Theories and Therapies

Question 1

How can neurotransmitters be destroyed?

Answer 1

Degraded by enzymes in synaptic space (e.g. acetylcholinesterase)
Degraded by enzymes in the presynaptic cell during the process of re-uptake (e.g. monoamine oxidase)

Question 2

Abstract thinking, decision making. Pleasure and reward system. Integration of thoughts and emotions. Stimulates hypothalamus to release hormones (sex, thread, adrenal). Meds?

Answer 2

Dopamine/DA

Antipsychotics block it at the spot synaptic receptor

Question 3

What does an excess of dopamine cause?

Answer 3

Disorganized thinking, loose associations, delusions. Disabling compulsions, tics.
These symptoms are very characteristic of schizophrenia

Question 4

What does a deficit of dopamine cause?

Answer 4

Poor impulse control, poor spatial ability, motor and movement abnormalities, inability to think abstractly. No joy, anticipation of pleasure.
Parkinson’s disease

Question 5

Mood, calmness, contentedness. Regulation of temp, appetite, sleep, and pain. Aggression and libido. Hormonal activity. Meds?

Answer 5

Serotonin/5-HT

SSRI’s to norepinephrine reuptake inhibitors/NERI’s

Question 6

Mood, attention and arousal, fight or flight response. Meds?

Answer 6

Norepinephrine/NE

SSRI’s to norepinephrine reuptake inhibitors/NERI’s

Question 7

Reduces anxiety, excitation, and aggression. Maintains calmness, contentedness. Anticonvulsant and muscle-relaxing properties. Meds?

Answer 7

Gamma-aminobutyric acid
GABA
Anti-anxiety meds/ benzodiazepines
Benzos mimic GABA

Question 8

Is the major mediator of excitatory signals in the CNS. Is involved in most aspects of normal brain function, including alertness, cognition, memory, and learning. Meds?

Answer 8

Glutamate

Under investigation

Question 9

What does an excess of norepinephrine cause?

Answer 9

Hyperalertness, anxiety, panic, paranoia, loss of appetite

Question 10

What does a deficit of norepinephrine cause?

Answer 10

Dullness, low energy, depression.

Some antidepressants can increase NE.

Question 11

What does an excess of GABA cause?

Answer 11

Sedation, impaired recent memory, cognition and psycho motor functioning.

Question 12

What does a deficit of GABA cause?

Answer 12

High levels of anxiety, irritability, seizures.

Question 13

What do excesses and deficits of glutamate cause?

Answer 13

Neurotoxicity

Psychosis

Question 14

What enzyme acts on serotonin and NE? Meds?

Answer 14

Monoamine oxidase
Monoamine oxidase inhibitors
MAOI’s

Question 15

What enzyme acts on acetylcholine?

Answer 15

Acetlycholinesterase

Inhibotrs AKA anti-acetyl…. meds

Question 16

What enzyme acts on serotonin and NE? Meds?

Answer 16

Monoamine oxidase
Monoamine oxidase inhibitors
MAOI’s work by destroying MAO, the enzyme that breaks down norepinephrine and serotonin.

Question 17

Stable mood, learning, memory. Affects sexual and aggressive behavior. Control of muscle tone by balance with dopamine. Meds?

Answer 17

Acetylcholine

Inhibitors, which destroy the enzyme thus keeping more acetylcholine in the synapse to act.

Question 18

What does an excess of acetylcholine cause?

Answer 18

Self-consciousness, excessive inhibition, anxiety. Somatic complaints. Depression.

Question 19

What does a deficit of acetylcholine cause?

Answer 19

Lack of inhibition, poor short-term memory, inappropriate behaviors, Parkinson’s disease and Alzheimers

Question 20

Alertness. Inflammatory response. Stimulates gastric secretion. Deficit?

Answer 20

Histamine.

Sedation, substantial weight gain.

Question 21

The effects of a specific medication on persons from the same ethnic group?

Answer 21

Cross-cultural psychopharmacology

Question 22

How genes influence drug metabolism in an individual?

Answer 22

Pharmacogenetics

Question 23

What are examples of biological therapies?

Answer 23

Psychopharmacology, moderating stress, managing the basics (exercise, nutrition, sleep/wake patterns), brain stimulation therapies (ECT, transcranial magnetic stimulation/TMS, vagal nerve stimulation)

Question 24

Explain defense mechanisms according to Freud.

Answer 24

Operate on an unconscious level. Deny, falsify, or distort reality to make it less threatening. Are normal response to overwhelming anxiety.
Importance of individual talk sessions. Attentive listening. Transference/countertransference

Question 25

Counseling whereby therapist actively guides and challenges maladaptive behaviors and distorted views.

Answer 25

Interpersonal therapy/IPT
“here and now” focus
Emphasis on relationships

Question 26

Hildegard Peplau’s theory of nursing?

Answer 26

Sullivan’s concept of participant observer

Described 4 levels of anxiety. Defined the stages of the nurse-pt relationship

Question 27

What are some examples of behavioral therapy?

Answer 27

Systematic desensitization, aversion therapy, biofeedback, reward/point systems

Question 28

Maslow’s hierarchy?

Answer 28

Physiological, safety, love and belonging, esteem, self-acutaliztion, self-transcendent

Question 29

Gently challenge distorted beliefs and help client to be more realistic in beliefs.

Answer 29

Cognitive-behavioral therapy (Beck)

When thinking is more realistic, symptoms of depression and anxiety are lessened.

Question 30

A model in which nurses focus on self-adminstration of meds, relapse prevention programs, supported employment, psychiatric advanced directives.

Answer 30

Recovery model
A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

Question 31

What are some questions used to assess function level of the client?

Answer 31

Does the client have some insight into their illness? How well does the client understand the goal of treatment? Is the client in contact with reality? How motivated is the client?

Question 32

What some examples of milieu therapy?

Answer 32

The community meeting, therapeutic communication, scheduled activities, safety. The opportunity for clients to be part of unit management and participate in goal setting. A system of positive and negative reinforcement.