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NUR 304 Flashcards

1
Q

Therapeutic Use of self

A

the ability to intentionally use one’s personality to build a relationship and form nursing interventions.

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2
Q

Mental health- A state of well-being in which each individual is able to realize his own potential, cope with normal stress, work productively, and

A

make a contribution to society

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3
Q

Mental illness

A

all mental disorders with definable diagnoses

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4
Q

DSM –V- the official guideline for diagnosing psychiatric disorders. It also provides

A

epidemiological statistics

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5
Q

DSM –V organization

A

child disorders are listed first in the chapter, and adults are listed later. Also, disorders that are related (eating disorder and elimination disorder) are usually bunched together.

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6
Q

ICD-10 Includes all diseases. Divides mental illness into 2 main categories, which are

A

psychosis and neurosis

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7
Q

Maslow’s Hierarchy

A 
Physical
Safety 
Love
Esteem (achievement and praise)
Self-actualization
Self-Transcendence
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8
Q

cognitive theory includes

A

rational-emotive behavior therapy (REBT) and Cognitive-Behavioral Therapy

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9
Q

REBT

A
  • Developed by Ellis.
  • The goal is to eliminate negative thoughts that are illogical.
  • The illogical thoughts are things like, I SHOULD always be nice or I MUST be the best.
  • Ellis said negative thoughts are an ABC event.
  • REBT is about seeing the glass as half full.
  • It focuses more on the present than the past
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10
Q

CBT

A
  • Developed by Beck.
  • Neo-freudian.
  • The way people feel is determined by the thoughts they have about the world.
  • The thoughts people have are called schemas.
  • Rapid, unthinking responses based on schemas are called automatic thoughts or cognitive distortions.
  • Cognitive distortions are irrational; CBT identifies these distortions, reality tests them, and corrects the distortion
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11
Q

Ego

A

reality tester. Leader.

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12
Q

Superego

A

strict morality. Super christian

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13
Q

Psychoanalytic- came up with

A

transference and countertransference

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14
Q

Behavioral theory

A
  • Personality is not about inner thoughts, it’s just about learned behaviors.
  • Behaviorism was originally thought of by Watson.
  • Watson did the experiment with little albert. –Operant conditioning was developed by Skinner.
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15
Q

Behavior therapy works best on

A

specific problems, like a phobia of snakes

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16
Q

There are 5 kinds of behavior therapy:

A

modeling, OC, desens, aversion therapy, biofeedback

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17
Q

Interpersonal

A
  • Sullivan believed that personality is behaviors that can be seen in interpersonal relationships.
  • Sullivan said that the purpose of all behavior is to get needs met through interpersonal interactions and to decrease anxiety.
  • Sullivan coined the term security operations to describe measures the individual employs to reduce anxiety and enhance security. All of the person’s security operations combined are called the self-system.
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18
Q

Peplau

A

Influenced the shift from what nurses do TO patients to what nurses do WITH patients.

Emphasized keeping the nurse’s needs out of the picture.

Described 4 levels of anxiety (mild, moderate, severe, panic)

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19
Q

Lithium adverse effects

A 
tremor
ataxia
confusion
convulsions
NVD
arrhythmia
polyuria
polydipsia
edema
goiter
hypothyroidism
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20
Q

Lithium TI

A

.8 to 1.5

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21
Q

Lithium contraindication

A

pregnancy

below age 12

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22
Q

Lithium drink…

A

plenty of water

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23
Q

Lithium, older adults are

A

more sensitive to it

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24
Q

Lithium, diet

A

don’t change the amount of salt you eat

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25
Q

Lithium patient instructions

A

take with food to avoid GI problems

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26
Q

Clozaril

A
  • Atypical antipsychotic
  • Blocks DA, ACH, NE, and histamine
  • Emotional quieting and reduced movement
  • Antiemetic
  • Alter temp
  • Increases prolactin
  • HAS ANTICHOLINERGIC EFFECTS (dry mouth, urine retention, constipation)
  • Orthostatic hypo
  • Causes sedation (because it’s antihistamine)
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27
Q

