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NU250 > N235 > Flashcards

N235 Flashcards

1
Q

Thalamus and hypothalamus are part of what system

A

Limbic system

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2
Q

What does the forebrain consist of

A

Cerebellum and diencephalon (connects cerebellum to limbic)

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3
Q

A few major neurotransmitter categories

A

Chollinergics
Monoamines
Amino acids
Neuropeptides

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4
Q

Chollinergics

A

Acetylcholine

Primary in junctions of nerves and muscles
Plays a role in most all functions
Could play a role in Parkinson’s and Alzheimer’s

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5
Q

Monoamines

A

Norepinephrine
Dopamine
Serotonin
Histamine

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6
Q

Monoamine
Norepinephrine

A

Creates activity in the post synaptic terminal of nerves in ANS
Used for fight or flight
Regulates mood, cardiovascular system, sleep.

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7
Q

What mood disorders can be implicated from norepinephrine

A

Depression
Mania
Anxiety
Schizophrenia

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8
Q

Monoamine
Dopamine

A

Functions to regulate mood
Movement/ coordination

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9
Q

Increased dopamine levels are seen in what mood disorders

A

Mania
Schizophrenia

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10
Q

Monoamine
Serotonin

A

Play a role in sleep arousal, libido, mood, agitation.

Seen in schizophrenic disorders as well as anxiety states

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11
Q

Monoamine
Histamine

A

Functions as allergic and inflammatory reactions.
Sustaining wakefulness

Shown to be associated to some depressive illness

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12
Q

Amino acids types

A

Inhibitory and excitatory amino acids

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13
Q

Two of the biggest inhibitory amino acids

A

Gamma aminobutyic acid (GABA)

Glycine

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14
Q

How does GABA and glycine work

A

They prevent excitation of postsynaptic terminal impeding the impulse of electrical current. (Stops/slows down the message signal)

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15
Q

What disorder has GABA been implicated to

A

Anxiety disorders
Movement disorders
Some forms of epilepsy

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16
Q

What disorders has glycine been implicated with

A

Spastic disorders

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17
Q

What are the two common excitatory amino acids

A

Glutamate
Aspartate

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18
Q

Excitatory amino acids role

A

Relay sensory information
Regulate motor and spinal reflexes

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19
Q

Excitatory amino acids are implicated in

A

Neurodegenerative disorders
Huntingtons disease
Temporal epilepsy

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20
Q

The longer you are awake for what happens to your inhibitory amino acid numbers

A

They increase

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21
Q

Three main neuropeptides

A

Opioid peptides
Substance P
Somatostatin

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22
Q

Circadian rhythm

A

24 hour sleep wake cycle

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23
Q

Abnormal circadian rhythm correlated to

A

Depression
Bipolar disorder
Seasonal affective disorder

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24
Q

Neurochemicals that effect sleep

A

Serotonin
Norepinephrine
Acetylcholine

Melatonin

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25
Q

Is there a correlation of the immune system to psych illnesses

A

Yes
Serotonin can be triggered by micro biome in gut.

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26
Q

What is the function of the limbic system

A

Helps stabilize emotional behavior

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27
Q

What was the primary psychotropic drugs before 1950

A

Sedatives
Amphetamines

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28
Q

Post 1950 psychotropic therapy

A

Extended to anti anxiety
Antidepressant
Antipsychotic

Used in adjunct with psychotherapy

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29
Q

Role of nurses with psychotropic medications

A

Patient education
When to take
How to take them
Side effects
Benefit time line

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30
Q

How do psychotropic medications work

A

Psychotropic medications affect neurotransmitters

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31
Q

How does reuptake effect neurotransmitter

A

Inactivation

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32
Q

What are the 4 kinds of psychotropic medications

A

Antidepressant
Antipsychotic
Benzodiazepines
Psychostimulants

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33
Q

Anti anxiety agents would be used in

A

Anxiety disorders
Alcohol withdrawal
Convulsive disorder
Skeletal muscle spasm
Pre operative sedation

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34
Q

Anti anxiety agent action

A

Depression of the central nervous system

Antagonist of GABA receptors the inhibitory neurotransmitter

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35
Q

Anti anxiety medications

A

Benzodiazepines (pams)

