Spring Final 2014.. Flashcards
Agnosia
loss of sensory ability to recognize objects.
EX: can’t identify common objects, or does not recognize family.
Aphasia
loss of language ability. First the correct word, then a few words, finally mute.
Apraxia:
Loss of purposeful movement. Example: non ambulatory or can’t dress self.
Auditory hallucinations
hearing voices more common in psychotic depression or schizophrenia.
Confabulation
making up stories for periods not remembered, in order to maintain self-esteem. Not the same as lying. If lyon, they are aware they are making up the answer, confabulation is an unconscious attempt to maintain self-esteem
Flight of ideas
A nearly continuous flow of accelerated speech with abrupt changes from topic to topic that are usually based on understandable associations, distracting stimuli, or plays on words. When severe, speech may be disorganized and incoherent.
Hyper vigilance:
clients are extraordinarily alert and their eyes constantly scan the room; they may have difficulty falling asleep.
Illusions
errors in perception of sensory stimuli: misinterpretation of real objects in the enviornment.
Example: IV tubing is a snake climbing a pole.
Illusions can be explained or clarified to an individual, hallucinations cannot!
Labile
abnormal sudden rapid shifts in affect.
Perceptual disturbances
false process of information about one’s internal and external environment.
Perseveration
repetition of phrases or behavior. Eventually seen/intensified with stress.
Pseudodementia
a disorder that mimics dementia (drug toxicity, depression, infection, nutritional deficiencies, and metabolic disorders). Always provide a thorough assessment that is comprehensive.
Sundown syndrome
Symptoms and problem behaviors become more pronounced in evening, may occur in both delirium and dementia
Tactile hallucinations
Example: feels bugs crawling on them.
Visual hallucinations
More common in delirium-Example: seeing spiders drawing on the walls.
Labile
abnormal sudden rapid shifts in affect.
Perceptual disturbances
false process of information about one’s internal and external environment.
Perseveration
repetition of phrases or behavior. Eventually seen/intensified with stress.
Pseudodementia
a disorder that mimics dementia (drug toxicity, depression, infection, nutritional deficiencies, and metabolic disorders). Always provide a thorough assessment that is comprehensive.
Sundown syndrome
Symptoms and problem behaviors become more pronounced in evening, may occur in both delirium and dementia
Tactile hallucinations
Example: feels bugs crawling on them.
Seclusion
only seclusion if door is shut! one-on-one observation at all times offer food and water must have an order Priority nursing care: prevent injury to self and others.
MSA
mental status assessment
AMA
Against Medical Advice
Clients voluntarily admitted to a mental health institute can leave AMA.
Be aware of insurance regulations
Always double check the chart if someone wishes to leave AMA, their situation could have changed.
Slander
spoken defamation of character
DSM Axis I
Clinical disorders, treat with medications
Battery
placing your hands on someone
DSM Axis III
Medical conditions, treat physical first! (Asthma, CHF)
DSM Axis VI
Behavioral and Environmental Issues. (4 families living together in one household)
Emergency admission
when a client is being admitted on an emergency basis and meets certain criteria.
Directly admitting harm to others, or spoke a specific threat! A specific plan and someone who believes them. It take 3 people to initiate an emergency admission. Physician, law enforcement officer, and psychologist/psychiatrist.
AMA
Against Medical Advice
Clients voluntarily admitted to a mental health institute can leave AMA.
Be aware of insurance regulations
Always double check the chart if someone wishes to leave AMA, their situation could have changed.
Informed consent
only person performing procedure can get! Nurses witness signature.
DSM Axis II
Personality disorder and MR (treat symptoms of behavior)
DSM Axis III
Medical conditions, treat physical first! (Asthma, CHF)
DSM Axis VI
Behavioral and Environmental Issues. (4 families living together in one household)
Higher needs
lower needs come first! physical comes first! (Higher to Lower)
- Self-transcendent needs
- Self-actualization needs
- Esteem Needs
- Love and Belonging Needs
- Safety Needs
- Physiological Needs
Repression
Unconsciously keeping unacceptable feelings out of awareness.
