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Psychiatric Nursing Flashcards

1
Q

Structure of personality that operates on pleasure principle, is the primary process thinking, irrational and not based on reality

A

ID

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2
Q

Structure of personality that is the chief executive office, operates on reality principle, secondary process of thinking, mediates between the person and the environment

A

Ego

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3
Q

Structure of personality that is the conscience, ego-ideal,

A

Superego

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4
Q

Defense mechanism:

An involuntary, automatic submerging of painful unpleasant thoughts and feelings into the unconscious

A

Repression

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5
Q

Defense mechanism:

Intentional exclusion of forbidden ideas and anxiety producing situations form the conscious level; voluntary

A

Suppression

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6
Q

Purposely imitating movements made by others

A

Echopraxia

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7
Q

Freud’s stages of psychosexual development and age of development of each

A 
Oral (birth -18 months)
Anal (18 months-3 years)
Phallic (3-6 years)
Latency (6-12 years)
Genital (13-20 years)
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8
Q

Stage of ego development

A

4-6 months of age

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9
Q

Age of superego formation

A

6-12 years old

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10
Q

Erikson’s psychosocial theory of human development

A 
Trust vs mistrust (birth-18 months)
Autonomy vs shame and doubt (18 months-3 years)
Initiative vs guilt (3 years to 5 years)
Industry vs inferiority (6 years to 12 years)
Identity vs role confusion (12-18 years)
Intimacy vs isolation (18-30 years/0
Generativity vs stagnation (30-60)
Ego integrity vs despair (65-death)
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11
Q

Piaget’s theory of cognitive development

A

sensorimotor (0-2 years)
pre-operational (2-6 years)
Concrete operation (6-12 years)
Formal operation (12-15 years +)

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12
Q

Sullivan’s stages of healthy interpersonal development

A

Infancy (birth to onset of language)- gratification of needs
Childhood (language to 6 yo) - parents are a source of praise and acceptance for positive self-esteem
Juvenile (6-9 yo)- satisfactory relationships with peer groups
Preadolescence (9-12 yo) - relationships with same sex
Early adolescence (12-14 yo)- relationship with opposite sex
Late adolescence (14-21)- interdependence within the society, lasting intimate relationship with a selected member of the opposite sex

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13
Q

Mode of action of antipsychotic drugs

A

Block dopamine receptors

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14
Q

Neurotransmitter imbalance in schizophrenia

A

Increased dopamine

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15
Q

Neurotransmitter imbalance in alzheimers disease

A

Acetylcholine decreased

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16
Q

Neurotransmitter imbalance in anxiety

A

Decreased GABA

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17
Q

Side effect of high potency antipsychotics

A

EPSE

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18
Q

Side effect of low potency antipsychotics

A

Anticholinergic (sympathetic)

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19
Q

Typical antipsychotics treat which symptoms

A

Positive symptoms

  • Hallucination
  • Delusion
  • Disorganized thinking
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20
Q

Typical antipsychotic with a daily dose limit

A

Thiridazine (Mellaril)

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21
Q

Daily dose limit of Mellaril and side effects

A

800 mg/day

  • Retinal pigmentation
  • Impaired night vision
  • decreased visual acuity
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22
Q

Typical antipsychotic in decanoate form

A

Fluphenazine (Prolixin)

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23
Q

Properties of Prolixin

A

Decanoate form
Slow release
administered every 2-3 weeks via IM and SQ
Increases drug compliance

