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MENTAL HEALTH > Mental Health ABC's > Flashcards

Mental Health ABC's Flashcards

1
Q

What is a 302

A

Involuntary admittance ( court hearing must be within 72 hr, after 72 hours if a judge determines you are safe to go home; you go home, if deemed unsafe, you get 303 all the way up to 305.

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2
Q

How do hospitals manage relaying info in accordance to

HIPPA?

A

Give a code out to ppl authorized to receive info

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3
Q

What does ROI mean

A

Release of information

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4
Q

When can info be disclosed without consent

A

To protect the safety of others. If the person states a plan to cause harm to a specific person, putting a person in immediate danger.

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5
Q

What does informed consent entail

A

A person has the right to know about treatment, alternatives, right to decline.

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6
Q

What is the exception to informed consent

A

2 Drs must deem the person may cause harm to self or others which leads to the informed consent to be overturned. The meds will be forced usually by injection.

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7
Q

What is least restrictive seclusion

A

In a room by ones self with the door open

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8
Q

What is restrictive seclusion

A

In a room by ones self with door closed and locked

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9
Q

Can a nurse initiate restraints?

A

Yes! She doesn’t have to call the dr first. After applying the restraints, she MUST THEN CALL THE DR WHO MUST PHYSICALLY ASSESS THE PT WITHIN 1 HOUR

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10
Q

What does Mileu mean

A

Environment

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11
Q

What is a 201

A

Voluntary admittance

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12
Q

What are the positive symptoms of szhizophrenia

A

Altered perception, hallucinations, delusions

Hallucinations can occur with all 5 senses

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13
Q

Exhopraxia

A

Imitating movements of others

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14
Q

Echolalia

A

Repeat words said

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15
Q

Flat affect

A

No expression on face

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16
Q

Apathy

A

Don’t care

Unconcerned

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17
Q

Positioning

A

Take on bizarre positions

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18
Q

What are nursing diagnosis Related to schizophrenia

A

Risk for violence: self directed or others directed
Disturbed thought process
Social isolation
Disturbed sensory perception

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19
Q

What are typical antipsychotics

A

The oldest form of antipsychotics
BLOCKS DOPAMINE
targets positive symptoms

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20
Q

What are contraindications to typical antipsychotics

A

Parkinson’s disease, liver, renal or cardiac insufficiency ( may prolong QT INTERVAL), uncontrolled seizure disorder

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21
Q

What are interactions of typical antipsychotics

A

They have an additive hypotensive effect with hypotensive agents

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22
Q

Why is Parkinson’s a contraindication to typical antipsychotics

A

Parkinson’s already is due to a decreased dopamine and you don’t want to decrease the levels of dopamine even further.

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23
Q

What is a select prototype of typical antipsychotics

A

Chlorpromazine ( Thorazine)

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24
Q

What are other typical antipsychotics

A

Haloperidol ( haldol)
Fluphenazine ( prolixin)
Perphenazine ( trilafon)
There are many more this is only a short list.

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25
Q

What are atypical antipsychotics

A

They were developed after typical antipsychotics, they have less side effects.
THEY BLOCK SEROTONIN AND to some degree DOPAMINE
Target both positive and negative symptoms

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26
Q

What are contraindications of atypical antipsychotics

A

Severly depressed ppl

Elderly ppl with dementia related psychosis

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27
Q

What are commonly used atypical antipsychotics

A 
Risperidone ( risperdal)
Olanzapine ( zyprexa)
Quetiapine  ( seroquel)
Aripipraziole ( abilify)
Ziprasidone ( geodon)
Clozapine ( clozaril) this does not include a list all drugs.
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28
Q

What are potential side effects of all antipsychotics

A
  • seen to a lesser degree in atypical antipsychotics*
    Extrapyramidal symptoms
    Pseudoparkinsonism- tremor, shuffling gait, drooling, rigidity
    Akathisia- restlessness
    Akinesia- muscle weakness
    Dystonia- spasms and stiffness of neck, face, arms or legs
    Oculogyric crisis- rolling back of eyes
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29
Q

What are medications to reverse EPS

A

anticholinergics such as benztropine ( cogentin), trihexphenidyl ( artane)

Antihistamines such as diphenhydramine ( Benadryl)

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30
Q

What anticholinergic can be given in conjunction with psychotic meds

A

Benztropine ( cogentin) can be given as a maintenance dose in conjunction with psychotic meds to prevent dystopia and oculogyric crisis.

