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Hesi PN > psychiatric nursing > Flashcards

psychiatric nursing Flashcards

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1
Q

signs and symptoms of depression

A

loss of interest in life activities
negative world view
anhedonia (loss of interest in pleasurable things)
usually related to loss
weight gain (mild depression)
weight loss (severe depression)
crying spells with mild to moderate
no more tears (severe)
sleep disturbances
slow thoughts, think slow,
can have delusions and hallucinations

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2
Q

Treatment

A

may need help with self care
prevent isolation
help them experience accomplishments
be careful with compliments (may make them feel worse)
just sit there
encourage them to describe feelings as they feel better
help them set accomplishable goals
if able walking, weight lifting, running
assess for suicide risk

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3
Q

Suicide risks

A

as depression lifts suicide risks increase
antidepressants increase suicide risk
American Indians have highest suicide rate and the elderly especial men
a sudden change in mood may indicate they have a plan
ask if they have a plan, what it is, how Lethal
do they have access to plan? watch for isolation, will writing, collecting harmful objects, giving away belongings

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4
Q

suicide prevention

A

direct, closed ended statements
provide a safe environment
safe-proof the room

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5
Q

signs of mania

A

continuous high
emotions-labile (extreme depression, manic)
flight of ideas
delusions are just a false idea
delusions of grandeur
delusions of persecution
constant motor activit> exhaustion
no inhibitions, innapropriate
altered sleep patterns
poor judgement
manipulation makes the feel powerful

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6
Q

mania treatment

A

decrease stimuli
dont argue or try to reason
dont talk about delusion
let them know you accept they need to believe it but you dont
look for the underlying need in delusion
persecution the need to feel safe
grandeur they need to feel good about themselves
set limits and be consistent
feel most secure in one on one relationships
remove hazards
stay with them as anxiety increases
need a structured schedule
provide activity to replace non-purposeful activity
supply finger food
dont forget fluids
maintain dignity

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7
Q

What is ECT treatment

A

can induce a tonic clonic seizure
used for severe depression

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8
Q

what do you do pre ECT

A

NPO, Void and give atropine
consent
succinylcholine given to relax muscles

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9
Q

what do yo do post ECT treatment

A

position on their side to prevent aspiration
stay with client
temporary memory loss expected
reorient them repeatedly
return to daily activities ASAP

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10
Q

schizophrenia symptoms

A

inward focus/ create their own world
inappropriate affect, flat affect or blunted affect
disorganized thoughts (looseness of asociations
ineffective communication skills (echolalia, neologism, word salads)
concrete thinking
religiosity
delusions
hallucinations (usually auditory)

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11
Q

what is echolalia

A

repeat what they hear

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12
Q

what is neologism

A

make up new worlds (seek clarifications)

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13
Q

schizophrenia treatment

A

decrease stimuli
observe frequently without looking suspicious
orient frequently
keep conversations reality based
observe for hallucinations
warn before you touch them
dont refer to hallucinations as they it makes them seem real
let them know you do not share the perception
hallucination connected to anxiety
get them involved in activity
elevate HOB
turn off TV
offer reassurance

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14
Q

what are command hallucinations

A

hallucinations that command the client to just themselves or others, can be frightening and can signal a psych emergency

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15
Q

signs and symptoms of paranoid personality disorder

A

always suspicious, but nor reason to be, distrust of others,
cannot explain away their delusions or false beliefs
pathological jealousy
hypersensitive to comments or actions
can’t relax, no humor, unemotional
abnormal anger response, responds with rage when provoked

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16
Q

treatment of paranoid personality disorder

A

be reliable
be honest
consistent nurses and brief visits
be matter-of-fact
respect personal space
be careful with touch, dont mix medications (always ID meds)
may need to eat sealed foods
use restraints as last resort

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17
Q

when must a provider evaluate a patient in restraints

A

within an hour

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18
Q

how often must restraint orders be renewed,

A

every 4 hours for adults
every 2 hours 9-17
every hour for less than 9 years
check client face to face every 15 min

remember hydration

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19
Q

signs and symptoms of anxiety

A

a universal emotion
becomes a disorder when interferes with functioning
increased performance at mild levels
decreased performance at high levels
may not need nurse with low anxiety
nurse should stay with high anxiety
highly anxious person needs step by step instructions

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20
Q

signs and symptoms of generalized anxiety disorder

A

chronic anxiety
fatigued due to constant activity and muscle tension always uncomfortable
always seek help

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21
Q

treatment of generalized anxiety disorders

A

short-term use of anxiolytics
relaxation techniques, deep breathing, imagery, deep muscle relaxation, or meditatin
journaling over time may help gain insight into anxiety peaks and valleys and triggers
re-channel anxiety through exercise
stay calm, because anxiety is contagious

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22
Q

panic disorders signs and symptoms

A

onset of panic attacks start in late 20s
they can be as frequent as weakly, or spread out like monthly
may present in ed with symptoms of an MI

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23
Q

treatment of panic disorders

A

if hyperventilating, slow down their breathing and breath with them
use simple words or messages when talking
teach ways to stop anxiety
symptoms should peak in 10 minutes and be gone in 20-30 minutes
journaling to help manage anxiety
use relaxation techniques