TCA general info

A
  • Anticholinergic effects
  • Antihistamine effects
  • Takes 2-3 weeks to work
  • Can cause arrhythmia
  • Very severe interaction with MAO
  • Also interacts with barbis
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28
Q

TCA SE

A

dizzy
ortho
sedation
risk of suicide

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29
Q

TCA toxic effects

A

cardiac
coma
seizure
delirium

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30
Q

SSRI has no

A

anticholinergic effects

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31
Q

SSRI SE

A

insomnia
nervous
tinnitus
weight loss followed by gain

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32
Q

MAOI

A
  • irreversibly inactivate MAO to increase amine levels
  • reduce REM sleep
  • enhances effects of anesthesia, sedatives, narcotics, and TCAs
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33
Q

MAOI toxic effects

A
  • liver
  • don’t take it within 2-3 weeks of taking TCA
  • agitation, cardiac, convulsions
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34
Q

Criteria for admission: harm to self, harm to others or

A

unable to care for self

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35
Q

Even if the patient is involuntarily admitted, they have the right to refuse

A

meds

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36
Q

Informal admission

A

similar to a regular hospital admission, there’s no formal application.

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37
Q

Voluntary admission

A
  • patients formally requests in writing to be admitted.
  • If the person is a minor, the guardian may be allowed to apply on their behalf.
  • They can ask to leave, however if their condition is really bad it may be forced to stay
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38
Q

Temporary admission

A
  • used for people so confused that they can’t make a decision or people so ill that they need to be admitted right away.
  • Usually they can only be held under temporary admin for 15 days
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39
Q

Long-term involuntary admission doesn’t always require a

A

judicial hearing beforehand, but usually the patient can have a hearing at a later point

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40
Q

Tort

A

A civil wrong for which money damages may be collected by the injured party (plaintiff) from the responsible party (the defendant)

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41
Q

Intentional tort

A

Willful or intentional acts that violate another person’s rights or property

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42
Q

Intentional tort examples

A 
➢	Assault
➢	Battery 
➢	False imprisonment
➢	Invasion of privacy
➢	Defamation of character (slander or libel)
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43
Q

Unintentional tort example

A

negligence

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44
Q

Cause in fact

A

if it was not for what the nurse did, would this injury have occurred?

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45
Q

Proximate cause

A

aka legal cause, may be evaluated by figuring out what caused the harm

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46
Q

Accepting

A

Doesn’t necessarily communicate agreement, but it’s nonjudgemental

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47
Q

Giving recognition

A

Indicates awareness of change and personal efforts. Does not imply good or bad

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48
Q

Restating

A

Repeats the main idea expressed. It’s different from paraphrasing because it repeats so of the exact same words the patient used

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49
Q

Example of Reflecting

A

You sound as if you’ve had many hard times.

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50
Q

Projective questions

A

Asking a “what if” question

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51
Q

Presupposition question

A

What if you woke up and this problem went away? What would your life be like?

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52
Q

Alarm (acute) stress level

A

Characterized by sympathetic response, corticosteroids, endorphins. It’s very brief and intense.

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53
Q

Resistance stage of stress

A

Aka adaptation phase. It’s the time of sustained and optimal stress resistance. Normally stressors are overcome here, but if not you can fall into the exhaustion stage.

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54
Q

Exhaustion stage of stress

A

Resources are depleted and you can no longer combat the stress.

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55
Q

Mild anxiety

A

Normal amount.

The person perceives more information and can better problem solve.

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56
Q

Moderate anxiety

A 
Perception decreases. 
The person has selective attention. 
Problem solving can occur, but it’s not optimal.  
Sympathetic nervous system kicks in.  
May have tremors and shaky voice.
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57
Q

Severe anxiety

A
  • Unable to problem solve.

- Behavior is automatic and aimed at reducing stress.

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58
Q

Panic

A

May lose touch with reality.

Hallucinate.

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59
Q

Indicates that the nurse has heard and has followed the trend of though; e.g. “I follow what you said.” “Yes” “Uh Huh”.

