T2 - Blueprint 2 (Josh) Flashcards
What are indications for ECT?
Major Depression
Mania
Schizo
ECT therapy is most commonly prescribed for:
a) BPD (manic)
b) Paranoid schizo
c) Major Depression
d) OCD
c) Major Depression
Place client on – – post ECT to facilitate — and prevent —-
left-side
drainage
aspiration
CV effects of Cannabis:
- Tachycardia
- Orthostatic hypotension
The client is NPO — before ECT.
6-8 hrs
Meds to treat BPD:
- Lithium
- Valproic Acid
— is second to ETOH in in use in USA.
Cannabis
EPS s/e of Antipsychotics:
Involuntary muscular movements (spasms) of face, arms, legs, and neck
Dystonia
Four Major Dimensions that support a life in recovery.
- Health
- Home
- Purpose
- Community
What is a common reaction to ECT?
short-term memory loss / confusion
ECT can be used to treat…
- depression
- mania
- schizo
- neurosis and OCD
What is the desired outcome of crisis therapy?
resolution of immediate crisis and restore client to pre-crisis level of functioning
More harmful for pregnant mothers, ECT or Meds?
Meds are MORE harmful
Therapeutic range of Valproic Acid?
50-150 mcg/mL
20 minutes before ECT therapy, what is administered?
Atropine Sulfate
- to decrease secretions and counteract vagal stimulation
Pupils — with opioids.
consrict
— is a non-invasive therapy that uses a magnetic pulsation to stimulate specific areas of the brain
TMS (Transcranial Magnetic Stimulation)
Resp. effects of Cannabis:
decrease lung performance due to large amount of tar (more than cigs)
What to do before ECT?
- decrease/discontinue meds that lower seizure threshold for several days
- discontinue MAIO and Lithium for 2 weeks
Medications for Alcohol Abuse:
- Disulfrium (abstienence)
- Benzos
- Thiamine (to manage withdrawal)
— is the restoration to a former and/or better state or condition.
Recovery
Therapeutic range of Lithium?
0.6-1.2
— is a therapeutic process of assessing unconscious thoughts and feelings, and resolving conflict by talking to a psychoanalyst.
Psychoanalysis
Avoid foods w/ — when taking MAOI.
Thiamine
- aged cheese
- cream
- coffee,
- chocolate
- cured meats
- bananas
- raisins
- red wines
- beer
- yeast
Suicidal ideation is a s/e of which class of antidepressants?
SSRI
- fluoxetine
- sertraline
- paroxetine
- escitalopram oxalate
Behavioral theory is based upon what concept?
that behavior is learned and has consequences
abnormal behavior results from an attempt to avoid painful feelings
Symptoms of NMS:
- hyperpyrexia (high fever),
- sweating,
- unstable blood pressure (normally elevated)
- tachycardia,
- incontinence
- stupor
- severe muscular rigidity
- autonomic dysfunction.
Which of the following best describes the avg # of ECT treatments given and timing of administration?
a) 1 treatment per mth for 6 mths
b) 1 treatment every other day for total of 6-12 treatments
c) 1 treatment 3x’s per week for total of 20-30 treatments
d) 1 treatment q day for a total of 1-15 treatments
b) 1 treatment every other day for total of 6-12 treatments
EPS s/e of Antipsychotics:
Rigidity, masklike faces, stooped posture, drooling, shuffling gait, “pill-rolling”, tremor
Parkinsonism
EPS s/e of Antipsychotics:
Facial: protruding tongue, smacking, licking, spastic facial distortion, smacking movements
Limbs: choreic, athetoid
Trunk: pelvic thrusts, neck & shoulder movements
Tardive Dyskinesia
- irreversable!!
- withdraw drug at first sign
Anti-cholinergic s/e with which drugs?
SSRI
ECT is used primarily to treat —
major depression
— occurs most frequently in women; symptoms may occur 50 to 60 days following initiation of therapy
Akathasia
— is the induction of a grand mal (generalized) seizure into the brain.
Electroconvulsive Therapy (ECT)
What is the purpose of ECT?
cause a Grand Mal seizure that lasts 25-60 secs
What is given before ECT?
- Muscle Relaxer
- Atropine Sulfate
Is ECT a cure or a treatment?
treatment only, not a cure
Adverse effects of VNS?
- Voice changes
- Dysphagia
- Neck Pain
Can ECT treat substance abuse?
No
What is administerd during Dystonia / Oculogyric Crisis?
IV benztropine mesylate
Do not alter — when taking Lithium?
sodium/fluid intake
EPS s/e of Antipsychotics:
Uncontrolled rolling back of the eyes
Oculogyric Crisis
Chronic — use results in obstructive airway disorders.
cannabis
Most common s/e of ECT is —
temporary memory loss
confusion
How long should the seizure induced by ECT last?
15-25 secs
May occur as part of Dystonia and is to be treated as an emergency.
Oculogyric Crisis
EPS s/e of Antipsychotics:
Motor inner driven restlessness
Akathasia
Opioid withdrawal symptoms:
- dysphoric mood
- n/v
- muscle aches
- piloerection
- sweating
- diarrhea
- fever
- insomnia
The priority nursing intervention before starting ECT is to:
a) Take vitals and record
b) Have client void
c) Administer succinylcholine
d) Ensure that the consent form has been signed
d) Ensure that the consent form has been signed
Barbiturates are in which class of drugs?
Sedative, Hypnotic and Anxiolytic Drugs
Atropine sulfate is administered to a client receiving ECT for what purpose?
a) alleviate anxiety
b) decrease secretions
c) relax muscles
d) as a short-acting anesthetic
b) decrease secretions
Meds to treat depressoin:
- SSRI
- Tricyclic
- MAOI
- Welbutrin
Barbiturates end in —
-barbital
What is the only absolute contraindication for ECT?
ICP (Intracranial Pressure)
- b/c ECT is associated w/ a physiological rise in CSF
Meds to treat Anxiety?
- Antihistamines (hydroxyzine)
- Benzos
- Buspirone
Robert and Otten’s Seven Stage Crisis Intervention Model:
Stage 1: Psychosocial Assessment
Stage 2: Establish Rapport
Stage 3: Identify Crisis Precipitants
Stage 4: Handle Emotions
Stage 5: Explore Alternatives
Stage 6: Action Plan
Stage 7: Follow-up
— is a life-threatening, neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs.
Neuroleptic malignant syndrome
Why is a blood pressure cuff inflated over a lower limb in ECT?
to ensure that the seizure activity can be observed in this one limb that is unaffected by the muscle relaxant
What is VNS?
Vagus Nerve Stimulation
- provides electrical stimulation through the vagus nerve through a device that is implanted under the client’s chest
Physiological symptoms of cannabis use may include:
- tremors
- muscle rigidity
- conjuctival redness
Which involves more verbal therapist-to-client interaction:
a) Psychoanalysis
b) Psychotherapy
b) Psychotherapy
— occurs most often in men and in people younger than 25.
Dystonia
— enhances sexual experience.
Cannabis
How long is the electrical shock w/ ECT?
0.2-0.8 secs
What is WRAP?
Wellness Recovery Action Plan
- a self-designed prevention and wellness process that anyone can use to get well, stay well and make their life the way they want it to be
