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Psych Final Flashcards

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1
Q

SSSRI mnemonic

A

Suicide risk, slow onset and taper, serotonin syndrome, sweaty, rigid muscles, increased HR

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2
Q

Can’t see, can’t pee, can’t spit, can’t shit

A

TCA side effects

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3
Q

True or false you can take MAOI’s with other antidepressants

A

False, must take two weeks to come off MAOI before taking another one

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4
Q

MAOI mnemonic

A

Massive HTN risk, Avoid tyramine, OTC drugs HTN crisis, Increased risk suicide

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5
Q

MAOI food to avoid

A

Wine and cheese, beer and sausage, chocolate, fermented fruits or veggies

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6
Q

maoi otc drugs to avoid CAAN

A

Calcium, antacids, acetaminophen, NSAIDS

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7
Q

Which meds have most potential risk for injury?

A

Looking for which ones are sedating like amytriptyline, diphenhydramine, and alprazolam

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8
Q

Lithium therapeutic level

A

0.6-1.2

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9
Q

What can contribute to lithium toxicity

A

Diuretics

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10
Q

Anticholinergic side effects from TCA

A

Blind as a bat, mad as a hatter, dry as a bone, red as a beet

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11
Q

Meds linked to Steven’s Johnson syndrome

A

Carbamazepine, lamotrigine

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12
Q

Do not take if have hx of head injury or seizures

A

Welbutrin bupropion

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13
Q

Which MAOI can come in a patch?

A

Selegeline

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14
Q

Which class of meds can cause hypoglycemia?

A

SSRIs

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15
Q

Hypotension is associated with this class of antidepressants

A

TCA

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16
Q

Med given to help with hand tremors associated with lithium

A

Propranolol

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17
Q

What three mood stabilizers to avoid during pregnancy

A

Lithium,carbamazepine, Depakote

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18
Q

Hyper reflex fever agitation abdominal pain nause vomiting

A

Serotonin syndrome

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19
Q

Why are antipsychotics used with mood stabilizers

A

They work faster to manage the patients symptoms before the mood stabilizers gets in their system

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20
Q

Abdominal cramping, vomiting, tremors, restlessness, inability to sleep, Increased HR, Increased Respiratory rate, and temperature, transient hallucinations, anxiety, Increased BP, tonic clonic seizures.

A

Alcohol withdraw symptoms

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21
Q

Confusion, disorientation, hallucination, BP Abnormal, tremors, seizures, hyperthermia, cardiovascular collapse

A

Delirium tremens

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22
Q

How do you treat delirium tremens?

A

With benzos to keep the GABA neurotransmitters regulated

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23
Q

What is wernicke syndrome ?

A

Ataxia, poor coordination, falls, and abnormal eye movement

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24
Q

What deficiency causes wernicke encephalopathy and korsakoff psychosis?

A

Vitamin B1 or thiamine

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25
Q

What medications do we give someone going through alcohol withdraw

A

Acamprosate calcium, Ativan, benzos, carbamazepine, clonidine, propranolol, atenolol

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26
Q

What are nursing interventions for the medications we give to withdrawing alcoholics?

A

Around the clock or PRN, baseline vitals, seizure precautions, neuro status, check HR prior to propranolol

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27
Q

What are medications used for alcohol abstinence and maintenance?

A

Disulifiram, naltrexone, acamprosate

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28
Q

What drugs are classified as opioids?

A

Heroin, morphine, hydromorphone

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29
Q

What are the s/s of opioid overdose?

A

Respiratory depression, lethargy

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30
Q

Sweating, nose bleed, gooseflesh, tremors, irritability, weakness, diarrhea, fever, insomnia, n/v, pain in muscles/bones, muscle spasms

A

Opioid withdraw

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31
Q

Is withdraw from opioids life threatening

A

No

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32
Q

What meds are used to treat opioid addiction for detox?

A

Naloxone, flumazenil

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33
Q

What meds are used to treat opioid addictions for maintenance?

A

Methadone, clonadine, and buprenorphine

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34
Q

Withdraw symptoms of cocaine?

A

Depression, fatigue, suicidal, severe craving for coke, agitation, sleep disturbances

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35
Q

Is cocaine withdraw life threatening?

A

Nope but depression and SI can occur

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36
Q

What puts a patient at risk for abuse?