Atypical anxiolytic

SSRI’s

SNRI’s

Off label prescriptions

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36
Q

Benzodiazepines

A

Anti anxiety

Lorazepam
Alprazolam
Clonazepam
Diazepam

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37
Q

Atypical anxiolytic

A

Anti anxiety
Busprione

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38
Q

SSRI’s

A

Anti anxiety
Selective serotonin reuptake inhibitors

Paroxetine
Fluoxetine
Citalopram
Sertraline

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39
Q

SNRI’s

A

Anti anxiety
Venlaxafine
Duloxetine
Desvenlafaxine

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40
Q

Off label prescriptions for anti anxiety

A

Propranolol
Prazosin
Gabapentin
Pregabalin

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41
Q

What medication is usually prescribed for a patient PRN with anxiety symptoms

A

Benzodiazepines
Pams usually used as a PRN anti anxiety

Alprazolam

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42
Q

What is the action of anti depressant medication

A

Increase the concentration of
Serotonin
Dopamine
Norepinephrine

Blocks the reuptake of these neurotransmitters

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43
Q

Classes of anti depressants

A

MAOI. (Monoamine oxidase inhibitors)

Tricyclic antidepressant (TCA)

Selective serotonin reuptake inhibitors (SSRI’s)

Serotonin/norepinephrine reuptake inhibitors (SNRI’s)

Norepinephrine/dopamine reuptake inhibitors (NDRI’s). Bupropion

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44
Q

Common SSRI’s

A

Paroxetine
Fluoxetine
Citalopram

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45
Q

How long does it take SSRI’s to take effect

A

No immediate affect maybe placebo
Improvement in 4-6 weeks
Full effect in months
Feel side effects before benefits

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46
Q

One problem with SSRI’s

A

Take a while before effect side effects are seen first.

Patients might have more energy
Might be prone to commit suicide

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47
Q

SSRI’s nurse education

A

Take at same time everyday
Night time to avoid side effects

Must be tapered off
Do not double dose if missed
Suicide assessment report any new thoughts immediately

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48
Q

SSRI’s side effects

A

Nausea
Agitation
Headache
Sexual dysfunction
Etc
Sleep disorders
Appetite disorders

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49
Q

Serotonin syndrome

A

Too much serotonin in the body causing over stimulation of receptors in CNS

Hyper reflex
Tachycardia
Tremor
Hypertension
Hyper bowel sounds
Dilated pupils
Sweating

Double dose
Taking 5HTP one cleave away from serotonin same effects

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50
Q

MAOI action

A

Inactivation of norepinephrine
Serotonin dopamine enzyme leaving more left

Drug interaction with other anti depressants

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51
Q

What do you have to do with MAOI’s

A

Avoid tyramine rich foods
Can cause hypertensive crisis
Cheeses
Red wine
Smoked meats
Soy sauce
MSG

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52
Q

Mood stabilizing agents

A

Lithium
Anti convulsant
Second generation atypical antipsychotic

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53
Q

What is the relation between lithium and sodium

A

Lithium is a salt that is a imperfect substitute for sodium

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54
Q

What happens if your sodium goes down to lithium

A

More sites are available for lithium risk for lithium toxicity

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55
Q

Lithium side effects

A

Weight gain
Lethargic
Hypotension
Hyponatremea
Narrow therapeutic range
High risk for patient discontinuation

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56
Q

Lithium therapeutic range

A

0.6-1.2mEq/L

1.0-1.5 mEq/L for mania

Don’t change diet enough sodium and water intake

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57
Q

Lithium toxicity

A

Nausea vomiting diarrhea
Over 2mEq/L tremors
Over 3.5mEq/L delirium seizures coma death

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58
Q

ADHD medication agents can they be dependent

A

Yes both physically and psychologically

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59
Q

When would you give ADHD medication

A

Early in the morning to avoid insomnia and sleep disorders

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60
Q

Conditions that are essential to a therapeutic relationship

A

Rapport
Trust
Respect
Genuineness
Empathy

61
Q

What are the 4 phases of the therapeutic relationship

A

Pre interaction
Orientation
Working
Termination

62
Q

Pre Interaction phase

A

Obtain information
Examine own feelings
Goal is to explore one’s own self perceptions

