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Level 2 > Mental Health exam 3 > Flashcards

Mental Health exam 3 Flashcards

1
Q

substance use nursing history Q’s

A
  • type of substance
  • amount of substance
  • pattern and frequency of use (look for changes)
  • age at onset
  • date of last substance use
  • changes in occupational/school performance
  • hx of abstinence periods
  • previous withdrawal manifestations
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2
Q

rate of substance abuse is highest in ages

A

18-25

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3
Q

people at increased risk of substance disorder

A
  • alaska natives
  • native american groups
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4
Q

people at a decreased risk of substance disorder

A

asian groups

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5
Q

older adult indications of substance abuse

A
  • decreased self care
  • incontinence
  • manifestations that look like dementia
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6
Q

opioid intoxication antidote

A

naloxone

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7
Q

opioid abstinence syndrome s/sx

A
  • starts with sweating and rhinorrhea
  • piloerection
  • tremors
  • irritability
  • diarrhea
  • weakness
  • insomnia
  • N/V
  • pupil dilation
  • muscle weakness/pain
  • suicidal ideation
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8
Q

things BAC depends on

A
  • weight
  • gender
  • alcohol concentration
  • number of drinks
  • gastric absorption rate
  • tolerance level
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9
Q

when does alcohol withdrawal start?

A

4-12 hours after last drink

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10
Q

how long does alcohol withdrawal last?

A

5-7 days

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11
Q

when does alcohol delirium start?

A

2-3 days after last drink

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12
Q

alcohol delirium is considered a

A

medical emergency

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13
Q

nicotine abstinence syndrome s/sx

A
  • cravings
  • irritability
  • nervousness
  • restlessness
  • anxiety
  • insomnia
  • anger
  • depressed mood
  • increased appetite
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14
Q

safety for substance use disorders

A
  • prevent falls
  • seizure precautions
  • 1:1 observation (withdrawal)
  • low stimulation
  • monitor for covert substance use during detox
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15
Q

education for substance use disorders

A
  • addiction
  • initial tx goal
  • removing unnecessary meds
  • not sharing meds
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16
Q

emergency plan components

A
  • what client needs to do
  • who client needs to contact
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17
Q

12 step program

A

Alcoholics Anonymous (AA)

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18
Q

family groups

A
  • Al-anon
  • Ala-teen
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19
Q

what does a 12-step program teach?

A
  • abstinence is needed for recovery
  • a higher power can assist with recovery
  • clients are not responsible for their disease, but are responsible for their recovery
  • client cannot blame others
  • client must acknowledge their feelings and problems
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20
Q

disulfiram: acetaldehyde syndrome s/sx

A
  • N/V
  • weakness
  • sweating
  • palpitations
  • hypotension
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21
Q

what tests/labs should you monitor while taking disulfiram?

A

LIVER (hepatotoxicity)

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22
Q

should you take naltrexone with food?

A

yes to decrease GI distress

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23
Q

who should not take acamprosate?

A

pregnant women

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24
Q

what medication must be administered from an approved tx center?

A

methadone

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25
Q

what medication does not reduce the cravings of opioids?

A

clonidine

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26
Q

mild tension relieving behaviors

A
  • finger/foot tapping
  • fidgeting
  • lip chewing
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27
Q

at what level of anxiety should gross motor activities be encouraged?

A
  • severe
  • panic
    (walking)
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28
Q

how should you speak to those with severe/panic level anxiety?

A
  • firm, short, simple, statements
  • repetition
  • slow, low-pitched, calm voice
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29
Q

generalized anxiety disorder criteria

A

uncontrollable, excessive worry
- majority of days
- at least 6 months

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30
Q

manifestations of separation anxiety

A
  • during or in anticipation
  • HA
  • N/V
  • sleep disturbances
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31
Q

how might people with specific phobias try to decrease anxiety?

A

alcohol or substances

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32
Q

panic attack criteria

A
  • 15-30 minutes
  • 4+ manifestations
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33
Q

what type of environment should be provided for anxiety?

A
  • safe
  • calm
  • quiet
  • structured
34
Q

when should you teach someone with anxiety?

A

after acute anxiety subsides

35
Q

obsessive-compulsive behaviors are

A
  • time consuming
  • repetitive
36
Q

how long does ASD last?

A

3 days to 1 month following event

37
Q

how long does PTSD last?

A

longer than 1 month following event

38
Q

how long does dissociative fugue last?

