Mental Health Exam #4 Flashcards
what is bulimia?
patients may have a normal weight or be overweight
what is the difference between bulimia and anorexia?
bulimia: includes purging
anorexia: significant side effects like cardiac problems
how do we care for patients with eating disorders?
nurses that do not have a power struggle
why do we nourish emaciated patients slowly?
avoid the body from going into shock since it has not received nutrients in a while. electrolyte shift and they can die. S and S: decreased HR, hyperactive, no menses, altered body image
how do patients with conduct disorder behave?
loud, distributive, bullies, aggressive
how do patients with paranoid PD behave?
suspicious, distressed, hold grudges: CLUSTER A
what is antisocial personality disorder?
manipulates and violates the rights of others without remorse
what are signs and symptoms of autism?
stoic, overly emotional, move around a lot (repetitive behavior)
what is avoidant PD?
patients avoid all social encounters, have low self-esteem, low self-worth
how do we care for patients with avoidant PD?
have patients say one good thing about themselves
interventions for an adolescent with conduct disorder
therapy, family therapy, safety (untreated can become CLUSTER B disorder) Rule out: substance abuse, MSE
what are some expected findings of PTSD?
insomnia, fatigue, isolation, withdrawal
how do personality disorders usually start? what behaviors do you see with patients with antisocial PD?
conduct disorder (CLUSTER B) acting out as a child, doing bad in school, entitlement
what are manipulative behaviors?
feed off of fear, obligation, and guilt (CLUSTER B: antisocial)
CLUSTER A
odd and eccentric, exploit and deceive, magical thinking, delusions, hallucinations, uncooperative, don’t interact with others
what is bipolar disorder? how should we care for these patients?
“manic phase” monitor in quiet dimmed area, decrease stimulation
what is OCD? how should we care for patients with OCD? what characteristics do these patients have?
obsessions and compulsions
weaning process: identify what triggers the compulsion
repetitive action that causes distration
how should a nurse handle a patient who is escalation?
“What is upsetting you?”, de-escalate the situation, clear the room
what is the difference between conduct disorder and ODD?
conduct disorder: aggression
ODD: do not exhibit physical abuse
autonomy
patients have the right to choose their care
what to do with a patient who is acting out?
decreased stimulation
what do you do ist for a patient who comes into the ER with bulimia?
EKG monitor, vitals, CBC, CMP, BMP, fluids, assess for depression, education
why is St. Johns’s wort not the best treatment choice for depression?
increases SI and has a lot of contraindications
educate patient that this is not the best choice
what are some side effects of escitalopram (Lexapro)?
sexual dysfunction decreased libido
what patient education should be provided for a patient who has just been prescribed amitriptyline?
don’t stop abruptly, if you miss a dose do not double up, increased SI, takes 6-8 weeks to work, follow up with a provider, make sure to get refills
what medications should a patient on phenelzine avoid?
tyramine foods (aged cheese, turkey, caffeine) can cause hypertensive crisis: increased BP if taken with OTC meds
what education should be provided for a patient who is prescribed sertraline?
makes you drowsy so take at bedtime, may benefit from therapy
transference
person redirects their feelings for another person to a different person
EX: the new pt reminds the nurse of one of their ex-relationships, so the nurses treats the patient like their ex
what are positive signs?
delusions, hallucinations, somatic delusions, confused thoughts and speech, trouble concentrating, movement disorders
what health risks do patients with anorexia face?
osteopenia, osteoporosis, heart problems due to lack of electrolytes, malnutrition, SI Decreasd HR, BP, temp
how should we care for a client who is cognitively impaired?
something from home, pictures, make them feel comfortable
what are erotomanic delusions?
patient thinks celebrity is in love with them
who is most likely to be a victim of domestic violence? what do we know about the abusers?
women or anyone in vulnerable position
gets worse when they are pregnant
abuser: keeps them isolated, is manipulative, have lo self-eteem
what is the underlying cause of somatic symptom disorder?
childhood trauma or abuse
repress anxiety by focusing on made-up illness, repression of feelings
many doctor and hospital visits
decreased serotonin and endorphina
what is narcissistic PD?
people think they are perfect and rules don’t apply to them
