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Health And Healing > Mental Health FINAL Extras > Flashcards

Mental Health FINAL Extras Flashcards

1
Q

What are the criteria for the diagnosis of schizophrenia? (Criterion A, B, C, D, E)
(DHDGN)

A 
A - Delusions
Hallucinations
Disorganized speech
Grossly disorganized behaviour
Negative symptoms

B - Social/occupational impairment

C- Six months duration of a disturbance

D and E - Symptoms are not due to any other disorder

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2
Q

Define the three phases of Schizophrenia:
Prodromal
Active
Residual

A

Prodromal - Loss of interest, withdrawn, confused and preoccupied. Obsession with philosophy/religion. Lasts a few weeks to months.

Active - Delusions, hallucinations, distorted thinking, distortions in behavior and feelings, sudden onset.

Residual - Similar to prodromal. Hard to concentrate and withdrawn.

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3
Q

What is the circumstantial communication patterns in schizophrenia?

A

Disturbance in thought process in which one gives and excessive amount of detail that is often elaborate, irrelevant, and avoids a direct answer to a statement.

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4
Q

What is Tangential communication pattern in schizophrenia?

A

When the topic of conversation digresses from one to another rapidly.

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5
Q

What is Word Salad in schizophrenia?

A

The jumbling of meaningless words and expressions in communication.

“The minister’s donkey penis was the reason for the password in the state of Idaho, because green clouds aren’t as fluffy as Hulk Hogan’s beard hairs”

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6
Q

What are some positive symptoms of schizophrenia?

A

Delusions (fixed or false belief)
Hallucinations (Disturbance in perception)
Disorganized Thoughts & Behaviour

(Positive doesn’t mean good)

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7
Q

What are some negative symptoms of schizophrenia?

A 
Loss/diminished functioning
Reduced motivation
Social withdrawal
Change in habits/ability to function
Low energy
Decreased pleasure
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8
Q 
Which of the following is a psychotropic med for schizophrenia? What is it's most common side effect?
A/ Escitalopram
B/ Clonazepam
C/ Haloperidol
D/ Domperidone
A

Haloperidol

Common side effect is Tardive dyskinesia

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9
Q

What med is given typically as a “last resort” to treat severe mental illness/schizophrenia?

A

Clozapine

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10
Q

What are some nursing interventions for schizophrenia?

A
  • Monitoring meds/side effects
  • Therapeutic relationship
  • Health teaching
  • CBT
  • Family Therapy/management
  • Social/vocational life skills
  • Physical health maintenance
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11
Q

Which of the following is not considered a criteria for substance abuse diagnosis?
A/ Failure to fulfill role obligations at work/school/home due to substances
B/ Recurrent legal problems related to substance
C/ Recurrent use in physically hazardous situations (driving)
D/ A tolerance to the substance has occurred requiring larger doses to achieve therapeutic goal.
E/ None of the above

A

D/ Substance tolerance is not a requirement of abuse.

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12
Q

What is physiological dependence?

A

When a person feels they cannot function or feel comfortable without using their drug of choice.

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13
Q

What is the C.A.G.E. assessment tool for? What does CAGE stand for?

A

Assessing alcoholism.

Cut down on drinking
Annoyed by criticism of your drinking
Guilty about your drinking
Eye-opener about your drinking

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14
Q

Nurse is caring for a patient who overdose on lorazepam (Ativan). Which is the following the priority symptom to monitor?

  1. Euphoria
  2. Respiratory depression
  3. Slurred speech
  4. Unsteady gait
A
  1. Respiratory Depression
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15
Q 
Type 1 personality disorder is known as Highly emotional. Explain each subtype under this category:
Antisocial
Borderline
Histrionic
Narcissistic
A

Antisocial - Lacks empathy
Borderline - Interpersonal difficulties and impulsive behaviour
Histrionic - Overly emotional, seeks attention through actions
Narcissistic - Thinks very highly of self, desires to be admired, blames others for problems.

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16
Q

Type 2 personality disorder is known as Highly cautious. Explain each subtype under this category:
Avoidant
Dependent
Obsessive-compulsive trait

A

Avoidant - VERY shy, overly sensitive to criticism

Dependent - relies on others heavily (clingy)

OCD - Needs everything to be perfect, needs control.

17
Q

Type 3 personality disorder is known as having trouble in socializing. Explain each subtype under this category:
Schizoid
Paranoid
Schizotypal

A

Schizoid - Difficulty forming relationships

Paranoid - doesn’t trust others

Schizotypal - Uncomfortable with close relationships; has odd ideas and behaviours

Appear Anxious

18
Q

What is loss of association, in the communicative patterns of schizo’s?

A

A thought disorder in where the patient responses do not relate to the interviewer’s questions. Or a sentence, paragraph or phrase is not linked to previous expressed ones.

19
Q

Risperdal, Olanzapine, Seroquel, and Clozapine are Atypical drugs for schizophrenia with these common side effects.

A

Weight gain
Fatigue
Restlessness

20
Q

Substance dependence is manifested by 3 or more of the following:

A

Withdrawal from drug, or related drug is required to relieve or avoid withdrawal symptoms

Substance is taken in larger amounts or longer than intended

Persistent desire or unsuccessful effort to cut down and control dependence

Time is spent in activities to obtain the substance

Important events are given up to use or due to the use of substance

Continued knowledge of persistent effects of use, but use it anyways

21
Q

What is Physiological dependence?

A

When a person feels they NEED the drug to function or feel comfortable (relaxed)

22
Q

What is a physical Dependence?

A

When a person has done so much of a drug that they require more of the drug to reach the desired high.

