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Mental Health > Midterm 11, 12, 13 > Flashcards

Midterm 11, 12, 13 Flashcards

1
Q

Autism

A
  1. Complex neurobiological and developmental disability
  2. Affects normal development of social interaction and communication skills
  3. Ranges from mild-moderate-severe
  4. more common in boys
  5. only 1/3 can live independently
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2
Q

When does Autism appear

A

first 3 years of life

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3
Q

Autism S/S

A

i. Deficits in social relatedness and relationships
ii. Repetitive speech
iii. Obsessive focus on specific objects
iv. Over-adherence to routines
v. Hyper or hyporeactivity to sensory
vi. Resistance to change

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4
Q

ADHD

A
  1. Inappropriate degree of inattention, impulsiveness, and hyperactivity
  2. Often linked with poor health
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5
Q

ADHD S/S

A
  1. unable to complete tedious tasks
  2. become easily bored
  3. lose thing frequently
  4. require frequent prompting to complete things
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6
Q

ADHD in children

A
  1. Only inattentive are diagnosed with ADD
  2. To diagnose a child with ADHD —> s/s must occur in two setting like home and school and occur before age 12
  3. Often detected when the child has a difficult time adjusting to elementary school
  4. Peer relationship suffer due to difficulty taking turns, poor social boundaries, intrusive behaviors, and interrupting others
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7
Q

When does ADHD onset?

A

Usually onset at age 7 and occurs more frequently in boys

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8
Q

Haloperidol

A
  1. Dopamine antagonist

2. used for schizophrenia and targets positive symptoms like hallucinations and delusions

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9
Q

How often do you take Haloperidol?

A

Every 4 weeks

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10
Q

Advantage of Haloperidol

A

Not as expensive since it is a first generation

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11
Q

Disadvantages of Haloperidol

A
  1. EPS (tardive dyskinesia and minimal to none)
  2. Acetylcholine effects
  3. weight gain
  4. sexual dysfunction
  5. gynecomastia
  6. agranulocytosis
  7. QT prolongation
  8. Neuroleptic malignant syndrome
  9. dyslipidemia
  10. increase blood glucose
  11. insulin resistance
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12
Q

What are early signs of agranulocytosis

A
  1. Sore throat and fever

2. monitor CBC

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13
Q

S/S of neuroleptic malignant syndrome

A
  1. Muscle rigidity
  2. sudden high fever
  3. seizures
  4. cardiac arrest
  5. rhabdo (muscle pain)
  6. acute renal failure (b/c rhabdo –> muscle wasting)
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14
Q

Positive symptoms of schizophrenia

A

Presence of something that should not be present and usually appear early

  1. Hallucinations (Visual and auditory most common)
  2. Delusion (False beliefs)
  3. Disorganized speech
  4. Bizarre behavior
  5. Paranoia
  6. disorganized or bizarre thoughts
  7. concrete thinking - can’t think abstractly
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15
Q

Negative symptoms of schizophrenia

A

Absence of something that should be present

  1. Blunted affect or absence of essential human qualities (Reduced or minimal emotional response)
  2. Poverty of thought (Reduction in speech/thought)
  3. Loss of motivation
  4. inability to experience pleasure or joy
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16
Q

Cognitive symptoms of schizophrenia

A

Sudden or obvious impairment in memory, attention or thinking

  1. Inattention, easily distracted
  2. Impaired memory
  3. Poor problem-solving skills
  4. Poor decision-making skills
  5. Illogical thinking
  6. Impaired judgment
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17
Q

Affective symptoms of schizophrenia

A

Symptoms involving emotions and their expression

  1. Dysphoria (dissatisfaction)
  2. Suicidality
  3. Hopelessness
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18
Q

Bipolar Treatment: ECT

A
  1. Used to subdue severe manic behavior especially for treatment resistant mania or patients with rapid cycling
  2. More effective than medications
  3. Indication for this treatment severe depression, catatonic, and treatment resistant depression
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19
Q

Bipolar Treatment: Teamwork and safety

A
  1. Treatment team is trained to recognize changes that may lead to unsafe behavior
  2. Frequent team meetings to plan strategies for dealing with challenging patient behaviors
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20
Q

Bipolar Treatment: Seclusion protocol

A
  1. When dangerously out of control, danger to others or themselves, patient is unable to control their actions, or other measures have failed
  2. Both restraint and seclusion require an order
  3. If emergency, nurse can place seclusion or restraint without an order, but an order must be obtained within 15-30 minutes
  4. Vitals every 1-2 hours
21
Q

Bipolar Treatment: Health teaching and health promotion

A
  1. Information about bipolar disorder and that it is chronic and highly recurrent
  2. Learn warning signs and symptoms of episodes of mania (Changes in sleep patterns)
  3. Importance of maintaining a schedule that includes eating, sleeping, exercise and other activities
  4. Teaching aimed at weight reduction and management is essential to keeping the patients physically healthy and emotionally stable as bipolar medications can cause weight gain
  5. Follow collaborative care model to encourage adherence to treatment
22
Q

Bipolar Treatment: Cognitive-behavioral therapy (CBT)

