PsychoSocial Emergencies Flashcards
What is Anxiety?
- “faceless fear”
- Patient responds with difficulty to stressors that otherwise would not become problems for the average individual.
What are the 3 major sources of Anxiety?
- Biological (food, shelter, clothing)
- Psychological (low self esteem, death of a loved one, abandonment)
- Sociological (lack of a sense of belonging)
What are some manifestations of an Acute Anxiety Attack?
- Hyperactive
- restless hand movements
- Tremors
- Dyspnea
- Dry mouth
- Chest pain
- Dysphagia
- Palpitations
- Hyperventilation
- Tachycardia
- Increased urination
- Feeling of “impending doom”
- Diaphoresis
- Choking sensation
- Sweaty palms
- Attempt to escape environment.
What are some differential diagnosis that you need to rule out before diagnosing a patient with having an Acute Anxiety Attack?
- alcohol/substance abuse
- Hyperventilation syndrome
- cerebral carcinoma
- schizophrenia
- Angina
- Hypoglycemia
- Neuropathies
- Tachydysrhythmias
- CHF/Pulmonary edema
- Pneumonia
- Toxicities
- Depression/Suicidal ideation
- Mitral valve prolapse
- Pneumothorax
- Withdrawals
- Thyroid disturbances
- Acute myocardial infarction
- Pulmonary embolus
- Costochondritis
What is a Grief/Bereavement/Situational Crisis?
- response to significant loss which does not have to be a death.
-process of mourning influenced by many factors.
What are some manifestations of a Grief/Bereavement/Situational Crisis?
- Labile
- Decreased speech
- Inability to concentrate
- Differing emotions
- Focus on “lost object”
- Helplessness
- Normal vital signs
- Sleep disturbances
- Change in weight/ appetite.
What are the 5 stages of grief?
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance
What are the etiologies of Depression?
- changes in receptor/ neurotransmitters
- Biological/ Physiologic/ Genetic psychosocial factors
- Medications
- Familial
What are the primary manifestations of Depression?
Primary
- persistent sadness
- no pleasure from usual activities
What are the secondary manifestations of Depression?
- Helplessness
- feelings of guilt
- fatigue
- inability to concentrate
- restlessness
- somatic complaints
- worthlessness
- Pessimism
- decreased energy
- inability to make decisions
- weight changes
- decreased libido
- loneliness
- crying
- decreased memory
- irritability
- sleep disturbances
- pacing
What are 3 special patient populations with regard to Depression?
- Children
- Adolescents
- Seniors
What are some manifestations that may occur in children with Depression?
- Hyperactivity
- Enuresis
- Regressive behavior
What are some manifestations that may occur in adolescents with Depression?
- Delinquency
- Traumatic injuries
- Sexual promiscuity
- Acting out behavior
- Alcohol/drug use
What are some manifestations that may occur in seniors with Depression?
- Memory loss
- Saying “I don’t know” a lot.
Before diagnosing with Depression, you need to rule out these other physical etiologies:
- Chronic fatigue
- Electrolyte disturbances
- Hypothermia
- Liver failure
- Medication side effects/ abuse/ Overdose
- Endocrine disorders
- Renal failure
- Vitamin deficiency
- Withdrawal syndrome
What are some risk factors for Suicide?
- Gender
- Age
- Foreign born
- Homosexuality
- Religion
- Marital status
- Season
- Day of the week
What are some manifestations of Suicide?
- Suicide attempts
- Hopelessness
- Indifference
- G-I complaints
- Fatigue
- Agitated/ irritable
- Worthlessness
- Helplessness
- Insomnia
- Restlessness
- Decrease in physical activity
What are some Psychoses?
- Schizophrenia
- Paranoia
- Hypomania/Manic psychosis
- Bi-polar Affective Disorder
When is Schizophrenia usually diagnosed?
Under the age of 45.
What are some manifestations of Schizophrenia?
- Delusional
- Hallucinations (usually auditory)
- Disordered thought with a clear sensorium.
- Behavior (range from combative to catatonic)
- Bizarre Gesturing
- False interpretations of normal perceptions
- Speech patterns
- Affect
- Social Withdrawal
What should you DO with Schizophrenics?
- Use simple concrete sentences.
- Be confident
- Avoid figures of speech.
- Always have an escape.
- Give anti-psychotics
- Do not agree with reality disturbances.
- Avoid arguing
- Patient should be in gown.
What are some side effects of Anti-psychotics?
- fever
- tachycardia
- heat stroke
- Tardive Dyskinesia
- Tremors
- Muscle rigidity
What is important to note about a Paranoid patient?
They can be very dangerous.
What should you DO with a paranoid patient?
- avoid threats
- provide limits
- simple, concrete expressions
- be in control
- use slow movements
- speak in a low tone
- Do not assume a “power” position.
- Allow verbalization
- Notify authorities of threats.
What are some manifestations of Bi-Polar Affective Disorder?
- Elation
- Sexual acting out.
- Overdone make up
- Demanding
- Rapid speech
- Decreased sleep
- Grandiose Ideas
- Focus on sexual content
- Loud clothing
- Irritable
- Increased motor activity
- Increased Mental excitement.
