Mental health nursing Flashcards
What are some historical treatments of mental health problems?
- drive out evil spirits
- Remove a piece of skull (so brain could relax?)
- Exorcism
- lobotomy (take out a piece of lobe)
- exclusion
- burnt at the stake
- locked up in an institution
What is the mission statement for Queenslands plan for mental health
“To provide a comprehensive, resilience and recovery-based mental health system across Queensland, with emphasis upon promotion, prevention and early intervention”
What are the principles for Queenslands plan for mental health?
- Consumer participation
- Resilience and recover
- Social inclusion
- Collaboration and partnerships
- Promotion prevention and early intervention
- Evidence
What is self awareness?
Knowing how you are going to respond to specific situations, knowing your values, attitudes and biases towards people and situations, and knowing how your human needs might manifest your work.
What are the core concepts of the effective nurse?
Empathy Autonomy Self-disclosure Confidentiality Advocacy Boundariesm
What is the role of the mental health nurse?
Mental state assessment Social/personal assessment Physical health assessment Counselling Monitoring, planning and evaluation Administration of medication Linking consumer with social activities Advocating for consumer and family Assisting with lifestyle choices Education - illness and treatment options Education for consumers,carers, family, other nurses, health professionals, members of the public. Linking with families Case management Member of the multi dis team Research Build therapeutic relationships with consumer, carers mad family
What is a therapeutic relationship?
A balance between the personal self, offering human closeness and professional distance.
An enabling relationship that supports the needs of the client
Based on rapport, establishing a connection with the person and developing trust
What is the consumer consultant, and how do they help the mental health service team?
People who have had a mental illness or are being treated with a mental illness.
Work in the facilities, congruent between the client and the staff help to assist the person to feel more part of the process, monitor how the service is working with the consumer. And give staff advice on what is best
How can the stigma of mental health be changed within the community?
Updated mental health act
Transportation via ambulance or mental Health care workers
Giving care in the least restrictive way for the client
Early interventions
Using GP
What is the role of the GP
Discussion and education of treatment
Deinstitutionalisation
Keeping the client in the community
What are the components of the psychosocial health assessment?
Identifying data Presenting problem History of presenting problem Family history Psychiatric history Occupational/educational history Spirituality/religion Mental state assessment Previous physical health Coping and stress Substance use and medications Other problems/issues
What are the components of the mental state assessment?
Appearance and behaviour Speech Mood and affect Form of thought Content of thought Sensorium and cognition Perception Insight
What is included in appearance and behaviour?
What do they look like Their clothes Where they clean Their hair Piercings Tattoos Clothes appropriate for the weather Motor behaviour Pacing, fiddling? Did they want to be here How do they feel about being here Make no judgements, only state what you see
What is included in speech for the Msa?
Rate
Volume
Quality of information
What is included in mood and affect for a MSA?
Mood - what they say they feel
Affect - how they appear to feel, your impression
Is the mood congruent with the affect?
What is included in form of thought for an MSA?
How the thinking is formed?
Amount of thought and rate of production
Continuity of ideas
Disturbance in language and meaning
What is included in content of thought for an MSA?
Delusions
Suicidal thoughts
What is included in perception for an MSA?
Hallucinations - auditory, visual, gustatory.
Voices - how many voices, what do they say, is it a make or female, do they have a name?
Perceptual disturbances eg. Derealisation, depersonalisation, dulled perception
What is included in sensorium and cognition for a MSA?
Level of consciousness Memory - immediate, recent, remote How did they get here? Orientation - time place and person Concentration - serial 7's Abstract thinking
What is included in insight for an MSA?
Extent of individual’s awareness of problem
I’m here because I’m drinking to much….
I’m here because the aliens have inserted probes into my head…
What is included in a risk assessment?
Suicidal/homicidal thoughts or ideas Do they have a plan? Do they have means? Sold property Given pets away Rope in car What is the intention? To not wake up in the morning Do they have a timeframe?
Give the definition of insight
The persons awareness of their situation or problem, including the existence of a mental health problem. Insight may exist in varying degrees ranging from no or little insight or awareness, through to a good level of insight. Assessment of insight is important in terms of the persons willingness to accept treatment - if they do not believe they have a problem for instance they are unlikely to accept help for it.