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31
Q

What is tardive dyskinesia

A

Seen months to years after prolonged use of antipsychotics
Consists of bizarre facial and tongue movements, stiff neck, difficulty swallowing
Symptoms are potentially irreversible

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32
Q

What is neuroleptic malignant syndrome ( NMS)

A

Rare but potentially life threatening
Typically seen after initiation of antipsychotics but can be years afterwards
Consists of muscle rigidity, VERY HIGH FEVER, tachycardia, tachypnea, and changes in LOC

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33
Q

What is treatment for neuroleptic syndrome

A

Immediately stop antipsychotics

Monitor VS, IV fluids, I&O

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34
Q

What are other side effects seen with antipsychotic therapy

A

Anticholinergic effects- dry mouth, paralytic ileus, urinary retention, photophobia,
Metabolic syndrome- seen with new atypical antipsychotic meds, causes pt to gain weight as a result diabetes develops.

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35
Q

What drug must be monitored very carefully because of agranulocytosis

A

Clozaril- before initiation a baseline WBC cont and absolute neutrophil count is drawn.
WBC must be at least 3500/mm3. WBC count and absolute neutrophil must be drawn weekly for first 6 months, then every 2 weeks

36
Q

What is the definition of depression

A

A mood disorder expressed by feelings of sadness, despair, and pessimism
It is one of the leading causes of disability in the U.S.
rates are higher in woman but suicide rate is higher in men

37
Q

What are types of depressive disorders

A

Seasonal affective disorder (SAD)
Postpartum depression
Major depression disorder (MDD)

38
Q

What is major depressive disorder characterized as

A

Characterized by a depressed mood and or loss of interest or pleasure in ones usual activities. There must be impaired social and occupational functioning that has lasted for at least 2 weeks.

39
Q

What are the rating scales for major depressive disorder

A

Beck depression inventory (BDI)

Hamilton depression rating scale

40
Q

What is subjective assessment data of major depressive disorder.

A 
Anergia
Anhedonia
Anxiety 
Fatigue
Somatic complaints 
Loss of appetite 
Sleep disturbances 
Negative thoughts
41
Q

What is objective assessment data of major depressive disorder

A 
Affect 
Disheveled appearance 
Slowed physical movements 
Socially isolated 
Slowed thought process and speech patterns
42
Q

For a suicide assessment what should the nurse do

A

Be direct
Talk openly and matter of factly about suicide. Ask ARE YOU AHVING THOUGHTS OF KILLING YOURSELF?
Assess for a plan,means and intent

43
Q

What are nursing diagnosis For major depressive disorder

A

Risk for suicide
Social isolation
Self care deficit
Imbalanced nutrition; less than body requirements

44
Q

What Are interventions for major depressive disorder

A

Cognitive behavior therapy- a type of therapy that helps a person realize and change negative thoughts

Group therapy
Individual therapy

45
Q

What is true regarding therapeutic levels of antidepressants

A

Relief is not immediate. May take 2-4 weeks to reach full therapeutic level. Patients are at risk for suicide because as the mood lightens the patient experiences more energy to act out

46
Q

What is the prototype TCA

A

Amitriptyline ( elavil)

47
Q

What are side effects of TCAs

A

Orthostatic hypotension
Anticholinergic effects
Sedation - advise to take at bedtime
Decreased seizure threshold- use cautiously in someone with seizure disorder

48
Q

What do TCAs do

A

Blocks the reuptake of norepinephrine and serotonin in the synaptic space

49
Q

What is the prototype SSRI

A

fluoxetine ( Prozac)

50
Q

What are side effects of fluoxetine ( Prozac)

A

Sexual dysfunction
CNS stimulation - take in the am can make A person more alert
Changes in weight
Serotonin syndrome

51
Q

What is serotonin syndrome

A

Can become life threatening
May begin 2-72 hr after initiation of SSRI treatment
Symptoms include mental confusion, fever, hallucinations,diaphoresis,,abdominal pain with diarrhea

52
Q

How do SSRIs work

A

By blocking the reuptake of serotonin

53
Q

What are MAOIs

A

Blocks MAO in the brain thereby increasing norepinephrine, dopamine, and serotonin

54
Q

What is the prototype MAOI

A

Phenelzine (Nardil)

55
Q

What are side effects of phenelzine (Nardil)

