T3 - Blueprint 2 (Josh) Flashcards
What are some reasons an older person may not report pain?
Fearing the meaning of pain, diagnosis, or treatment.
They may think pain is normal
Also, different cultures present pain differently
Worden’s Four Tasks of Grieving:
Task 1: Accepting reality of loss
Task 2: Using coping mechanisms to experience the emotional pain of the loss
Task 3: Changing the environment to accomodate the absence of the deceased
Task 4: Finding a meaningful connection w/ the lost entity while learning to live again
Which street drug used in Date Rape is called ‘black hole’ ‘kit kat’ and ‘special K’?
Ketamine
Somatic symptoms of — are common in elderly and mimic the signs of NCD.
depression (pseudodementia)
In what way can Life Review actually produce a negative response in Elderly Client?
if after reviewing they believe they have nothing of note accomplished in their life
What is difference b/t Reminiscence and Life Review?
Life Review is more directed or guided and constructs their story in an autobiographical way
What are the phases of Rape-Trauma Syndrome?
Acute Phase (2 weeks)
Long-Term Reorganization
What are the five categories of the Personality Theory of Aging?
Mature Men
Rocking Chair
Armored Men
Angry Men
Self-Haters
Which Aging Personality is strongly independent and presents a strong silent front and rely on activity to express their continuing independence?
Armored Men
Maladaptive Responses to Grief
Delayed (Inhibited) Grief
Distorted (Exaggerated) Grief
Chronic (Prolonged) Grief
Type of Loss:
loss that is not obvious to others
no one else can see/understand the loss
Perceived Loss
Type of Grief:
uncomplicated
usually goes through stages of grief and is accepting by 6 months
Normal Grief
Which drugs are used to sedate victims of Date Rape?
Gamma-hydroxybutyrate (GHB)
Flunitrazepam
Ketamine
Empathy or Sympathy w/ Borderline PD?
Empathy
- encourage client to solve own problems
Type of Grief:
diffucult progression through the expected changes of the grieving process
work of grief is pronlonged
Dysfunctional Grief
— is a complex, eclectic treatment that combines cognitive, behavioral, and interpersonal therapies with Eastern mindfulness practices.
Dialectical Behavior Therapy
15% of all suicides are committed by persons –
65 or older (especially white men)
Anxiety in Elderly clients usually presnts as –
physical symptoms
- fatigue
- trembling
- muscle tension
- headache
- nausea
— is similar to PTSD and often occurs to the victim of rape.
Rape-Trauma Syndrome
Which type of PD will attempt to split the staff and uses threat of self-harm?
Borderline
Class B
With which type of PD is it very important that we set limits?
Anitsocial
Class B
Type of Loss:
any loss of a valued person/item
Actual Loss
Why is the response to a major stressor more intense with elderly clients?
Autonomic Nervous System is more fragile
When would a Obsessive Compulsive PD need meds?
if they’re depressed
Schizoid vs. Schizotypal
Which one is the LONER and which one is the ECCENTRIC?
Schizoid = Longer
Schizotypal = Eccentric
What is the difference b/t Self-Haters and Angry Men?
Self-Haters turn their animosity on themselves instead of others
Individual psychotherapy/cognitive behavioral therapy (like completing a project) is helpful w/ which PD?
Avoidant
Class C
Which methods of drug administration work best w/ elderly?
Drugs given IM, SubQ, orally, rectally, are not absorbed as efficiently as drugs inhaled, applied topically, given IV
With a schizoid personality, what should we respect?
the client’s need for privacy
Type of Loss:
part of the cycle of life
anticipated but still intensely felt.
ex: retirement, menopause
Necessary Loss
Which Theories of Aging are Psychosocial?
Personality Theory
Developmental Task Theory
Disengagement Theory:
Activity Theory:
Continuity Theory
What should we remember concerning rape victims, even if it’s difficult for the client?
don’t shower until forensics have done tests
What is the goal w/ Narcissistic PD?
place the client’s exaggerated self importance in perspective
help them develop empathy
Cognitive functions that change w/ age.
BRAIN BEGINS TO SHRINK (atrophy)
Fluid intelligence declines (emotion, creative capability, spatial perceptions, esthetic)
Slower response/reaction time to questions or to danger
Slower reflexes
Slower response to changes in balance
Brain affects the sleep-wake cycle so changes in sleep pattern occur (more frequent awakening)
Loss in smell and taste
Change in gait
Problem solving ability declines
Which street drug is called G or Liquid Ecstasy and is used in Date Rape?
