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Nursing 221-222 > Test 4 psych > Flashcards

Test 4 psych Flashcards

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1
Q

Rivastigmine(Exelon)

A
  • Treatment to mild to moderate AD and PD
  • Can be used in later stages
  • Inhibits AChE selectively in the cortex and the hippocampus more than in other parts of the brain.
  • This drug is advantageous for patients who do not respond to other anticholinergic drugs or who are in the later stages of AD
  • Side effects: nausea, vomiting, and dizziness
  • Transdermal form is effective and has fewer peripheral side effects as compared with the oral form.
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2
Q

tacrine(Cognex)

A

potential for hepatic toxicity, rarely used because of side effects

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3
Q

donepezil(Aricept)

A

– it requires only once-per-day dosing.
– Enhances cholinergic function by the reversible inhibition of the hydrolysis of Ach by AChE.
– Slows progression
– Effective when cholinergic neurons are intact.
– May produce gastrointestinal side effects by inhibiting AChE in the periphery

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4
Q

Glantamine (Razadyne)

A
  • Treats mild to moderate AD
  • It is a reversible inhibitor for AChE
  • It increases the availability of ACh; affects nicotinic cholinergic receptors in such a way that AChE inhibition can theoretically be enhanced
  • Shown to decrease agitation and to increase cognition
  • Twice daily dosing
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5
Q

Memantine (Namanda)

A
  • Treats moderate to severe AD
  • It is an N-methyl-D-aspartate receptor antagonist that blocks the effects of excess glutamate.
  • Blocks the excitotoxic effects of glutamate while allowing normal glutamate neurotransmission to occur.
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6
Q

Kubler Ross (5 Stages)

A
  1. Denial – Shock and disbelief
  2. Anger – struggling with fate(Why me? Or It’s not fair!)
  3. Bargaining – making deals with a higher power in the hope of a cure
  4. Depression and despair – realizing that death is inevitable
  5. Acceptance – succumbing to fate with relative calmness
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7
Q

Stages of Grief

A
  1. Avoidance (numbing and blunting)
  2. Confrontation (disorganization and despair)
  3. Reestablishment (reorganization and recovery)
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8
Q

Chronic Sorrow

A
  • a form of grief that often includes characteristics of other forms of grief but that differs with regard to several essential aspects.
  • 1st chronic sorrow is a response to ongoing loss; 2nd persons who are experiencing chronic sorrow seldom experience disability
  • Who would be at risk? Parents with children with mental disabilities, schizophrenia, or other chronic illness; spouses of persons with long term chronic illnesses, such as multiple sclerosis alcoholism, or AD; and persons with similar disorders
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9
Q

Primary (Irreversable) Dementia

A

Alzeimer’s Disease, Vascular Dementia, Picks Disease, Huntington’s Disease
Parkinson’s Dementia, Creutzfeidt-Jakob disease

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10
Q

Dementia: Reversible (secondary)

A

Delirium, Depression, Amnestic disorders, Tumors, Infection, Trauma, Some cerebral emboli

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11
Q

Recent memory loss but keeps long term memory

A

Stage 1: Mild (2-4 years)

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12
Q
  • Patients have problems naming common items, they repeat things, and they lose things easily, and they get lost frequently.
A

Stage 1: Mild (2-4 years)

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13
Q

Inability to find words and the use of inappropriate words

A

Stage 1: Mild (2-4 years)

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14
Q

Neologism – invented and meaningless words

A

Stage 1: Mild (2-4 years)

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15
Q

Show signs of personality changes

A

Stage 1: Mild (2-4 years)

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16
Q

They are self awareness of loss that many patients suffer profound depression

A

Stage 1: Mild (2-4 years)

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17
Q

Intellectual decline continues to increase and includes amnesia, disorientation, apriaxia, aphasia, and depression

A

Stage 2: Moderate (2-10 years)

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18
Q

Lead to the loss of the ability to care for oneself

A

Stage 2: Moderate (2-10 years)

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19
Q

Difficulty making decision as a result of decreased concentration

A

Stage 2: Moderate (2-10 years)

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20
Q

Lack the cognitive skills to make appropriate judgments

A

Stage 2: Moderate (2-10 years)

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21
Q

Develop delusion that are paranoid in nature

A

Stage 2: Moderate (2-10 years)

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22
Q

Both short- and long-term memory are affected

A

Stage 2: Moderate (2-10 years)

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23
Q

Perseveration

A

Stage 2: Moderate (2-10 years)

24
Q

Sundowning

A

Stage 2: Moderate (2-10 years)

25
Q

Sleep Disturbance

A

Stage 2: Moderate (2-10 years)

26
Q

Catastrophic reactions: A sudden or gradual negative change in behavior caused by the inability to understand and cope with environmental stimuli. Reach excessively, out of proportion to the situation, or panic and act out violently.

