Psychiatric/Mental Health (Exam Two) Flashcards
What is recovery?
A process of moving toward improvement in health and quality of life
T/F: Recovery is an ongoing process rather than a set of interventions with a distinct endpoint.
True
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), recovery from mental health disorders and substance use disorders is a process of change through which individuals do what? (SATA)
A. Improve their health and wellness B. Continue to deteriorate C. Live a self-directed life D. Strive to reach their full potential E. Solely focus on treatment of their symptoms
A, C, D
Life in recovery is supported by what four dimensions?
- Health
- Home
- Purpose
- Community
Overcoming or managing one’s disease as well as living in a physically and emotionally healthy way describes which of the four dimensions listed by the Substance Abuse and Mental Health Services Administration (SAMHSA)?
Health
A stable and safe place to live describes which of the four dimensions listed by the Substance Abuse and Mental Health Services Administration (SAMHSA)?
Home
Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society describes which of the four dimensions listed by the Substance Abuse and Mental Health Services Administration (SAMHSA)?
Purpose
Relationships and social networks that provide support, friendship, love and hope describes which of the four dimensions listed by the Substance Abuse and Mental Health Services Administration (SAMHSA)?
Community
List the guiding principles of recovery.
- Emerges from hope
- Person-driven
- Occurs via many pathways
- Holistic
- Supported by peers and allies
- Supported through relationships and personal networks
- Culturally based and influenced
- Based on respect
What is the primary focus of all recovery models?
Empowerment of the patient to make their own choices about their care
The Tidal Recovery Model is based upon how many commitments and competencies?
Ten
List the six steps of the Wellness Recovery Action Plan (WRAP) process in order.
Step 1: Developing a wellness toolbox Step 2: Daily maintenance list Step 3: Triggers Step 4: Early warning signs Step 5: Things are breaking down/getting worse Step 6: Crisis planning
Which step of the Wellness Recovery Action Plan (WRAP) model identifies symptoms indicating that individuals can no longer care for themselves and caregivers become the administrator of the plan?
Step 6: Crisis planning
What are the five stages of the Psychological Recovery Model?
Stage 1: Moratorium Stage 2: Awareness Stage 3: Preparation Stage 4: Rebuilding Stage 5: Growth
Which stage of the Psychological Recovery Model is identified by dark despair and confusion, and seems as if life is on hold?
Stage 1: Moratorium
In which stage of the Psychological Recovery Model does the individual realize that a possibility for recovery exists and they are not paralyzed by the disease?
Stage 2: Awareness
Which stage of the Psychological Recovery Model begins with the individuals resolve to begin the work of recovery?
Stage 3: Preparation
In which stage of the Psychological Recovery Model does the individual take the necessary steps to work towards his or her goals in rebuilding a meaningful life?
Stage 4: Rebuilding
Which stage of the Psychological Recovery Model is considered the overall outcome and allows individuals to feel confident about achieving their goals?
Stage 5: Growth
______________ is a mental state characterized by an acute disturbance or cognition, manifested by short-term confusion, excitement, disorientation, and clouded consciousness.
Delirium
List the signs and symptoms of delirium.
- Illusions
- Hallucinations
- Difficulty sustaining attention
- Difficulty shifting attention
- Highly distracted
- Disorganized thinking
- Impaired reasonability
- Disoriented to time and place
- Impairment of recent memory
What clinical manifestation may cause delirium in older adults?
Urinary tract infection (UTI)
Which of the following conditions are known to precipitate delirium? (SATA)
A. System infections B. Febrile illness C. Seizures D. Migraine headaches E. Social isolation F. Renal failure
A, B, C, D, E, F
Delirium may result in autonomic manifestations, such as:
- Tachycardia
- Sweating
- Flushed face
- Dilated pupils
- Hypertension
An 68-year-old female develops delirium due to an underlying urinary tract infection. The nurse should expect her symptoms begin to diminish over how many days?
A. 10 to 12 days
B. 4 to 8 days
C. 3 to 7 days
D. 1 to 2 days
C. 3 to 7 days
What is a neurocognitive disorder (NCD)?
Impairment in the cognitive functions of thinking, reasoning, memory, learning, and speaking
What are the two types of neurocognitive disorders?
- Mild
- Major
Describe the difference between mild and major neurocognitive disorder (NCD).