A

Accepting – giving indication of reception

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60
Q

Not only words are important but the facial expression, the tone of voice and inflection, and the posture of the nurse.

A

Accepting

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61
Q

To greet the patient by name, to note efforts the patient has made, to indicate awareness of change “Good morning Mr. M.”

A

Giving Recognition

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62
Q

“I’ll sit with you awhile.”

A

Offering self

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63
Q

By calling patient’s attention to what is happening to him, the nurse seeks to encourage the patient’s noticing for himself so that he can do the describing

A

Making observations

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64
Q

“Tell me whether my understanding of it agrees with yours.”

A

Seeking consensual validation

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65
Q

PATIENT: “I’m dead.” NURSE: “Are you suggesting that you feel lifeless or is it that life seems without meaning?”

A

Attempting to translate into feelings

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66
Q

“Perhaps you and I can discuss and discover what produces your anxiety.”

A

suggesting collaboration

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67
Q

Paraphrasing: restating another’s message more briefly and in your own words; lets another know

A

you are actively seeking understanding of what they are saying

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68
Q

help person be aware of inconsistencies in his/her feelings, attitudes, beliefs, or behaviors

A

confrontation

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69
Q

Diathesis

A

biological predisposition

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70
Q

Stress (in terms of the diathesis-stress model)

A

Environmental stress or trauma

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71
Q

Diathesis-Stress Model

A

Most accepted explanation for mental illness

Combination of genetic vulnerability and negative environmental stressors

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72
Q

New Freedom Commission on Mental Health

A

created to conduct a study of the U.S. mental health service delivery system and make recommendations based on its findings.

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73
Q

Incidence

A

the of new cases popping up

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74
Q

Prevalence

A

how many people have the condition at the a given time

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75
Q

Sullivan’s Interpersonal Theory: Purpose of all behavior is to get needs met through interpersonal interactions and to reduce or avoid

A

anxiety

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76
Q

5 Foundations of Peplau’s theory

A 
Participant observer
Mutuality
Respect for the patient
Unconditional acceptance
Empathy
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77
Q

The art of nursing and science

A

Peplau

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78
Q

Peplau’s theory aims to

A

improve patient’s ability to think and function

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79
Q

Theory: Dynamic interplay between individuals and the environment

A

Cognitive

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80
Q

Theory: Thoughts come before feelings and actions

A

Cognitive

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81
Q

Cognitive theory: Thoughts about the world and our place in it are based on our own unique perspectives, which

A

may or may not be based on reality

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82
Q

Theory: Test distorted beliefs and change way of thinking; reduce symptoms

A

CBT (Beck)

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83
Q

Theory: Recognize thoughts that are not accurate

A

REBT (Ellis)

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84
Q

Theory: Emphasis on human potential and the patient’s strengths

A

Maslow

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85
Q

Theory: Consider other influences that play a role in the development and treatment of mental disorders
Social, environmental, cultural, economic

A

Biological

86
Q

Theory: Focus on
Qualities of a therapeutic relationship
Understanding patient’s perspective
Communicating to facilitate recovery

A

Biological

87
Q

Neuropeptides

A

Long-term changes in cells

88
Q

Neurotrophic factors

A

Proteins and gases that influence growth, shape, etc of neurons

89
Q

Brain: Basic drives and link between thought and emotion and function of internal organs

A

Hypothalamus

90
Q

Brain: Processing center for sensory information

A

brain stem

91
Q

Structured imaging techniques

A

CT and MRI

92
Q

Functional imaging techniques

A

PET and SPECT

93
Q

CT

A

special X-ray tests that produce cross-sectional images of the body using X-rays and a computer

