psychosocail Flashcards
anorexia is more common in
women (90% of cases)
anorexia is a
clients refusal or inability to maintain minimal body weight
males with anorexia are more likely to
not seek treatment
anorexia is an intense fear of
gaining weights or becoming fat, a disturbed body image and inability to acknowledge the problem
subgroup of anorexia 1
lose weight through diet, fasting, excessive exercising
subgroup of anorexia 2
binge eating and purging
bulimia nervosa is
binge eating characterized by any recurrent episodes of binge eating and the inappropriate behaviors to avoid weight gain such as purging, fasting, and exercising (they often engage in eating in secret)
anorexia is onset at ages of
14-18yrs
risk factors for anorexia
intense fear of becoming over weight
distorted body image
control issues/OCD
B/c we emphasize self worth equated to beauty
start assessing for anorexia around what age?
age 9
other signs of anorexia
isolation, mistrust, paranoia
treatment of anorexia
can be very difficult if the patient is refusing to seek treatment/help
medical management of anorexia
weight restoration, nutritional rehab, rehydration, correct electrolyte imbalance, TPN
people with anorexia are at risk for
osteoporosis (rt amenorrhea)
cardiac problems
pharmacological treatment of anorexia
has shown little success
people with anorexia have
decreased metabolism
decreased thyroid
become emaciated
Bulimia is
begins in late adolescence or early adulthood, binge eating after dieting or fasting then purging between binge eating and purging episodes eat restrictively which sets them up for the next episode of binging and purging
Signs of someone with bulimia
bad teeth, bad breath, calluces on fingers from shoving finger in throat, appearance, motor behavior, mood and effect, self-concept, roles and relationships, physiologic and self care considerations
most effective treatment for bulimia
cognitive/behavioral therapy
when therapeutically communicating with someone with bulimia you want to
remain calm and praise small things
nursing interventions for someone with bulimia
establish nutritional and eating patterns, identifying emotions, developing coping strategies, dealing with body image issues, providing client and family education
therapeutic communication while talking to someone with an eating disorders
remain empathetic and non judgmental
avoid sounding parental
do not label clients as “good” when they avoid purging or eat a whole meal (maybe just acknowledge what they say)
remaining calm and praising small things
Altruism
stressors and emotional conflicts are addressed by meeting the needs of others
Sublimation
substituting a socially acceptable activity for an impulse that is unacceptable
humor
emphasizing the amusing aspects of life and stress
suppression
conscious exclusion of unacceptable thought and feelings from conscious awareness
repression
excluding emotionally painful or anxiety producing thoughts and feelings from the conscious (long term)
displacement
ventilation of intense feelings towards persons less threatening than the one who aroused those feelings (chain of screaming)
reaction formation
acting the opposite of what someone thinks or feels
somatization
transferring anxiety on an unconscious level to a physical symptom that has no organic cause
undoing
exhibiting acceptable behavior to make up for or negate an unacceptable behavior
rationalization
excusing own behavior to avoid guilt/responsibility/conflict/anxiety/loss of self respect
passive agressive
indirectly and unassertively expressing aggression towards others
acting out behaviors
addresses stressors by actions rather than reflections or feelings
dissociation
dealing with emotional conflict by a temporary alteration in consciousness or identity
devaluation
conflicts handled by attributing negative qualities to self or others
idealization
conflicts handled by attributing exaggerated positive qualities to others
splitting
inability to integrate positive and negative qualities of self and others into a cohesive whole ( personality disorders)
projections
unconsciously rejects emotionally unacceptable personal features and attributes them to other people, objects or situations through projection
denial
failure to acknowledge an unbearable condition or reality of a situation
anxiety is
a vague feeling of dread or apprehension or response to external or internal stimuli that can have behavioral, emotional, cognitive, or physical symptoms
anxiety is not the same as
fear
fear is feeling
threatened by external stimulus
anxiety can serve a
positive function
alarm reaction stage
the first stage of the general adaptation syndrome, in which the body responds to stress by exhibiting shock
resistance stage
Resistance is the second stage of the general adaptation syndrome. During this stage the body has increased capacity to respond to the stressor. Due to high energetic costs the body cannot maintain high levels of resistance to stress forever
exhaustion stage
The third stage is exhaustion. Hopefully the issue is resolved in the alarm or resistance stage, but the body cannot maintain the resistance stage for a long period of time.
levels of anxiety
mild, something that is different and warrants special attention
moderate, something definitely wrong becomes nervous or agitated
severe, defensive response ensures, cognitive skills decrease
anxiolytic drugs
benzodiazepines
nonbenzodiazepines
anxiety is the highest prevalent
mental disorder in the united states
gerentological considerations when it comes to anxiety
they may have dementia/anxiety related to not being able to remember things
why is anxiety so strong in the us
were a future focused society rather then present focused society
agorophobia
fear if people/talking to people/ going out
panic disorder
composed of discrete episodes of panic attacks 15-30 minutes, persons feel extreme fear and discomfort
s and s of an anxiety attack
SOB, sweating, tremors, palpitations, sense of suffocation , chest pain, nausea, sense of suffocation, nausea, abd pain, distress, parethesias, chills, hot flashes
primary gain of anxiety
I dont wanna deal with anxiety so i am not gonna go out
secondary gain of anxiety
using someone to enable your anxiety
Nursing intervention
using theraputic communication, managing anxiety, and providing client and family education
deffinition of a phobia
an illogical intense and persistent fear of a specific object or social situation that causes extreme distress and interferes with normal functioning. people may not understand why they have this fear and may even joke about it being “silly”
treatment for phobias
desenitization and flooding
flooding
doing fear all at once, in controlled safe enviorment
desensitization
slowly exposing the person to the fear
Generalized anxiety disorder
worries excessively about and feels highly anxious at least 50% of the time for 6 months or more
three or more of the symptoms indicate GAD
uneasiness, irritability, muscle tension, fatigue, difficulty thinking, sleep alterations, decreases quality of life for older adults
what happens when a person looses excess amounts of sleep?
