Psych Flashcards
Incomprehensibility (define)
When the general public can’t understand the motive behind someone’s behavior (Horowitz)
Cultural Relativity (define)
When the “normality” of behaviors is determined by a culture (wailing in mourning vs silent coping)
Dorothea Dix
Developed the concept of asylum (sanctuary), provided food, shelter, clothing to mentally ill.
What was the unintended consequence of deinstitutionalization
Thousands of mentally ill concentrated in prisons, state hospitals, homeless, and nursing homes.
Risk factors for violence among the mentally ill
History of violence
Command Auditory Hallucinations
Drug/Alcohol Abuse
Not compliant with treatment (or out of treatment)
Peplau believed…
That the work of psych nurses is interpersonal, and that using the relationship between nurse and patient can help move them towards wellness.
What are Peplau’s five roles?
Teacher Resource Counselor Technical Expert Surrogate
Transference
When a patient takes their baggage, especially feelings about a specific significant person, and places it upon the nurse/therapist.
Countertransference
When a nurse/therapist takes their history/baggage and it colors their perspective/opinions about the patient.
Milieu Therapy: Assumptions
Every individual has the ability to be healthy/realize health.
Every interaction is an opportunity for therapeutic intervention.
The client owns his own environment.
The client is accountable for his own behavior.
Inappropriate behavior comes with logical repercussions.
Milieu Therapy: Characteristics
Meeting of the patient’s basic physical needs
Facilities are home-like
Structured program of social and work-like activities
Community and family are involved
Democratic government in which patient is encouraged to participate.
What is the role of the nurse in the psychiatric setting?
Meeting the patient’s physiological needs Provides reality orientation Medication Administration Therapeutic Interactions Teacher Provide Hope
What are the recovery models and what are their shared components?
They’re based on the idea that recovery is possible.
The desire is for the patient to manage their illness the best as they are able.
The patient is provided a safe place to live.
The patient needs to feel as though they have meaningful activities.
The patient needs a social network for support.
Tidal Model
WRAP model.
What is the Tidal Model?
Recovery Model that uses the metaphor of water.
Focuses on the patient’s story, builds on their strengths.
Recognizes that change is constant (comes in waves)
Nurse should:
- spend time with patient
- be transparent.
What is the WRAP model
Wellness Action Recovery Plan (recovery model).
Structured process with concrete steps:
- Builds a “wellness toolkit”
- involves patient identifying their triggers/early warning signs and what tools they can use if it occurs.
- making a maintenance list and reviewing it daily
- spells out how to recognize when the condition worsens
- incorporates crisis planning: how friends/family can manage so as not to call 911.
What are the four major groups of neurotransmitters?
Cholinergics
Monoamines
Neuropeptides
Amino Acids
What’s the basic physiology of neurotransmitter release?
Neurons talk to each other across the synaptic space
AP fires and the NT is released into the synaptic cleft
NT attaches to receptors on the postsynaptic membrane
AP continues to the next nerve cell
(Presynaptic neuron “reuptakes” extra/leftover NT for recycling).
What NT is the primary cholinergic? Is it excitatory or inhibitory? Where is it located? What is it synthesized from? What does it do? What disease processes are associated with it?
Acetylcholine. (Synthesized from choline)
Both excitatory and inhibitory.
Location: Mostly PNS (also brain and spinal cord) - NMJs of skeletal muscles, especially.
Coordination of movement, sleep, arousal, pain, perception, memory retention.
Increased in: depression
Decreased in: Alzheimer’s, Huntingdon’s, Parkinsons.
What are the monoamines?
Norepinephrine
Dopamine
Serotonin/5HT
Histamine
What type of NT is neuroepinephrine? What is NE synthesized from? Is it inhibitory or excitatory? Where is it synthesized? What are its functions? What disorders are associated with it?
Monoamine.
Synthesized from Tyrosine
Excitatory
Synthesized in pons, medulla, lymbic system, hippocampus (more?)
Functions: Mood, cognition, attention/vigilance, perception, cardiovascular function, sleep.
Increased in: anxiety, mania, schizophrenia
What metabolizes norepinephrine? What drugs prevent this?
Monoamine oxidase
MAO inhibitors
What kind of NT is dopamine? What is it synthesized from? Where is it located? Is it excitatory or inhibitory? What does it do? What disorders is it associated with?
Monoamine
Synthesized from Tyrosine
Located in: brainstem (mostly), especially at the substantia nigra
Usually excitatory. (Inhibits prolactin release: gynecomastia)
Controls complex movements, motivation, cognition, regulates emotional responses, involved in pleasure.
Associated with addictions, movement disorders, psychosis.
Increased in mania and schizophrenia
Decreased in depression and Parkinson’s
What kind of NT is Serotonin? What is it synthesized from? Where is it located? Is it inhibitory or excitatory? What are its jobs? What disorders is it associated with?
Monoamine
From tryptophan
Located in the brain (especially at the raphe nuclei of the brainstem)
Mostly inhibitory
Plays a role in sleep/arousal, libido, appetite, mood, aggression, pain perception, temperature regulation.
Decreased in depression
Increased in anxiety
What kind of NT is Histamine?
What does it to?
Monoamine
Plays role in mediating allergic reactions
Associated with wakefulness
What are the Amines?
What are they synthesized from?
Where are they located?
What functions are they associated with?
GABA, Glycine (Inhibitory)
Glutamate, Aspartate (Excitatory)
Synthesized from tyrosine, tryptophan, histidine
Found in the brain
Involved in learning, emotions, motor control
What type of NT are GABA and Glycine? What do they do? What are they synthesized from? Where are their receptors located? What drug class is GABA associated with? What disorders are they associated with?
Amines
GABA is the major NT of post-synaptic inhibition: it interrupts the impulse at the synaptic junction.
(Synthesized from glutamate?)
Most CNS neurons have receptors
Associated with Benzodiazepines
Decreased in Anxiety, Schizophrenia, some Epilepsy, Huntingdon’s
What type of NT are Glutamate and Aspartate? Are they excitatory or inhibitory? What do they do? Where are they located? What is the risk? What disorders are they associated with?
Amines
Excitatory
Relay sensory info and regulate motor/spinal reflexes
Synthesize structural/functional proteins
Located in the CNS
Too much can be neurotoxic
Decreased in Schizophrenia
Increased in anxiety, depression, temporal lobe epilepsy