What is the definition of labile?
A term in relation to mood, where the person fluctuates between extremes of emotional states
What is the definition of thought disorder?
A disturbance of thought where expressions of thoughts is disrupted, resulting in illogical and awkward thinking and speech
What is the definition of thought form?
A component of the MSA that refers to the manner in which thoughts are expressed, as opposed to the content of thought.
What is autonomy?
Right to make own decisions, with ought violating the rights of another
What is beneficence?
Conduct that is good for the wellbeing of another
What is non-maleficence?
Above all, to do no harm and consider potential harm.
What are ethical violations?
Improve neglect of moral obligation (eg. Neglect of competent care provision)
What is an ethical dilemma?
Ethical reasons for and against a particular course of action - and one must be chosen.
What are some common ethical dilemmas?
Confidentiality violations Use of restraint Involuntary admission Informed consent Sexual attraction/relationship between professional and consumer
What elements are involved in the continuum of professional behaviour?
Disinterested neglectful-therapeutic relationship-boundary violations
Under involvement-zone of helpfulness-over involvement
How can you identify boundary violations?
Excessive self disclosure Secretive behaviour Super nurse Singled out treatment Selective communication Flirtations Sexual misconduct
What are some strategies to prevent boundary transgressions?
Reflective practice Peer support Clinical supervision Education Remaining current with professional groups
What are some ethico-legal issues in mental health nursing?
Right of a person to receive treatment may conflict with right to refuse
Right to refuse takes precedence unless person legally deemed a danger to self/others
Nurses have to make decisions balancing clients expressed wish vs. what is best interest
What is the purpose of the QLD MH act 2000?
Provides for the involuntary assessment and treatment, and protection, of persons while at the same time safeguarding their rights
Provides for the determination of a persons mental state when they have a mental illness and have been charged with a criminal offence
What is the definition of a mental illness in the QLD mental health act 2000?
A condition characterised by a clinically significant disturbance of thought, mood, perception or memory.
What are the principles of the QLD MH act 2000?
Respect for basic human rights
Persons particular needs and circumstances to be taken into account
Treatment under the act only to be given if it’s appropriate to maintain MH and wellbeing
Person has the right to confidentiality
Must be used if no less restrictive way to protect
What are the patients rights under the act?
Privacy and rights Least restrictive environment Individual treatment plans Informed consent Right to refuse, unless legally required Confidentiality Provision to info in a timely manner
What orders can be used for involuntary assessment?
JEO justice examination order
EEO emergency examination order
What is a JEO, justice examination order?
Can be made by a JP or magistrate
Person must reasonably believe that the person has a mental illness and that the person should be examined to determine whether a recommendation for assessment should be made and the examination cannot be carried out unless the order is made
Valid for up to 7 days and forwarded directly to AMHS
But person must be seen within 3 days
What is an EEO emergency examination order?
Can be made by a police officer or ambulance officer or psychiatrist
The person can be detained for up to 6hours
Examination by a doc or AMHP to decide if the assessment documents should be made
If documents are not made the person must be taken back to the place they were taken from or another place the person reasonably asked to be taken
In order be be assessed what criteria does the person need to meet?
Person appears to have a mental illness
Person requires immediate assessment
The assessment can be made at an authorised mental health service
There is a risk the the person may, cause harm to themselves, or someone else or suffer serious mental or physical deterioration
There is no less restrictive way of ensuring the person is assessed
The person lacks the capacity to consent or has refused to be assessed
What is the treatment criteria for a person under the mental health act?
The person has a mental illness
The persons illness requires immediate treatment
The treatment is available at the MH service
Because if their illness the person may cause harm to themselves or others
The person is likely to suffer deterioration
No less restrictive way
Person lacks the capacity to consent
Refuses treatment
What is psychosis?
Is a condition in which a person has impaired cognition, emotional, social and communicative responses and interpretation of reality
What is a hallucination?
A sensory perception that seems real but occurs without external stimulation. (Unlike an illusion, which is a misinterpretation of real phenomena)
Name the different types of hallucinations
Auditory - voices, inside head, outside, who are they, embrace them?
Visual- seeing things,
Olfactory- smells, querie organic?