94
Q

PET

A

Positron emission tomography

uses a radioactive substance called a tracer to look for disease in the body

95
Q

SPECT

A

Single photon emission computed tomography

uses a radioactive substance and a special camera to create 3-D pictures

96
Q

Benzos

A

Pams and lams

97
Q

Melatonin receptor agonists

A

Ramelteon
Doxepin
Buspirone

98
Q

TCA examples

A

Nortriptyline
Amitriptyline
Imipramine

99
Q

SSRI examples

A

Fluoxetine
Paroxetine
Citalopram
Escitalopram

100
Q

SNRI examples

A

Venlafaxine
Desvenlafaxine
Duloxetine

101
Q

Serotonin-norepinephrine disinhibitors (SNDIs) example

A

Mirtazapine

102
Q

MAOIs examples

A

Isocarboxazid
Phenelzine
Selegiline
Tranylcypromine

103
Q

Anticonvulsant drugs

A 
Valproate 
Carbamazepine 
Lamotrigine 
Gabapentin 
Topiramate 
Oxcarbazepine
104
Q

First-generation, conventional, typical of standard antipsychotic drugs strongly block

A

DA attachment (antagonistic)

105
Q

First-generation, conventional, typical of standard antipsychotic drugs also block (besides DA)

A

ACH
NE
Histamine

106
Q

First-Generation (Conventional) Antipsychotic Drugs main side effects

A

Weight gain

Sedation

107
Q

Second-Generation (Atypical) Antipsychotic Drugs block

A

DA and Serotonin

108
Q

Second-Generation (Atypical) Antipsychotic Drugs examples

A 
Clozapine (Clozaril)
Risperidone 
Quetiapine 
Olanzapine 
Ziprasidone
109
Q

Third-GenerationAntipsychotic Drug

A

Aripiprazole (Abilify)

Dopamine stabilizer

110
Q

Drugs For Alzheimer’s disease

A

Tacrine

Donepezil

111
Q

Herbal Medicine- major concerns:

A

Potential long-term effects:
Nerve damage
Kidney damage
Liver damage

112
Q

If a person has decreased circulating levels of GABA, which health problem would be expected?

113
Q

Thorazine

A

typical antipsyc
Primarily used for schizo. Also does bipolar, attention deficit hyperactivity disorder, nausea and vomiting, anxiety before surgery, and hiccups

114
Q

Cultural ____: Examine beliefs, values, and practices of own culture

A

Cultural awareness

115
Q

Cultural ____: Recognize that during a cultural encounter, three cultures are intersecting

A

Cultural awareness

116
Q

Cultural ____: Learn by attending cultural events and programs

A

Cultural knowledge

117
Q

Cultural ____:
Deter nurses from stereotyping
Help nurses gain confidence in cross-cultural interactions
Help nurses avoid or reduce cultural pain

A

Cultural encounters

118
Q

Cultural ____: Ability to perform a cultural assessment in a sensitive way

A

Cultural skill

119
Q

Cultural ____: Use professional medical interpreter to ensure meaningful communication

A

Cultural skill

120
Q

Cultural ____:
Genuine concern for patient’s welfare
Patience, consideration, and empathy

A

Cultural desire

121
Q

Ethics

A

study of philosophical beliefs about what is considered right or wrong in a society

122
Q

Bioethics

A

Used in relation to ethical dilemmas surrounding health care

123
Q

Justice

A

Distribute resources or care equally

124
Q

Fidelity

A

Maintaining loyalty and commitment; doing no wrong to a patient

125
Q

Writ of habeas corpus

A

You must get a court order to hold someone

126
Q

Example of unintentional tort (besides negligence)

A

malpractice

127
Q

Five Elements to Prove Negligence

A 
Duty
Breach of duty
Cause in fact
Proximate cause
Damages
128
Q

which phase: Evaluate problems and goals

129
Q

Hans Selye came up with the

A

General Adaptation Syndrome

130
Q

Distress and Eustress were coined by

131
Q

Neurotransmitter Stress Responses: serotonin production becomes

A

more active

132
Q

Neurotransmitter Stress Responses: Increased serotonin may impair

A

the brain’s ability to use serotonin

133
Q

Lifetime prevalence of schizophrenia is __% worldwide

134
Q

schizo has no differences related to

A

Race
Social status
Culture

135
Q

Schizo Comorbidity

A

Substance abuse disorders
Anxiety, depression, and suicide
Physical health or illness
Polydipsia

