quiz 1 Flashcards
what are the levels of maslow hierarchy?
1, physiological needs, safety and security, love nd belonging, self esteem from others, self actualization (feeling of self fulfillment)
definition of mental illness from sociocultural
maladaptive responses to stressors from internal or external environment, evidenced by thoughts
- comes with incomprehensibility and cultural relativity
what happens to body during fight or flight?
alarm reaction stage: its initiated
stage of resistance: physiological responses occur
stage of exhaustion: prolonged exposer
Immediate response of fight or flight entails?
-adrenal medullas releases nore/epinephrine
-pupils dilate, cardiac increases, GI slows down
Sustained response entails?
-water retention occurs because of glucocorticoids and mineralcorticoids causing glujconeogeneis and from vasopressin
-Growth hormones causes increased glucose nd freefatty acids
-thyroid increases metabolic rate
what are the two psychological responses to stress?
anxiety and grief
what are the levels of anxiety and what do they consist of?
-mild: day to day, sharpens senses, increases motivation and heightened awareness of environment. ex; crying, cursing, eating ,fidgeting
-mild to moderate:increased muscular tension and restlessness perceptual field diminishes
-moderate: unresolved for an extended period.
-severe: headaches, insomnia, confusion, dread , horror, neurosis (psychiatric disturbance seen through use of defense mechanism)
-panic: loss of reality, delusions/hallucinatiosns , communication is ineffective; experience psychosis
people with psychosis experience?
-minimal distress, unaware behaviors are maladaptive, unaware of psychological problems (anosognoia)
who experiences psychosis?
people with schizophrenia
what is the diencephalon consisted of?
thalamus, hypothalamus
what is the mesencephalon
pons, medulla, cerebellum
what are the inhibitory NT?
GABA, serotonin?
which NT’s are monoamines?
norepinephrine, dopamine, serotonin, histamine
which nt’s are amino acids?
GABA, glucose and glutamate
Dopamine
-excitatory; responsible for emotional resp, cognition, release of prolactin
-affected by stress
-decreased: depression
-increased: schizophrenia, mania
Serotonin
-inhibitory, emotional regulations, sexual behavior SLEEP pain
-decreased: depression, anxiety
-increased: anxiety states
Norepinephrine
- excitatory; learning, mood, memory, cardiovascular
-decreased: depression, memory loss, social withdrawal
-increased mania, anxiety, schizophrenia
Histamine
-from hypothalamus;regulates GABA, glutamate, and serotonin
-as well as gastric secretions,
-decreased: depression
-increased: sleep disorders, alzheimers, psychosis
what do antihistamine meds do?
they block histamine which will result in sedation adn weight gain
GABA
-inhibitory; promotes neuronal development, improves sleeplessness, minimizes depression
-decreased: huntingotns, anxiety, schizophrenia,epiliepsy
Glutamate
excitatory; interacts with dopamine, to regulate motor, affective, cognitive
-increased : psychosis
-decreased: schizophreniaA
acetylcholine
inhibitory &excitatory, regulate sleep wake cycle
-low levels: alzheimers
High levels of prolactin are associated with?
depression, low libido, anxiety and schizophrenia
T or F
GH will inhibit immune functioning while testorone will enhance it
False; its the other way around; GH will enchance
Utilitarianism vs kantianism
-actions are right to the degree where they promote happiness and wrong if the reverse happiness
-kantianism: the motivation of an action depends if its right or wrong
what is needed in building a therapeutic relationship?
-rapport, trust, genuineness, empathy, respect
what are the phases of therapeutic nursing?
-preinteraction: obtaining available information form report, examine ones owns feeling
-orientation: creating comfortable environment,setting goals, develop plan
-working phase
-termination phase
transference vs counterference
-patient acts out feeling on nurse about someone else
-nurse acts out feeling on the patient
What meds are used to treat anxiety?
benzos, buspirone
Benzos
-used to treat anxiety
-examples lprzolam, chlordiazepoxide, diazepam,lorazepam
-ADVERSE EFFECTS: cns depression, impired memeory, sedation,
-antidote flumazenil
-should not stop abruptly
what is paradoxical response?
side effects are the opposite of intended
buspirone
-treat anxiety; partial serotonin receptor agonist , doesnt affect GABA receptors
What meds are antidepressant?