- Mild NCD is modest decline from a previous level of functioning
- Major NCD is significant decline from a previous level of functioning
Major neurocognitive disorder (NCD) is also known as what?
Dementia
What is the most common form of neurocognitive disorder (NCD)?
Alzheimer’s disease (AD)
Differentiate between primary and secondary neurocognitive disorder (NCD).
- Primary is not directly related to another illness
- Secondary is caused by or related to another illness
What is an example of primary neurocognitive disorder (NCD).
Alzheimer’s disease (AD)
What is an example of secondary neurocognitive disorder (NCD)?
Head injury
An individual is transported to the emergency department (ED) by ambulance after suffering a fall. It is discovered that during the fall, the individual hit their head and is now displaying symptoms of a neurocognitive disorder (NCD). Is the patient most likely suffering from a primary or secondary neurocognitive disorder (NCD)?
Secondary
What type of nursing management is necessary for a patient suffering from Alzheimers disease (AD) who exhibits progressive memory loss, personality changes, verbal aggression, and frustration?
Structured daily routines
Structured daily routines reduce what symptoms for a patient diagnosed with Alzheimer’s disease (AD)?
- Reduces frustration
- Reduces verbal aggression
Which nursing diagnosis is most appropriate for a patient with neurocognitive disorder (NCD) who has progressive symptoms?
A. Risk for injury/trauma
B. Disturbed thought process
C. Impaired memory
D. Impaired verbal communication
A. Risk for injury/trauma
The progression of symptoms associated with Alzheimer’s disease (AD) is divided into how many stages?
Seven
What are the progressive symptoms of Stage 1 Alzheimer’s disease (AD) called?
No apparent symptoms
What are the progressive symptoms of Stage 2 Alzheimer’s disease (AD) called?
Forgetfulness
What are the progressive symptoms of Stage 3 Alzheimer’s disease (AD) called?
Mild cognitive decline
What are the progressive symptoms of Stage 4 Alzheimer’s disease (AD) called?
Mild-to-moderate cognitive decline
What are the progressive symptoms of Stage 5 Alzheimer’s disease (AD) called?
Moderate cognitive decline
What are the progressive symptoms of Stage 6 Alzheimer’s disease (AD) called?
Moderate-to-severe cognitive decline
What are the progressive symptoms of Stage 7 Alzheimer’s disease (AD) called?
Severe cognitive decline
During which stage of Alzheimer’s disease (AD) does the individual begin to lose things or forget names of people?
Stage 2: Forgetfulness
During which stage of Alzheimer’s disease (AD) does the individual have changes in thinking and reasoning that interfere with their work performance?
Stage 3: Mild cognitive decline
During which stage of Alzheimer’s disease (AD) does the individual forget major events in their personal history, such as their child’s birthday?
Stage 4: Mild-to-moderate cognitive decline
During which stage of Alzheimer’s disease (AD) does the individual lose the ability to independently perform some of their activities of daily living, such as hygiene, dressing, and grooming?
Stage 5: Moderate cognitive decline
During which stage of Alzheimer’s disease (AD) does the individual become unable to recall the name of their spouse and may begin to misidentify people?
Stage 6: Moderate-to-severe cognitive decline
During which stage of Alzheimer’s disease (AD) is the individual unable to recognize family members, confined to bed, and aphasic?
Stage 7: Severe cognitive decline
What is the priority nursing intervention for an individual who is in Stage 7: Severe cognitive decline of Alzheimer’s disease (AD)?
- Provide comfort
- Provide dignity
- Provide all self-care measures
- Provide safety
The onset of a neurocognitive disorder (NCD) due to Alzheimer’s disease (AD) is _________ and _________.
- Slow
- Insidious
Vascular neurocognitive disorder (NCD) occurs as a result of what?
Cerebrovascular disease/accident
A patient with vascular neurocognitive disorder may present with what signs and symptoms?
- Memory loss
- Confusion
- Disorientation
- Depression
- Anxiety
The toxicology report of a patient suspected of having substance-induced neurocognitive disorder (NCD) comes back negative for all substances. What question(s) should the nurse anticipate asking the patient?
- Where do you work?
- Do you inhale any chemicals at work?
___________ is the most common mental illness in the elderly, but is often misdiagnosed.
Depression
List the signs and symptoms of neurocognitive disease (NCD).