136
Q

The neurobiological contribution to schizo is the ___ theory

137
Q

Psychological and environmental factors causing schizo

A

Prenatal stressors
Psychological stressors
Environmental stressors

138
Q

3 Phases of Schizophrenia

A

Acute, Stabilization, Maintenance

139
Q

Concrete thinking

A

Inability to think abstractly

140
Q

Neologisms

A

made up word

141
Q

Echolalia

A

meaningless repetition of another person’s spoken words

142
Q

Alogia

A

can’t speak

143
Q

Depersonalization

A

These thoughts in my head are someone else’s

144
Q

Derealization

A

my surroundings aren’t real

145
Q

Echopraxia

A

imitate someone’s movements

146
Q

For schizo patients, it is crucial to assess for

A

depression

147
Q

1st gen antipsycs are ___ antagonists

148
Q

advantage of 1st gen antipsycs

149
Q

disadvantages of 1st gen antipsycs

A
  • Anticholinergic side effects
  • Tardive dyskinesia
  • Weight gain, sexual dysfunction, endocrine disturbances
150
Q

disadvantage of 2nd gen antipsycs

A

significant weight gain

151
Q

3rd gen antipsycs are DA system

A

stabilizers

152
Q

Advantages of 3rd gen antipsycs

A

Improves positive and negative symptoms and cognitive function

Little risk of EPS or tardive dyskinesia

153
Q

Potentially Dangerous Responses to Antipsychotics

A

Anticholinergic toxicity
Neuroleptic malignant syndrome (NMS)
Agranulocytosis

154
Q

Lifetime prevalence of bipolar disorder in the United States is

155
Q

Bipolar I – more common in

156
Q

Cyclothymia – usually begins in

A

adolescence or early adulthood

157
Q

In the Maintenance phase of bipolar, the only planned intervention is to

A

prevent relapse (everything else is acute phase of continuation phase. That phase is before Maintenance phase)

158
Q

Lithium Therapeutic blood level:

A

0.8 to 1.4

159
Q

Lithium Maintenance blood level:

A

0.4 to 1.3

160
Q

Advanced Practice Interventions for bipolar

A

CBT

interpersonal and social rhythm therapy

161
Q

Major Depressive Disorder: Persistently depressed mood lasting a minimum of

162
Q

Disruptive mood dysregulation disorder

A

disorder in children, characterized by persistently irritable or angry mood

163
Q

Dysthymic disorder

A

mild but long term depression

164
Q

Premenstrual dysphoric

A

severe, sometimes disabling extension of premenstrual syndrome (PMS)

165
Q

Leading cause of disability

A

Major Depressive Disorder

166
Q

3 phases of Major Depressive Disorder

A

acute, continuation, maintenance

167
Q

Other Treatments for Depression

A 
Electroconvulsive therapy (ECT)
Transcranial magnetic stimulation
Vagus nerve stimulation
Deep brain stimulation
Light therapy
168
Q

Fear

A

Reaction to specific danger

169
Q

Adjustment disorder is precipitated by

A

a stressful event

170
Q

The theory specifies two functionally distinct branches of the vagus, or tenth cranial nerve. The branches of the vagal nerve serve different evolutionary stress responses in mammals: the more primitive branch elicits immobilization behaviors (e.g., feigning death), whereas the more evolved branch is linked to social communication and self-soothing behaviors.

A

Polyvagal theory

171
Q

Individuals respond to stress with severe interruption of consciousness

A

Dissociative Disorders

172
Q

A disorder characterized by the presence of two or more distinct personality states

A

Dissociative identity disorder

173
Q

Without significant physical findings and medical diagnosis
Suffering is authentic
High level of functional impairment

A

Somatic Symptom Disorder

174
Q

Misinterpretation of physical sensations
Overconcerned for health and preoccupied with symptoms
Extreme worry and fear
Course of illness chronic and relapsing

A

Illness Anxiety Disorder

175
Q

Presence of deficits in voluntary motor or sensory functions
Common symptoms—paralysis, blindness, movement and gait disorders, numbness, paresthesias, loss of vision or hearing, or episodes resembling epilepsy
“La belle indifférence” versus distress