-MAOIs,TCA’s,SSRI’s,SNRI’s
MAOIs
-inhibits monoamine oxidase which increases serotonin/ dopamine function
-phenelzine
-adverse effects: weight gain, daytime sedation
-refrain from eating tyrosine
TCAs
-affect reuptake of serotonin and norepinephrine
-amitriplyin
-causes anticholinergic side effects; dry mouth, constipation, blurry vision, ortho hypotension
-will take 2-4 weeks
SSRI
-inhibits serotonin inhibition
-fluoxetine
-nausea, agitation, sexual dysfunction
-4-6 weeks
SNRI
-blocks reuptake serotonin and norepinephrine
-venlafaxine
-appetite suppression
what are antipsychotics?
first generation; conventional/typical
second generation; unconventional/atypical
First gen
-dopamine antagonists
-haloperidol, loxapire, chlorapromazire
-treat severe schizophrenia
second gen
-block dopamine receptors and inhibit reuptake of serotonin
-aripiprazole, cariprazine
-high sugar/bp/cholesterol
What are common side effects of antipsychotics?
-anticholinergic symptoms
-should increase fiber and fluid, and suck on hard candies
-wear shades, can increase breast size and decrease libido
Mood stabilizers
examples are lithium, anticonvulsants (carbamazepine, valproic acid)
lithium
-controversal; regulates reuptake of monoamine NT
-can’t prevent relapse into manic spades
-range 0.6-1.4
check liver, blood work, kidney
-side effects: diarrhea, nausea, increase thirst, fine hand tremors
-consume water
what is the kindling process?
seizure activity increases
sedative hyponitcs
-used to treat sleep wake insomnia
-benzos, non benzos hypnotics (zolpidem), melatonic receptor agnostics, ramelon (melatonin agnostics)
-side effects: headache fatigue, dizziness, nausea, amnesia
-AVOID OTHER CNS DEPRESSANTS
Stimulants
-used to treat ADHD, narcolepsy
-methylphenidate, amphetamine, dextroamphetamine
-cuases presynaptic neuron to release serotonin, dop and more
-side effects: nausea, dry mouth, heart palpitations, decreased appetite, growth suppression
-can be enteric coated
what remedies are used to treat mental illness?
-st johns wort, ginseng, chamomile, echinacea
what with st john wort cause serotonin syndrome?
fluoxetine
serotonin syndrome
-influx of serotonin
-can be caused by overdose, multiple antidepressants, or mixing with pain meds
-symptoms: dilated pupils, high bp, muscle rigidity, sweating
-treatment: sedation w/benzo, serotonin antagonist
Activation syndrome
-happens when you take antidepressants
-irritability , anxiety, aggressive, suicide
Antidepressant discontinuation synd
-difficulty sleeping, anxiety, depression, flu like symptoms, ELECTRIC SHOCK SENSAITON IN HAND
what can happen if you stop MAOIs?
can cause psychosis
lithium toxicity? early vs advanced vs severe
early
-more than 1.5
-causes: dehydration, loop diuretics
-symptoms: poor coordination, confusion, coarse tremors, vomiting
advanced
-2.0-2.5
-seizures,stupor, diluted urine, blurred vision, tinnitus, jerking motor movements
severe
-more than 2.5, comatose
What can with the antipsychotic med, clozapine?
Agranulocytosis
-contact if less than 3500
-flu like symptoms, sore throat , fatigue, fever, muscle aches
Neuroleptic malignant syndrome
-muscle rigidity, hyperthermia, elevated creatine kinase
- initial exposure or discontinuation of antipsychotic , HALOPERIDOL
-monitor fluid, cooling measures, cardiac monitoring
extrapyrimdal symp
-effects of blocking dopamine; FGAs
-acute dystonia: muscle rigidity in eye
-akathisia:severe restlessness, suicide
-pseudoparkinsonism: shuffling gait, drooling , tremors, pill rolling
-tardive dyskinesia: PERMANENT involuntary movements of face, neck, tongue, upper/lower extremities
what is increased when someone is experiencing alcohol withdrawal?
increased glutamate