63
Q

Orientation introductory phase

A

Set mutually agreeable goals
Gather assessments
Create environment of trust

64
Q

Working phase

A

Maintain trust
Goal is to promote patient change

65
Q

During working phase two issues arise what are they

A

Transference Patient transfers feelings of someone else on to you

Countertransference Nurse emotional/ behaviors to the patient

66
Q

What are some therapeutic communication techniques

A

Using silence :patient is able to take control

Accepting: coveys positive regard

Offering self:

Giving recognition: acknowledging indicating awareness

Giving broad opening open ended questions. : allows patient to select topic

Offering general leads

Placing events in a time sequence.

Making observations. Verbalize what you see

Encourage description of perception. Have the patient tell you what they are seeing or going through.

Restating

Reflecting

67
Q

Non therapeutic communication techniques

A

Giving reassurance: may discourage patient from further expression of feelings

Rejecting:

Approving or disapproving:

Giving advice:

Probing:

Defending:

68
Q

Depression is a risk factor for what?

A

Cardiovascular disease
Diabetes
Asthma
Hyperlipidemea
Dementia

69
Q

1 in _ women have depression in their life

A

5

70
Q

1 in _ men have depression in their life

A

10

71
Q

Clients with a significant mental illness die _ sooner than the normal population

A

25 years

72
Q

Why do you give a benzodiazepine to someone withdrawing from alcohol

A

They have been taking a depressor and need another depressor to wean off the withdrawals with out rebounding

73
Q

AD

A

Alztihmiers disease

74
Q

What drugs do you want to give and avoid in patients with AD

A

You would give drugs to help with depression such as SSRI
avoid TCA antidepressant since this will be a anticholinergic medication making condition worse

75
Q

What are some causes of AD

A

having too much Acetylcholine enzyme in the brain or having a deficit of acetylcholine

76
Q

what is the percentage of people in the workforce taht can be classified as a addiction or substance use disorder

A

75%

77
Q

What gender is using illicit drugs more than the other

A

males

78
Q

What is CIWA used for

A

This is used for alcohol withdraw score

79
Q

What is one way to make sure the score is true without patients fasly boosting the score

A

introduce yourself and shake their hands you can usually tell right away with out being obvious if they are shaking

80
Q

What are the categories of CIWA

A

Tremors 0-7
A&O 0-4
sweating 0-7
Auditory hallucinastions 0-7
visual hallusinations 0-7 light sensitive
headache 0-7 tight band feeling
tactile disturbance 0-7
anxiety 0-7
agitation 0-7

81
Q

What are the common medication used for alcoholism

A

Disulfiram (antabuse) doesn’t stop drinking but will take away the good feeling from drinking. Is used in combination with life change

Thiamine to replace what is deficient in the body

Benzodiazepine – alcohol has a huge impact on GABA when you stop abruptly all of your body has been consent depressed. Using this will depress the body not allowing a deadly rebound effect after body has been suppressed for so long.

Anticonvulsants - after the depression of the brain used to help symptoms of tremors and seizures

82
Q

What are the common medication used for alcoholism

A

Disulfiram (antabuse) doesn’t stop drinking but will take away the good feeling from drinking. Is used in combination with life change

Thiamine to replace what is deficient in the body

Benzodiazepine – alcohol has a huge impact on GABA when you stop abruptly all of your body has been consent depressed. Using this will depress the body not allowing a deadly rebound effect after body has been suppressed for so long.

Anticonvulsants - after the depression of the brain used to help symptoms of tremors and seizures

83
Q

what percent of the population uses THC

A

8.4%

84
Q

What is the effect of cannibals on the body

A

cardiovascular effects
respiratory effects
Depress CNS
suppress sexual function

85
Q

Zolpidem

A

Sedative called Ambien

depresses CNS
non barbiturate hypnotics

sleep disorders
addictive
makes you dependent on it for sleep

86
Q

What parts does a sedative or a hypnotic effect

A

They will all have effects on your
respiratory depression
body temp

Effects RAS (reticular activating system) which can cause respiratory depression

Hypotension possible

87
Q

what are the pharmocological drugs used for opioid dependence

A

Methadone (slow long term replacement for dependence) can taper off used clinically to wean off opioid addiction.

