Mental Health Flashcards
Personality disorders: Cluster A
paranoid, schizoid, schizotypal
Personality disorders: cluster B
Antisocial, borderline, narcissistic, histrionic
Personality disorders: Cluster C
Dependent, obsessive-compulsive, avoidant
Nursing interventions: Paranoid
avoid being too nice or too friendly; give clear explanations; warn about changes in tx plan and explain reasons for delay
Nursing interventions: schizoid
not impacted by approval or rejection of others; do not try to increase socialization
Nursing interventions: schizotypal (may exhibit extreme anxiety in social situations r/t severe social and interpersonal deficits
Respect client’s need for social isolation; be aware of client’s suspicious behavior; be aware that superstition and magical thinking is common
Nursing interventions: antisocial
be aware of and assess for substance abuse; set clear limits on specific behavior; be cautious of manipulation through guilt when client doesn’t get what he wants.
Nursing interventions: borderline
provide clear and consistent boundaries; use clear communication; review therapeutic goals and boundaries when behavior issues are evident; assess for self-manipulating behaviors.
Nursing interventions: narcissistic
remain neutral and avoid power struggle; convey unassuming confidence
Nursing interventions; histrionic
understand seductive behavior as a response to stress; assess for suicidal behavior if admiration is withdrawn; model concrete, descriptive vs. vague language.
Nursing interventions: dependent
be aware of counter transference that can occur d/t client’s clinging behavior; identify current stresses; satisfy client’s needs when setting limits.
Nursing interventions: obsessive-compulsive
guard against power struggles w/ client as need to control is high; assess for use of intellectualization, rationalization, and reaction formation as defense mechanisms; be aware of client’s critical nature toward self and others.
Nursing interventions: Avoidant
maintain a friendly, accepting, reassuring approach; do not push client into social situations.
signs of w/d with CNS depressants (alcohol, barbiturates, benzos)
N/V, tachycardia, diaphoresis, tremors, grand mal seizures, restlessness, irritability
signs of w/d with CNS stimulants (cocaine, amphetamines, methamphetamines)
fatigue, depression, agitation, apathy, anxiety, craving, increased appetite.
signs of w/d with opiates (heroin, meperidine, fentanyl, hydromorphone).
yawning, insomnia, panic, diaphoresis, cramps, N/V, chills, fever, diarrhea.
Delirum vs. dementia
Delirium is characterized by disturbance of consciousness and change in cognition that develop over a SHORT period of time; whereas, Dementia is progressive deterioration of cognitive functioning and global impairment of intellect with no change in consciousness and has an onset of months to years.
Characteristics of Severe Stage (Stage 3) alzheimers
losing ability to converse with others; assistance required for ADL’s, incontinence, losing awareness of ones’ envir’t, progressing difficulty with physical abilities, eventually losses all ability to move - can develop stupor and coma; death frequently r/t choking or infection.
Characteristics of Stage 2 alzheimers (Moderate)
incontinence, can wander and get lost, changes in sleep patterns, difficulty performing tasks that require planning and organizing (pay bills, manage $)
Nursing interventions for delirium
- establish baseline LOC by interviewing family;
- asses VS and do neuro checks
- assess for acute onset and fluctuating LOC
- assess ability to function in immediate env’t
- determine physiologic reason delirium is occurring
- maintain safety
