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Psychiatric Nursing Flashcards

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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
Q

Second generation or atypical antipsychotics treat which symptoms

A 
Positive and Negative symptoms
Negative symptoms include:
-anhedonia
-apathy
-alogia
-anergia
-avolition
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26
Q

Classification of clozapine

A

Second generation antipsychotic

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27
Q

Side effect of clozapine

A 
Agranulocytosis, decreased immune system
Ssx:
-sore throat
-recurrent fever
-body malaise
-decreased WBC (<3,500; normal: 5-10k)
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28
Q

Drug of choice for acute mania

A

Olanzapine

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29
Q

Second generation antipsychotics

A 
Clozapine (clozaril)
Risperidone
Olanzapine
Quetiapine
Zispradone (Geodon)
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30
Q

2nd generation antipsychotic that may cause long QT and dysrrhythmias

A

Zispradone (Geodon)

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31
Q

2nd generation antipsychotic which is most associated with weight gain

A

Quetiapine

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32
Q

2nd generation antipsychotic with same potency as clozapine, but safer

A

Risperidone

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33
Q

Third generation antipsychotic and properties

A

Aripiprazole (Abilify); dopamine system stabilizers

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34
Q

Side effects of antipsychotics

A

Photosensitivity
Anticholinergic
Sedation
EPSE

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35
Q

Anticholinergic side effects

A 
Blurred vision
Dry mouth
Urine retention
Constipation
Tachycardia
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36
Q

Drug of choice for alcohol aversion therapy

A

Antabuse

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37
Q

Hildegard Peplau’s theory

A

Interpersonal Relations

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38
Q

Psychiatric tools

A

Self (requires self awareness)
Medications
Milieu /environment

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39
Q

Main strategy of primary prevention

A

Empowerment by health teaching

40
Q

Components of secondary level of prevention

A

Early diagnosis

Prompt treatment

41
Q

Functions of mental health

A

Productive activities
Fulfilling relationships
Coping with stress

42
Q

Jahoda’s six indicators of mental health

A 
Attitude of self acceptance
Growth and development and actualization
INtegrative capacity (balanced ID, EGO, superego)
Autonomous behavior
Perception of reality
Environmental mastery
43
Q

Types of public health burden

A

Hidden (discrimination, stigma)
Defined (change in quality of life)
Undefined (financial costs)
Future (unknown)

44
Q

Characterize Freud’s psychoanalytic theory

A

All behavior can be explained
All behavior has meaning
Developed from 0-6 years old

45
Q

Three levels of consciousness and description

A

Conscious (here and now)
Preconscious (memory that can be recalled)
Unconscious (memory that cannot be recalled)

46
Q

Piaget’s cognitive development stages

A

Sensorimotor (sense of self, object permanence)
Preoperational (express self with language, egocentric)
concrete operational (classify objects, apply rules)
formal operational (abstract thinking)

47
Q

MAOI

A

Parnate
Marplan
Nardil

48
Q

TCAs

A

Tofranil
Nortriptyline
Elavil
Sinequan

49
Q

SSRIs

A

Prozac
Zoloft
Paxil

50
Q

Action of TCAs

A

Nonselective inhibition of reuptake of norepi and serotonin and dopamine

51
Q

Mode of action of MAOIs

A

Prevents breakdown of norepi, serotonin, and dopamine

52
Q

If SSRIs are combined with MAOIs

A

Serotonin syndrome

53
Q

Treatment for hypertensive crisis from MAOI overdose

A

Phentolamine Mesylate (Regitine), slow IV or IM administration, hydration, F&E balance

54
Q

Treatment fro MAOI overdose

A

Emesis and gastric lavage

55
Q

Novel antidepressants

A

NDRIs: Bupropion (Wellbutrin, Zyban)
SNRIs: Venlafazine (effexor), Duloxetine (Cymbalta)
NaSSA: Mirtazapine (Remeron)

56
Q

Haldol + ___ is used to help aggressive or psychiatric patients to stay in control

A

Lorazepam (Ativan)

57
Q

Drugs for anti-EPS

A

Cogentin (Benztropine)
Artane (Trihexyphenidyl)
Benadryl (Diphenhydramine HCl)
Akineton (Biperiden)

