Test 3 Flashcards

Question

Delirium Signs and Symptoms

Answer 1

Difficulty with attention/Extreme distractibility Disorganized thinking/Speech is rambling, irrelevant, pressured, incoherent and switches from topic to topic Impaired reasoning Disorientation to time and place Hallucinations and illusions Disturbances in sleep Psychomotor activity fluctuates between agitation and vegetative states Emotional instability Tachycardia, sweating, flushed face, dilated pupils, elevated blood pressure

Answer 2

``` Systemic infections Febrile illness Metabolic disorder Hepatic encephalopathy Head trauma Seizures Migraine headaches Brain abscess Stroke Post-op state Electrolyte imbalance Substance induced (Alcohol, amphetamines, cannabis, cocaine, opioids) Substance withdrawal (Alcohol, opioids, sedatives, hypnotics, anxiolytics) Medication induced Multiple etiologies ```

Answer 3

``` A general term that describes a range of disorders and symptoms associated with a decline in memory and at least one other area of functioning such as: Concentration Orientation Language Judgment Visuospatial skills Sequencing ```

Answer 4

``` Age Family History Genetics Culture African Americans twice as likely to develop Alzheimer’s disease ```

Answer 5

``` Cardiovascular health status Smoking Sleep disturbances Social engagement Traumatic brain injury Concussions ```

Answer 6

Characterized by memory loss, confusion, decreased reasoning or judgment ability, difficulty with language, behavioral changes Brain changes caused by amyloid plaques and neurofibrillary tangles (PET scan) REDUCED production of ACETYLCHOLINE EXCESS GLUTAMATE leading to increased intracellular calcium and subsequent nerve cell death

Answer 7

``` Anomia Apraxia Aphasia Amnesia Agnosia ```

Answer 8

Inability to remember the name of things

Answer 9

Misuse of object because of failure to identify them

Answer 10

Inability to express oneself through speech

Answer 11

Memory loss

Answer 12

Inability to recognize familiar objects, tastes, sounds

Answer 13

1. No impairment 2. Forgetfulness 3. Mild Cognitive Decline 4. Mild - Moderate 5. Moderate 6. Moderate to Severe 7. Severe

Answer 14

Short-term memory, lose things or forget names Long term memory intact Blocks of lost memory and fabricate memories to fill in blanks

Answer 15

Work impacted Get lost, fill in more memory blanks Noticed by others Personal events are forgotten

Answer 16

Personal events forgotten, confabulation | Social withdrawal, isolation, don't understand current events

Answer 17

ADLs negatively impacted May not remember name of spouse or children Disoriented and starts to wander

Answer 18

Major disorientation Can't remember the name of spouse or children Incontinent, sleeping problems, agitation, impaired communication

Answer 19

Not recognize significant others, bedfast Difficulty swallowing, unaware of environment Death by pneumonia or sepsis

Answer 20

Disturbed mood, thought, perception, motor function, and alteration in personality Causes increased stress and frustration for patients and care givers

Answer 21

Apathy, depression Irritability Agitation Anxiety

Answer 22

Euphoria Hallucinations Disinhibition

Answer 23

``` Pain, impaction, comorbidities, boredom, loneliness, depression, and stressors such as social or environmental conditions. Pain Hunger Anxiety Lonely Tired Toilet Thirsty ```

Answer 24

Correct underlying cause

Answer 25

``` CHOLINESERASE INHIBITORS: -Donepezil (Aricept) -Rivastigmine (Exelon), Memantine (Namenda) NMDA RECEPTOR ANTAGONIST -works to decrease glutamate ```

Answer 26

Substance interferes with ability to perform role obligations Failed attempts to cut down Intense craving for the substance Excessive time focused on the substance Continue use despite negative consequences Tolerance develops and amount of use increase Takes over social and occupational functioning

Answer 27

``` Excessive use of substance Effects the CNS Disturbed physiological and psychological functioning Impaired judgment Specific symptoms dependent on substance Denial and rationalization ```

Answer 28

Abrupt reduction after prolonged use Physical and psychological symptoms Changes in thinking, feeling, and behavior Specific symptoms dependent on substance Stress related triggers can relapse addiction

Answer 29

Biological Psychological Sociocultural

Answer 30

Genetics | Biochemical

Answer 31

Developmental | Personality

Answer 32

Social Learning Conditioning Culture

Answer 33

Alcoholism

Answer 34

Phase I: Pre-alcoholic phase Phase II: Early alcoholic phase Phase III: The crucial phase Phase IV: The chronic phase

Answer 35

Characterized by use of alcohol to relieve everyday stress and tensions of life.

Answer 36

Begins with blackouts, brief periods of amnesia that occur during or immediately following a period of drinking; alcohol is now required by the person. Denial

Answer 37

Person has lost control; physiological dependence is clearly evident.

