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FNP boards > Psychosocial disorders > Flashcards

Psychosocial disorders Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

How soon after the patient’s last drink will alcohol withdrawal symptoms present?

A

12 hours after last drink (peak symptoms seen at 24 to 48 hours)

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2
Q

What are the three stages of alcohol withdrawal?

A

Stage 1 (mild) - symptoms develop 8-12 hours after last drink

  • Anxiety, nervousness, depression, fatigue, N/V, abdominal pain, irritability, jumpiness, shakiness, mood swings, nightmares

Stage 2 (moderate) - symptoms develop after 24 hours

  • HTN, hyperthermia, rapid and/or irregular heartbeat, elevated RR, sweating, mental confusion, heightened mood disturbance

Stage 3 (severe) - aka delirium tremens

  • Autonomic hyperactivity (agitation, hallucinations, disorientation), seizures
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3
Q

Alcohol withdrawal pharmacotherapy

A
  • Benzodiazepines
    • Chlordiazepoxide (Librium), diazepam (valium) for adequate hepatic function
    • Lorazepam for patients with hepatic dysfunction
  • Adjunct with anticonvulsants to prevent cravings
    • Carbamazepine, oxcarbazepine, divalproex
  • OR neuroleptic agents to reduce severity of withdrawal symptoms and agitation
  • Phenothiazine, haloperidol
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4
Q

Alcohol withdrawal treatment and management

A

Correct alcohol induced nutritional deficiencies

  • Vitamin B supplementation
  • Vitamin C
  • Folic acid
  • Magnesium

Adequate fluid intake, psychosocial support and counseling

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5
Q

Medications that can be prescribed to treat anxiety (as adjunctive therapy in depression with anxiety)

A
  • Buspirone
  • Lorazepam
  • Oxazepam
  • Alprazolam
  • Clonazepam
  • Diazepam
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6
Q

Benzodiazepine withdrawal symptoms

A

Seen within hours or days of cessation

  • Tachycardia, sweating, tremors, insomnia, N/V, transient hallucinations or illusions, psychomotor agitation, anxiety, grand mal seizures
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7
Q

Benzodiazepine treatment and management

A
  • Gradually reduce dose by 25% a week
  • CBT
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8
Q

Clinical presentation of opioid intoxication

A
  • Constricted pupils
  • Respiratory depression
  • Extreme drowsiness
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9
Q

Opioid withdrawal symptoms

A
  • HTN
  • Tachycardia
  • Diarrhea, nausea
  • Temperature dysregulation
  • Fever
  • Papillary dilation
  • Restlessness
  • Myalgia
  • Lacrimation
  • Rhinorrhea
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10
Q

Opioid use disorder treatment and management

A
  • Long term rehab
  • Methadone
    • Alternative: buprenorphine with naloxone (suboxone)
      • Lower abuse potential, less withdrawal discomfort, greater safety against overdose
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11
Q

Stimulant (cocaine, amphetamine, meth, MDMA) clinical presentation

A
  • Enlarged pupils
  • Increased body temp
  • Increased HR and BP
  • Headache
  • Abdominal pain and nausea
  • Increased energy and alertness
  • Insomnia
  • Restlessness
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12
Q

What are the three stages of eating disorder recovery?

A
  • Physical recovery
  • Behavioral recovery
  • Psychological recovery
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13
Q

What reported symptom strongly suggests a patient is suffering from anorexia?

A

Amenorrhea - for 3+ cycles when not using contraception

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14
Q

C GASP DIE mnemonic to describe depression symptoms

A
  • Concentration difficulties or indecisiveness
  • Guilt or feeling worthless
  • Appetite abnormality or weight change
  • Sleep disturbance
  • Psychomotor retardation or agitation
  • Death or suicide (thoughts or acts of)
  • Interest (diminished)
  • Energy (loss)
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15
Q

WATCHERS mnemonic to identify symptoms of GAD

  • At least three of the following occurring on most days for 6+ months
A
  • Worry
  • Anxiety (“on edge”)
  • Tension (in muscles)
  • Concentration (difficulty)
  • Hyperarousal
  • Energy (loss)
  • Restlessness
  • Sleep disturbance
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16
Q

Bipolar I vs bipolar II

A

Bipolar I → cycles of elevated or irritated mood lasting >1 week (depression and mania)

Bipolar II → depression with episodes of mania lasting <4 days with little social incapacitation

  • Hypomania - can be productive
17
Q

DIG FAST mnemonic for bipolar disorder

  • Symptoms present for at least 1 week, or less if hospitalized
A
  • Distract-ability
  • Irresponsibility
  • Grandiosity
  • Flight of idea
  • Activity increased
  • Sleep (decreased)
  • Talkativeness
18
Q

TCA adverse effects

A

Anticholinergic activity

  • Blurred vision
  • Dry mouth
  • Memory loss
  • Sweating
  • Anxiety
  • Postural hypotension
  • Dizziness
  • Tachycardia
19
Q

SSRI and SNRI adverse effects (general)

A
  • Nausea
  • Dry mouth
  • Dizziness
  • Excessive sweating
  • Sexual dysfunction
    • Can switch to bupropion (wellbutrin), venlafaxine, duloxetine
20
Q

True/false: In early SSRI/SNRI therapy, patients often complain of drug-related AEs (headache, nausea, diarrhea)

A

True - typically resolves within 2-6 weeks of medication use

21
Q

Recommended length of pharmacological intervention in depression

A

Acute + continuation phase

  • In acute phase, 4-8 weeks of treatment needed before concluding that patient is partially responsive or unresponsive
  • Patient’s successfully treated during acute phase should continue same course of treatment for 4-9 months
    • Minimum of 6 months or minimum of 9 months total treatment
22
Q

Pharmacologic treatment options for bipolar disease

A

Severe mania → lithium, valproic acid, carbamazepine, second generation antipsychotic (risperidone)

Bipolar depression → olanzepine-fluoxetine, lamotrigine

Closely monitored for first 6 weeks with dose adjustments made based on serum concentrations

23
Q

Initial treatment of choice for panic disorder

A

SSRIs

  • Paroxetine (paxil) first choice since less energizing
24
Q

Pharmacological treatment of PTSDq

A
  • SSRI/SNRI
  • Beta blockers or alpha adrenergic agonist (clonidine) for hyperarousal
  • Nighttime dose of prazosin (minipress) to decrease nightmares and sleep disturbance

FNP boards (20 decks)

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