Physical Health

Question 1

What is metabolic syndrome?

Answer 1

A cluster of abnormal clinical and metabolic findings that result in an increased risk of developing type 2 diabetes mellitus, cardiovascular disease (CVD), and CVD mortality.

Question 2

SMI (Severe mental illness) is associated with much higher rates of what?

Answer 2

Obesity and abdominal obesity

Question 3

Weight gain is a well-established side effect of what type of medications?

Answer 3

Antipsychotic medications particularly clozapine and olanzapine

Question 4

Which antipsychotic medications are less likely to cause weight gain?

Answer 4

Aripiprazole, asenapine, and ziprasidone

Question 5

What does metabolic screening involve?

Answer 5

Taking a persons waist circumference, blood pressure, height, and weight, and calculating body mass index.

Question 6

What is the best indicator of metabolic health?

Answer 6

Waist circumference

Question 7

Type 2 diabetes greatly increases the risk of what?

Answer 7

Cardiovascular disease, renal failure, amputation and blindness

Question 8

Why are people with SMI (Severe mental illness) more likely to have Type 2 diabetes?

Answer 8

Lifestyle factors, genetic predisposition as well as disease and treatment-specific effects (Such as the use of antipsychotic medications)

Question 9

What does the term ‘Cardiovascular diseases’ (CVD) refer to?

Answer 9

Any disease that affects the heart and blood vessels (Coronary heart disease and cerebrovascular disease ect)

Question 10

What are the major risk factors for Cardiovascular disease (CVD)?

Answer 10

Smoking, obesity, hypertension, raised blood cholesterol, genetics and T2 diabetes

Question 11

What is the most common cause of death in people with SMI (Sever mental illness)

Answer 11

CVD (Cardiovascular disease)

Question 12

What type of lifestyle interventions can nurses advise, encourage and implement for cardiometabolic health?

Answer 12

Tobacco cessation, physical activity/nutrition, medication changes ect

Question 13

The high rate of smoking among people with SMI can be attributed to what?

Answer 13

A high smoking take up rate that occurs early in life often before a mental health diagnosis, combined with fewer and less successful quit attempts

Question 14

What would be an intervention for smoking cessation?

Answer 14

Getting the patient to participate in a smoking cessation program

Question 15

What is an intervention for poor diet / sedentary lifestyle?

Answer 15

Structured nutritional counselling and modifying lifestyle.

Question 16

What is an intervention regarding obesity?

Answer 16

Structured nutritional counselling and modifying lifestyle + considering antipsychotic switching, reviewing medications and rationalising any polypharmacy.

Question 17

What would an intervention for a high blood pressure be

Answer 17

Structured nutritional counselling and modifying lifestyle + considering antipsychotic switching, reviewing medications and rationalising any polypharmacy.

Question 18

What kind of pharmacological support can be offered for a patient wanting to quit smoking

Answer 18

Nicotine replacement therapy or bupropion ect

Question 19

People with SMI commonly have diets lower in what?

Answer 19

Fruit and fibre and their diets are high in saturated fat compared to the general population

Question 20

What nutritional interventions can nurses implement?

Answer 20

Interventions that aim to reduce caloric intake and improve diet quality by increasing core foods and reducing discretionary foods (Vegetavles, fruit, milk, cheese, yoghurt, lean meat, fish, eggs, nuts ect)

Question 21

Which type of diet is shown to be beneficial for mental health by preventing and/or reducing depressive symptoms?

Answer 21

Mediterranean diet

Question 22

Physical activity can be defined as…..

Answer 22

Any bodily movement produced by skeletal muscle resulting in an increased energy expenditure

Question 23

Are people with mental illness known to be more or less physically active in comparison with the general population?

Answer 23

Less

Question 24

Low levels of physical activity are an established risk factor for what?

Answer 24

Cardiometabolic dysfunction (Diabetes and obesity)

Question 25

Good sleep is essential for what?

Answer 25

Good physical and mental health

Question 25

What can be one of the more distressing and persistent symptoms of a mental disorder?

Answer 25

Sleep disturbance

Question 26

How many hours of sleep does an adult need on average?

Answer 26

7-8 hours per night

Question 27

How many hours of sleep does an adolescent need on average?

Answer 27

9-10

Question 28

How many hours of sleep does a child need on average?

Answer 28

11-13 hours

Question 29

What is the most important primary action regarding a persons sleep?

Answer 29

Asking about a persons sleep

Question 30

Regarding sleep disorder nurses may play an important role in what?

Answer 30

Encouraging patients to manage any lifestyle issues that may be contributing to their sleep problems and encouraging sleep hygiene

Question 31

What are the important principles of sleep hygiene?

Answer 31

Going to bed and waking up at the same time each day, regular meal times, avoiding naps, avoiding eating and working out before bed, avoiding caffine after midday, ensuring bedroom is comfortable, dark + quiet, engage in exercise during the day, practice relaxation, and avoid stimulating activities before bed.

Question 32

What are some common issues that affect a persons sexuality and sexual health?

Answer 32

Sexually transmitted infections, body image, gender identity, psychological changes, medications, and stigma

Question 33

Sexual health screening includes….

Answer 33

Breast, prostate, cervical, and sexually transmitted infection screening

Question 34

Why is it important to take a correct physical assessment that includes history taking and checking with relatives?

Answer 34

So that a patient receives the correct diagnosis and you do not miss a physical health issue

Question 35

Why do people mis diagnose people with lyme disease for mental illness?

Answer 35

Because they often present with psychiatric symptoms such as paranoia, anxiety, and depressive symptoms

Question 36

How can we increase physical activity for those with a mental illness?

Answer 36

Behavioural techniques such as motivational interviewing, face to face group-based excersise sessions as well as structured excerisise prescriptions and interventions reflecting individual variations in mood, motivation, and access to facilities and resources. Physical reccomendations can be unrealistic for some living with MI so reccomend realistic goals such as breaking up sitting time with a small walk

Question 37

Do people with SMI have issues with oral health?

Answer 37

Yes, they are less likely to seek treatment and have a higher risk of dental disease

Question 38

What nursing actions/strategies can the nurse consider for a patient with poor oral health?

Answer 38

Use clinical interactions as an opportunity to promote oral health as a vital part of general health, consider health promotion that focuses on smoking, diet, alcohol use, and dental hygiene that should be routinely incorporated into mental health nursing care.