraint proteins can go onto blood stream and can be a medical emergency

Question 9

ECT Adverse Reactions

Answer 9

achy, fatigue ,nausea, right after session. memory loss right before a session. Rare: can’t remember weeks and months

Question 10

Prior to ECT

Answer 10

• Pre-ECT medical work up
  -Often complete a MoCA as a baseline measure to monitor for potential memory loss
• NPO after midnight before treatment
• No benzo’s evening prior to ECT (Benzo’s raise the seizure threshold and the whole point of ECT is to get a seizure)
• MAOIs / anticonvulsants stopped 2 weeks prior

Question 11

Morning of ECT Treatment

Answer 11

• Void
• Vital signs
• Remove dentures, nail polish, & jewelry
• Dress in hospital gown
• Administer anticholinergics 30-60 minutes prior to ECT treatment

Question 12

ECT Recovery

Answer 12

• Placed in recovery position
• Vitals sign monitored
• 1-1 stand-by observation by recovery nurse
• Oxygen removed once sign of gagging noted
• Nurse checks for any injury to mouth
• Orient individual several times as they wake up
• Tylenol PRN for headache

Question 12

The Beers Criteria

Answer 12

for Potentially Inappropriate Medication Use in Older Adults (Beers List), are guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults.

Question 13

Older Person’s Absorption
and Distribution

Answer 13

Absorption: drugs are in the body longer.
distribution: drugs have more impact, use lower doses.

Question 14

Charles Bonnet Syndrome

Answer 14

In older persons
Associated with low vision. Vivid hallucinations described as movie like
Person is aware theyre hallucinating
partially intact sight + visual impairment

Question 15

Suicide in older persons

Answer 15

Older adults are a higher risk group for suicide- especially older men. They don’t tend to tell anyone and choose lethal means

Question 16

CAM

Answer 16

confustion assessment method.
Screening tool used to screen for delirium.
4 features
1) acute onset and fluctuating course
2) inattention
3) disorganized thinking
4) altered level of consciousness.

Question 17

Disordered Sleep in elderly

Answer 17

With aging, the stage that tends to shorten the most is the REM stage (important for learning and memory).
- Melatonin is not recommended for the eldery
may decrease blood pressure and cause hypothermia
- After the age of 50 sleep declines by 27 minutes per decade

Question 18

Insecure avoidant attachment

Answer 18

may avoid interaction with peers and teachers
may refuse to work in groups, or they may not want teachers to comment on their work
learned early in life that they will likely be rejected and that they need to be independent of others
TREAT:get to know the child in a calm, non-intrusive manner –> facilitate a safe game of catch; they could also involve a peer

Question 19

Insecure ambivalent attachment

Answer 19

often view others as being unavailable
view themselves as inadequate and see others as inconsistent and unavailable
look for reassurance
depend heavily on the adults in the classroom
If they want attention, they may try to provoke a reaction from teacher
TREAT:look for opportunities to connect at times when their anxiety is low and they are not being vigilant
Teaching them appropriate interactions, such as turn-taking and how to request assistance

Question 20

Disorganized attachment

Answer 20

learned that they are not worthy of care and often believe that adults would rather hurt them than be nice to them
aggressive and abusive
they try to control the classroom and everything that happens there
low frustration tolerance exhibit destructive behaviour
TREAT:Structure and routine,predictable limits and boundaries