Mental Health Flashcards
Benzodiazepines
“pam” and “lam”; antianxiety, anticonvulsant, and sedation; avoid alcohol on these, monitor for resp depression; short acting (midaz), intermediate (clonazepam an lorazepam), long acting (diazepam)
Benzodiazepine antidote
flumazenil
Antidepressant classes
SSRIs, TCAs, MAOIs
SSRIs common medications
fluoxetine, sertraline, escitalopram
SSRIs
antidepressants, prevent reuptake of serotonin increasing its availability in the body
SSRI nursing considerations
first line, monitor for serotonin syndrome, suicide precautions are important for 2-3 weeks
Serotonin syndrome
htn, confusion, anxiety, tremors, ataxia, sweating
TCAs
“-triptyline”; antidepressants, prevents reuptake of norepinephrine and serotonin increasing these neurotransmitters in the body
TCAs side effects
Tachycardia
Cardiac effects (arrhythmias, prolonged QT intervals)
Anticholinergic effects
Sedation/sexual dysfunction
MAOIs common meds
isocarboxazid, phenelzine
MAOIs
antidepressant, blocks levels of all neurotransmitters (dopamine, norepi, epi, serotonin)
MAOIs nursing considerations
avoid foods high in tyramine - aged cheeses, wine, pickled meats; can cause a hypertensive crisis
Lithium
mood stabilizer, inhibits dopamine and glutamate, need to monitor drug levels as it has a narrow therapeutic range, used in manic phase of bipolar disorder
Lithium cannot be administered with
NSAIDs
Lithium side effects of toxicity
seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors
First generation antipsychotic
Haloperidol; inhibits effects of dopamine
first generation antipsychotic nursing considerations
monitor for extrapyramidal side effects, tardive dyskinesia, neuroleptic malignant syndrome, can prolong QT interval, contraindicated in pregnancy
Electroconvulsive therapy (ECT)
brain stimulation therapy that passes an electric current through the brain and induces a brief seizure, is a highly effective treatment for psychiatric disorders
tardive dyskinesia
extrapyramidal side effect of first generation antipsychotics; ticks, tremors, lip smacking, sticking out tongue, grimacing - repetitive involuntary movements
neuroleptic malignant syndrome
extrapyramidal side effect of first generation antipsychotics; high fever, altered mental status, confused, muscle rigidity
ECT pt teaching
short term memory loss is normal, typically 6-12 treatments, may need maintenance treatments following
ECT indications
severe depression, bipolar disorder, schizophrenia, schizoaffective disorder, mania
repression
unconscious suppression of unwanted thoughts or information from consciousness; unable to recall experiences/traumatic events
denial
ignoring or refusing to acknowledge unacceptable realities
projection
attributing one’s own feelings, thoughts, behaviours, or motives to others
displacement
redirecting feelings to a safer, substitute object
regression
reverting to behaviors from an earlier stage of development in response to extreme stress
sublimation
channeling negative emotions or socially acceptable behavior
Anxiety
body’s natural response to stress, can be normal but is concerning if chronic and in response to normal life activities
GAD symptoms
excessive worry, fatigue, irritability, muscle aches/soreness, restlessness, impaired concentration, difficulty sleeping
GAD management
ensure safe environment, reduce stimuli, monitor for self harm, establish trust, encourage expression of thoughts, rationalize their thoughts, determine triggers, antianxiety agents in severe cases
depression
state of low mood, aversion to activity, affects their thoughts, behaviours, and feelings
depression S&S
feelings of worthlessness/anger/inappropriate guilt/hopelessness, withdrawal from friends and family, poor concentration, changes in appetite, sleep problems, decreased energy, thoughts of death/suicide, drug/alcohol abuse, unintentional weight loss
depression management
nutrition/hydration, sleep, safe environment, assess risk for self harm, express feelings, validate frustration and sadness, get moving, ADLs
bipolar disorder
mood disorder where there is difficulty regulating extreme emotions, periods of mania, periods of depression, and inability to self-regulate these emotions
bipolar mania signs
extremely high energy, grandiose levels of self-esteem, loud rapid speech, very little need for sleep, engaging in risky behaviours
