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NCLEX-RN® > NCLEX-RN (6) Mental Health > Mental Health Problems > Flashcards

Mental Health Problems Flashcards

Review the different types of mental health problems, hallucinations and delusions, and ECT.

1
Q

Why are psychiatric clients admitted to the hospital?

A

Because of suicidal or homicidal tendencies, or because they are unable to care for themselves such as a drug addiction or another psychological disorder.

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2
Q

What is the priority when working with a client with a mental health problem?

A

Keep the client SAFE by preventing them from harming themselves or someone else:

  • Implement suicide precautions
  • Restraints if client is violent
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3
Q

What is the difference between a psychotic and a non-psychotic mental health problem?

A
  • Psychotic clients are not grounded in reality and can have delusions and hallucinations. They do not realize that they have a problem.
  • Non-psychotic clients understand that they have a problem such as depression or anxiety, but aren’t sure how to manage it.
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4
Q

What are the main psychotic disorders?

A
  • bipolar
  • schizophrenia
  • schizotypical
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5
Q

What is the treatment for psychotic clients?

A
  • antipsychotics
  • therapeutic communication focuses on presenting reality and acknowledging feelings
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6
Q

What are the main non-psychotic disorders?

A
  • depression and anxiety
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • phobias
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7
Q

What is the treatment for non-psychotic clients?

A
  • antidepressants and anxiolytics
  • therapeutic communication focuses on getting client to open up about problem and learning how to cope and problem solve
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8
Q

Describe:

Anxiety

A

A feeling of apprehension, uncertainty, or dread.

It is a normal response to stress and can be mild to severe.

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9
Q

Describe:

Panic

A

A severe type of anxiety where death can occur.

Clients can experience panic attacks.

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10
Q

Signs and symptoms:

Severe anxiety

A
  • increased tremors
  • pounding heart
  • hyperventilation
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11
Q

Interventions:

Anxiety

A
  • provide a quiet environment
  • promote relaxation techniques
  • monitor vital signs and give anxiolytics
  • don’t force client into situations that cause anxiety
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12
Q

What are therapeutic communication techniques for a client with mild to moderate anxiety?

A
  • ask client to identify what and how they feel
  • encourage discussion of feelings
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13
Q

What are the immediate interventions for severe anxiety and panic?

A
  • stay with client
  • provide clear, simple instructions
  • use a low-pitched voice
  • give anxiolytics
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14
Q

Describe:

Generalized anxiety disorder

A

An unrealistic anxiety about everyday worries that persist for more days than not for at least 6 months.

It is not associated with any other mental health or medical problem.

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15
Q

Describe:

Post-traumatic stress disorder (PTSD)

A

When a client experiences a psychologically traumatic event and experiences scary flashbacks.

The symptoms last at least 1 month and can occur months to years after the event.

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16
Q

Interventions:

Post-traumatic stress disorder

A
  • encourage client to talk about feelings
  • encourage recognition between feelings and traumatic experience
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17
Q

Describe:

Phobia

A

An irrational fear of an object, activity, or situation. The phobia can cause severe anxiety and panic.

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18
Q

Interventions:

Phobia

A
  • allow client to discuss fears
  • teach relaxation techniques
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19
Q

Describe:

Obsessive-compulsive disorder (OCD)

A

A preoccupation with thoughts or impulses. It is brought on by anxiety and the need for control.

Ritual behaviors are performed such as constant handwashing or checking the locks.

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20
Q

Interventions:

Obsessive-compulsive disorder

A
  • help client recognize what caused behavior
  • let client do behavior unless safety is an issue
  • set limits on behavior
  • provide activities to distract from behavior
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21
Q

Describe:

Somatic symptoms

A

Also known as the “hypochondriac”. The client frequently thinks there is a medical problem when there is NO medical problem.

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22
Q

Interventions:

Somatic symptoms

A
  • put a time limit on letting client discuss symptoms
  • don’t respond with positive enforcement about physical complaints
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23
Q

Describe:

Conversion disorder

A

When a mental health issue is converted into physical symptoms.

Example: a client that was emotionally abused becomes blind.

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24
Q

Interventions:

Conversion disorder

A

Let client talk about relating the physical symptoms with their feelings.

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25
Q

Describe:

Dissociative disorder

A

When a client develops different personalities to deal with a traumatic event.

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26
Q

Interventions:

Dissociative disorder

A
  • encourage discussion of feelings and experiences
  • focus on strengths and skills
27
Q

Describe:

Bipolar mood disorder

A

Extreme changes in mood, going from mania to depression.

28
Q

Interventions:

Bipolar mood disorder

A
  • ignore or distract grandiose thinking
  • present reality
  • set limits on behavior
  • provide high calorie finger foods
  • no group activities when manic and aggressive
29
Q

Describe:

Depression

A

An unpleasant feeling after some type of loss.

Many times there is no obvious cause of it.

30
Q

Interventions:

Depression

A
  • assess for suicidal tendencies
  • make a contract for suicide
  • gentle encouragement for simple activities
31
Q

Describe:

Schizophrenia

A

When the client experiences illogical, disorganized thoughts such as delusions and hallucinations.

32
Q

Signs and symptoms:

Schizophrenia

A
  • delusions/hallucinations
  • talk to themselves and repetitive speech
  • may be completely still or put their body in strange positions (catatonic behavior)
  • negative symptoms (diminished emotional expression)
33
Q

What are delusions?

A

A false belief with evidence showing that it’s false.

34
Q

What are some examples of a delusion?

A
  • client thinks they are very powerful
  • partner is cheating
  • are being singled out for harm

All evidence would show that none of the delusions are true.