Buprenorphine partial agonist. weaker than methadone. used for withdraw seen to be safer

Suboxone: combination drug ( naloxone and buprenorphine) this is both an agonist and an antagonist

Narcan (Naloxone) used to treat overdose very short half life

88
Q

what is the estimate for nurses with a chemical dependence

A

10-15%

89
Q

What are the four phases of schizophrenia

A
  1. premorbid ( signs of odd behavior shy and anti social poor in school)
  2. prodromal Can last years still doing poor with relationships
  3. Active psychotic symptoms are present
  4. Residual flat affect similar to prodromal
90
Q

positive symptoms

A

Adding to the individual visual or auditory symptoms that are added to a patient that the normal person doesn’t have

91
Q

Negative symptoms

A

These are symptoms that are taken away flat affect

92
Q

Delusions

A

Fixed or false personal beliefs

93
Q

common delusions that can occur

A

grandiose ( fantasy of greater they are president or know so and so)
persecutory
reference
control think they are in charge and can put you in jail for example
religious think that they are doing gods work.
jealous

94
Q

Echopraxia

A

repeating movements that are being observed

95
Q

Negative symptoms

A

affects that are taking away from one’s mood
inappropriate affect one’s emotions are in concurrent with the situation (laughing at someone’s pain)

Bland = weak emotional tone overall

Flat= appears to be absent of any emotional tone

apathy = disinterest in one’s environment

96
Q

Avolition

A

Negative symptom in schizophrenia impairment in goal directed activity as well as ADL’s

97
Q

Anergia

A

lack of energy

98
Q

Anhedonia

A

inability to experience pleasure

99
Q

What are other negative symptoms taht can happen

A

Abnormal eye movement
regression in age development stage
strange posture

100
Q

Is suicide a diagnosis or a disorder

A

No it is a behavior

101
Q

True or false 90% of suicides are from people with diagnosed mental disorders

A

True

102
Q

Suicide risk factors

A

Feeling trapped
feeling helpless
feeling lonely
feels like a burden
has means to carry it out
thoughts of committing it
intoxicated
history of violence
exposure to suicide
substance abuse
out of touch with reality

103
Q

If someone walks into a clinic is that protective

A

yes this is a protective factor just coming into talk is trying to stop doing suicide.

104
Q

988

A

national suicide hotline

105
Q

do you leave someone who is suicidal alone for a little bit to go get help?

A

NO!! you never leave anyone who might be suicidal alone.

You want to remove kids from the situation to avoid trauma.

106
Q

What is the prevalence of depression

A

17% of the population will have depression

2:1 ratio for women to men experiencing depression

The older you get the more prevalent depression is at a higher rate for those 45 years or older.

107
Q

Types of depression

A

Major depressive disorder (symptoms present for at least 2 weeks) lose interest in pleasurable things

Persistent depressive disorder (chronic)
most days rather than not most of the day for over 2 years.

premenstrual dysphoric disorder (depression, anxiety, mood swings, symptoms surrounding menses)

substance medication induced= depression associated to or lack of drugs

108
Q

Hypomania

A

milder form of mania

109
Q

What are the 3 stages of mania

A

hypomania
acute mania what is normally seen for mania
delirious mania (rare)

110
Q

What are the different forms of bipolar disorder

A

Bipolar 1 more extreme shift from mania to hypo mania or depressive mood
Bipolar 2 hypomanic to depressive
cyclothymic chronic mood shifts for 2 years
Substance bipolar

111
Q

What stage of mania is needing to be hospitalized

A

Acute mania and delusional mania

not hypomania

112
Q

Signs of a mania

A

Changes in sleep pattern
always active
great feeling
high risk activity
easily distracted
rapid conversation

113
Q

What do you want to do as a positive for the patient when going through a mania

A

Keep things calm and quiet

finger food so they don’t forget to eat

weight daily
daily I&O
healthy outlets for energy

114
Q

medications that are used to treat OCD

A

SSRI’s Fluoxetine, Fluvoxamine, Sertaline

115
Q

Symptoms that are a part of PTSD

A

Survivors guilt
depression
anger aggression
substance abuse
relationship problems

116
Q

What is an acute stress disorder time line

A

<1month

117
Q

true or false 25% of men have anorexia

A

false 25% of those with anorexia are men

118
Q

true or false most people with bulimia are within a normal weight range

A

true

119
Q

What are common mental health disorders that are found with people with bulimia

A

anxiety, depression, substance abuse are commonly found with bulimia and eating disorders.