bipolar depression signs
feelings of lethargy both physically and mentally, sense of personal worthlessness, eating too much or too little, overwhelming sadness, suicidal ideations
bipolar disorder management
physiological needs (provide high calorie food they can eat on the go), safe environment, therapeutic communication, antipsychotics, mood stabilizers
PTSD
develops after exposure to a life-threatening or traumatic experience, recurring thoughts (flashbacks, nightmares), structural changes in brain
PTSD management
avoid triggers, adequate sleep, psychotherapy, SSRIs
for diagnosis of clinical depression symptoms need to present for
2 weeks or longer and is affecting ADLs
schizophrenia
long term mental disorder involving a breakdown in the relation between thought, emotion, behaviour; faulty perception, inappropriate actions and feelings, withdrawal from reality and relationships, sense of mental fragmentation
schizophrenia diagnosis
strong genetic predisposition, brain imaging shows enlargement of ventricles, reduced volume of thalamus, reduced volume of frontal lobe, abnormalities in dopamine and glutamate neurochemicals
schizophrenia S&S
negative: decrease emotional range (flat effect), decrease interest/drive in life, decrease inertia and initiative
positive: hallucinations, delusions, disorganized speech, bizarre behavior
schizophrenia managament
safe environment, decrease stimulation, are auditory hallucinations telling them to do something?, therapeutic communication, ask about delusion to understand what they are experiencing, do not argue about delusion or hallucination, set limits, medications such as haloperidol
Obsessive compulsive disorder
irrational obsessions and ritualized acts, obsessions: belief that negative outcome will occur if a specific act is not performed, impairs normal functioning (relationships, job performance, academic success)
OCD management
safety (harmful compulsions?), therapeutic communication, identify triggers, psychotherapy (CBT, exposure/response), SSRIs
Personality Disorders
Cluster A: paranoid, schizoid, schizotypical
Cluster B: antisocial, borderline, histrionic, narcissistic
Cluster C: avoidant, dependent, obsessive compulsive
paranoid personality disorder
distrustful towards others, hostile
schizoid personality disorder
emotionally aloof, anhedonia
schizotypical personality disorder
bizarre behavior, magical thinking
antisocial personality disorder
lacks empathy for others, manipulative, selfish, fails to conform to societal norms, very deceptive
borderline personality disorder
splitting, craves attention, risk of self harm, depression, poor self image, unstable relationships
histrionic personality disorder
attention seeking, inappropriate clothing, seductive, provocative
avoidant personality disorder
avoids social situations because of self image, feels inadequate, lacks support systems
dependent personality disorder
struggles to make decisions, relies on others
anorexia nervosa S&S
distorted body image and low self esteem, restricts or avoids food and denies hunger, extreme fear of weight gain, excessive compulsive exercise, frequent dieting and obsession with calories, not maintaining a healthy weight, rituals around eating
anorexia nervosa assessment findings
low body temp, bradycardia, hypotension, cyanosis, hormonal and electrolyte imbalances, sleep disturbances, bone degeneration, amenorrhea, lanugo, GI upset
Anorexia nervosa management
physiological needs (body temp, HR, imbalances), ensure safety (self harm), therapeutic communication, establish rapport, validate feelings, no judgement, explore triggers, make plan to avoid triggers and what to do when triggered
bulimia nervosa S&S
consuming food in binge-episodes, purging food after eating, shame anxiety or guilty about eating, fixation with body weight, use of medications (diuretics, laxatives), excessive exercise
bulimia nervosa assessment findings
labile mood, helplessness, purging via vomiting (esophageal varices, tooth enamel break down, Russel’s signs (skin breakdown on knuckles of hands)
Bulimia management
physiological needs (varices, electrolyte imbalances, dehydration), safe environment, therapeutic communication, validate feelings, help identify triggers and avoid
