Mental Health Flashcards
what are the 4 components of the mental health “puzzle”?
cognition
behaviour
appearance
thoughts
what are the components of the mental status exam?
ASEPTIC
appearance
speech
emotion
perception
thoughts
insights
cognition
how do we assess appearance?
grooming
facial expression
dress
tattoos
piercings
scars
age
body build
position
affect
psychomotor
- gait
- pacing
- crying
- withdrawn
- angry
- eye contact
how do we assess speech?
rate
amount
tone
volume
slurred
incoherent
stuttering
mute
how do we assess perception?
hallucinations
illusions
depersonalizations
derealization
how do they view themselves and others?
how do we assess thoughts?
content
- suicidal
- homicidal
- guilt
- worthlessness
- hopelessness
- obsessions
- phobias
- delusions
process
- choherence
- logical
- tangents
- attention
how do we assess insights?
what are their insights into illness and treatment?
(ie. do they understand that they’re sick and need help)?
judgment
how do we assess cognition?
LOC
orientation
attention
memory
what is mental health?
ability to process information
what is emotional health?
ability to express feelings
what is behavioural health?
what a person does
what are some risk factors for mental health disorders?
trauma
lack of environmental safety and stability
toxic stress
adverse childhood events
genetics
lack of access to resources
comorbidities
what is the nurse’s main role? how can you achieve this?
supporting healthy child development
- help them find words to express their feelings
- safety and stability
- early intervention to prevent long-term issues
mental health disorders are often dependent on _________________ and ____________________
environmental safety and stability
adolescents tend to lack ______________. why?
lack impulse control
- more likely to act on their suicidal ideation
- can’t see that things will get better
frontal lobe is not fully developed until 25
what are the different types of anxiety?
general
obsessive compulsive
separation
phobia
panic
PTSD
what are some symptoms of anxiety?
Difficulty concentrating
Irritable
Unusually upset
Difficulty sleeping
Unusually tired
Alexithymia
what is alexithymia?
difficulty feeling and describe eemotions
what is the primary goal of nursing care for anxiety?
resume typical activities appropriate to development
what symptoms should be assessed for an anxiety assessment?
mental
behavioural
emotional
what are some questions you might ask during an assessment for anxiety?
“When you feel overwhelmed do you think about hurting yourself?”
“Is there something in particular, or a situation that makes you feel afraid?”
“Do these worries affect your sleep, performance at school or relationships with family and friends?”
what are some coping strategies for anxiety?
relaxation techniques
play
discuss feelings
what are some interventions for anxiety?
cognitive behavioural therapy
medication
what is temporary depression?
acute
caused by a traumatic event
what is the most common type of depression in children?
temporary
what is chronic depression?
often accompanies chronic illness
family circumstances
history of disruptions in relationship
what are some behavioural symptoms of depression?
sad expression
lack of play
withdrawn
low grades
crying
clingy
aggressive/disruptive
what are some emotional signs of depression?
low self-esteem
hopelessness
guilt
lack of interest
what are some mental/cognitive signs of depression?
lack of concentration
slow cognitive processing
suicidal
all or nothing thoughts
what are some questions you might ask during an assessment for depression?
“Did your sad mood start right after a stressful event?”
“Have you felt really down, depressed, or uninterested in things you used to enjoy?”
“Have you been using drugs or alcohol?”
what are some questions you mights ask during an assessment for suicide risk?
“Have you been thinking about harming yourself?”
“Have you ever hurt yourself or attempted suicide?”
“Do you have any plans to hurt yourself?”
what are the interventions for depression?
cognitive behaviour therapy
medication (antidepressants)
environmental support
what is a risk associated with antidepressants?
increased risk of suicidal ideation
why do we often see improvement and decreased anxiety once the child is admitted?
coming from an unstable environment
lack of support at home
safety
not alone
- surrounded by people who are also sick
- feel normal and accepted
no phones/social media
what is suicide?
deliberate act of self-injury with intent of death
what is the 2nd leading cause of death in adolescents?
suicide
what are some warnings signs for suicide?
Talk of desire to die
Loss of energy and interest
Irritable, argumentative, reckless
Antisocial
Poor academic performance
Sad or flat affect
Feel worthless
Change in appetite
what are the high risk populations for suicide?