Tactile- touch, feel something on my skin… Drug and alc withdrawal
Gustatory- taste, quierie organic?
Somatic-
Thought disorder - What is clanging?
Often person is elevated, coming up with puns and rhymes eg. Here’s a pen, my names Ben, I have 10
Thought disorder - What is circumtantiality?
Starts a story and goes off on a tangent then comes back, adding in so much detail
Thought disorder - What is derailment?
Often no connection in story, jumps from one part to another.
I grew up in Adelaide, I don’t like fish and chips I’m good at cooking
Thought disorder - What is tangentiality?
Off on tangent, the story continues but never finishes on the main point.
Thought disorder - What is incoherence?
Making no sense at all can not cohere what the person is telling
Thought disorder - What is thought blocking?
On the tip of the tongue, the person looses the thought entirely.
Thought disorder - What is word approximations?
Person finds it really difficult to explain things
Thought disorder - What is neologisms?
Making up new words
Thought disorder - What is a word salad?
Jumbled words coming together, eg. Cold battleship major cat phone flower wing rang
Expressive aphasia
What is a delusion?
A false belief based on incorrect inference about an external reality that is firmly sustained despite what almost everyone else believes and despite incontrovertible and obvious proof or evidence to the contrary
Can often sound like plausible things, need to be careful
Delusion - what does persecution mean?
I’m being watched all the time, sometimes I feel like I’m on camera and people are watching me and are stealing my thoughts
Delusion - what is somantic?
Feeling a snake moving within her stomach
Delusion - what is a religious delusion?
Believing they are the chosen one, I’m a bad person because I a previous life I did this and now I have to pay for my sins
Delusion - what is thought broadcasting?
When I think something you can all hear what I’m thinking and it’s really uncomfortable, your taking the thoughts out of my mind
Delusion - what is nihilistic?
Loosing hope and positivity, world is ending what’s the point.
Delusion - What is thought insertion?
You are putting thoughts into my mind there is a probe or a computer chip, people are controlling me through satellites
Delusion - what is erotomania?
Kyrie monouige wants to shag me, a sexual delusion
Delusion - what is grandiose?
I am king of the world! The reason I’m going to buy a porche is because I deserve a porche
Delusion - what is a control delusion?
The persons actions are being controlled the person has no independence
Delusion - what is a reference delusion?
When I watch family feud, the person is talking to me, the person is talking about me, they are telling me things passing me messages
Psychotic symptoms can also mean?
Neuro conditions Metabolic or endocrine disturbances Vitamin deficiencies Auto immune disorders Med or drug intoxication or withdrawal Dementia and or delirium
What is brief reactive psychosis?
Psychosis in reaction to an incredible stress
What is puerperal psychosis?
Immediate postpartum period of psychosis
What is a delusional disorder?
No thought disorder, no hallucinations, only delusions
What is a mood related psychiatric disorder
Bipolar affective disorder, or depression
What is schizophrenia?
A group of disorders characterised by a major disturbance in thought, perception cognition and psychosocial functioning
A split in the mind
Not split personality
Not violent
Not developmentally delayed
Not low intelligence
What is schitzophreniform?
Schizophrenia that lasts longer than 1 month but less than 6
What is schitzoaffective disorder?
A disorder where the person experiences a combination of schizophrenia symptoms and mood disorder symptoms such as mania or depression
How to psychotic symptoms get diagnosed as schitzophrenia?
Two or more of the following symptoms will present for a significant portion of time during a 1 month period. At least one symptom must be 1,2 or 3. Full diagnosis is achieved after 6 months
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms
What is a positive symptom
Excess functioning, everything is over clocking
Hallucinations
Delusions
Thought disorders
What is a negative symptom?
Deficit symptoms going to slow
Loose your drive - avolition Decreased energy - anergia Decreased pleasure - anhedonia Affect blunted Decreased speech - alogia
What care common co mormidities of schitzophrenia?
Diabetes Cardiovascular disease Lipidemia Risk of smoking Increased risk of suicide Decreased life expectancy
What are the treatments for psychosis?
Supportive psychotherapy
Therapeutic use of self
Cognitive behavioural therapy, unlearn and relearn new skills
Psychotropic medications
What are psychotropic medications?
