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Psychology > Test 1-psych > Flashcards

Test 1-psych Flashcards

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1
Q

Hallucinations

A

sensory perceptions for which there are no external stimulus (Auditory = most common for schizophrenics.)

NURSE: What is the voice telling you to do?

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2
Q

Delusions

A

Fixed false beliefs (someone is talking about them, persecution, grandiosity, unusual bodily function, jealousy, being controlled)

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3
Q

Positive Symptoms of Schizophrenia

A

Delusions

Hallucinations

Bizarre Behavior

Paranoia

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4
Q

Waxy flexiblity

A

excessive maintenance of a posture for long periods of time

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5
Q

Neoglisms

A

newly coined words that have meaning only for the client

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6
Q

Echolia

A

pathological repeating of another’s words

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7
Q

Clang association

A

meaningless rhyming of words

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8
Q

Word Salad

A

mixture of words meaningless to the listener

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9
Q

Primary Prevention

A

Health Promotion (before any diagnosis)

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10
Q

Secondary Prevention

A

Early detection and tx of symptoms (eg. depression screening, mammogram)

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11
Q

Tertiary Prevention

A

Restorative care–goal is to restore patients to best level of functioning; keep health problems from worsening.

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12
Q

Axis I

A

Clinical Disorders (depression, bi-polar, schizophrenia)

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13
Q

Axis II

A

Personality Disorders (borderline, histrionic, narcissistic, antisocial) and mental retardation.

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14
Q

Axis III

A

General medical conditions (HTN, DM, CA, arthritis)

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15
Q

Axis IV

A

Psychosocial and Environmental problems (death, divorce, loss of job, homelessness, financial strain, stressful work schedule)

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16
Q

Axis V

A

Global Assessment of Function (0-100) Pts in acute care psych will have GAF scores ranging from 30-40, some impairment in reality testing or cognition such as hallucinations, delusions

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17
Q

Thought Disorder

A

when an individual has serious problems with thinking, feelings, and behavior. The symptoms can include false belief about self or others, paranoia, hearing or seeing non-existent things, disconnected speech or thinking, and feelings that don’t match the situation

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18
Q

Negative Symptoms

A

apathy, flat affect, lack of emotion, anhedonia (inability to derive pleasure from anything), poor social functioning, poverty of thought, speech

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19
Q

Prolixin

A
  • med for schizophrenia-traditional anti-psychotic (blocks dopamine receptors in the brain)
  • expect high EPS, low anticholinergic
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20
Q

Cogentin (benzotropine)

A

Treatment of EPS

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21
Q

Parkinsonian Reaction

A

rigid expressions, shuffling gait, cogwheel rigidity

22
Q

Akathisia

A

(EPS)

restlessness, inability to sit still, motoric hyperactivity

23
Q

Traditional Antipsychotics

A
  • block dopamine receptors in the brain
  • SE: sedation, anticholinergic, EPS, TD, neuroleptic malignant syndrome (NMS), hyperpyrexia, mental status changes, diaphoresis, muscle stiffness, lower seizure threshold
  • (Thorazine, Prolixin, Haldol, Mellaril, Navane, long-acting (IM) Haldol D, Prolixin D)
24
Q

Neuroleptic Malignant Syndrome

A
  • severe muscular rigidity, altered consciousness, stupor, catatonia, febrile, respiratory depression
  • treatment: discontinuation of meds and stabilization of symptoms
  • can give bromocritpine
  • occurs with both traditional and atypical antipsychotics
25
Q

Atypical Antipsychotic Medications

A
  • block dopamine and serotonin
  • target both positive and negative symptoms (whereas traditional drugs target positive symptoms only)
  • SE: dizziness, tachy, orthostasis, syncope, weight gain, rhinitis, sleep distrubance, agranulocytosis (Cloraril only-weekly WBCs)
  • incidences of EPS and TD are much less
  • increased prolactin level, increased QTC interval, hyperglycemia, type II diabetes, increased lipids
  • can cause suicidal ideation
  • tend to be more expensive that traditional antipsychotics
  • lowers impulse control
  • get baseline weight before starting
  • (Clozaril, Risperdal, Invega (metabolite of risperdal), Invega Sustenna (long acting), Zyprexa, Zydis, Seroquel, Geodon, Abilify, Saphris, Fanapt, Latuda)
26
Q

Zyprexa (olanzapine)

A
  • Atypical antipsychotic
  • most likely to cause hyperglycemia and weight gain
  • takes 1 week to reach steady state
27
Q

Dystonia

A
  • muscle cramping of head and neck
  • acute dystonic rxn-head twisted to one side, complain of thick tongue
  • Nurse: give Cogentin or Artane or Benedryl (IM not PO)
28
Q

Artane (trihexyphenidyl)

A

For treatment of EPS

29
Q

EPS

A

Acute dystonic reactions (tonic contraction of muscles in mouth and torso)

Parkinsonian reactions

Akathisia

Tardive Dyskinesia

NMS

30
Q

Tardive Dyskinesia

A
  • EPS
  • results from long-term use of traditional agents
  • unusual mouth movements (lip smacking, tongue protrusion)
  • choreic movements (rocking)
  • NO TREATMENT for TD
31
Q

Avolition

A

a psychological state characterized by general lack of drive, or motivation to pursue meaningful goals

32
Q

Apathy

A

is a state of indifference, or the suppression of emotions such as concern, excitement, motivation and passion. An apathetic individual has an absence of interest in or concern about emotional, social, spiritual, philosophical and/or physical life.

