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HESI > Mental health > Flashcards

Mental health Flashcards

1
Q

what is the hallmark of psychiatric nursing?

A

therapeutic communication

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2
Q

face to face communication involves

A

verbal and nonverbal expression of the senders thoughts or feelings

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3
Q

What things convey cognitive and and affective messages?

A

voice inflection, rate of speech and words

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4
Q

how are nonverbal messages communicated?

A

via body language, eye movements, facial expressions, and gestures.

– nurses should always be aware that their nonverbal communication affects clients

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5
Q

messages are conveyed by the sender by what mediums

A

sight, sound, touch, smell, non-verbally

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6
Q

what are coping styles?

A

automatic psychological processes that protect the individual against anxiety and from awareness of internal and external dangers and stressors. The individual may or may not be aware of these processes

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7
Q

what are treatment modalities?

A

psychiatric and mental health treatment modalities used to promote mental health???

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8
Q

types of treatment modalities

A

Milieu Treatment
Behavior Modification
Family Therapy
Crisis Intervention
Cognitive Therapy
Electroconvulsive Therapy
Group Intervention

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9
Q

Milieu Treatment

A

planned use of people, resources, and activities in the environment to assist in improving interpersonal skills, social functioning , and performing the ADLs as well as safety and protection for all clients

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10
Q

Where does milieu treatment occur

A

in inpatient and outpatient settings where clients are provided an opportunity to actively participate in treatment , decrease social isolation, encourage appropriate social behaviors and educate clients in basic living skills

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11
Q

What do milieu treatments provide

A

safe places to learn and adopt mature and responsible behavior through through limit setting and client responses to maladaptive social responses

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12
Q

limit setting

A

a component that requires consistent setting of appropriate limits by all staff, nurses, physicians and health care workers to work with one another via shared communication to maintain and reestablish limit setting

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13
Q

Therapeutic communication techniques

A

acknowledgement
clarifying
confrontation
focusing
information giving
open-ended questions
reflecting/restating
silence
suggesting

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14
Q

acknowledgement

A

recognizing the client’s opinions and statements without imposing your own values and judgement

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15
Q

clarifying

A

process of making sure you have understood the meaning of what was said

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16
Q

confrontation

A

should be used judiciously calling attention to inconsistent behavior

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17
Q

focusing

A

assisting the client to explore a specific topic which may include sharing perceptions and theme Identification

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18
Q

information giving

A

feedback about clients observed behavior

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19
Q

reflecting/restating

A

paraphrasing or repeating what the client has said (do not overuse as client will feel as though you are not listening)

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20
Q

silence

A

can be therapeutic or can be used to control interaction; used cautiously with paranoid patient, may support paranoid ideation

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21
Q

suggesting

A

offering alternatives such as “Have you ever considered…?”

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22
Q

antianxiety drugs categories

A

benzos
nonbenzos

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23
Q

benzo drugs

A

chlordiazepoxide HCl

diazepam

Clorazepam

Lorazepam

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24
Q

nonbenzo drugs

A

busparone

zolpidem

ramelteom

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25
Q

benzo indications

A

reduce anxiety

induces sedation

treats etoh withrawl

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26
Q

busparone indications

A

reduces anxiety

helps ctrl symptoms insomina sweating palpitations related to anxiety

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27
Q

zolpidem indications

A

ST tx for insomina

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28
Q

ramelteon indications

A

LT tx for insomina

binds melatonin receptors

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29
Q

benzo rxns

A

sedation

drowsiness

ataxia

dizziness

irritbility

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30
Q

benzo implications

A

at bedtime to reduce daytime sedation

dont mix with etoh

taper

ST drug

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31
Q

busparone rxn

A

dizziness

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32
Q

zolpidem rxn

A

daytime drowsiness

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33
Q

ramelteon rxn

A

dizziness

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34
Q

busparone NI

A

takes weeks to become apparent

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35
Q

zolpidem NI

A

give with food 1-1.5 before bedtime

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36
Q

ramelteon NI

A

appropriate for clients with delayed sleep onset

37
Q

tricyclics indications

A

depression

clients with morbid fanatasiess that do not respond well to these drugs

38
Q

tricyclic rxns

A

anticholinergic (dry mouth, blurred vision, consitpation, retention)

