psychiatric nursing Flashcards
signs and symptoms of depression
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
Treatment
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
Suicide risks
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
suicide prevention
direct, closed ended statements
provide a safe environment
safe-proof the room
signs of mania
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
mania treatment
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
What is ECT treatment
can induce a tonic clonic seizure
used for severe depression
what do you do pre ECT
NPO, Void and give atropine
consent
succinylcholine given to relax muscles
what do yo do post ECT treatment
position on their side to prevent aspiration
stay with client
temporary memory loss expected
reorient them repeatedly
return to daily activities ASAP
schizophrenia symptoms
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)
what is echolalia
repeat what they hear
what is neologism
make up new worlds (seek clarifications)
schizophrenia treatment
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
what are command hallucinations
hallucinations that command the client to just themselves or others, can be frightening and can signal a psych emergency
signs and symptoms of paranoid personality disorder
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
treatment of paranoid personality disorder
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
when must a provider evaluate a patient in restraints
within an hour
how often must restraint orders be renewed,
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
signs and symptoms of anxiety
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
signs and symptoms of generalized anxiety disorder
chronic anxiety
fatigued due to constant activity and muscle tension always uncomfortable
always seek help
treatment of generalized anxiety disorders
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
panic disorders signs and symptoms
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
treatment of panic disorders
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
treatment of phobias
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