A

Stage 2: Moderate (2-10 years)

27
Q

What is a Catastrophic reaction?

A

: A sudden or gradual negative change in behavior caused by the inability to understand and cope with environmental stimuli. Reach excessively, out of proportion to the situation, or panic and act out violently.

28
Q

What is sundowning?

A
  • Increased negative behavioral disturbance such as irritation or confusion occurring during the afternoon or eveninga
29
Q

What is perseveration?

A

Repetitive verbalizations or motions

30
Q

JAMCO

A 
Judgment
Affect
Memory
Cognition
Orientation
31
Q

unable to perform motor activities despite intact function

A

Apraxia

32
Q

difficulties with object identification

A

Agnosia

33
Q

difficulties writing things down

A

Agraphia

34
Q

deficits in language functioning

A

Aphasia

35
Q

Etiology of AD

A

Pathological: Cerebral atrophy, neuritic plaques, neurofibrillary tangles
Genetic: chromosome 19, Apolipoprotein E gene
Nongeneitc: inflammation, decreased folic acid, decreased estrogen
Neurochemical: decreased acetylcholine ACh

36
Q

ACT – crisis intervention approach

A
  • Assess immediate needs and treats
  • Connect to support groups, social services, disaster relief, etc.
  • Trauma treatment plans, treatment of acute stress reactions and trauma recovery groups
37
Q

Psychological stages after a disaster

A
  1. Heroic Phase
  2. Honeymoon Phase (1 week to 3 to 6 months)
  3. Disillusionment phase (2 months to 2 to 3 years)
  4. Reconstruction phase (2 months to 1 to 2 years)
38
Q

real events that threaten physical health or loss

A

External (Situational)

39
Q

May not be obvious to someone else: feelings of betrayal or fear, threat to a belief

A

Internal (Subjective)

40
Q

(phase of life): e.g. Midlife crisis

A

Maturational

  • Old coping skills no longer helpful
  • Ineffective defense mechanisms until new coping skills develop
  • Adventitious (disaster): natural or man-made disaster
41
Q

Unplanned and accidental

• Natural disaster (hurricane, car accident), Crime of violence (murder, rape)

A

Adventitious

42
Q

Cycle of Violence Phase 1: Tension Building

A

• Major battering usually does not occur. Perpetrator establishes complete control usually by inflection of emotional abuse

43
Q

Cycle of Violence Phase 2: Acute Battering

A

• Tension can no longer be contained and acute battering occurs

44
Q

Cycle of Violence Phase 3: Honeymoon Stage

A

• Perpetrator begs for forgiveness, promises never to do it again. Appears to have remorse then tension starts to build and cycle is repeated

45
Q

Emergency escape plan

A
  • A plan for a fast escape when violence occurs
  • Identify signs of escalation of violence and designate this as the time to leave
  • Include in plan a destination and a way to get there
  • Have the hotline referral telephone number of a shelter or safe house and a contact person
  • Keep important papers hidden in a place they can be obtained easily
46
Q

Who is at risk for spousal abuse?

A

• Spousal: Legal marriage, pregnant, partner who tries to leave the relationship

47
Q

Who is at risk for child abuse?

A

under the age of 3, kids who are looked as to be different, child of an unwanted pregnancy, premature kid, child who has a prolonged illness

48
Q

Atypical medication for eating disorders - Cause weight gain

A

Zyprexa

49
Q

SSRI medication for eating disorders

A

Prozac

50
Q

Patients cannot use or understand words

A

Stage 3: Severe (1-3 years)

51
Q

Cannot recognize themselves or others

A

Stage 3: Severe (1-3 years)

52
Q

No longer care for themselves

A

Stage 3: Severe (1-3 years)

53
Q

Totally dependent on others

A

Stage 3: Severe (1-3 years)

54
Q

Lose weight and bladder control

A

Stage 3: Severe (1-3 years)

55
Q

Develop secondary illnesses and conditions

A

Stage 3: Severe (1-3 years)

56
Q

Immobility may lead to pneumonia, UTI, and development of pressure ulcers

A

Stage 3: Severe (1-3 years)

57
Q

Progressive loss of neurons leads to the loss of the ability to swallow which may lead to aspiration pneumonia

A

Stage 3: Severe (1-3 years)

Nursing 221-222 (9 decks)

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