A

Serotonin syndrome, if used with SSRIs

Hypertensive crisis

56
Q

What is a hypertensive crisis

A

Results from ingestion of foods containing tyramine

57
Q

What foods contain tyramine that should be avoided while on MAOI therapy

A

Cheese
Figs
Yogurt
Raisins

58
Q

What are atypical antidepressants

A

They are a alternate to SSRIs

Blocks the reuptake of dopamine

59
Q

What is the prototype atypical antidepressant

A

Bupropion ( Wellbutrin)

* also combats nicotine addiction**

60
Q

What are side effects of bupropion ( Wellbutrin)

A

Weight loss
Seizures
Anticholinergic effects

61
Q

What are indications for electro convulsive therapy

A

MDD- no response to medications
Certain schizophrenia disorders
Acute manic

62
Q

Can ECT happen on a outpatient basis

A

It can happen on a inpatient or outpatient basis

63
Q

Can a client eat food before ECT

A

they must be NPO after midnite of the procedure

64
Q

What are nursing interventions of ECT

A

Establish IV line, monitor VS, IM robinul or atropine 30 min prior to treatment

65
Q

What is nursing care during ECT

A

Mechanical ventilation with 100% O2
Cardiac monitoring
Anesthesiologist administers anesthetic breuvital and then a muscle relaxant anectine by IV
Electrical stimulus provided by physician

66
Q

What is aftercare of ECT

A 
Transfer to recovery room 
Monitor VS especially HR and BP
position in side to prevent aspiration
Assess for headache, muscle soreness, and nausea
Assess memory
67
Q

What is the definition of bipolar

A

A mood disorder manifested by cycles of mania and depression

68
Q

What is the prevalence of bipolar

A

Incidence of bipolar equal between males and females
Average age is 20’s
Genetic predisposition

69
Q

Types of bipolar disorder

A

Bipolar 1 disorder- full blown manic episodes

Bipolar 2 disorder- distinguished by bouts of MDD with episodes of hypomania.

70
Q

What are nursing diagnosis of bipolar disorder

A

Risk for injury
Risk for violence: self directed or other directed
Imbalanced nutrition: less than body requirements
Disturbed thought process
Insomnia

71
Q

What are medications for bipolar disorder

A

Lithium carbonate

72
Q

What are contraindications of lithium carbonate

A

Cardiac or renal disease, dehydration, sodium depletion

73
Q

What are side effects of lithium carbonate

A

The margin between therapeutic levels and toxic levels is very narrow

74
Q

What is the therapeutic ranges of lithium

A

Acute mania- 1.0 to 1.5
Maintenance- 0.6 to 1.2
Lithium toxicity- symptoms begin to appear at levels above 1.5

75
Q

How often are labs drawn on a person prescribed lithium

A

1-2 times a week until levels are stable then monthly afterwards
Hold med until lithium levels are drawn

76
Q

What are the clinical manifestations of lithium toxicity with a serum level of 1.5 to 2.0

A 
Blurred vision
Ataxia
Tinnitus 
Fine hand tremors 
Persistent nausea and vomiting 
Severe diarrhea
77
Q

What are clinical manifestations of lithium toxicity with serum levels of 2.0 to 3.5

A

Excessive output of dilute urine
Increasing tremors
Mental confusion

78
Q

What are clinical manifestations of lithium toxicity with a serum level above 3.5

A 
Decreased LOC
anuria
Seizures
Coma 
Death
79
Q

What is pt education for lithium administration

A

Drink 2-3 liters of water daily,by not drinking enough, lithium levels can rise
Maintain a sufficient level of sodium not more not less
Avoid use of NSAIDs
Use diuretics cautiously

80
Q

What is the anticonvulsant valproic acid ( depakote) used for

A

It is used to treat bipolar disorder

81
Q

What is the prototype typical antipsychotic

A

Haldol

82
Q

What is the prototype atypical antipsychotic

A

Risperidal

83
Q

What is a major symptom to watch out for with clozaril

A

Agranulocytosis

84
Q

What are anticholinergic meds used to treat side effects

A

Cogentin

Diphenhydramine

85
Q

What labs are assoc with depakote therapy

A

LFT

PLATELETS

86
Q

What is included in a suicide assessment

A

Plan means intent hx of past attempts

87
Q

What are assoc side effects of TCAs

A

Orthostatic hypotension

MENTAL HEALTH (17 decks)

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