A

Female partner, vulnerable persons, pregnancy, older adults, child under 4, child is unwanted, disabled, or vulnerable

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37
Q

Educations for client with ECT therapy

A

ECT is not permanent cure, weekly or monthly maintenance ECT can decrease incidence of relapse

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38
Q

Nursing care for a patient undergoing ECT

A

Frequent orientation, safety, assist with ADL as needed, continuous monitoring, vitals

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39
Q

What patient is a good candidate for ECT

A

One who has been unsuccessful with medication

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40
Q

What are the various types of crisis?

A

Adventitious (natural disaster), situational/external (unanticipated loss), maturational/internal (new development stages)

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41
Q

Assessment questions for crisis?

A

Immediate safety, time since last crisis, coping skills, problem that is identified, perception of event, resources used, no hx questions!

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42
Q

What is normal grief

A

Uncomplicated, anger, resentment, withdraw, hopelessness, guilt but change to acceptance with time

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43
Q

What is anticipatory grief?

A

Terminal illness, letting go before the loss, have chance to greive before loss

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44
Q

What is disenfranchised grief?

A

Cannot be publicly shared or not socially acceptable (suicide, abortion)

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45
Q

What is delayed grief?

A

Does not demonstrate expected behaviors, can remain in denial for long time

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46
Q

What is an appropriate meal for someone who is manic?

A

Finger food and high calorie drink cuz they’re on the go!

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47
Q

What meds are cardiotoxic in an overdose?

A

TCA’s

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48
Q

What med class can cause hyponatremia?

A

Lithium and SSRI

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49
Q

Psychological risk factors for addiction

A

Hx of abuse, anxiety, low self esteem, difficulty expressing emotions, mental illness

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50
Q

Result of alcoholic portal HTN due to cirrhosis?

A

Esophageal varices

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51
Q

CAGE Questionnaire

A

Have you ever CUT down on drinking? Have people ANNOYED you by telling you about it? Have you ever felt GUILTY about drinking? Have you ever had a drink first thing in the morning? (EYE opener)

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52
Q

Alternative to methadone during pregnancy

A

Buprenorphine

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53
Q

Why can clonidine be used to treat withdraw?

A

Decreases autonomic hyperactivity

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54
Q

What is exaggerated grief?

A

Somatic manifestations to an exaggerated level, unable to perform ADL, remain in anger stage, can develop depression

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55
Q

What are the signs of mild lithium toxicity?

A

Apathy, lethargy, irritability, muscle weakness, nausea

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56
Q

What are the signs of severe lithium toxicity?

A

Cardiovascular collapse, coma, seizure

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57
Q

What are the signs of moderate lithium toxicity?

A

Blurred vision, confusion, drowsiness, progressing tremor, slurred speech, unsteady gait

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58
Q

Sexual dysfunction, CNS stimulation, weight loss/gain, serotonin syndrome, withdraw, hyponatremia

A

SSRI adverse effects

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59
Q

Do not take SSRI with…

A

Other antidepressants, warafrin, lithium, NSAIDs and anticoagulants

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60
Q

TCA adverse effects

A

BP problems (low) anticholinergic effects, CNS effects (sedation, sweating)

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61
Q

CNS stimulation, orthostatic hypotension, hypertensive crisis, rash

A

MAOI adverse effects

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62
Q

MAOI should not be taken with…

A

other antidepressants, antihypertensive, mepredine, tyramine, vasopressors (caffeine)

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63
Q

CNS effects, blood effects, teratogensis, hypo-osmolarity, skin disorders (SJS)

A

Carbamazepine adverse effects

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64
Q

LaMotRiGinE adverse effects

A

Double or blurred vision, dizziness, headache, nausea, vomiting, serious skin rash

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65
Q

Nausea, vomiting, indigestion, hepatotoxicity, pancreatitis, thrombocytopenia, teratogensis

A

Depakote adverse effects

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66
Q

Carbamazepine should not be taken with…

A

Warfarin, oral contraceptives, grapefruit, phenytoin, phenobarbital

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67
Q

Lamotrigine should not he taken with….