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24
Q

Drug of choice for agitation, for elderly with psychosis

A

HALDOL

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25
Second generation or atypical antipsychotics treat which symptoms
``` Positive and Negative symptoms Negative symptoms include: -anhedonia -apathy -alogia -anergia -avolition ```
26
Classification of clozapine
Second generation antipsychotic
27
Side effect of clozapine
``` Agranulocytosis, decreased immune system Ssx: -sore throat -recurrent fever -body malaise -decreased WBC (<3,500; normal: 5-10k) ```
28
Drug of choice for acute mania
Olanzapine
29
Second generation antipsychotics
``` Clozapine (clozaril) Risperidone Olanzapine Quetiapine Zispradone (Geodon) ```
30
2nd generation antipsychotic that may cause long QT and dysrrhythmias
Zispradone (Geodon)
31
2nd generation antipsychotic which is most associated with weight gain
Quetiapine
32
2nd generation antipsychotic with same potency as clozapine, but safer
Risperidone
33
Third generation antipsychotic and properties
Aripiprazole (Abilify); dopamine system stabilizers
34
Side effects of antipsychotics
Photosensitivity Anticholinergic Sedation EPSE
35
Anticholinergic side effects
``` Blurred vision Dry mouth Urine retention Constipation Tachycardia ```
36
Drug of choice for alcohol aversion therapy
Antabuse
37
Hildegard Peplau's theory
Interpersonal Relations
38
Psychiatric tools
Self (requires self awareness) Medications Milieu /environment
39
Main strategy of primary prevention
Empowerment by health teaching
40
Components of secondary level of prevention
Early diagnosis | Prompt treatment
41
Functions of mental health
Productive activities Fulfilling relationships Coping with stress
42
Jahoda's six indicators of mental health
``` Attitude of self acceptance Growth and development and actualization INtegrative capacity (balanced ID, EGO, superego) Autonomous behavior Perception of reality Environmental mastery ```
43
Types of public health burden
Hidden (discrimination, stigma) Defined (change in quality of life) Undefined (financial costs) Future (unknown)
44
Characterize Freud's psychoanalytic theory
All behavior can be explained All behavior has meaning Developed from 0-6 years old
45
Three levels of consciousness and description
Conscious (here and now) Preconscious (memory that can be recalled) Unconscious (memory that cannot be recalled)
46
Piaget's cognitive development stages
Sensorimotor (sense of self, object permanence) Preoperational (express self with language, egocentric) concrete operational (classify objects, apply rules) formal operational (abstract thinking)
47
MAOI
Parnate Marplan Nardil
48
TCAs
Tofranil Nortriptyline Elavil Sinequan
49
SSRIs
Prozac Zoloft Paxil
50
Action of TCAs
Nonselective inhibition of reuptake of norepi and serotonin and dopamine
51
Mode of action of MAOIs
Prevents breakdown of norepi, serotonin, and dopamine
52
If SSRIs are combined with MAOIs
Serotonin syndrome
53
Treatment for hypertensive crisis from MAOI overdose
Phentolamine Mesylate (Regitine), slow IV or IM administration, hydration, F&E balance
54
Treatment fro MAOI overdose
Emesis and gastric lavage
55
Novel antidepressants
NDRIs: Bupropion (Wellbutrin, Zyban) SNRIs: Venlafazine (effexor), Duloxetine (Cymbalta) NaSSA: Mirtazapine (Remeron)
56
Haldol + ___ is used to help aggressive or psychiatric patients to stay in control
Lorazepam (Ativan)
57
Drugs for anti-EPS
Cogentin (Benztropine) Artane (Trihexyphenidyl) Benadryl (Diphenhydramine HCl) Akineton (Biperiden)
58
Drugs to combat acute dystonia
Benadryl | Cogentine
59
Drug from pseudoparkinsonism
Amantadine (Symmetrel)
60
Most common EPSE and responds poorly to treatment
Akathisia (continuous restlessness, fidgeting, jittery feelings, and nervousness)
61
Drug of choice for NMS
Dantrolene (Dantrium) | Bromocriptine (PArlodel)
62
LITHIUM must-knows:
Lethal if >3 meq/l (needs hemodialysis) Indicated for bipolar disorders Therapeutic range is 0.6-1.2 meq/L Hyponatremia leads to toxicity Increase excretion with mannitol and diamox Uncoordination and tremors are early signs of toxicity Metallic taste and fine hand tremors are normal SEs
63
Anticonvulsants:
``` carbamazepine (Tegretol) Valpric acid (Depakene, Depakote) Lamotrigine *Lamictal) Gabapentin (Neurotin) Topiramate (Topamax) Oxcarbazepine (Trileptal) ```
64
Calcium channel blockers, mood stabilizers
Verapamil (calan, Isoptin) Nifedipine (Adalat, Procardia) Nimodipine (Nimotop)
65
First line agents for status epilepticus
Diazepam | Lorazepam
66
Mode of action of benzodiazepines
GABA agonist leading to enhancement of action of GABA which is the inhibition of neurotransmission, thus decreasing anxiety
67
Blood alcohol level defining intoxication
0.15%
68
Blood alcohol level that could lead to coma, respiratory depression, death
0.40%
69
Most serious form of alcohol withdrawal
Delirium tremens
70
Drug of choice for delirium tremens
Benzodiazepine (Librium)
71
Chronic irreversible disorder following Wernicke's encephalopathy
Korsakoff's syndrome
72
Aldehyde dehydrogenase inhibitor
Disulfiram (antabuse)
73
Opiates
``` Heroin Morphine Codeine Opium Methadone ```
74
Signs of dependence to opiates
Pinpoint pupuls
75
Signs of dependence to amphetamines
Fine tremors
76
Amino acid precursor of serotonin
Tryptophan
77
Most common side effect of ECT
temporary memory loss and confusion
78
Bleuler's 4 As of Schizophrenia
Associative looseness Affective disturbances Ambivalence Autism
79
Sign of dependence to hallucinogens
Distorted perception
80
Sign of dependence to cocaine
Grandiosity, pressured speech
81
Sign of dependence to marijuana
Red eyes
82
Drug for antisocial behavior
Phencyclidine
83
4As of Alzehimer's disease
Amnesia Agnosia Aphasia Apraxia
84
Medications for Alzheimer's disease
Cognex (Tacrine) Aricept (Donepecil) Reminul (Galantamine) Exelon (Rivastigmine)
85
Personality disorders and their clusters
Cluster I: Paranoid, schizoid, schizotypal Cluster II: Antisocial, borderline, histrionic, narcissistic Cluster III: Avoidant, dependent, obsessive compulsive
86
Safe, yet aggressive activities that are used to express anger
Catharsis
87
5 Key symptoms of schizophrenia
``` Delusions Hallucinations Disorganized Speech Disorganized behavior Negative symptoms ```
88
Diagnosis of schizophrenia
2 out of the 5 key symptoms, and at least 1 symptom is one of the first three
89
Novel antidepressant used as a smoking cessation agent
Bupropion
90
Novel antidepressant used to lower potential for drug interactions
Venlafaxine
91
Novel antidepressant used for diabetic neuropathy
Duloxentine
92
Novel antidepressant used for major depression and to reduce ssri induced sexual dysfunction
Mirtazapine
93
TCA overdose intervention
Gastric lavage or cathartics with activated charcoal
94
TCA overdose intervention
Gastric lavage or cathartics with activated charcoal
95
FIve areas of higher brain functioning measures by MMSE
``` Orientation Registration Attention Recall Language ```

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