Antipsychotics
Antidepressants
Mood stabilisers
Anxiolytics
What do psychotropic medications do scientifically?
Modify reputable to the neuron
Activate receptors
Inhibit receptors
Inhibit enzyme activity
What are the roles of the nurse with medications?
Administration
Education
Understand effects
Understand the unwanted side effects
What are some nursing strategies around medications
Correct misconceptions Emphasise personal choice Empathy Support Goal setting/ motivational interviews
What are some first generation antipsychotic drugs? (Typical antipsychotics)
Phenothiazines - thioridazine Thioxanthines - flupenthixol Butyophenones - haloperidol Diphenylbutylpipridines - pimozide Trifluoperazine - stelazine Chlorpromazine - largactil Zuclopenthixol - clopixol
What does typical antipsychotics do?
Dopamine antagonists
Reduce positive symptoms
What are some second generation (atypical antipsychotics)?
Clozapine Risperidone Olanzapine Quetiapine Amisulpride Sulpiride Aripiprazole Paliperidone
How does an atypical antipsychotics work?
Block action of dopamine and serotonin receptors
Reduce pos symptoms
Reduce negative symptoms
Less extra primidial side effects
What are some potential side effects of medications?
Extraprimidial side effects (EPSE) Sedation Photosensitivity Anticholinergic Endocrine Metabolic
What are some Extraprimidial side effects?
Explain each
Acute dystonic reaction
- involuntary movement characterised by sustained muscle contraction of head back and torso, occurs suddenly
Oculogyric crisis
- transient stare followed by upward and lateral rotation of eyes
Akathasia
- restlessness, leg aches, cannot sit still
Parkinsonism
- rigid, mask like facial expression, shuffling gait, drooling
Tardive dyskinesia
- involuntary movement of the tongue, lips, feet, results from prolonged use of typical antipsychotics
Neuroleptic malignant syndrome
- potentially fatal with hyperthermia, eps, sweating, muscle rigidity, clouding of conciousness
Seizures
- typical antipsychotics reduce the seizure threshold by about 1%
What are some EPSE treatments
Anticholinergic drugs
- benztropine mesylate - cogentin - Imi, Iv oral
Shorter half life than the causative agent
Reduce dose or cease antipsychotic
Change traditional antipsychotic to atypical
What are the classes of antidepressants?
Tricyclics (TCA)
Monoamine oxidase inhibitors (maois)
Selective serotonin reuptake inhibitors (ssri’s)
Serotonin-norepinephrine reuptake inhibitors (snri’s)
Mood stabilisers are?
Lithium carbonate
What are the 3 primary anticonvulsants?
Carbamazepine
Sodium valproate
Topiramate
How do mood stabilisers work?
Lithium - compromises the ability of neurons to release, activate or respond to neurotransmitters
Sodium valporate - believed to affect the function of GABA
What medications can be used for anxiety?
There are 2 classes
Benzodiazepines
- diazepam, clonazepam, alprazopam, lorazepam, Temazepam, nitrazepam
Non-benzodiazepines
- buspirone, propanolol
Name some anxiolytic side effects
Sedation/ drowsiness Reduced mental activity Impaired motor performance Headache Dizziness Hypotension Restlessness Rebound insomnia Rebound anxiety Tolerance buildup Dependence Withdrawal
What gender is more likely to be diagnosed with depression?
Women
What does BPAD stand for?
Bipolar affective disorder
When is the onset of bipolar affective disorder?
Usually teenage years
What are some risk factors for depression?
Genetics Loss/ trauma/ abuse/ stressors Decrease in supports Alcohol and other drugs Illness and disability Neurochemical/ neurotransmitter Circadian rhythms, melatonin and sleep
What is the scale of mood, bottom to top?
Dysphoria - low mood
Euthymic - normal mood
Euphoric -
What are the different levels of depression?
Mild, moderate, severe
What is the difference between mania and hypo mania?
Hypo mania is closer to a euthymic mood.
Name the scale of signs and symptoms of mania and hypo mania?
Hypo mania- pressured speech, loose associations, lots of activity, decreased judgement, increased spending, decreased sleep, increased impulsivity, loss of empathy, increased thoughts.