A
  1. Preformed by advanced practice providers
  2. Used with medications
  3. Changes the persons negative thought and behaviors about themselves
    1. I’m always going to be a loser
    2. I might as well drink
  4. Focuses on adherence to medications, early detection and intervention for manic and depressive episodes, stress, and lifestyle management
  5. CBT = more likely to take medications as prescribed
23
Q

Bipolar Treatment: Interpersonal and social rhythm therapy

A
  1. Preformed by advanced practice providers

2. Aims to regulate social routines and stabilize interpersonal relationships to improve depression and prevent relapse

24
Q

Bipolar Treatment: Family-focused therapy

A
  1. Preformed by advanced practice providers
  2. Improves communication among family members
  3. Help people recognize and reduce negative expressed emotions and stressors that provoke episodes
25
Q

Bipolar Treatment: Medications

A
  1. Second generation antipsychotics
  2. Mood stabilizer
  3. Anticonvulsant mood stabilizer
  4. First generation antipsychotics
26
Q

Second generation antipsychotics

A
  1. Olanzapine (Zyprexa)

2. Risperidone (Risperdal)

27
Q

Mood stabilizer

A
  1. Lithium
28
Q

Anticonvulsant mood stabilizer

A
  1. Valproate (Depakote)
  2. Carbamazepine (Tegretol)
  3. Lamotrigine (Lamictal)
29
Q

First generation antipsychotics

A
  1. Chlorpromazine (Thorazine)

2. Loxapine (Adasuve) inhaled

30
Q

Bipolar treatment

A
  1. Medications
  2. Family-focused therapy
  3. Interpersonal and social rhythm therapy
  4. Cognitive behavioral therapy
  5. Health teaching and health promotion
  6. Support groups
  7. seclusion protocol
  8. teamwork and safety
  9. ECT
31
Q

Bipolar Etiology: Biological factors

A
  1. Genetics
  2. Neurotransmitter
  3. Brain structure and function
  4. Neuroendocrine
32
Q

Bipolar Etiology: Neurotransmitter

A
  1. Too many –> mania
  2. Not enough –> depression
  3. Receptor site insensitivity (enough neurotransmitter but not getting where it needs to go)
33
Q

Bipolar Etiology: Brain structure and function

A
  1. Dysfunction in the prefrontal cortical region associated with executive decision making, personality expression and social behavior
34
Q

Bipolar Etiology: Neuroendocrine

A
  1. Hypothyroidism is most common physical abnormality

2. In manic and depressive states peripheral inflammation is increased

35
Q

Bipolar Etiology: environmental

A
  1. Children w/ biological risk are vulnerable in bad environments
  2. Stressful family life and adverse life events —> severe course of treatment
  3. Stress = common trigger for mania and depression
36
Q

Bipolar Etiology: Psychological

A
  1. Mania thought to be a defense against underlying anxiety or depression
  2. Faulty ego uses mania when it’s overwhelmed by pleasure or fear impulses like aggression
  3. Overactive and critical superego is replaced with the euphoria of mania
37
Q

Lithium levels

A
  1. Therapeutic: 0.6-1.2 mEq
  2. Toxicity: 1.5 mEq
  3. Maintenance: 0.4 to 1.3 mEq/L
  4. Takes 7-14 days to reach a therapeutic level
38
Q

Blood monitoring - Lithium

A
  1. Blood levels should be measures 5 days after beginning and changing doses until therapeutic
  2. Blood levels are checked every month until stability has been reached for 6 months to a year and then can be checked every 3 months
  3. Blood should be drawn in morning, 10-12 hours after last lithium dose
39
Q

Why are children with ADHD given a stimulant?

A

Kids need to stimulant to calm down. They need something to focus on. The extra stimulation will help them not get bored and tune everyone out. For example, if you give a child with ADHD a pad to color on while teaching, they will understand more.

40
Q

Interventions for ADHD

A
  1. Family involvement

2. Stimulant

41
Q

Interventions for autism

A
  1. play therapy
  2. expressive arts therapy
  3. music therapy
  4. family interventions
42
Q

Bipolar DSM-5 criteria

A
  1. two or more of symptoms for a significant portion of time (delusions, hallucinations, disorganized speech, gross disorganization or catatonia, negative symptoms, functional impairment of some kind)
  2. Continuous disturbance for at least 6 months
43
Q

Phases of schizophrenia: acute

A

Exacerbation of symptoms

44
Q

Phases of schizophrenia: stabilization

A

Symptoms diminishing

Movement toward previous level of functioning

45
Q

Phases of schizophrenia: Maintenance or residual

A
  1. New baseline is established – symp. free or manageable
  2. New normal for the patient
  3. Established at the beginning as the goal
  4. Goal: function independently and in society
46
Q

Potential nursing diagnosis for positive symptoms

A
  1. Disturbed sensory perception
  2. Risk for self-directed or other-directed violence
  3. Impaired verbal communication
47
Q

Potential nursing diagnosis for negative symptoms

A
  1. Social isolation

2. Chronic low self-esteem

48
Q

Two main foci for pharmacological interventions for bipolar

A
  1. Agitation

2. Mood stabilization

49
Q

What 4 things to assess to determine if in manic or depressive state

A
  1. Mood
  2. Behavior
  3. Thought processes and speech patterns
  4. Cognitive functioning

Mental Health (7 decks)

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