35
Q

Interventions:

Delusions

A
  • ask client to describe delusion for safety reasons
  • don’t say the delusion doesn’t exist (to them it does exist)
  • focus on feelings that the delusion causes
  • set limits on delusion
  • focus on reality-based topics
36
Q

How would the nurse respond to a client who is delusional and is reporting “the person in the mail truck is the FBI and they want to kill me!”

A
  1. Address feelings - “It sounds like you are scared”
  2. Focus on reality - “That is the mailman delivering the mail”
37
Q

What are hallucinations?

A

When the client senses something that isn’t real.

This can include hearing, tasting, smelling, feeing, and seeing things that aren’t there.

38
Q

Interventions:

Hallucinations

A
  • ask to describe hallucination for safety reasons
  • don’t pretend it’s real, but don’t deny the hallucination either
  • focus on reality instead
  • don’t touch the client
  • distract client with an easy activity
39
Q

What is a personality disorder?

A

When the client’s inflexible behavior impairs life functioning and relationships.

It is usually NOT associated with substance abuse.

40
Q

What are the Cluster A Personality disorders?

A
  • schizoid
  • schizotypal
  • paranoid

These clients have a hard time forming relationships and tend to be paranoid.

41
Q

Describe:

Schizoid Personality Disorder

A

When a client cannot form personal relationships.

They lack emotion and interest in others.

42
Q

Describe:

Schizotypal Personality Disorder

A

When a client is suspicious, paranoid, or uses magical thinking.

43
Q

Describe:

Paranoid Personality Disorder

A

When the client is suspicious, argumentative, and critical of others.

44
Q

What are the general interventions for Cluster A Personality Disorders?

  • schizoid
  • schizotypal
  • paranoid
A

Due to the “paranoid” tendency of Cluster A Personality Disorders, do not laugh or whisper in front of them.

These clients are typically NOT admitted to the hospital since they are not usually violent or a harm to themselves.

45
Q

What are the Cluster B Personality Disorders?

A
  • histrionic
  • narcissistic
  • borderline

These clients have a tendency to be manipulative and overly dramatic.

46
Q

Describe:

Histrionic Personality Disorder

A

When the client is overly dramatic and expressive.

These clients are frequently admitted due to suicide attempts.

47
Q

Describe:

Narcissistic Personality Disorder

A

When the client has an increased sense of self-importance.

They frequently lack empathy and sensitivity.

48
Q

Describe:

Antisocial Personality Disorder

A

When the client can seem charming but are actually very manipulative.

They can be irresponsible, selfish, cannot maintain relationships, and tend to be irritable and hostile. These clients are frequently admitted because of risk of harming others.

49
Q

Describe:

Borderline Personality Disorder

A

When the client is impulsive, unpredictable, and manipulative. They tend to see everything as either all good or all bad.

These clients have a tendency for self-mutilation.

50
Q

What are the general interventions for Cluster B Personality Disorders?

  • histrionic
  • narcissistic
  • borderline
A
  • set limits on behavior
  • discuss consequences for unacceptable behavior
  • remove from group if aggressive or attention-seeking behavior occurs
  • provide praise for non-manipulative and positive behavior in social situations

Cluster B Personality Disorders have a tendency to be manipulative and overly dramatic:

51
Q

Regardless of the mental health disorder, how should the nurse respond to clients that are having feelings that could harm themselves or someone else?

A

Encourage clients to discuss feelings instead of acting the feelings out.

52
Q

Describe:

Alzheimer’s and Dementia

A

Intellectual deterioration. First there is short-term memory loss and then long-term memory loss.

Eventually, the client forgets how to care for themselves.

53
Q

Interventions:

Alzheimer’s and Dementia

A
  • room close to the nurses’ station
  • provide safety measures for wandering
  • put familiar objects around
  • have a routine and simple tasks
  • avoid stimuli if agitated
  • don’t argue or force activity
  • encourage discussion of feelings
  • provide caregiver support
  • Anti-alzheimer meds
54
Q

Why should sedative medications like anxiolytics be avoided by clients that have Alzheimer’s or dementia?

A

Sedatives can cause more confusion.

55
Q

What are communication disorders?

A

When the client has a hard time communicating for a variety of reasons.

Causes are from hard of hearing, eye disorders, CVA, and other neurological issues.

56
Q

How should the nurse talk to a client with a communication disorder?

A
  • firm volume, calm and low-pitched voice
  • speak slowly with simple words
  • don’t yell or speak in a loud voice
  • stand in front of client and maintain eye contact
  • repeat questions, don’t rephrase questions
57
Q

What is sundowners?

A

A condition in which older clients get more confused in the evening.

58
Q

What are the interventions for confused and agitated clients?

A
  • first rule out any physical problem
  • provide a calm environment
  • allow wandering in a safe place
  • don’t argue and don’t force any activity
  • orient frequently
  • avoid sedatives as it usually causes more agitation
  • provide simple activities like folding washcloths
59
Q

What is Electroconvulsive treatment (ECT)?

A

Inducing a seizure to provide relief for severe mental health problems such as severe depression, bipolar and schizophrenia.

It is used when medications or other therapies aren’t working.

60
Q

Is informed consent needed for a client receiving electroconvulsive treatment (ECT)?

A

Yes!

ECT is an invasive procedure that include risks.

61
Q

Interventions:

Electroconvulsive treatment (ECT)

A

Client will receive muscle relaxers and anesthesia to prevent full body seizures. Also assess for breathing.

62
Q

What is the characteristic symptom after ECT?

A

Confusion.

62
Q

What is the nursing care after a client has undergone ECT?

A
  • assess vital signs
  • re-orient

NCLEX-RN (6) Mental Health (5 decks)

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