A

conversion disorder

176
Q

Artificially, deliberately, and dramatically fabricate symptoms or self-inflict injury
Goal of assuming a sick role

A

Factitious Disorders

177
Q

Examples of Factitious Disorders

A

Self-directed
Other-directed
Malingering

178
Q

3 eating/elimination disorders

A

Anorexia nervosa
Bulimia nervosa
Binge eating disorder

179
Q

Pica

A

eating dirt etc

180
Q

an eating disorder in which a person – usually an infant or young child – brings back up and re-chews partially digested food

A

Rumination disorder

181
Q

Enuresis

A

wet the bed

182
Q

Encopresis

A

shit the bed

183
Q

cataplexy

A

strong emotion or laughter causes a person to suffer sudden physical collapse though remaining conscious

184
Q

hypnagogic hallucinations

185
Q

Irresistible attacks of refreshing sleep, cataplexy, sleep paralysis, and hypnagogic hallucinations

A

Narcolepsy/Hypocretin Deficiency

186
Q

Treatment—lifestyle modifications and long-acting stimulant medication

A

Narcolepsy/Hypocretin Deficiency

187
Q

Circadian Rhythm Sleep Disorder, Treatment:

A

aggressive lifestyle management strategies aimed at adapting to or modifying the required sleep schedule

188
Q

Difficulty with sleep initiation
Sleep maintenance
Early awakening

189
Q

Insomnia: symptoms last for

A

at least 3 months (and occur 3 times a week)

190
Q 
Angry and irritable mood 
Defiant and vindictive behavior
Experience
Social difficulties
Conflicts with authority figures
Academic problems
A

Oppositional Defiant Disorder

191
Q 
Inability to control aggressive impulses
Adults 18 years or older
Leads to problems with 
Interpersonal relationships
Occupational difficulties 
Criminal difficulties
A

Intermittent Explosive Disorder

192
Q

Behavior is usually abnormally aggressive

Rights of others are violated and societal norms or rules are disregarded

A

Conduct Disorder

193
Q

therapy designed to help people change patterns of behavior that are not helpful, such as self-harm, suicidal thinking, and substance abuse.[1] This approach works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states

A

Dialectical behavioral therapy

194
Q

teaching parents positive reinforcement methods

A

Parent management training (PMT)

195
Q

an intensive, family-focused and community-based treatment program for chronically violent youth

A

Multisystemic therapy (MST)

196
Q

Delirium is a medical

197
Q
  1. Acute onset and fluctuating course
  2. Reduced ability to direct, focus, shift, and sustain attention
  3. Disorganized thinking
  4. Disturbance of consciousness
198
Q

Delirium diagnoses:
Risk for injury
Acute confusion
Risk for ___ __ __

A

deficient fluid volume

199
Q

Dementia does not show change in

A

consciousness

200
Q

inability to interpret sensations and hence to recognize things

201
Q

Difficulty with skilled movements

202
Q

cant talk

203
Q

People with ____ personality disorder are often described as odd or eccentric and usually have few, if any, close relationships

A

Schizotypal Personality Disorder

204
Q

A disorder characterized by social discomfort and avoidance of interpersonal contact.

A

avoidant personality disorder

205
Q

personality disorder that is characterized by a pervasive psychological dependence on other people.

A

dependent disorder

206
Q

Antisocial, obsessive-compulsive, and schizotypal personality disorders occur most frequently in

207
Q

Types of Crisis:
New developmental stage is reached
Old coping skills no longer effective
Leads to increased tension and anxiety

A

Maturational

208
Q 
Types of Crisis:
Arise from events that are
Extraordinary
External 
Often unanticipated
A

Situational

209
Q 
Types of Crisis:
Unplanned and accidental
Natural disaster
National disaster
Crime of violence
A

Adventitious

210
Q

In the hospital, violence is most frequent in

A

Psychiatric units
Emergency departments
Geriatric units

211
Q

Cycle of Violence

A

Tension-building stage
Acute battering stage
Honeymoon stage

212
Q

Therapeutic use of self: studies show that relationships established by therapeutic use of self

A

improve treatment outcomes

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