Answer 38

Characterized by emotional and physical disintegration. The person is usually intoxicated more often than sober.

Answer 39

``` Peripheral neuropathy Alcoholic myopathy Wernicke’s encephalopathy Korsakoff’s psychosis Alcoholic cardiomyopathy Pancreatitis Alcoholic Hepatitis Cirrhosis of the Liver Leukopenia Thrombocytopenia Sexual dysfunction Esophagitis Gastritis ```

Answer 40

Most serious form of thiamine deficiency in alcoholic patients

Answer 41

Syndrome of confusion, loss of recent memory, and confabulation

Answer 42

Have you ever felt you should |C|ut down on your drinking? Have people |A|nnoyed you by criticizing your drinking? Have you ever felt bad or |G|uilty about your drinking? Have you ever had a drink first thing in the morning to steady your nerves (|E|ye-opener)?

Answer 43

Domestic/Family Violence Spouse Abuse Wife or husband battering

Answer 44

``` Behaviors of power and control through fear and intimidation over partner Physical Verbal/emotional Sexual Financial ```

Answer 45

Battered women represent all age, racial, religious, cultural, educational, and socioeconomic groups. Low self-esteem Inadequate support systems Some grew up in abusive homes

Answer 46

``` Low self-esteem Pathologically jealous “Dual personality” Limited coping ability Severe stress reaction Views spouse as a personal possession ```

Answer 47

Tension Building Phase Acute Battering phase Honeymoon Phase

Answer 48

FEAR (for their lives or their children's lives, retaliation or of losing custody of their children) Lack of financial resources Lack of support network Religious reasons Having hope that the partner will change and they can have good times again

Answer 49

Acquaintance (date) rape Marital rape Statutory Rape Rape is an act of aggression, not one of passion

Answer 50

Seductive but rejecting and dominating mother, often from abusive homes

Answer 51

16-34 years old, single, chosen at random, amount of resistance dependent on presence of weapon

Answer 52

Within a few hours of rape Expressed: outbursts of crying, laughing, hysteria, anger Controlled: calm, yet difficulty making decisions, ‘numbing’

Answer 53

Tolerance for frustration for her and life is declining Hard to cope, threats Quick to apologize She becomes nurturing and walking on eggshells Treat to keep her submissive Verbal abuse Weeks, months, year

Answer 54

Most violent, where abuse starts 24 hours Verbal to physical abuse Dissociate with her body, watching it happen to someone else

Answer 55

He becomes loving and plays on guilt Very apologetic, promises to get help She wants to believe him, makes excuses for his actions

Answer 56

Days to weeks after the rape She is dealing with physical and emotional parts of rape Bruising, muscle tension, HA, GI, sleep disorders Emotional - rage, guilt, self blame, humiliation, embarrassment

Answer 57

``` Weeks, months, years Nightmares, fears/phobias Sense of vulnerability, loss of control Sexual dysfunction Substance abuse ```

Answer 58

``` Physical Abuse Emotional Abuse Physical and Emotional Neglect Sexual Abuse of a Child Children need time, attention and direction ```

Answer 59

Any non-accidental physical injury caused by the parent or care giver Unexplained injuries Child is frightened of adults Child reports injury by parent or caretaker Conflicting or unconvincing explanation for injuries Bruises and coloration Excessive clothing

Answer 60

A pattern of behavior on the part of the parent or caretaker that results in serious impairment of the child’s social, emotional, or intellectual functioning Extremes of behaviors Delayed physical or emotional development Lack of attachment to parents

Answer 61

Refusal or delay in seeking health care, abandonment, expulsion from the home, refusal to allow a runaway to return home, inadequate supervision Failure to provide the child with the hope, love, and support necessary for the development of a sound, healthy personality

Answer 62

``` Frequently absent from school Begs or steals food or money Lacks needed medical or dental care Consistently dirty and has body odor Lacks sufficient clothing for winter Abuses alcohol or drugs States there is no caregiver at home ```

Answer 63

“Employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person in, any sexually explicit conduct or simulation...” (Child Welfare Information Gateway, 2013)

Answer 64

Has difficulty walking or sitting Suddenly refuses to change for gym or to participate in physical activities Reports nightmares or bedwetting Change in appetite Demonstrates bizarre, sophisticated, or unusual sexual behavior Becomes pregnant or contracts an STD

Answer 65

``` Emotional/behavioral difficulties Chronic illness Physical disability Developmental disabilities Preterm birth Unwanted Unplanned ```

Answer 66

``` Abused as children Experiencing a stressful event Poverty Social isolation Lacks knowledge of growth and development Lacks coping strategies Expects child to be perfect ```