Gamma-hydroxybutyrate (GHB)
Which Aging Personality leans on others for support, disengage, and let most of lief’s activities pass them by?
Rocking Chair Men
What are the three phases of Cycle of Battering?
Phase 1: Tension-building
Phase 2: Acute or Serious Battering
Phase 3: Respite or Honeymoon
Who has advanced training in the collection of evidence for suspected or actual cases of sexual assault or other forms of abuse?
Forensic Nurse
Which street drug used in Date Rape is called ‘roofies’ ‘club drug’ and ‘roachies’?
Flunitrazepam (Rohynpnol)
In which phase of the Cycle of Battery does the batterer actually batter the victim?
Phase 2: Acute or Serious Battery
What are physiological issues that cause increased drug S/E in elderly?
Decreased intracellular fluid
Increased gastric pH
Decreased gastric blood flow and motility
Reduced cardiac output and circulation
Decreased liver function
Slower metabolism
Which anxiety disorder is strongly co-morbid with depression in elderly clients?
GAD
Type of Grief:
letting go before the actual loss
Anticipatory Grief
— has been shows to diminish self-destructive behaviors in clients with borderline PD.
Dialectical Behavior Therapy
Which Aging Personality is bitter about life and have always shown some instability in their work and personal lives, and now feel extremely threatened by old age?
Angry Men
Type of Grief:
loss that cannot be publicly shared or is not socially acceptable
ex: loss through suicide
Disenfranchised Grief
Which maladaptive response to grief can lead to disabling behaviors preventing ADLs?
Chronic (Prolonged) Grief
What are risks for cognitive decline w/ age?
Reduced efficiency of nerve transmission affecting response time and coordination
Decrease in neurotransmitters
Reduced brain weight due to loss of neurons – 10% loss in brain weight by age 90
Cerebral blood flow reduced 20%
Some changes in brain structures with aging – atrophy in frontal, temporal, parietal lobes; widening of the sulci; ventricular enlargement
T/F: Provide nonjudgmental and sympathetic care to rape victims.
FALSE
nonjudgmental and EMPATHETIC care
Men who batter are usually characterized as persons with —
low self-esteem
Type of Loss:
unanticipated loss caused by an external event
ex: loss of job
Situational Loss
Why are elderly clients more sensitive to Opioids?
Does this mean we don’t use them?
body doesn’t metabolize or excrete them as efficiently
we STILL give them for pain relief
Mnemonic to remember Worden’s Four Tasks of Grieving
TEAR
To accept
Experience pain of loss
Adjust to new environment
Reinvest in the new reality
Which phase of the Cycle of Battering is the abuse loving, attentive and contrite?
Phase 3: Respite or Honeymoon
Does learning ability normally change w/ age?
no, it just takes longer to process info
Can minor battering incidents occur during Phase 1 of the the Cycle of Battery?
Yes
victim will accept the abuse as deserved
What are the three D’s that affect cognitive status as we age?
Delirium
Depression
Dementia (NCD)
What is a SANE?
Sexual Assault Nurse Examiner
clinical forensic RN who has received specialized training to provide care to the sexual assault victime
What is the primary task for Erikson’s Integrity v. Despair stage?
primary task of old age is to see one’s life as having been lived w/ integrity
in the absence of achieving that sense of having lived well, the older adult is at risk for becoming preoccupied w/ feelings of regret or despair
What is Battering?
a pattern of coercive control founded on and supported by physical and/or sexual violence OR threat of violence of an intimate partner
Two myths about aging and depression:
Myth 1: Pain is expected with aging
Myth 2: If patient doesn’t complain of pain, they’re not in pain
Type of Loss:
losses normally expected due to the developmental processing of life
ex: not being able to move around like normal
Maturational / Developmental Loss
Which Theories of Aging are Biological?
Genetic Theory
Wear and Tear Theory
Environmental Theory
Immunity Theory
Neuroendocrine Theory
What are the Theories of Aging?
Genetic Theory
Wear-and-Tear Theory:
Environmental Theory:
Immunity Theory:
Neuroendocrine Theory
Personality Theory
Developmental Task Theory:
Disengagement Theory:
Activity Theory:
Continuity Theory