they become irritable and can have hallucinations
Autism spectrum disorder is the newer term for
disorders previously known as pervasive developmental disorder
during 4-6 what happens that can cause autism
issues with neural tube defects, no blood brain barrier so brain is unprotected
head of a child consists of about ____% of BW
25%
head of an adult consists about __% of BW
2%
what could be the cause of autism?
drugs/poor nutrition
traumatic brain injury
lack of touch and compassion
Shaken baby syndrome
autism is more coming in what gender group?
boys
autism is often identified in the age group of
18 mos to 3 years
signs of autism
limited capacity to relate to peers, facial expressions, limited gestures to communicate, lack of spontaneous enjoyment, no emotional affect and cannot engage in make believe toys, little intelligible speech and engage in stereotyped motor behaviors
there is a what to autism?
genetic factor
autism can improve as
children learn how to communicate
goals of treatment include
reduce behavioral issues and symptoms to promote acquisition of language skills
pharamacological management
Haldol and risperidol for temper tantrums
expressive aphasia
cannot say what you want to say
receptive aphasia
cannot understand what people say
Retts multiple deficits
formal diagnosed disorder
deficits after a normal period of functioning
exclusive in girls 5mos to 1yr severe impairement and expressive and receptive language becomes evident as you get older
childhood disintrgrative disorders are
rare and more common in boys
aspergers disorder PPD
same impairment of social interactions restricted interests or behaviors, no language or cognitive disorders, more often in boys than girls
encopresis
pooping in bed
enuresis
bed wetting
ADHD
characterized by inattention, over activity, and impulsiveness
common however more common in boys, accounts for more mental health referrals than any other single disorder
distinguishing ADHD from ______ is important butu difficult
bipolar disorder
onset of ADHD
preschool, fussy, temperamental poor sleeping patterns, dart back and forth and cannot tolerate sedentary things such as stories.
starts school symptoms and significantly interfere with performance and behavior
70% of those diagnosed can continue to have problems into adulthood
70-75% of adults with ADHD have other psychiatric diagnoses
(OCD, risky behaviors, depression)
etiology of ADHD
unknown, difference in brain imaging and genetic link
risk factors for ADHD
Hx. male relatives with ADHD, Alchoholism, male relatives antisocial personalities, female relatives with somatization disorder, lower socioeconomic status, males, family discord, low birth weight and various kinds of brain insult
treatment of ADHD
no one found effective, different approaches, chronic issue
psychopharm- Ritalin and adderall (have some bad adverse effects)
assessment of a child with ADHD
inattention, cannot concentrate on anything, cannot get organized, can not follow 3 step commands
interventions for child with ADHD
ensuring safety improving role performance simplify instruction promote a structured daily routine providing client, family education, and support
intellectual disability defined as
below average intellectual functioning IQ less than 70 and limitations in adaptive functioning
causes of intellectual disability
tay-sachs disease, fragile X syndrome, trisomy 21, maternal alcohol intake, (FAS), fetal malnutrition, hypoxia, infections, trauma, lead poisoning, deprivation of nurturing or stimulation
physical features of FAS
flat mid-face, failure to thrive, wide set face, PKU is off, if corrected early enough the child wont have as many severe issues
dissociative disorders
subconscious defense mechanisms that help protect a person from recognizing some horrific or traumatic event by allowing the mind to forget or remove self from painful situation/memory
disruption integrated functions of consciousness, memory, identity or environmental perception
dissociative disorders are seen in
patients with PTSD
Dissociative amnesia
Dissociative amnesia occurs when a person blocks out certain information, usually associated with a stressful or traumatic event, leaving him or her unable to remember important personal information, caused by extremely traumatic events
dissociative identity disorder
A disorder characterized by the presence of two or more distinct personality states.
depersonalization disorder
perception of self is skewed in order to protect emotional well being
derealization disorder
reoccuring experience with the unreality of surroundings, however reality remains intact, “dream like sense”
somatic symptom disorder
transfer of mental experience into symptoms, illness characterized by presence of physical symptoms with out organic cause
conversion disorder
conversion reaction- unexplained sudden sensory or motor deficits caused by extreme stress. paralysis or blindness for example
pain disorder
pain unrelieved by analgesics affected by psychological factors in terms of onset, severity, exacerbation and maintenance
hypochondriasis
fear that one will develop a serious disease
difference between somatic disorders and malingering disorders
somatic disorders are not fabricated
in malingering and factitious disorders people will,
willfully control their symptoms
people with malingering disorder is
motivated by something they need, external incentives, (ex. get out of work) and they can stop the symptoms as soon as they wanted
factitious disorder
imposed onself- person intentionally produces or feigns physical harm ex munchausen’s syndrome
munchausens syndrome
hurting yourself for attention
munchausens syndrome by proxy
hurting your child or family member for attention
interalization
keep stress, anxiety and frustration with in and express through physical somatization of symptoms
primary gains of somatization disorders
direct relief of being sick provides relief of anxiety conflict or distress
secondary gains of somatization disorders
internal or personal benefits received from others because one is sick, such as attention from family and comfort measures. Person “needs to be sick” to have emotional needs met