Ex: a man who has a fear of the dentist drill, continuously “forgets” his dental appointments
Sublimation
Dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expressions.
Ex: a person who has feelings of anger and hostility towards his work supervisor, sublimates those feelings by working out vigorously at the gym during his lunch period
Displacement
(kick the dog syndrome) Discharging of pent-up feelings on persons less dangerous than those who initially aroused the emotions.
Ex: A student who has received a low grade on a term paper blows up at his girlfriend.
Projection
Attributing one’s own unacceptable feelings and thoughts to others.
Ex: A man who is quite critical of others thinks that people are joining about his appearance
Compensation
Ex: A short man becomes assertively verbal and excels in business.
Reaction Formation
Unacceptable feelings disguised by regression of the real feelings and by reinforcement of the opposite feeling
Ex: a woman who dislikes her mother-in-law is always nice to her.
Denial
Blocking out painful or anxiety inducing events or feelings
Ex: a boss tells and employee he may have to fire him. On the way home the employee shops for a new car.
Conversion
Ex: a student is unable to take the final examination because of a headache.
Undoing
Performing an act to make up for prior behavior.
Ex: an adolescent completes his chores without being prompted after having an argument with his parents.
Rationalization
Falsification of experiences through the construction of logical or socially approved explanations of behavior.
Ex: A man cheats on his income tax return and tells himself it’s all right because everyone does it.
Identification
Unconscious assumption of similarity between oneself and another.
Ex: after hospitalization for minor surgery a girl decides to be a nurse
Suppression
Consciously keeping unacceptable feelings and thoughts out of awareness.
Ex: a student taking an examination is upset about an argument with her boyfriend but puts it out of her mind so she can finish the test.
Intellectualization
separating an emotion from an idea or thought because the emotional reaction is too painful to be acknowledged
Ex: a man learns from his Dr. that he has cancer. He studies the physiology and treatment of cancer without experiencing andy emotion.
Altruism
Dealing with anxiety by reaching out to others
Ex: a nurse who lost a family member in a fire is a volunteer firefighter.
Rules for effective nurse-client relationships
*Ask What. This will give you assessment findings
*Do not ask why. you will not get the assessment data, it is better to know what happened than why it happened.
*Open ended questions are always best, especially with anxiety or panic clients
*Do Not State “I understand how you are feeling” you will cause the client to be angry
*Do not overcompensate
Do not tell a client not to worry or that they will get through, this gives them false hopes.
Depression
4th leading cause of disability.
Anhedonia (loss of pleasure) “gold standard”
Assess for suicide tendencies, risk of self harm, loss: significant factor, nutrition.
*Therapy, Meds, Reorientation, Socialization
MDD
Major Depressive Disorder.
6 months or longer with sustained loss of function.
Learned helplessness: they don’t try, they have talked themselves out of it.
Assess for suicide risk.
physical changes such as (poor posture, appearing older than stated age, flat affect, lack of eye contact, poor grooming/hygiene, slowed thought process, dwelling on perceived failures, poor judgment decision.
Cultural: higher rates seen in whites, african americans, latinos, and asians.
* Medication: SSRI (start low, go slow) drowsiness, sleep disturbances, sexual dysfunction, serotonin syndrome.
ECT: consent is needed, NPO, client may be confused afterwards.
Bipolar
*Bipolar stage 1: one episode of mania altering with major depression, can be psychotic.
*Bipolar stage 2: hypomania w/ major depression, no psychosis,
high suicide risk!!
*Rapid cycling bipolar: 4 or more episodes in a year. substance abuse is common.
more prevalent in upper socioeconomic classes.
Assess:
Euphoric, quick to anger, irritable, energy level boundless, no boundaries, may give away money or possessions, promiscuous.
Cannot learn in manic phase, no teaching.
Risk for injury is the highest priority.
Lithium first choice of treatment