Mania - euphoric/ irritable, elated, grandiose, labile, increased sex drive, Psychosis, delusions, hallucinations
Explain the scale of symptoms of depression and major depression
Depression- decreased mood, flat, a motivated, rumination, tearful, irritable, anxious, labile, increase pain, decreased pain tolerance
Decreased libido, socially withdrawn, isolated, decreased activity, catastrophic I f, negative, egocentric
Decreased or increased sleep, decreased or increased weight, decreased thought, poverty of speech, self harm, suicidal ideation.
Severe- psychomotor retardation or agitation, psychosis, delusions, hallucinations
What is dysthymia?
A mood that never really has any life to it. Constant mild depression. All of life is just a bit bland
What is the difference between the two BPAD?
Both have up and down mood, but BPAD1 has more severe symptoms ranging from psychotic mania to severe depression.
What does C.A.R.E stand for?
Containment
Awareness
Resilience
Engagement
What are tools of the trade for treatment of mood disorders?
Emotional intelligence psychoeducation Rational emotive therapy Cognitive behavioural therapy Interpersonal therapy Occupational therapy Psychotherapy Supportive therapy Dialectical behaviour therapy
Is it suicidal or deliberate self harm? Explain in detail
All about the perceive lethality
- as perceived by the client not the clinician
Why do people self harm?
Maladaptive coping Self loathing Release Empowerment Just wanted to feel something Loss of sense of self
What are some strategies to avoid self harm?
Finding other coping strategies
Exercising
Holding a piece of ice
What increases the risk of self harm or suicide?
Loss- recent/ anniversary Men 20-54 Intoxication Mental illness Exposed to suicide Rural and remote areas Indigenous
What does a self harm or suicide risk assessment contain?
Ideation Plan Means Timeframe Intent Lethality Rapport Recent losses Previous attempts Previous exposure Alcohol and other drugs Resources/ supports Psychopathology Contract
What are protective factors for self harm or suicide?
Strong social support Family cohesion Good coping mechanisms Peer group affiliation Good coping mechanisms Good problem solving skills Positive values and beliefs Ability to seek and access help Resilience Social participation Early intervention
What is ECT mainly used for?
Severe depression that has not been effectively treated with anything else.
What are some side effects of ect?
Amnesia - anterograde and retrograde
What is the nursing role in ECT?
Education
Legal
Assist client
Physical observations after
What is the definition of child sexual assault ?
Involves any sexual act or sexual threat imposed on a child
Use of coercion, or force either physical or psychological
Exploits immaturity
What social and interpersonal effects are linked to child sexual assault?
Sexual problems Instability in relationships Increased rate of divorce and separation Lowered self esteem Precocious sexual behaviour and risk of prostitution Possible lower socioeconomic status
What are nursing strategies to manage the affects of child sexual abuse?
Believe the person who is disclosing Listen to then Reinforce they aren't alone Refer to services Encourage to share their feelings If client is under 16 must report to child safety Reassure they have not caused the abuse Don't force them to talk about it
How can child sexual assault be prevented?
PRIMARY Educate children Promote healthy interactions Empower child to seek help Identify at risk children
SECONDARY
Providing positive school experiences
Encourage positive relationships with parents
TERTIARY
Improve clients self esteem
Assist person to overcome sexual difficulties
Developers social support
Encourage to find or maintain work and leisure activities
When asking a child if the have been sexually assaulted what should the nurse make sure to do?
Know how you are going to respond the the person
What is a personality?
The expression of an individual’s feelings, thoughts and behaviour the evolves over time
What are personality traits?
Characteristics that make up our individual personality.refers to the consistency of persons response to a variety of situations
Eg. Introverted or extroverted
Anxious or calm
Conscientious or careless
What are some characteristics that make a healthy personality?
Identifies self as a total of their strengths and weaknesses
Identifies types of interactions or thoughts that create sadness, anger, love, hate
Relates to others without expecting them to meet all their needs
Is able to define where they end and another person begins
Is able to achieve a healthy work/life balance
Identifies goals accomplished through self-discipline and creativity
Resilient when confronted with adversity
What is a personality disorder?
When a trait or manifestation of personality interfere with or inhibit a persons life
How does a personality originate?
