Mental Health exam 2 bp Flashcards
Typical Antipsych are
first gen
Atypical Antipsych are
second gen
When do we use Typical antipsych
positive symptoms
When do we use Atypical anti
negative symptoms
What are positive symptoms
symptoms present in a client that should not be there
hallucinations, delusions, illusions, bizzare behaviors
What are negative symptoms
Symptoms that are not present or lacking,
5 a’s
What are the 5 a’s?
Affect, Avolition, Anergia, anhedonia, Alogia
Affect
loss of affect: instead flat or blunted
Avolition
loss of motivation, hygiene
Anergia
no energy
Anhedonia
no pleasure
Alogia
poverty in thought, and changes in speech
What can happen when we are treating depression in a client?
can trigger an episode of mania
Grief and depression…
mimic each other.
Difference between Bipolar 1 and Bipolar 2
Bipolar one has an episode of mania and usually requires hospitalization
Bipolar 2 is
hypomania and usually does not result in hospitalization
What is the priority intervention for Bipolar Disorders?
safety
1.9 lithium level or less interventions
hold medication, and notify provider, get blood lithium and sodium level.
Carbamazepine is a
anticonvulsant and anti-epileptic
Risk with Carbamazepine
blood dyscrasia:
leukopenia, anemia, thrombocytopenia
What blood test should we do to test for with the use of Clozapine?
ANC(absolute neutrophil count)
Monitor for what during Clozapine use
Agranulocytosis, neutrophil suppression
MAOI can cause what to happen if patients ingest tyramine foods?
Hypertensive crisis
What is a fatal side effect that should be included in patient education for clozapine?
agranulocytosis
What diet education should the nurse include for a client taking phenelzine?
restrict foods containing tyramine
Which client teaching is correct for sertraline?
sertraline will not have an immediate effect on the body. It will take even up to 3 months to see an effect
What symptoms only exist with bipolar 1
mania
a client experiencing confusion, blood pressure changes, and diaphoresis while taking an SSRI, you suspect?
Serotonin Syndrome
What statement might indicate a manic episode?
” I have not slept for seven days”
What nursing intervention should be implemented for a client experiencing mania?
Place client in a quiet, separate area and maintain safety.
A client replies, “hip hooray, the flip is cast and wide sprinting in the forest”, this is an example of what finding?
Word salad
2 most common surgeries that cause delirium
cardiac and orthopedic
Unit with the most delirium in the hospital
ICU
Describe Echolalia
When a patient repeats the exact words you said to them during a conversation
Characteristics of mania
lasting one week and present most of the day, every day
decreased need for sleep, more talkative, flight of ideas, distractibility, inflated self-esteem, or grandiosity.
ECT
Need to do an ekg, before hand.
Phenelzine client education
risk for hypertensive crisis if patient eats tyramine.
Sertraline client education
can cause sexual dysfunction which can result in low medication adherence.
Monitor for seratonin syndrome.
Selegiline (MAOI) client education
Transdermal patch, observe for cns stimulation )anxiety, agitation, hypomania, and mania).
Remove old patch before applying new one,
Lithium client education
No NSAIDs, weight gain, (5 lb difference notify provider).
SSRIS and hyponatremia client education
ssris: citalopram, fluoxetine, sertraline
Seratonin syndrome can occur. If this occurs hold medication and notify provider.
sexual dysfunction can occur.
Hyponatremia risk
Meds that trigger mania?
anti-depressants
Why is it important to reduce stimulation in patients with Bipolar?
can increase mania
Promoting nutritional intake for Patients with Bipolar
finger foods, high protein, high calorie, and drinks
Chicken nuggets,
avoid caffeine
Delirium Vs Dementia
Delirium is short term with rapid onset and can be reversed.
Dementia is chronic and occurs gradually with no reversal
Which disorder is reversible?
delirium
Dementia does what at 65?
once you hit 65, every 5 years your chances double
Dementia is leading cause of death. Dementia does not lead to death but what does
bed sores, infections, aspiration pneumonia
First stages of dementia are?
symptomless
Risk for Dementia
age, head trauma, genetics, lewy body disease, hiv infection, vacular disease, prion disease
Sundown syndrome
insomnia, anxiety, agitation, pacing, walking, confusion, paranoia, hallucinations, restlessness
Interventions for dementia
safety, structured schedule activities, strict feeding and toileting times, walk with client, restrict access to departure on unit.
DO NOT come up behind them or put hands on them.
What is Catatonia
Refers to a significant motor disturbance (no motor activity) to excessive motor activity and agitation,
Symptoms of psychosis
Disorganization of the personality, deterioration in social functioning, and loss of contact with or distortion of reality.
Symptoms of Schizoaffective disorder
Client may appear, depressed with psychomotor delay, si, euphoria, grandiosity, and hyperactivity
Symptoms of dementia
aphasic, self-care deficit, isolation, difficulty naming objects, common personality changes, inability to carry out purposeful motor activities or use objects properly.
Vague language, inappropriate behavior.
Frontal lobe effects what?
A client has difficulty with brushing their teeth and buttoning their shirt.
Parietal lobe does what
recognizes my own environment and where things are located.
Temporal lobe
A client is experiencing hallucinations and cannot ask for help