Answer 67

Impaired spousal relationship 8-10 At first, sign of affection

Answer 68

Domineering, impulsive, | Physically abusive

Answer 69

Passive, submissive, and denigrates her role as wife and mother Often aware of the incestuous relationship but uses denial or keeps quiet out of fear of being abused by her husband

Answer 70

``` Lacks trust Low self-esteem Absence of pleasure with sexual activity Promiscuity At risk for PTSD, sexual dysfunction, somatic symptom disorders, compulsive sexual behavior, depression, anxiety, eating disorders, substance use disorders, and intolerant of or constant search for intimacy ```

Answer 71

Yelling, insulting, threats, silence, intimidation, manipulation, deprivation, social isolation

Answer 72

Strike, shove, beat, restraint

Answer 73

Intentional or unintentional | Unfilled needs-dehydration, unclean, malnourished

Answer 74

No consent

Answer 75

Misuse of funds, property, possessions

Answer 76

``` Increase in number of elderly alive Fast growing age group Physically and mental ill Finically depended on children Caregiver strain ```

Answer 77

White female age 70 or greater | Unable to complete ADLs

Answer 78

Finically and mentally strained Abusing substances Victims of abuse themselves

Answer 79

Do not have the means Fearful of retaliation Embarrassed Protecting abuser (family)

Answer 80

Defined by a disruption in the usually integrated functions of Consciousness Memory Identity

Answer 81

An inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness and which is not due to the direct effects of substance use or a neurological or other medical condition

Answer 82

Usually follows severe psychosocial stress

Answer 83

Localized Selective Generalized Subtype: Dissociative fugue

Answer 84

The person has the inability to recall any information for the periods time the abuse or trauma took place

Answer 85

When a person had the ability only certain incidents around the traumatic event

Answer 86

Amnesia of a persons whole life, no memory of themselves or their entire life

Answer 87

``` Temporary loss of recall memory Hours, months, years Sudden onset Episodes of leaving home or work without any explanation Assume a new identity ```

Answer 88

Characterized by the existence of two or more personalities within a single individual Transition from one personality to another usually sudden, often dramatic, and usually precipitated by stress Brought on by trauma experience which overwhelms persons ability to cope causing the personality to shatter resulting in two or more distinct personalities to emerge

Answer 89

Characterized by a temporary change in the quality of self- awareness that often takes the form of: Feelings of unreality Changes in body image Feelings of detachment from the environment A sense of observing oneself from outside the body

Answer 90

Disturbance in the perception of oneself Outside observer of thoughts and feelings Emotional numbness or memories are not their own

Answer 91

An alteration in the perception of external environment Living in dream or movie, sensory fog Distortion of distance, size and shape of objects

Answer 92

``` Anxiety and depression Fear of going insane Obsessive thoughts Somatic complaints Disturbance in the subjective sense of time ```

Answer 93

Genetics Psychodynamic Theory Psychological Trauma

Answer 94

Based on freud in combination using his approach Behaviors are defense mechanisms Buried memories manifest in dissociative disorders

Answer 95

Eating behaviors are influenced by: Society Culture Historically, society and culture also have influenced what is considered desirable in the female body

Answer 96

``` Anorexia Nervosa Bulimia Nervosa Binge-eating Disorder Obesity *cognitive distortions ```

Answer 97

Occurs predominantly in girls and women ages 12 to 30 years Characteristics: Gross distortion of body image Preoccupation with food Low self esteem Perfectionist/Self disciplined *denial and rationalization

Answer 98

``` Weight <85% expected Hypothermia Lanugo Bradycardia Hypotension Amenorrhea ```

Answer 99

``` Malnutrition Anemia Cardiac dysfunction Loss of muscle tone Loss of skin turgor Osteoporosis ```

Answer 100

Bulimia nervosa is an episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period (binging). The episode is followed by inappropriate compensatory behaviors to rid the body of the excess calories (self-induced vomiting or the misuse of laxatives, diuretics, enemas, or excessive exercise)

Answer 101

``` Concern about appearance Binging Purging (secretive) Normal weight range Substance Abuse ```

Answer 102

``` Purging Dehydration Dental caries Esophageal tears Electrolyte imbalance ```

Answer 103

The DSM-5 identifies binge eating disorder (BED) as an eating disorder than can lead to obesity The individual binges on large amounts of food, as in bulimia nervosa BED differs from bulimia nervosa in that the individual does not engage in behaviors to rid the body of the excess calories

Answer 104

Family Hx Eating Disorders Enmeshed relationships Conflict avoidance Power and control

Answer 105

A body mass index of 30 is considered obese Obesity can contribute to increases in morbidity and mortality DSM-5

Answer 106

``` Hyperlipidemia Diabetes mellitus Osteoarthritis Angina Respiratory insufficiency ```

Answer 107

Genetics Physiological factors Lifestyle factors Psychosocial influences

Answer 108

History of panic disorders doubles the risk of stroke and cardiac mortality Current anxiety predicts future cardiac events

Answer 109

Post-menopausal panic attacks triple cardiac mortality

Answer 110

Is the response disproportionate to the threat? Does the response continue beyond existence of threat? Is their intellectual, social, or occupational functioning impaired?