Can be cause by adverse events or psychological trauma in infancy
Neglect
Hereditary
Name the 3 clusters that personality disorders are grouped into
A- odd or eccentric
B- dramatic, erratic and emotional
C- anxious and fearful
Explain cluster A (odd or eccentric) personality disorders
There are 3
Paranoid: distrust and suspiciousness
Schizoid: detachment from social relationships, emotionally frigid
Schizotypal: eccentric beliefs, acute discomfort in relationships
Explain cluster B (dramatic, erratic and emotional) personality disorders
There are 4
Antisocial: disregard for/violates others rights
Borderline: instability in relationships
Histrionic: high emotionality and attention seeking
Narcissistic: grandiosity, need for admiration, self important, arrogant, exploitative
Explain cluster C (anxious and fearful) of personality disorders
There are 3
Avoidant: social inhibition, feeling inadequate
Dependent: submissive clinging behaviour
Obsessive/compulsive: pre-occupational with order, perfection and control
What assessment is done for a potential personality disorder?
Drug and alcohol use Self harm or mutilation Suicidal thoughts, plan, intent, previous history Sexual activity Family relationship history Forensic history Childhood relationships
Ask how would other people describe you?
How you you describe yourself?
What are some symptoms of borderline personality disorder?
Chronic feelings of boredom/emptiness Identity disturbance (unstable self image) Impulsive and self harm behaviours eg promiscuity, substance use, compulsive spending, suicide gestures
How can borderline personality disorder be MANAGED?
Set clear limits, plan, guidelines
Crisis intervention and management for suicide gestures/attempts
Keep as short as possible in hospital
Group therapy often helpful
Individual psychotherapy
Case management
Community mental health treatment
Dialectical behaviour therapy
Family and coup,e therapy
Medication eg. Antidepressants, antipsychotics
Metallisation - recognising mental states within themselves
What is transference?
Client displays feelings for significant person in early life, on to the nurse
What is counter transference?
Nurse displaces feelings for significant people in own lives on to clients
What are some risk factors for drug misuse?
Parenting and family issues Access to education Social and economic factors Community and environmental issues Inequalities Poor housing Employment
How can we address addiction issues?
Health promotion
Harm minimisation
Some Target drugs are?
Tobacco, alcohol, cannabis, opiates
Target groups that are at risk of substance abuse are?
Young people
Indigenous people
Young adults
General population - tobacco and alcohol
What are some environments that can be targeted for education and why?
Schools
Tertiary Learning settings
Workplace
These are places where people congregate together
What is primary prevention, provide some examples?
Preventing harm from happening in the first place
Prevent, delay, reduced uptake
Eg. Improving parenting skills Building resilience in children Positive mental health Social support Improving economic factors
What is secondary prevention? Provide examples
Actions targeted at a population at risk
Already exhibiting problems
Eg. Early intervention (young parent support, family therapy)
Reducing alcohol consumption
Smoking cessation programs
Promoting alternative methods
What is tertiary prevention? Provide some examples
Interventions aimed at individuals experiencing significant problems related to their drug use
Eg. Opiate substitution pharmacology
Relapse prevention and rehabilitation
Provision of information about safer injecting
What are legal problems of intoxication?
Drunkness Criminal damage Assault Drink driving Manslaughter Homicide
What are some social problems of intoxication?
Domestic disputes Arguments with friends Aggression to self or others Domestic violence Child abuse and neglect Absenteeism
What are some medical problems with intoxication?
Hangover Nausea Gastritis Overdose Head injury Accidental trauma Spontaneous abortion
What or some legal problems of REGULAR use?
Debt Theft Fraud Convictions Vagrancy
What are some social problems of REGULAR use?
Financial difficulties Work difficulties Narrowing leisure Family problems Child abuse/neglect Marital difficulties Divorce Homelessness
What are some medical issues of REGULAR use?
Brain damage Withdrawal symptoms Foetal alcohol syndrome Cancer Impotence Obesity Heart disease Epilepsy Diabeties Anxiety Phobias Depression Personality change Hallucinations Psychological problems
What are the 3 components of thorleys balls?