A

weeks to months

39
Q

what does severity of trauma depend on?

A
  • duration
  • amount of personal threat
  • far from home or familiar surroundings
40
Q

individual vulnerabilities of ASD/PTSD

A
  • past coping mechanisms
  • personality
  • preexisting mental disorders
41
Q

intrusive findings of ASD/PTSD

A
  • involuntary, distressing
  • memories
  • flashbacks
  • nightmares/dreams
42
Q

behavior changes in adjustment disorder

A
  • arguing
  • erratic driving
43
Q

when should the nurse help with decision making in dissociative disorders?

A

during dissociative periods

44
Q

when are grounding techniques used and what are they?

A
  • clapping hands
  • touching objects
45
Q

should you talk to those with dissociative disorders about their past?

A

not too much

46
Q

what problems are avoided with buspirone that are problems with benzos?

A
  • sedation
  • tolerance
  • dependence
  • withdrawal
47
Q

defense mechanisms without a maladaptive use

A
  • altruism
  • sublimation
48
Q

defense mechanisms without an adaptive use

A
  • conversion
  • splitting
  • projection
49
Q

3 characteristics of ADHD

A
  • inattention
  • hyperactivity
  • impulsivity
50
Q

what are those with ADHD at risk for?

A

injury

51
Q

ADHD criteria

A
  • behaviors present prior to age 12
  • behaviors present in more than 1 setting
52
Q

autism s/sx

A
  • delayed cognitive/language development
  • inability to maintain eye contact
  • repetitive actions
  • strict routines
53
Q

when is autism diagnosed?

A

early childhood

54
Q

who is autism more common in?

A

boys

55
Q

how should you talk to those with ADHD, disruptive, impulse control, and conduct disorders?

A
  • be calm, firm, and respectful
  • use short, clear explanations
  • obtain attention before giving directions
56
Q

how should you talk to those with autism?

A

be short, concise, and developmentally appropriate

57
Q

what system should you develop with parents?

A

a reward system

58
Q

when should you give plenty of notice to those with autism?

A

before changing routines

59
Q

what can separation anxiety in children develop into?

A
  • school phobia
  • phobia of being left alone
  • depression
  • panic disorder
60
Q

how is play affected in children with PTSD?

A
  • decreases
    or
  • involving aspects of traumatic events
61
Q

when do manifestations of disruptive, impulse control, and conduct disorders worsen?

A
  • situations that required sustained attention (classroom)
  • unstructured group situations (playground)
62
Q

when do those with ODD misbehave most?

A
  • home
  • toward the person they know the best
63
Q

what can ODD develop into?

A

conduct disorder

64
Q

temper outburst criteria

A
  • present 3+ times per week
  • observable by others
  • in at least 2 settings
  • does not correlate with situation
65
Q

DMDD onset

A

ages 6-18

66
Q

IED onset

A
  • typically ages 13-21
  • as early as age 6
67
Q

IED can lead to

A

chronic disease (HTN, DM)

68
Q

conduct disorder behaviors

A
  • aggression to people/animals
  • destruction of property
  • deceitfulness/theft
  • violation of rules
69
Q

conduct disorder childhood onset

A
  • before age 10
  • more common in males
70
Q

conduct disorder adolescent onset

A
  • after age 10
  • prevalence equal in males and females
71
Q

what do those with conduct disorder do?

A
  • lie
  • bully
  • threaten
  • intimidate
  • shoplift
  • truant from school
72
Q

education for children/adolescents

A
  • gun/weapon control
  • seat belts
  • protective sports gear
  • contraceptives, STI’s, abstinence
  • substance use
  • who to voice concern to: police, school nurse, counselor, teacher
73
Q

when should you take methylphenidate?

A
  • 30-45 mins before meals
  • last dose before 4 pm
74
Q

transdermal methylphenidate location and timing

A
  • hip (alternate)
  • no more than 9 hours
75
Q

what type of prescription is needed for methylphenidate?

A

handwritten

76
Q

when should atomoxetine/bupropion be taken?

A
  • with or after meals
  • last dose before 4 pm
77
Q

when should TCA’s be taken?

A

bedtime

78
Q

what happens when guanfacine/clonidine are stopped abruptly?

A

rebound HTN

79
Q

who should not be given guanfacine/clonidine?

A

children under 6 y/o

80
Q

when should you take SSRI’s?

A
  • in the morning
  • with food to decrease GI effects

Level 2 (8 decks)

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