120
Q

Cluster A

A

Odd or eccentric
paranoid, schizoid, schizotypal

121
Q

Paranoid personality disorder

A

Cluster A disorder
distrust others
thinks things are suspicious or going to be bad

122
Q

Schizoid personality

A

Cluster A disorder

detachment from others and emotions have a limited range of emotions

123
Q

Schizotypal personality disorder

A

acute discomfort with reduced capacity to hold and have a healthy relationship

124
Q

Cluster B personality disorders

A

Dramatic/ emotional/ erratic

borderline
antisocial
narcissistic
histrionic

125
Q

How many stages of mania are there?

A

3 stages

126
Q

What is phase 1 of mania entail

A

Elevated mood
Hypomania

No impairment to one’s life

127
Q

What phase of mania do patients get hospitalized for treatment

A

Phase 2 acute mania

128
Q

What are the signs of phase 2 mania

A

Impairment with normal functioning
Racing thoughts
Flight of ideas
Risky behavior
Decreased sleep

129
Q

What is another name for phase 3 of mania

A

Delirious mania
Having hallucinations

Rare usually doesn’t get here with medications.

130
Q

What medications can start a manic episode

A

Antidepressants Can jump start a manic episode

131
Q

What is the only medication used for manic episode control

A

Lithium carbonate

132
Q

What does cyclothymia mean

A

It is a bipolar disorder with fluctuations in mood from d repression to hypo manic

The swing doesn’t take the person out to acute mania but increases and decreases mood swings can last years.

Can’t be classified as depressive or manic states

133
Q

What is the most common other disorder in bipolar patients

A

ADHD

134
Q

What is cluster C personality disorders known for

A

Being anxious and fearful

135
Q

What are some common personality disorders in cluster C?

A

Dependent personality disorder

Obsessive compulsive disorder

Avoidant

136
Q

If someone is being avoidant to criticism what cluster are they showing

A

Cluster C

137
Q

What are some common traits that are shared across personality disorders

A

Manipulative
making conflict with others
cant maintain relationships
maladaptive responses to stress

138
Q

What is DBT

A

Dialectical Behavior Therapy

139
Q

What does Dialectical behavior therapy involve

A

cognitive behavioral therapy that is focused on emotional regulation

Has a validating environment

Uses mindfulness and meditation

140
Q

What is one of the biggest issues with personality disorder care

A

Splitting of the staff (Best nurse vs worst nurse)

Resolve this by having consistent caregivers
Maintain good healthy boundaries

141
Q

What percentage of adolescents 9-17 have an addiction disorder

A

21% of kids in this age group have an addiction or mental disorder

142
Q

True or false 11% of kids have a major mental illness leading to impairment in daily life

A

True

143
Q

True of false the most common mental disorders in kids are
Anxiety disorder
Disruptive behavior disorder
Mood disorders
Bipolar disorder
Substance use disorder

A

False

All are true except bipolar disorder

144
Q

What are some risk factors that lead a child to have a mental illness

A

Social situation
family history
genetics
Biochemical

145
Q

If a child Went through a adverse event such as a war
abuse (any kind)/ Neglect (any kind)
natural disaster
Are they at greater risk for health issues such as COPD, early pregnancy, mental illness, liver disease or heart disease.

A

Yes if a child goes through a hard time during childhood of any kind can lead to maladaptation.

Leading to addiction and unhealthy risk behaviors leading to higher stress mental illness as well as STD’s and liver or heart disease.

146
Q

ASD

A

Autism spectrum disorder

147
Q

IDD

A

Intellectual development disorder

148
Q

What are the categories for IDD

A

Mild
moderate
severe
profound

149
Q

What are the five forms of ASD

A

Asperger’s
Retts
Autistic disorder
Pervasive developmental disorder
childhood disintegrative disorder

NU250 (8 decks)

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