Problems of intoxication
Problems of regular use
Problems of dependence
Define tolerance
A need for markedly increased amounts of a substance
Markedly diminished effect with continued use of the same amount of the substance
What are some common comorbidities of substance use?
Depression Anxiety Personality Paranoia Psychosis
What assessment information is usually collected for someone who is a suspected substance abuser?
Personal demographics Substance use history Physical history Psychosocial Risk behaviours Motivation to change Urine sample Blood test
Name the stage of change model
Precontemplation Contemplation Determination/preparation Action Maintenance Lapse Relapse
What are some symptoms of alcohol withdrawal?
Tremor Perspiration Anxiety Agitation Tachycardia Hypertension Seizures Hallucination Depressed mood Irritability Panic Headache Insomnia Increased temperature Malaise Nausea/vomiting Diarrhoea
What is the management for alcohol withdrawal?
Diazepam
-exhibits anxiolytic,sedative,muscle relaxant and anticonvulsant effects
What is cognition?
The process of knowing, thinking and thoughts, the capacity to understand/interpret information
Memory
Processing information
What are some symptoms of a cognitive disorder?
Impaired awareness, reasoning, memory, judgment, perception, disorientation.
What is the definition of dementia?
A progressive illness that involves cognitive and non cognitive abnormalities and disorders of behaviour, presents as a gradual failure of brain function. It is not a normal part of life or ageing.
Dementia can be a comorbidity of what neurocognitive disorders?
Alzheimer's disease Vascular disease Levy bodies Prion disease HIV infection Traumatic brain injury Parkinson's Huntingtons Multiple aetiologies
What is delerium?
To go off the furrow or off the track
Not a disease, it’s a syndrome
A medical emergency
What are some frequent causes of delirium?
Hyponatraemia Urinary tract infection Stroke Unmanaged pain Fractures Alcohol Benzodiazepines Urinary retention Constipation Changes in environment Hypoglycaemia
What is a key component of delirium over a 24/7 period
Can fluctuate at night time
Eg sundowners
What are some environmental strategies to help with delirium or dementia? Name 5
Lighting appropriate to time of day Low stimulus environment Clock and calendar that clients can see Encourage family to visit or stay Bring in clients personal or familiar items Avoid room changes Use interpreter when required Indigenous liaison officer Eating and drinking Hearing aids Glasses Avoid constipation, bowel chart Mobilisation Encourage independence Medication review Proficient sleep at night Manage pain Provide orientation Minimise use of idc Avoid use of physical restraints Avoid medications as much as possible
What are some physical symptoms of anxiety?
Name 5
Nausea Upset stomach Tremors Feeling uncoordinated Profuse sweating Chills Diarrhoea Dizziness Muscle aches Sleep disturbances Chest pain Rapid heartbeat Rapid breathing High blood pressure
What’s are cognitive signs and symptoms of anxiety?
Name 5
Decreased thoughts Increased thoughts Preoccupation Can't make decisions Decreased problem solving Confusion Disorientation Decreased concentration Decreased calculating Decreased memory Thought blocking Distressing dreams
What are some emotional symptoms of anxiety?
Name 8
Anxiety Fear Guilt Grief Depression Feeling lost Feeling abandoned Feeling isolated Worry about others Wanting to avoid others Anger/irritability Feeling numb Anhedonia Startled/shocked Helplessness Despair
What is panic disorder?
Acute Unpredictable Sudden onset Rapid escalation Extremely distressing
How can you manage panic attacks?
Slow breathing is first line Decrease coffee intake Decrease nicotine Decrease soft drink Increase exercise Do yoga or meditation Psychoeducation Cognitive behaviour therapy Support Antidepressants Benzodiazepines are last line
What is obsessive compulsive disorder?
Obsessive thoughts
Compulsive behaviours
Exposure can equal a trigger
Trigger can equal a ritual
How can OCD be managed?
Focus on control rather than cure Education Exposure therapy and response prevention Cognitive behaviour therapy Medications
What is post traumatic stress disorder?
Happens after a traumatic event, with Intrusive recollections, Avoidance/ numbing, Hyper-arousal and Decreased functioning.
What is social phobia?
Happens on specific social or performance situations
Fear of embarrassing themselves or negative judgement
Their own thought are the trigger