A

Carbamazepine, phenytoin, phenobarbital, Depakote, oral contraceptives

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68
Q

Depakote should not be taken with…

A

Phenytoin, phenobarbital

69
Q

Cluster A personality disorders

A

Paranoid, schizoid, schizotypal

70
Q

Cluster B personality disorder

A

Antisocial, borderline, histrionic, narcissistic

71
Q

Cluster C personality disorder

A

Avoidant, dependent, obsessive compulsive

72
Q

A pattern of distrust and suspiciousness such that others motives are interpreted as malevolent

A

Paranoid personality disorder

73
Q

A pattern of detachment from social relationships and a restricted range of emotional expression, loners no interest in close relationships

A

Schizoid personality disorder

74
Q

A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior. Magical thinking, odd speech, inappropriate affect

A

Schizotypal personality disorder

75
Q

A pattern of disregard for and violation of the rights of others. Social norms and rules don’t apply, no remorse or guilt

A

Antisocial personality disorder

76
Q

Pattern of instability in interpersonal relationships, self-image, and affects and marked impulsivity. Unstable mood, relationships, self image, impulsive and self destructive.

A

Borderline personality disorder

77
Q

Pattern of excessive emotionally and attention seeking. Excessive expression overly dramatic, always drawing attention to themselves, seductive.

A

Histrionic personality disorder

78
Q

Pattern of grandiosity, need for admiration, and lack of empathy. Exaggerated sense of self importance, needs constant attention, preoccupied with fantasies

A

Narcissistic personality disorder

79
Q

Pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation and rejection. Feel inadequate, want unconditional acceptance, fear criticism.

A

Avoidant personality disorder

80
Q

Pattern of submissive and clinging behavior related to an excess need to be taken care of.

A

Dependent personality disorder

81
Q

Pattern of preoccupation with orderliness, perfectionism, and control. Loves rules, lists, devoted to work.

A

Obsessive compulsive personality disorder

82
Q

Odd and eccentric

A

Cluster A

83
Q

Dramatic and emotional

A

Cluster B

84
Q

Anxious, fearful, depressed, compliant, tense, inflexible, rigid routines, low self confidence

A

Cluster C

85
Q

Safety, gentle approach be consistent with care, respectful of client need fir distance, privacy, remember they withdraw to protect themselves

A

Nursing implications for cluster A

86
Q

Set limits, be aware of manipulative behavior, use consistency, be firm in what is expected

A

Nursing interventions for antisocial personality disorder

87
Q

Safety, set limits, be consistent with firm guidelines, provide structure, do not give a reaction to self injury

A

Nursing interventions for borderline personality disorder

88
Q

Use self awareness, need to relieve feedback on their behavior and how it affects others

A

Interventions for histrionic and narcissistic personality disorder

89
Q

Redirect their perceptions of self in relationships with others, short but frequent contacts to show interest, important to boost self esteem

A

Nursing interventions for avoidant personality disorder

90
Q

Teach assertive skills, help learn that it’s okay to express anger, reward for independence, ignore dependent behavior

A

Nursing interventions for dependent personality disorder

91
Q

Talk about behavior and gains, teach assertive behavior, modify perfectionist standard, decrease anxiety

A

Nursing interventions for obsessive compulsive personality disorder

92
Q

Haloperidol, fluphenazine, trifluophenazine, chlorpromazine

A

Typical antipsychotics

93
Q

Risperidone, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, ziprasidone, ariprozole, brexpiprazole

A

Atypical antipsychotics

94
Q

pseudoparkinsonism, akathesia, neuroendocrine effects, orthostatic hypotension, sexual dysfunction, skin effects, liver impairment, anticholinergic effects

A

Common and expected side effects of typical antipsychotics

95
Q

Metabolic syndrome, orthostatic hypotension, anticholinergic effects, agitation, dizziness, sedation, sleep disruption, mild EPS (tremor), elevated prolactin levels, sexual dysfunction, anticholinergic effects

A

Common and expected side effects of atypical antipsychotics

96
Q

Agranulocytosis, tardive dyskinesia, neuroleptic malignant syndrome, sedation, seizures, severe dysrhythmias, acute dystonia

A

Serious side effects of typical antipsychotics

97
Q

Prolonged QT interval, sedation, neuroleptic malignant syndrome, DRESS, Steven Johnsons, agranulocytosis, severe dysrhythmias, hepatotoxicity

A

Serious side effects of ATYPICAL antipsychotics

98
Q

Metabolic toxic state. Drug use, head injury, delirium, dementia, Huntington, MS, thyrotoxicosis

A

Neuro conditions that can cause psychosis

99
Q

Client has psychotic thinking or behavior present for at least 6 months areas of functioning are school, work, self-care, and interpersonal relationships are impaired

A

Schizophrenia

100
Q

Client has manifestations of schizophrenia but the duration is from 1 to 6 months and social/occupational dysfunction may or may not be present

