Mental Health Flashcards
A NP know a alcohol screen positive when the patient scores what?
2/4
What does the C stand for in the alcohol screen?
Do you feel the need to CUT down?
What does the A stand for in the alcohol screen?
Are YOU ANNOYED when your friends comment about your drinking?
What does the G stand for in the alcohol screening ?
Do you feel GULITY about your drinking ?
What does the E stand for in the alcohol screening?
Do you need to drink EARLY in the morning?
Assess EPS s/s what is akinesia ?
Inability to start moving
What is akathisia?
Strong inner feeling to move , unable to sit still
What is bradykinesia ?
Slowness in movement when starting actives that require successive steps such as buttoning shirt
What is tardive dyskinesia?
Involuntary movement of lips (smacking) tongue, face, trunk, and extremities.
What does serotonin affect?
Well being Calm Decrease impulsivity Decrease sex drive Decrease aggression Increase appetite
What does dopamine affect?
Make you worry
Increase vigilance
Increase motivation
What does norepinephrine affect?
Enchanted concentration
Enhance ambition
Enhance productivity
When starting a patient less than 24 years of age on antidepression med, what does the NP need to know?
Increase risk of suicidal thinking
List SSRI
Sertaline Paroxetine Citalopram Escitalopram Fluoxetine Fluvoxamine Vilazodone
List SNRI
Venlafaxine XR
Duloxetine
Desvenlafaxine
Leo Milan I-ran
List the TCA
Amitriptyline Nortriptyline Doxepin Despiramine Imipramine
List the atypical antidepressants
Bupropion Mirtazapine Trazodone Vilazodone Virtioxetine
Atypical antipsychotics
Olanzapine
Risperidone
Quetiapine
Typical antipsychotic
Haldol
What is the first line treatment for depression, OCD, anxiety, and PMD?
SSRI
What SNRIS know to help with?
Best effect on lifting and smoothing mood plus increase focus.
40% sexual se
Other than depression, what do TCA help treat
Post-herpetic neuralgia pain
Migraine Prophylaxis
What are the 9 s/s of depression?
“In Sad Cages”
IN: INterest
S: Sleep Disturbances
A: Appetite Changes
D: Depressed Mood
C: Concentration Difficulty A: Activity/ Agitation/ Retardation G: Guilty Feelings/ Low-Esteem E: Energy Loss S: Suicidal Ideation
What some s/s of depression in teens?
Failing grades
Acting out
Avoiding socialization
Moodiness
What is the difference in major and minor depression in regulars to dx?
Major >5/9
Minor 2-5
s/s maintained for a two period
BIG s/s anhedonia
Depressed mood daily or most days
What to discontinue antidepressants?
Taper over 6 weeks to reduce s/s
What are some s/s of antidepressant withdrawal?
FINISHH
F: Flu-like I: Insomnia N: Nausea I: Imbalance S: Sensory disturbance H: Hyperarousal H: Headache
What to dx anxiety?
> or = to 3 of the s/s
Last > = 6 months
What are the s/s used for anxiety dx?
WATCHERS
W: Worry A: Anxiety T: Tension in muscles C: Concentration difficulty H: Hyperarousal E: Energy loss R: Restless S: Sleep Disturbances
Before DX a patient with depression, what is the lab work up?
TSH BMP CBC LFTS U/A VDRL B12 Look at medication the patient is currently on and herbs too
When treating a patient with depression, what would warrant a referral?
Mania Hallucinations Delusions Loss of Reality contact Suicidal thoughts
A patient is on SSRI. what do they need to be monitored for? What is the number S/s?
Serotonin syndrome
FEVER
What are some serotonin syndrome s/s?
Acute onset of FEVER Muscular Rigidity Mental Status Change Hyperflexia Uncontrolled shivering Dilated pupils Tachycardia Diarrhea
What the air time before switching antidepressants?
2 weeks
NAme the MAOI
Isocarboxazid
Phenelzine
Tranylcypromine
A patient asking a MAOI, ingested aged cheese and red wine. What should be the number condition to assess for>
Hypertensive crisis
Wha this the difference between anxiety and GAD?
GAD occurs for 6 months or more.
How to treat GAD, Panic Attack and OCD?
SSRI TOP list line ( plus it treat depression)
BENZO; careful with addiction. Needs to be wean off
GAD: SSRI, SNRI, Buspirone
Panic Disorder: SSRI, SNRI, TCA, BB, MAOI
OCD: SSRI, SNRI, TCA
What are some herbal substances that a patient may use to treat their anxiety?
Kava Kava
Valerian Root
Passion Flower
A NP is caring for a patient with PSTD. How would you treat it?
First Line: SSRI
Treat for 6-8 weeks
Treat insomnia with mirtazapine
Why would a NP not prescribe Wellbutrin to patient with eating disorder?
Suppress appetite
Decrease seizure thresholds
It acts a weight loss aid.
What is the window for alcohol withdrawal?
2-3 days from that last drink
