psych final Flashcards
what is the antidote for benzodiazepine overdose?
flumazenil
what is administered for benzodiazepines withdrawal?
librium
what is given for benzo and alcohol use?
ativan and valium
OCD interventions
- allow pt to do rituals
- assess if ritual done in safe manor
- washing hands can cause abrasions from dryness
what is systematic desensitization
nurse needs to acknowledge fear and establish trust with pt
what is agoraphobia
excessive anxiety or fear about being in places or situations from which escape might be difficult or embarrassing
repression
the unconscious blocking of unpleasant feelings and events from one’s awareness over time
primary crisis intervenion
giving hem coping mechanisms, med management
secondary crisis intervention
screening for depression
tertiary crisis intervention
therapy, counseling
mild anxiety s/s
restlessness, irritable (tap feet, bite nails)
SNS not intact yet
moderate anxiety s/s
selective inattention, clear thinking tampered
- attention focus/problem solving -> not optimal
- person needs assistance with symptoms
- n/v, tachy
severe anxiety s/s
- blood moved to core, increased irritability, anger, lack of concentration, less problem solving, tremors, pacing, confused
- perceptual field greatly reduced
- difficulty concentrating
- somatic symptoms increase
panic s/s
running, shouting, screaming, pacing, unable to process reality, impulsivity, hallucinate
SE of anti anxiety medications
sedation, drowsiness
do not take St. John’s wort on top of HIV meds
medications of anxiety
SSRIS, SNRI, anti anxiety
OCD: Obsessions
thoughts, impulses or images that persist and reoccur
OCD: compulsions
ritualistic behavior an individual feels driven to perform in an attempt to reduce anxiety
what is the DSM-5 criteria for OCD
- obsessions, compulsions or both
- not due to a substance or condition
- not explained by another disorder
time consuming (>1 hr)
OCD risk factors
- child abuse and trauma
- post-infectious autoimmune syndrome
- genetics: 1st degree relative
- comorbidity with anxiety - disorders, eating disorders, tic disorders
biological treatment for OCD
- SSRI for OCD
- clomipramine (TCA)
- venlafaxine (SNRI)
- none for body dysmorphic disorder, hoarding, trichotillomania
surgical treatment for OCD
- gamma knife: creates lesions to form a disconnect of overactive circuits
- deep brain stimulation (DBS): implanted pulse generator uses low-dose current to reduce symptoms
paranoid personality disorder
defensive, jealous as adults
paranoid personality disorder treatment
adhering to schedules
schizoid personality disorder characteristics
loner
- little desire for intimacy
schizoid personality disorder treatment
psychotherapy, group therapy, antidepressants
schizotypal characteristics
intermittent hallucinations, anxiety in social settings
paranoia, suspicious
schizotypal treatment
check cult involvement
low dose antipsychotics
psychotherapy
borderline characteristics
splitting: can’t see the good or bad in others
- severe impairments in functioning
borderline treatment
pharm: psychotropics towards symptom relief
psychotherapy: CBT, DBT, schema-focused therapy
narcissistic characteristics
- entitlement
- lack of empathy
narcissistic treatment
CBT to deconstruct faulty thinking
group therapy
lithium for mood swings
antidepressants PRN
histrionic characteristics
excitable, dramatic
attention-seeking
histrionic treatment
psychotherapy
antisocial characteristics
rebels, sociopaths
antisocial treatment
boundaries, consistency, support, limits, mood stabilizers
avoidant characterstics
low self-esteem
subject to depression, anxiety, anger
avoidant treatment
group/individual therapy
antianxiety meds
beta blockers
antidepressants
dependent characteristics
high need to be taken care of
dependent treatment
psychotherapy
obsessive compulsive
unhelathy focus on perfection
obsessive compulsive treatment
clomipramine, fluoxetine
mild dementia
does not interfere with ADLs
major dementia
interferes with daily functioning and independencet
delirium s/s
- disturbance in attention
- abrupt onset with periods of lucidity
- disorganized thinking
- anxiety and agitation
- poor recall
- delusions and usually visual hallucinations
delirium implementation
prevent physical harm
minimize use of restraints
supportive measures to relieve distress
aphasia
loss of language ability
apraxia
loss of purposeful movement
agnosia
loss of sensory ability to recognized
confabulation
creation of stories in place of missing memories to maintain self-esteem
preservation
repetition of phrases or gestures long after stimulus is gone
agraphia
diminishing ability to read to write
sundowning/sundown syndrome
tendency for mood to drop and agitation to rise as light of day diminished
alzheimers treatment for cognitive symptoms
cholinesterase inhibitors
rivastigmine transdermal system
N-methyl-D-asppartate receptor antagonist
alzheimers medication for behavior symptoms
none approved, risk is high
alzheimers integrative therapy
omega-3 fatty acids
overt statements
“life isn’t worth living anymore”
covert statement
“its okay now. soon everything will be fine”
what are the 3 main elements that must be considered when evaluating lethality?
- specific plan?
- how lethal?
- access to method?
SAD PERSONS SCALE
sex
age
depression
previous attempt
excess alc
rational thinking loss
social supports lacking
organized plan
no spouse
sickness
signs of sexual abuse in children
- Precocious sexual behavior/ knowledge/ explicit talk or images/demonstration of sexual aggression
- PTSD symptoms
- Somatic complaints: abdominal pain n/v/d, chest pain
- Feelings of guilt
what are the legalities of reporting child and elderly abuse
older adult -> full head to toe exam before reporting
suspect -> report
risk factors for abuse towards a child
lifetime secondary effects: anxiety, depression, suicidal ideation, MDD and PTSD
sexual assault assessment five steps
- head to toe assessment for signs of injury
- detailed genital exam (pics will be taken, documentation)
- evidence collection and preservation
- documentation of physical findings
- treatment, discharge, follow-up care (plan b, test of HIV, Hep)
rape trauma syndrome
emotional reaction: outbursts, crying, laughing, hysteria, anger
control reaction: blunted affect, feeling numb
somatic reaction: HA, muscle tensions, sleep disturbance
what is the prophylactic treatment for STIs
antibiotics, doxy pep
anorexia s/s
refusal to eat
vital signs: irregular hr, dec pulse and bp, orothostatic hypo, amenorrhea, dehydration, electrolytes imbalance
intense fear of gaining weight
anorexia restricting type
individual has not engaged in recurrent episode of binge-eating or purging behavior
anorexia binge- eat/purge type
individual has engaged in recurrent episode of binge eating or purging
bulimia s/s
russell’s sign (dorsal lesions on hands caused by vomiting, the acid from stomach gets on hands)
dental damage, cardiotoxicity form syrup of ipecac, hypokalemia, EKG changes
bulimia comorbidities
depression, anxiety, bipolar, alc use, ptsd, borderline
bulimia behaviors
recurent episodes of binge eating, inappropriate compensatory behavior
grief: feelings
emptiness and loss
grief: intensity
intense sadness and anger that occurs in ways and gradually subsides
grief: self-esteem
intact, reorganization tasks may impact sense of self
grief: thoughts of death
may focus on someday reunited with the decrease