LGBTQ+
Indigenous
lack support from family
what are some risk factors for suicide?
social isolation
depression
substance abuse
impulsive
formulated plan
previous attempt
family history
medical illness
life altering events
access to toxins and firearms
what is suicidal ideation?
preoccupation with suicidal thoughts
what is suicide attempt?
intended to cause death or serious injury
what is parasuicide?
gesture or serious attempts to kill oneself
how can we prevent risk of suicide?
encourage and support healthy child development and supportive relationships
youth who express suicidal feelings and have a specific plan should be _________________________________
monitored at all times
cannabis increases risk of ____________
schizophrenia
what is one of the most successful interventions for substance abuse?
peer led programs
- focus on immediate consequences
- hearing from others they can relate to
what is an INEFFECTIVE intervention for substance abuse?
focusing on long-term effects
what are some questions you might ask during an assessment for substance abuse?
How has using affected your mood or anxiety?
Do you ever smoke, drink or use drugs when you are alone?
What is it like for you when you are drunk or high?
nursing care for substance abuse should focus on promoting skills for what?
parenting
socializing
distractible children
academic performance
resisting peer pressure
what are some risk factors for eating disorders?
Relationships with caregivers and peers
Stress
Adverse events
Digestive tract changes
how do eating disorders often start?
Often starts as “feeling sick” when they eat certain foods
This is misunderstood by many parents
what are the characteristics of Anorexia Nervosa?
Turns away from food to cope
Introverted
Avoid intimacy
Negate feminine role
“Model” child
Obsessive-compulsive
High achiever
Rigid
Distorted
Deny illness
Body weight < 85% of normal
Usually not sexually active
What are the characteristics of bulimia?
Turns to food to cope
Extroverted
Seek intimacy
Aspire to feminine role
Acts out
Impulsive
Variable
Lose control
Less frequent distortion
Recognize illness
Health fluctuates
Within 5-15 Ib of normal
May be overweight
Often sexually active
what are some questions you might ask during an assessment for an eating disorder?
“How would you describe your appearance?”
“Are there aspects of your appearance you’re dissatisfied with?”
“Do you feel guilty after eating?”
what are some physical side effects of EDs?
UTI
electrolyte imbalance
what does refeeding syndrome cause?
hyperphosphatemia
why are EDs so difficult to care for?
very structured
manipulative
controlling
require strict supervision
what are the 3 goals of treatment for EDs?
1) normal nutrition or reverse malnutrition
2) resolve disturbed family relationships
3) psychotherapy to improve physiological function
why might cognitive behavioural therapy be ineffective for EDs?
brain is starving
have to nourish the brain before therapy will be effective
children tend to develop ____________________ when trying to cope with cognitive dysfunction
maladaptive behaviours
what are some examples of maladaptive behaviours that children might develop when trying to cope with cognitive dysfunction?
socially challenging behaviours
inattention
impulsiveness
hyperactivity
ADHD
learning disorders
what ACE score would indicate increased risk for mental health issues?
4
what is alexthymia?
difficulty identifying and expressing emotions
HEADSS Assessment
Home
Education
Activities
Drugs
Sexual activity
Suicide
anorexia vs bulimia - COPING
Anorexia: turn away from food
Bulimia: turn towards food
anorexia vs bulimia - PERSONALITY
Anorexia
- introverted
- avoid intimacy
- negate feminine role
Bulimia
- extroverted
- seek intimacy
- aspire to feminine role
anorexia vs bulimia - BEHAVIOUR
Anorexia
- model child
- obsessive compulsive
Bulimia
- act out
- impulsive
anorexia vs bulimia - ACADEMIC PERFORMANCE
Anorexia: high achievers
Bulimia: variable
anorexia vs bulimia - CONTROL
Anorexia: rigid
Bulimia: lose control
anorexia vs bulimia - BODY IMAGE
Anorexia: distorted
Bulimia: less distortion
anorexia vs bulimia - WEIGHT
Anorexia: < 85% of normal
Bulimia: 5-15 Ibs within normal
what are the common side effects seen with eating disorders?
UTIs
vital signs
electrolyte imbalances
what are the 3 goals for ED treatment?
- reinstitution of normal nutrition and resolve malnutrition
- resolve disturbed family interactions
- psychotherapy to correct psychological function