A

Schizophreniform disorder

101
Q

Client meets both criteria for schizophrenia and bipolar disorder

A

Schizoaffective disorder

102
Q

Hallucinations, delusions, alterations in speech, bizarre behavior

A

Positive schizophrenia symptoms

103
Q

Blunted affect, alogia, anergia, anhedonia, avolition

A

Negative schizophrenia symptoms

104
Q

Disordered thinking, inability to make decisions,poor problem solving, difficulty concentrating, memory deficits

A

Cognitive symptoms of psychotic disorders

105
Q

Hopelessness, suicidal ideation

A

Affective symptoms

106
Q

Misconstrues trivial events and attaches personal significance to them, such as believing that others, who are discussing the next meal are talking about him

A

Ideas of reference

107
Q

Made up words that have meaning only to the client

A

Neologisms

108
Q

Client repeats the words spoken to him

A

Echolalia

109
Q

Meaningless rhyming of words often forceful such as oh fox box lox

A

Clang association

110
Q

Words jumbled together with little meaning or significance to the listener such as hip hooray the flip is cast and wide sprinting in the forest

A

Word salad

111
Q

I like birds, birds can fly, flying a plane is hard, hard boiled eggs are good

A

Loose association

112
Q

Extreme agitation, stereotyped behaviors, automatic obedience, wavy flexibility, stupor, negativism, echopraxia

A

Alterations in behavior

113
Q

Purposeful imitation of movements made by others

A

Echopraxia

114
Q

Excessive maintenence of behavior

A

Wavy flexibility

115
Q

Doing the opposite of what is requested

A

Negativism

116
Q

Lack of hygiene, outbursts, unusual behavior, anxiety, confusion, terror, unreasonable fear

A

Prodromal or initial phase

117
Q

Hallucinations, delusions, disorganized speech, disorganized behavior

A

Active or acute phase

118
Q

Positive symptoms tend to become less intense, may regain some social skills, not all individuals experience this

A

Residual phase

119
Q

How does benztropine work?

A

Blocks effect of acetylcholine to help relieve tremors, rigidity, and complete loss of muscle movement

120
Q

Late onset, very serious, can be irreversible, initial lip smacking, tongue darting, progress to rapid movement of arms, legs and trunk

A

Tardive dyskinesia

121
Q

Pacing, squirming, inability to sit still, uncontrollable need to move

A

Akathisia

122
Q

High fever, unstable VS, Muscle rigidity, can be fatal

A

Neuroleptic malignant syndrome (NMS)

123
Q

Your pt is taking olanzapine, what should you carefully monitor for?

A

Increased blood glucose

124
Q

Client takes quetiapine (seroquel) which lab tests should the nurse monitor

A

Lipid profile

125
Q

Client receiving haloperidol complains of stuff jaw and difficulty swallowing. Your first action is to

A

Administer as needed benztropine IM as ordered

126
Q

Which instruction by the nurse to a client prescribed diazepam for anxiety is appropriate

A

This medication Is good fir short term only

127
Q

How does the nurse differentiate fear and anxiety?

A

Fear results in physiological response, anxiety is psychological

128
Q

Which is the priority nursing action when providing care to a client who demonstrate signs of escalating anxiety?

A

Provide a safe, quiet, and protective environment

129
Q

A client is prescribed fluoxetine for treatment of obsessive compulsive disorder. During the office visit they note the client is still exhibiting OCD behaviors. What should be the priority assessment?

A

Whether the client is taking the medication as prescribed

130
Q

Which assessment findings would indicate that the client is experiencing PTSD?

A

fear of returning to sleep, terrifying nightmares, aggressive behavior

131
Q

Which outcomes would indicate the intervention in the plan of care has been effective for someone with PTSD

A

The client has been sleeping throughout the night, client verbalizes future plans with family and friends

132
Q

What medication do you anticipate client being ordered with PTSD who is depressed, suicidal, and irritable?

A

Prazosin

133
Q

What is the priority nursing dx for client with PTSD SI, and sleep disturbances with frequent nightmares

A

Risk for self-directed violence

134
Q

Which treatment is most appropriate for pt with generalized anxiety disorder

A

Long-term treatment with buspirone

135
Q

Nurse is giving d/c instructions for pt with benzodiazepine. What statement needs further teaching

A

I will need to schedule blood work in order to monitor for toxic levels of thus drug

136
Q

Best nursing interventions for pt with generalized anxiety disorder

A

Encourage client to recognize signs of escalation, employ newly learned relaxation techniques, cognitively reframe thoughts about situations that generate anxiety, avoid caffeine

137
Q

What symptoms can be present in both bulimia and anorexia?