33
Q

Clozaril (clozapine)

A
  • atypical antipsychotic
  • restrict to sever schizophrenia resistent to traditional antipsychotic meds
  • monitor WBC and ANC
  • risk of seizures
  • risk of myocarditis
  • potentially life-threatening side effects
34
Q

Schizophrenia

A
  • a brain disorder that interferes with cognition
  • social withdrawal…hallucinations….delusions
35
Q

Id

A

At birth we are all id

  • the id is the source of all drives, instincts, relexes, needs, genetic inheritance and capacity to respond, as well as all the wishes that motivate us.
  • operates according to the pleasure principle
  • if id is too powerful, person lacks control over impulses
  • unconscious
36
Q

Ego

A
  • emerges in the 4th or 5th month bc the needs, wishes, demands of the id can’t be met through primary processes and reflex actions
  • problem solver and reality tester
  • follows the reality principle which says to the id, “you have to delay gratification for right now.”
  • administrative leadership of the personality (id=devil, superego=angel)

how the world sees us

-mostly conscious

37
Q

Superego

A
  • last portion of the personality to develop
  • moral component of the personality
  • shoulds/should nots
  • seeks perfection as opposed to seeking pleasure or engaging reason
  • if too powerful, person may be self-critical and suffer from feelings of inferiority
  • half conscious/half unconscious
38
Q

Erikson

A
  1. Trust vs. Mistrust (0-1 1/2)
  2. Autonomy vs. shame and doubt (1 1/2 - 3)
  3. initiative vs. guilt (3-6)
  4. industry vs. inferiority (6-12)
  5. identity vs. role confusion (12-20)
  6. intimacy vs. isolation (20-35)
  7. generativity vs. self absorption (35-65)
  8. Integrity vs. despair (65 yr to death)
39
Q

Preconscious

A

just below the surface of awareness

contains material that cn be retrieved easily through conscious effort.

40
Q

Peplau’s stages of nurse-patient relationship

A
  1. Orientation
  2. Working
  3. Termination
41
Q

Psychoanalysis

A
  • developed by Freud, seldom used today
  • All mental illness is caused by early intra psychic conflict
  • go back to early childhood
  • not inpatient-takes a long time
42
Q

Cognitive Behavioral Therapy

A
  • used for depression, eating disorders
  • aims to change thought patterns
  • identify automatic thoughts
  • cognitive restructuring
  • active, time limited, structured
  • how people feel and behave is determined by the way they think about their world
  • thoughts can be distorted
  • empiricall (evidence) based
43
Q

4 Types of Behavioral Therapy

A
  1. Modeling (role model/role playing, pt learns thru imitation)
  2. Operant Conditioning (reward positive behavior with more privileges)
  3. Systematic desensitization
  4. Aversion therapy (maladaptive behavior is paired with noxious stimulus)
44
Q

Systematic Desensitization

A
  1. patient’s fear is broken down
  2. patient is incrementally exposed to the fear
  3. patient is instructed how to design hieracrchy
  4. patient practices these techniques daily

(for phobias, baby steps)

45
Q

Assessment

A

collect and organize data

46
Q

AIMS

(Abnormal Involuntary Movement Scale)

A
  • Facial and Oral Movements
  • Extremity Movements
  • Trunk Movements (neck, shoulder, hips)-rocking, twisting, squirming, pelvic gyrations)
  • Global Judgments-severity overall, incapactitation due to movements, pt’s awareness of abnormal movements
  • Dental Status
  • Do movements disappear in sleep?
47
Q

Haldol

A
  • for acute psychosis and schizophrenia
  • blocks dopamine receptors
  • causes CNS depression, narrow-angle glaucoma, hepatic disease
  • SE: EPS (TD, Parkinsonism, Acute dystonia, akathisia), NMS, QT changes and potential dysrhythmias, anticholinergic.

NURSE: assess for involuntary movements

-poor adherence is common cause of therapeutic failure

48
Q

Risperdal

A
  • atypical antipsychotic
  • highest risk of EPS among atypicals
  • SE: sexual dysfunction, orthostatic hypotension, weight gain, sedation, strange dreams
  • available in long-acting injectioin (Risperdal Consta)-q2wks
  • can be used for autism
49
Q

Assessment

A
  • *1. Establish rapport**
    2. Obtain an understanding of the current problem or chief complaint
    3. Review physical status and obtain baseline vital signs
    4. Assess for risk factors affecting the safety of the patient or others
    5. Perform a mental status examination
    6. Assess psychosocial status
  • *7. Identify mutual goals for treatment**
    8. Formulate a plan of care
50
Q

Diagnosis

A
  1. Problem
  2. Etiology
  3. Supporting Data
51
Q
A

Psychology (4 decks)

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