24
Q

treatment of phobias

A

must develop a trusting relationship with the client
desensitization is the key to recovery and must occur over time
do not talk about the phobia a lot
unconscious anxiety causes the phobia
normal coping hasn’t worked and fear may help them cope better

25
Q

OCD signs and symptoms

A

obsession is a recurrent thought
compulsion is a recurrent act they cannot stop
in comes from an unconscious conflict/anxiety

26
Q

OCD treatment

A

need a structured schedule
give time for ritual (increased anxiety if can’t perform) taper off and replace with another coping mechanism
provide distraction techniques
teach relaxation techniques like meditation

27
Q

anorexia signs and symptoms

A

distorted body image
preoccupied with food, but won’t eat
menses stop due to malnourishment
may have lanugo
decreased sexual development
lose weight
have hypothermia
dehydration and electrolyte imbalance resulting in low bp and pulse

28
Q

treatment of anxiety

A

increase weight gradually, weigh in underwear
monitor exercise routine
acknowledge the difficulty of clients situation
teach healthy eating and exercise
allow clients input into choosing healthy food items for meals
monitor for suicidal thoughts

29
Q

bulimia signs and symptoms

A

overeat and vomit
teeth have erosion of enamel
laxative and diuretic use
strict dieters: fasts, exercises and binges
binges are alone and secret
binges are pleasurable initially but after consuming thousands of calories intense self criticism may occur
low end of normal weight

30
Q

Bulimia treatment

A

sit with client at meals and observe for 1 hour after eating
allow 30 minutes for meals
take focus away from the food
intense family therapy is usually the cause
self-esteem building is important

31
Q

PTSD signs and symptoms

A

relives experience, nightmares, and flashbacks
emotionally numb
difficulty with relationships
isolate themselves

32
Q

PTSD treatment

A

establish a sense of safety
engage client in learning new coping skills
support groups

33
Q

what is considered a substance abuse disorder

A

when the use of the substance interferes with the ability to fulfill obligations such as work, school, or home

34
Q

what are the stages of alcohol withdrawl

A

minor withdrawal
moderate to severe withdrawal
delirium tremens

35
Q

signs of minor alcohol withdrawal

A

starts 4-12 hours of cessation of drinking
mild tremors, nervous, nausea, insomnia, headaches and palpitations
oriented to time, place and person

36
Q

describe moderate to severe withdrawal

A

increased tremors, confused, hyper-thermic, hyperactive, nightmares, increased BP, increased respirations, hallucinations, illusions
carefully assess and provide treatment to prevent delirium tremers

37
Q

signs of delirium trements

A

medical emergency
kinesthetics DT are most common (feel things crawling on them)
tonic clonic seizures possible

38
Q

treatment of alcohol withdrawal

A

keep light on (scared)
encourage friend or family to stay with the
provide a quiet environment
walk and talk to them
orient the client to time, place and person,
clarify illusions
seizure precautions
anxiolytics
sedatives
hydration

39
Q

why are sedatives used in alcohol withdrawal

A

they sedate
have anticonvulsant qualities

40
Q

examples of benzodiazepines

A

chlordiazepoxide
diazepam
lorazepam

41
Q

what are those in alcohol withdrawal deficient in

A

thiamine
manesium
calcium
potassium
phosphorous

42
Q

what can thiamine deficiency lead to

A

wernickes encephalopathy and korsakoffs psychosis

43
Q

what is wernickes encephalopathy

A

most serious form of thiamine deficiency in alcoholics
include paralysis of ocular muscles,
diplopia
ataxia
somnolence and supor
can lead to death

44
Q

what is korskaoffs psychosis

A

syndrome of confusion and loss of recent memory
seen when coming out of wernickes

45
Q

nursing considerations for alcohol withdrawl

A

observe for defense mechanisms (denial, rationalization)
disulfiram
support
12 step program

46
Q

things to consider with disulfiram (Antabuse)

A

connect form must be signed
must stay away from any form of alcohol including , cough syrup, aftershave, colognes and chemicals such as varnish

47
Q

what are the most common opioids

A

heroin
oxycodone
meperidine

48
Q

signs and symptoms of opioid addiction

A

need more drugs and needs them more often due to build up tolerance
drug seeking is no longer an option , its survival

49
Q

signs of opioid intoxication

A

pinpoint pupils
respiratory depression
coma

50
Q

emergency treatment of opioid use

A

Narcan (naloxone)

51
Q

how often must narcan be administered

A

every few hours until levels are non-toxic

52
Q

what happens if you do not continue naloxone

A

can lead to death

53
Q

when does opioid with draw start

A

within hours to days of stopping

54
Q

when do heroin users go through withdrawls

A

6-8 hours after use is stopped

55
Q

who goes through withdrawal faster

A

meperidine useres

56
Q

signs of opioid withdrawal

A

agitated and anxious mood,
nausea
vomiting
muscle aches
excessive tearing and running nose
sweating
pupil dilation

57
Q

treatment of opioid withdrawal

A

methadone

Hesi PN (24 decks)

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