58
Q

Drugs to combat acute dystonia

A

Benadryl

Cogentine

59
Q

Drug from pseudoparkinsonism

A

Amantadine (Symmetrel)

60
Q

Most common EPSE and responds poorly to treatment

A

Akathisia (continuous restlessness, fidgeting, jittery feelings, and nervousness)

61
Q

Drug of choice for NMS

A

Dantrolene (Dantrium)

Bromocriptine (PArlodel)

62
Q

LITHIUM must-knows:

A

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
Q

Anticonvulsants:

A 
carbamazepine (Tegretol)
Valpric acid (Depakene, Depakote)
Lamotrigine *Lamictal)
Gabapentin (Neurotin)
Topiramate (Topamax)
Oxcarbazepine (Trileptal)
64
Q

Calcium channel blockers, mood stabilizers

A

Verapamil (calan, Isoptin)
Nifedipine (Adalat, Procardia)
Nimodipine (Nimotop)

65
Q

First line agents for status epilepticus

A

Diazepam

Lorazepam

66
Q

Mode of action of benzodiazepines

A

GABA agonist leading to enhancement of action of GABA which is the inhibition of neurotransmission, thus decreasing anxiety

67
Q

Blood alcohol level defining intoxication

A

0.15%

68
Q

Blood alcohol level that could lead to coma, respiratory depression, death

A

0.40%

69
Q

Most serious form of alcohol withdrawal

A

Delirium tremens

70
Q

Drug of choice for delirium tremens

A

Benzodiazepine (Librium)

71
Q

Chronic irreversible disorder following Wernicke’s encephalopathy

A

Korsakoff’s syndrome

72
Q

Aldehyde dehydrogenase inhibitor

A

Disulfiram (antabuse)

73
Q

Opiates

A 
Heroin
Morphine
Codeine
Opium
Methadone
74
Q

Signs of dependence to opiates

A

Pinpoint pupuls

75
Q

Signs of dependence to amphetamines

A

Fine tremors

76
Q

Amino acid precursor of serotonin

A

Tryptophan

77
Q

Most common side effect of ECT

A

temporary memory loss and confusion

78
Q

Bleuler’s 4 As of Schizophrenia

A

Associative looseness
Affective disturbances
Ambivalence
Autism

79
Q

Sign of dependence to hallucinogens

A

Distorted perception

80
Q

Sign of dependence to cocaine

A

Grandiosity, pressured speech

81
Q

Sign of dependence to marijuana

A

Red eyes

82
Q

Drug for antisocial behavior

A

Phencyclidine

83
Q

4As of Alzehimer’s disease

A

Amnesia
Agnosia
Aphasia
Apraxia

84
Q

Medications for Alzheimer’s disease

A

Cognex (Tacrine)
Aricept (Donepecil)
Reminul (Galantamine)
Exelon (Rivastigmine)

85
Q

Personality disorders and their clusters

A

Cluster I: Paranoid, schizoid, schizotypal
Cluster II: Antisocial, borderline, histrionic, narcissistic
Cluster III: Avoidant, dependent, obsessive compulsive

86
Q

Safe, yet aggressive activities that are used to express anger

A

Catharsis

87
Q

5 Key symptoms of schizophrenia

A 
Delusions
Hallucinations
Disorganized Speech
Disorganized behavior
Negative symptoms
88
Q

Diagnosis of schizophrenia

A

2 out of the 5 key symptoms, and at least 1 symptom is one of the first three

89
Q

Novel antidepressant used as a smoking cessation agent

A

Bupropion

90
Q

Novel antidepressant used to lower potential for drug interactions

A

Venlafaxine

91
Q

Novel antidepressant used for diabetic neuropathy

A

Duloxentine

92
Q

Novel antidepressant used for major depression and to reduce ssri induced sexual dysfunction

A

Mirtazapine

93
Q

TCA overdose intervention

A

Gastric lavage or cathartics with activated charcoal

94
Q

TCA overdose intervention

A

Gastric lavage or cathartics with activated charcoal

95
Q

FIve areas of higher brain functioning measures by MMSE

A 
Orientation
Registration
Attention
Recall
Language

A Nursing Boards (5 decks)

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