Mental Health Flashcards
factors that influence mental health
individual (personal), interpersonal (relationship) & Social/cultural (environment)
Mental disorders affect a person’s
mood, behavior, thinking
DSM (Diagnostic and statistical manual of mental disorders purpose:
standardize nomenclature language, identifies defining characteristics or symptoms, assist in identifying underlying causes, allows practitioners to identify all factors that relate to a patients condition
Community of mental health act 1963
De-institutionalization, Legislation for disability income, changes in commitment laws
National league of nursing required schools to do what?
include psychiatric nursing
Hildegrad Peplau
therapeutic nurse-client relationship, dont talk down to them
Basic-level functions
self care activities, pschobiologic interventions, health teaching, health promotion/maintenance, counseling, milieu therapy, case management
Psychobiologic intervention
study of the biology of the psyche
milieu therapy
therapy that controls the environment of the patient to provide interpersonal contacts that will develop trust, assurance and personal autonomy
Advanced-level functions
psychotherapy,prescriptive authority for drugs, consultation/liaison, evaluation
psychotherapy
method of treating disease without pharmacological means eg. hypnotism
Issues and concerns for mental illness in the 21st century
revolving door effect due to deinstitutionalization, shorter hospital stays, decompensation, dual diagnosis, rehospitalization, Homelessness, lack of adequate community resources, access to address needs of full or part time homeless persons with mental illness
Neurotransmitters that Excite
dopamine, norepinephrine, Epinephrine, Glutamate
Neurotransmitters that Inibit
Serotonin, GABA
Norepinephrine
attention, learning, memory, mood regulation
Dopamine
motivation, cognition
Epinepphrine
fight-or flight response
Glutamate
major neurotoxic effects at high levels. It is shown at high levels in strokes, hypoglycemia
Seratonin
food intake, temp reg, pain control
GABA
modulate other neurotransmitters
Acetylcholine
excite or inhibitory, sleep-wakeful cycle, signals muscle to become alert
Chlorpromazine(thorazine)
Conventional, first generation
Fluphenazine(Prolixin)
Conventional, first generation
Haloperidol(Haldol)
Conventional, first generation
Clozapine (Clozaril)
Atypical, Second generation, Antipsychotic med
Risperidone (Risperdol)
Atypical, Second generation, Antipsychotic med
Ziprasidone (Geodon)
Atypical, Second generation, Antipsychotic med
Olanzapine (Zyprexa)
Atypical, Second generation, Antipsychotic med
Aripiprazole (Abilify)
3rd generation, Antipsychotic med
Antipsychotic med uses:
To treat psychotic symptoms and block dopamine receptors
Antipsychotic adverse effects
Extrapyramidal Syndrome (EPS), Acute dystonia, Torticollis, opisthotonus, oculogyric crisis, pseudoparkisnsonism, akathisia
Treatment of antipsychotic adverse effects
Benztropine (Cogentin)
Benztropine (Cogentin)
Treatment of antipsychotic adverse effects
Tardive dyskinesia
irreversible involuntary movements, antipsychotic adverse effect
Neuroleptic malignant syndrome (NMS)
increased fever, sweating, death
other side effects of antipschotic meds
prolonged QT intervals, Agranulocytosis (increased white blood cells), weight gain
Important things to tell patient about antipsychotic meds
Remain compliant,
Antidepressant action
interacts with norepinephrine and seratonin, Normalize reuptake of neurotransmitters (lithium), increases GABA level, kindling process
Antideprensant side effects
sedation, loss of appetite, priaprism (abnormal erection)
Serotonin Syndrome
MAOI + SSRI Aggitation, hypotention, rigidity, tachycardia, hyper-reflexia (back arching), fever, sweating, coma, death
When do you take an SSRI?
first thing in the morning
When do you take a TCA
at night
If you miss a SSRI dose how long do you have to take it?
up to 8 hours
if you miss a TCA dose how long do you have to take it
within 3 hours
what us Carbamazepine(Tegretol) used for and s/s?
Anticonvulsant, used to treat bipolar disorders. S/s: drowsiness,sedation, dry mouth, blurred vision, rassh, orthostatic hypotention
what is Valproic acid (Depakote) used for and s/s?
Anticonvulsant, used to treat bipolar disorder. S/s: drowsiness, sedation, dry mouth, blurred vision, weight gain, alopecia (hair loss), hand tremor
what is Lamotrigine (Lamictal) used for
Anticonvulsant, used to treat bipolar disorders
what is Gabapentin (Neurontin) used for
Anticonvulsant, used to treat bipolar disorders
what is Topiramate (Topamax) used for
Anticonvulsant, used to treat bipolar disorders
What is Lithium used for and s/s
Bipolar disorders, s/s: nausea, diarrhea, anorexia, fine hand tremor, polydipsia, weight gain, acne, metalic taste
Client teaching for mood stabilizers
periodic monitoring of blood levels (12 hrs after last dose taken), take with meals, safety measures.
Stages of group development
pregroup, beginning or initial, working & termination stage
Absolute Contraindications for ECT
increased intracranial pressure, brain tumor, recent CVA or other cerebrovascular lesion
Individuals at high risk for ECT
myocardial infarction or CVA within the past 3-6 months. Aortic or cerebral aneurysm & CHF, severe underlying hypertension