A

Binge eating and purging, highly focused on wt and appearance, inaccurate perceptions of the body

138
Q

Dehydration, hypophosphatemia, muscle cramps, irregular heart beat

A

Refeeding syndrome

139
Q

Avoid driving until client knows how it effects them, do not drink alcohol or take other CNS depressants, notify provider of all OTC medications, notify provider of any abnormal movements

A

Education for buspirone

140
Q

Advise pt to weigh self twice weekly to assess for fluid retention, may cause dizziness or drowsiness, avoid sudden changes in position, do not breastfeed on medication

A

Education for prazosin

141
Q

Restlessness, increased motivation, irritability

A

Mild anxiety

142
Q

Agitation, muscle tightness

A

Moderate anxiety

143
Q

Inability to function, ritualistic behavior, unresponsive

A

Severe anxiety

144
Q

Distorted perception, loss of rational thought, immobility

A

Panic level anxiety

145
Q

Stay with the pt, reassure you will not leave, give clear concise directions, assist to an environmental with little stimulation, walk or pace with the patient, administer medication, allow pt to vent

A

Interventions for panic

146
Q

Fear/anxiety, ineffective coping, social isolation, sleep pattern disturbance, impaired communication, risk for self harm

A

Nursing dx for anxiety

147
Q

Dizziness, nausea, headache, light headed, agitation, no sedation, do not take while pregnant, or breast feeding, caution in older adults, liver dysfunction, renal dysfunction, no not take with MAOI

A

Buspirone complications and contraindications

148
Q

Erythromycin, ketoconazole, St. John’s wort, grapefruit may increase levels

A

Buspirone medication/ food interaction

149
Q

Take with meals, effect does not occur immediately,should be taken on regular basis, tolerance, dependence, or withdraw are not an issue with this medication

A

Buspirone nursing admin

150
Q

CNS depression, ataxia, decreased cognitive function, amnesia, acute toxicity, paradoxical response, withdraw

A

Adverse effects of benzodiazepines

151
Q

Experience a loss or alteration in physical functioning, loss of functioning appears to be a physical problem. Really an expression of emotional conflict or need, la Belle indifference, primary and secondary gains

A

Conversion disorder

152
Q

Pt has seizure when it is their turn to share about their trauma, pt no longer has to share trauma. Later patient gets special care for having seizure

A

Primary and secondary gains

153
Q

The falsification of medical or psychological signs and symptoms in oneself or others that are associated with the identified deception

A

Fictitious disorder

154
Q

Individuals may take actions to misrepresent, stimulate, or cause signs and symptoms of illness or injury in the absence of obvious external rewards

A

Factitious disorder

155
Q

Establish therapeutic relationship, provide calm reassurance, show empathy but focus on feelings rather than physical complaints, encourage verbalizing feelings, redirect client, coordinate physical and psych care

A

Nursing care for somatic disirders

156
Q

Sudden high fever, blood pressure fluctuations, diaphoresis, tachycardia, muscle rigidity, decreased level of consciousness, coma

A

Neuroleptic malignant syndrome

157
Q

What is the difference between NMS and serotonin syndrome?

A

Serotonin syndrome is hyperrelfexive, NMS is muscle rigidity

158
Q

Which meds address both positive and negative symptoms?

A

Atypical antipsychotics

159
Q

Which meds only address positive symptoms?

A

Typical antipsychotics

160
Q

What do we watch for with antipsychotics?

A

Liver function, BP, ECG, CBC, cholesterol, glucose

161
Q

How often is a CBC done with clozapine?

A

Every 2 weeks

162
Q

What is the AIMS scale used for?

A

Delirium tremens

163
Q

Is prazosin a benzo?

A

No

164
Q

Which alcohol withdraw meds help with cravings

A

Naltrexone

165
Q

Which narcotic withdraw meds help with cravings

A

Buprenorphine

166
Q

Pseudoparkinsonism, acute dystonia, akathisia, tardive dyskinesia are associated with what?

A

EPS, associated with typical antipsychotics

167
Q

Restless, unable to sit still

A

Akathesia

168
Q

Confusion, agitation, poor concentration, hostility, disoriented, hallucinations, delirium, seizures, tachycardia, labeled blood pressure, diaphoresis HYPERREFLEXIA nausea, vomiting

A

Serotonin syndrome

Nursing Psych Final (2 decks)

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