Answer 111

Recurrent unpredictable panic attacks Manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort

Answer 112

``` Sweating, trembling, shaking Shortness of breath, chest pain or nausea or abdominal distress Dizziness, chills, or hot flashes Numbness or tingling sensations Derealization or depersonalization Fear of losing control or “going crazy” Fear of dying ```

Answer 113

``` 6 months, interfere w social & occupational functioning Restless Keyed up or on edge Muscle tension Spends a lot of time worrying Procrastinates Difficulty making decisions Seeks reassurance Depressed Physical complaints *Treatment is possible when patient gains insight ```

Answer 114

Illogical, intense, persistent, irrational fears Agoraphobia Social phobia Specific phobias

Answer 115

Fear of being in places or situations from which escape might be difficult or in which help might not be available in the event of panic-like symptoms or other incapacitating symptoms

Answer 116

Excessive fear of situations in which the affected person might do something embarrassing or be evaluated negatively by others

Answer 117

``` Animals Natural Environment Blood injection, injury type Situational Other ```

Answer 118

Freud | If a child was assaulted in the woods, phobia of the woods

Answer 119

Learned fear from parent | Avoiding the fear, strengthens the fear

Answer 120

Individuals anxiety is the reason for the cognitive distortion (phobia)

Answer 121

Lost someone because of object, fear of that object

Answer 122

Systematic desensitization | Implosion therapy

Answer 123

Medical conditions that may produce anxiety symptoms include: - Cardiac - Endocrine - Respiratory - Neurological

Answer 124

May be associated with intoxication or withdrawal from any of the following substances: - Alcohol, sedatives, hypnotics, or anxiolytics - Amphetamines or cocaine - Hallucinogens - Caffeine - Cannabis - Others

Answer 125

Interfere with daily functions Time consuming Self imposed Recognized by person as excessive and unreasonable Reduce anxiety, not to provide pleasure or gratification

Answer 126

Exaggerated belief that the body is deformed or defective in some way Depression and obsessive-compulsive personality traits are common

Answer 127

The recurrent pulling out of one’s own hair that results in noticeable hair loss Preceded by increasing tension and results in sense of release or gratification

Answer 128

Persistent difficulty discarding or parting with possessions, regardless of their actual value. Associated symptoms: perfectionism, indecisiveness, anxiety, depression, distractibility, and difficulty planning and organizing tasks.

Answer 129

Underdeveloped ego, inability of the id and the super ego to intervene

Answer 130

Learn that another activity can soothe anxiety (like OCD or trichotillomania)

Answer 131

Our history leads to anxiety

Answer 132

Looking more closely at the neurotransmitters

Answer 133

Symptoms occur after exposure to a traumatic stressor that threatens self and/or others - Natural / manmade disaster - Combat, hostage, tortured - Threat of death - illness, motor vehicle crash - Victims of crime/violence

Answer 134

``` Re-experiencing the traumatic event A sustained high level of anxiety or arousal A general numbing of responsiveness Intrusive recollections or nightmares Amnesia to certain aspects of the trauma Depression, survivors guilt *Substance abuse Anger and aggression Relationship problems ```

Answer 135

Characterized by physical symptoms suggesting medical disease but without demonstrable organic pathology or a known pathophysiological mechanism to account for them

Answer 136

Symptoms vague, dramatized, exaggerated; not explained medically - associated with psychosocial distress Doctor shopping, drug abuse and dependence Concurrent- anxiety, depression, and suicidal ideation Personality characteristics: heightened emotionality, strong dependency needs, and a preoccupation with symptoms and oneself

Answer 137

Unrealistic or inaccurate interpretation of physical symptoms or sensations leading to preoccupation and fear of having a serious disease Their behavioral response to even the slightest changes in feeling or sensation is unrealistic and exaggerated Anxiety and depression are common, and obsessive-compulsive traits frequently accompany the disorder

Answer 138

A loss of or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism The most obvious and “classic” conversion symptoms are those that suggest neurological disease Some instances of conversion disorder may be precipitated by psychological stress

Answer 139

Psychological factors may play a role in virtually any medical condition With this diagnosis, there is evidence of a general medical condition that has been precipitated by or is being perpetuated by psychological or behavioral circumstances

Answer 140

Conscious, intentional feigning of physical and/or psychological symptoms. Individual pretends to be ill in order to receive emotional care and support commonly associated with the role of “patient.” The disorder may also be identified as Munchausen syndrome The disorder may be imposed on another person under the care of the perpetrator