CNS sedation

CV TC HoT

GI effects

narrow therapeutic range

39
Q

tricyclic NI

A

admin at bed time

2-6 weeks for effects

2-3 weeks from ~ to MAOIs

avoid etoh and antiHT drugs

lethal overdose and eval suicide risk

40
Q

MAOI indications

A

depression

phobias

anxiety

41
Q

MAOI rxn

A

TC

urinary hesitancy, C

impotence

dizziness

insomnia

dry mouth

retention

HT crisis

confusion

42
Q

HT crisis

A

severe HT

severe HA

chest pain/palpitations

fever

sweating

NV

increased BP

43
Q

MAOI NI

A

mix with tricyclics for HT crisis

Tyramines can cause HT crisis

do not take with SSRIs

no OTCs

caution with machinery

44
Q

SSRI indication

A

depresssion

anxiety

panic

agression

OCD

anorexia

45
Q

SSRI rxn

A

drowsiness

lightheadedness

HA

insomnia

depressed appetite

serotonin syndrome

sexual dysfunction

wt gain

46
Q

SSRI NI

A

2-6 weeks

HT crisis when with MAOI

14 days from MAOI to fluoxitine - 5 weeks otherway around

bedtime in case of sedation

caution with st johns wart

taper

47
Q

serotonin syndrome

A

3> symptoms

rapid onset of altered mental state

agitation

myoclonus

hyperreflexia

fever

shivering

diaphoresis

ataxia

D

48
Q

atypical - trazodone

indications

A

depression

insomnia

dementia with agitation

49
Q

atypical - trazodone

rxn

A

safer than tricyclics or MAOI

50
Q

atypical - trazodone

NI

A

4-6 weeks

51
Q

SNRI indications

A

depression

anxiety

panic

agression

anorexia

OCD

DM neuropathic pain

52
Q

SNRI rxn

A

N

dry mouth

insomina

HA

fatigue

low appetitie

more sweating

sex dysfunction

withdrawl at cessation

53
Q

SNRI NI

A

no with MAOI

14 days from MAOI to SNRI

monitor BP can cause HoT

can worsen pretx symptoms

same as SSRIs

54
Q

NDRIs

norepi dopamine reuptake inhibs

indications

A

secondline antiD when SSRI and SNRI not effective enough

anxiety

sleep disturbances

55
Q

antidepressant drug classes

antiD

A

SSRI

SNRI

NDRI

MAOI

tricyclics

atypicals

56
Q

antipsychotic drug classes

antiP

A

phenothaizines

non-phenothiazines

long-acting drugs

atypicals

57
Q

phenothiazines indications

A

to control psychotic behavior, hallu, delu, and bizarre behaviors

58
Q

phenothiazines rxns

A

drowsiness

ortho HoT

wt gain

extrapyramindal effects

akathisia

tardive dyskinesia

pseudoparkinsons

59
Q

phenothiazines NI

A

extrapyramidal effect (EP effects) are a major concern

monitor older clients

2-3 weeks

avoid etoh sedatives antacids

60
Q

nonphenothiazines indications

A

ctrl psychotic behavior

useful in psychomotor agitation associated with thought disorders

61
Q

nonphenothaizines rxns

A

severe EP effects

leukocytosis

62
Q

nonphenothiazines NI (suas haldol)

A

avoid alcohol

63
Q

Long acting drugs like

fluphenazine decanoate

haloperidol decanoate

A

takes months

require supervision

64
Q

Atypical antipsychotic dugs like

risperidone

abilify

ziprasidone

clozapine

A

treats SZ +/- without EPS

monoitor WBCs

baseline vitals and ECG

65
Q

mood stabilizers drugs

A

lithium carbonate

valproic acid

carbamazepine

lamotrigine

66
Q

lithium indications

A

bipolar in mania

67
Q

lithium rxn

A

N

fatigue

thirst

polyuria

fine hand tremors

wt gain

hypothyroidism

renal impairment

68
Q

lithium toxicity

A

DV

drowziness

muscle weakness

lack of coordination

69
Q

anticonvulsant mood stabilizers indications

A

used as with lithium, as alts or for bipolar

70
Q

anticonvulsant mood stabilizers NI

A

admin with food and monitor blood leves

valproic acid - 50-125

carbamazepine - 8-12

lamotrigine given in low dose to prevent rash

71
Q

anticholinergic drugs

A

EP system effects

relaxes musles

given with antiP drugs

72
Q

mild anxiety

A

produces increased levels of sense awareness and alertness

daily living

pt is able to concentrate

73
Q

moderate anxiety

A

dulled perception, hesitation

rate of speech and volume increase

restlessness

HA, ND, TC

attentive but less optimal

74
Q

severe anxiety

A

fight or flight

disorganized sensory input

distorted perceptions and impaired concetration

selective concentration

75
Q

severe anxiety SS

A

increased HR and BP

rapid and shallow resp

dry mouth

muscle tension

anorexia

frequency

76
Q

panic

A

grossly distorted perceptions

unable to concentrate or be logical

loss of control

requires intervention

77
Q

what to do when dealing with anxious client

A

assess self anxiety

self calmness will help calm client

78
Q

generalized anxiety disorder (GAD)

A

excessive persistent anxiety with previous coping mechanisms insuffient

79
Q

GAD SS

A

severe anxiety

motor tension (restlessness, quickly fatigued, shakiness, tension)

autonomic hyperactivity (SoB, heart palpitations, dizziness, diaphoresis, frequency)

vigilence and scanning (diff concentrating, sleep disturbance, irritibility, nervousness, low self-esteem)

80
Q

GAD NI

A

assess anx and label feelings

help relate stressor to level of anx

encourage coping techniques

decrease environmental stimuli

81
Q

panic disorders and phobias

A

periods of intense fear of an external object or activity that is chronic that is unrealistic

82
Q

common phobias

acrophobia

agoraphobia

claustrophobia

hydrophobia

social anxiety

thanatophobia

A

heights

crowds or open spaces

tights spaces

water

social situations

death

83
Q

panic disorder coping styles used

A

displacement

projection

repression

sublimation

84
Q

how long do panic attacks last

A

peak in 10 min but last up to 30 min

85
Q

what to do when a pt has a phobia

A

acknoledge the fear and and dont expose them to the fear

gain trust and reduce stimuli

discuss alt coping strategies

after trust discuss desensitization

pair negative with positive

meds

86
Q

OCD

A

irresistibe imples to perform an action or repetivie thoughts

hoarding, excoriation (skin picking), trichotillomania (hair pulling)

87
Q

OCD coping styles

A

repression

isolation

undoing

88
Q

OCD assessments

A

magical thinking (belief that one’s thoughts can ctrl others)

hostile/delu thought content

difff interpersonal relationships

interferes with day to day living

safety issues

intrusive thoughts

repetetive

89
Q

OCD interventions

A

listen, acknowledge

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