- Slow progression
- Disoriented to time and place
- Impaired attention and concentration
- Progressive memory deficits
List the signs and symptoms of pseudodementia (depression).
- Rapid progression
- Oriented to time and place
- Intact attention and concentration
- Diminished appetite
T/F: Side rails are not considered a restraint.
- False
- Side rails are considered a restraint
A nurse administering donepezil (Aricept) for a patient with Alzheimer’s disease should educate the patient and the family on what?
- Slows the progression of the disease
- Delays the destruction of acetylcholine
- Most effective in the earliest stages of the disease
What class of medication therapy is prescribed for older adults who struggle with social isolation and concentration? Provide examples of medications that fall under this drug class.
-SSRI’s
- Sertraline
- Paroxetine
- Fluoxetine
Should pharmaceutical agents for sleep disturbances and anxiety be used on a short-term or long-term basis?
Short-term only
What is addiction?
A compulsive or chronic requirement
What is tolerance?
The amount of a substance required to achieve the desired effect is increased
Individuals who abuse substances are likely to have a higher rate of __________ use compared to the general population.
Tobacco
In which phase of alcohol use disorder do individuals use alcohol to relieve everyday stress and tensions of life?
Phase 1
Which phase of alcohol use disorder begins with blackouts and is now required by the individual?
Phase 2
In which phase of alcohol use disorder is physiological dependence clearly evident?
Phase 3
During which phase of alcohol use disorder is the person intoxicated more often than they are sober?
Phase 4
The most serious form of thiamine deficiency in alcoholic patients is known as what?
Wernicke’s encephalopathy
A syndrome of confusion, loss of recent memory, and confabulation in alcoholic patients is known as what?
Korsakoff’s psychosis
What are the complications of cirrhosis of the liver related to alcoholism?
- Portal hypertension
- Ascites
- Esophageal varices
- Hepatic encephalopathy
What therapeutic measures are used to treat ammonia toxicity due to hepatic encephalopathy?
- Remove protein from diet
- Neomycin
- Lactulose
Alcohol intoxication occurs at blood alcohol levels between ______ and _______ mg/dL.
100 and 200 mg/dL
What is the priority nursing assessment for a patient admitted during acute alcohol intoxication?
Assess aggressive behavior to assure they aren’t a harm to themselves or others
What are the signs and symptoms of detox?
- Course tremors in hands, tongue, eyelids
- Nausea/vomiting
- Weakness
- Tachycardia
- Anxiety
- Hypertension
- Headache
- Insomnia
What is the priority nursing diagnosis for a patient experiencing alcohol withdrawal or detox?
Risk for injury
What is the priority nursing intervention for a individual in alcohol withdrawal/detox who experiences hypertension?
- Notify the physician
- Initiate seizure precautions
Why is it important for the nurse to encourage non-pharmacological sleeping aids for a patient with substance-use disorder?
- Potentially addictive
- Depressive side effects
- Not as effective due to tolerance
What is cross-tolerance? What do patients who develop cross tolerance require?
- Patients who regularly abuse alcohol and benzodiazepines will develop a cross-tolerance to other analgesics
- Will require more analgesics for pain control
The nurse can expect a patient who has previously experienced complicated withdrawal from substances to be given what medication?
Chlordiazepoxide (Librium)
What medications are commonly administered for a patient withdrawing from benzodiazepines?
- Chlordiazepoxide (Librium)
- Phenytoin (Dilantin)
The nurse caring for a patient who has a colored tinge around their mouth and their nose expects the patient has been doing what?
Huffing
What are the signs and symptoms of inhalant intoxication?
- Dizziness
- Euphoria
- Nystagmus
- Slurred speech
- Psychomotor retardation
- Muscle weakness
- Stupor
- Coma
What is the first step in recovery from substance-use disorder?
Admitting powerlessness to the substance
What is disulfiram (Antabuse) therapy used for?
- Alcohol deterrent
- Helps avoid impulse drinking
Effects of disulfiram (Antabuse) and sensitivity to alcohol can last up to _____ ________ after the medication is discontinued.
Two weeks
What is the priority nursing diagnosis, aside from injury, for someone who has abused alcohol for extended periods of time?
Imbalanced nutrition: less than body requirements
What is the antidote for opiate intoxication?
Naloxone (Narcan)