23
Q

What are barriers to treating addiction?

A 
Denial
Guilt 
Shame
Priority level
Occurrance of co-existing illnesses
Poor health professional support
Staff attitude and biases
Stigma
24
Q

Dick is a 16 year old useless waste of space. Recently his whorish mother took time to acknowledge his pitiful existence and found that he is failing school, asking for money more often, and is sexually acting out in a gay way. These may be signs of….

A

Adolescent substance abuse.

Otherwise known as everyday life in Owen Sound.

25
Q

What are medically presenting signs of adolescent substance abuse?

A
  • Frequent injuries
  • Anxiety
  • Depression
  • STD’s (Full blown AIDS)
  • Unexplained sudden weight loss
  • Chronic GI symptoms
  • GI Complaints
26
Q

Explain what occurs during Alcohol Detox.

A

Symptoms occur 4-12 hours after cessation or marked drop in consumption

Symptoms: coarse hand tremors, sweating, elevated pulse and BP, insomnia, anxiety, nausea/emesis

27
Q

What are the more severe symptoms of Severe alcohol withdrawal?

A

Transient hallucinations
Seizures
Delirium
*Must be under medical attention (life threatening)

28
Q

True or False? A person with Depression is at a higher risk of developing substance abuse .

A

Truth.

Mental illness increases the likelihood of abuse, vise versa.

29
Q

What are 2 common substances that affect psychotropic meds?

A
  • Caffeine

* Nicotine

30
Q

What are common side effects of psychotropic meds?

A

Changes in liver function and metabolic rates

Photosensitivity

Upset GI

Weight Gain

Food intolerances

31
Q

What fall under the Extrapyramidal Symptoms of psychotropic meds?

A
  1. Tardive Dyskinesia
    (Involuntary body movements)
  2. Dystonia
    (Abnormal muscle tone/posture)
  3. Akathisia/Parkinsonism
    (Restlessness and shaking)
32
Q

What can Antidepressants do to children and teens?

A

Increase the risk of suicide or suicidal thoughts

33
Q

Rupert is a dillhole who hits his wife, has trouble with maintaining relationships, thinks VERY highly of himself, and lacks significant empathy towards others. What is wrong with Rupert?

A

Group 1 personality disorder

Antisocial - lacks empathy
Narcissistic

34
Q

The nurse is facilitating group therapy for clients with the diagnosis of chronic undifferentiated schizophrenia. The nurse begins the first meeting with an introduction of all group participants. What should the nurse do next?
A/ Ask the clients what they hope to gain from the meetings.
B/ Allow the clients to discuss anything they wish to bring up.
C/ Have each of the clients identify a specific concern and then discuss each one.
D/ Share with the clients the purpose of the meetings and explain the rules of behavior.

A

D/

Sharing the purpose of the meeting and explaining the rules is the most therapeutic option because it sets both the parameters of discussion and limits on behavior. Asking clients what they hope to gain, allowing clients to bring up any topic, or having each client express and discuss a concern is not therapeutic for a group of clients with the diagnosis of schizophrenia; because of the disruption of cognitive processes, these clients are unable to make these contributions.

35
Q

A client with alcohol dependence problem asks whether the nurse can see the bugs that are crawling on the bed. What is the nurse’s initial reply?
A/ “No, I don’t see any bugs.”
B/ “I’ll get rid of them for you.”
C/ “I’ll stay here until you’re calmer.”
D/ “Those bugs are a part of your sickness.”
E/ “Holy Hell, you’re so annoying. Like a little child. No wonder no one loves you.”

A

A/

Telling the client that there are no bugs presents reality and answers the client’s question. Offering to get rid of the bugs is entering into the misperception of reality. Offering to stay with the client and telling the client that the bugs are part of her sickness both provide comfort and may reduce anxiety but should each follow the priority intervention of pointing out reality.

36
Q

A child is found to have attention deficit–hyperactivity disorder (ADHD). What strategy should the nurse teach the parents to help them cope with this disorder?
A/ Orient the child to reality.
B/ Reward appropriate conduct.
C/ Suppress feelings of frustration.
D/ Sedate the child with industrial-strength German grade sedatives when the child is “unruly”

A

B/

External rewards can motivate as well as increase self-esteem in the child with ADHD. Orienting the child to reality is unnecessary because children with ADHD are alert and oriented. Feelings of frustration should not be suppressed; rather, the child should learn how to cope with these feelings in an acceptable manner.

37
Q 
What treatment should a nurse anticipate will be prescribed for a client with severe, persistent, intractable depression and suicidal ideation?
A/ Electroconvulsive therapy
B/ Short-term psychoanalysis
C/ Nondirective psychotherapy
D/ High doses of anxiolytic drugs
E/ A swift kick to the baby-maker
A

A/

Electroconvulsive therapy, which interrupts established patterns of behavior, helps relieve symptoms and limits suicide attempts in clients with severe, intractable depression that does not respond to antidepressant medication.

38
Q

When planning for a client’s care during the detoxification phase of acute alcohol withdrawal, the nurse anticipates the need to:
A/ Check on the client frequently.
B/ Keep the client’s room lights dim.
C/ Address the client in a loud, clear voice.
D/ Slip the client Vodka to reward compliance to medications and sobriety

A

A/

During detoxification frequent checks help ensure safety and prevent suicide, which is a real threat. Bright light is preferable to dim light because it minimizes shadows that may contribute to misinterpretation of environmental stimuli (illusions). The client who is going through the detoxification phase of acute alcohol withdrawal usually does not lose his sense of hearing, so there is no need to shout

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