theory exam 2 Flashcards
a. Complex attention
b. Executive function
c. Learning and memory
d. Language
e. Perceptual-motor
f. Social cognition
6 domains in diagnosis of neurocognitive disorder
a. Lewy Body disease
b. Traumatic brain injury
f. Prion disease
g. HIV
h. Parkinson’s disease
j. Huntington’s disease
d. Alzheimer’s Disease
disease processes can contribute to the development of a Neurocognitive Disorder
disturbance in cognition, awareness, attention
i. Memory deficit, disorientation, language disturbance, develops over a short period of time, fluctuate during cause of day, reversible
Delirium
a. 1: no apparent decline in memory
b. 2: stage of forgetfulness, lose things
c. 3: mild cognitive decline, family/friends notice
d. 4: mild/moderate forget major events
e. 5: moderate cognitive decline, needs help with ADL’s
f. 6: moderate/severe – can’t do any ADL’s, difficulty with communication
g. 7: Severe cognitive decline, rigid muscles, chair/bed fast, no longer able to recognize family, incontinence, sleep cycle disturbed
7 stages of Alzheimer’s
a. Mental status
b. Physical history
c. Family history
d. Drug/alcohol history
Important assessment data to gain when assessing a client with neurocognitive disorder
a. Persistent, irrational fear attached to object or situation that object does not pose significant danger
i. Zoophobia (animals)
ii. Claustrophobia (closed spaces)
iii. Acrophobia (heights)
iv. Algophobia (pain)
v. Nyctophobia (dark)
Phobia
excessive anxiety and worry about a number of events
i. S/S: impatience, irritability, hyperarousal, difficulty concentrating and sleeping
Generalized anxiety
involves excessive fear/anxiety concerning separation from home or attachment figures
separation anxiety
recurrent, persistent thought idea, impulse or image that is experienced as intrusive and inappropriate, causes anxiety
Obsession
repetitive, ritualistic behavior the person feels compelled to perform medication administration, repetitive behaviors, desensitization/relaxation
compulsion
physical symptom that suggests a medical condition but it doesn’t have a pathological cause
i. Patient is consumed with symptoms
Somatic symptom disorder
worried they have an illness but they are not consumed by symptoms
i. Focused on overall illness
Illness anxiety disorder
phenomena, no concern with symptoms
La Belle Indifference
medically unexplained symptoms (altered voluntary motor or sensory function)
i. Psychological component present, resolves within a couple weeks
1. Walking down aisle
2. Going to the airport
Conversion
a. Avoid naps to save up sleep
b. Daytime stimulants to keep awake during the day
c. Some antidepressants can help
interventions for sleep-wake disorders (insomnia,hypersomnolence, narcolepsy)
a. History of physical, psychological or sexual abuse
b. Repeated and severe, creates another personality that didn’t have the abuse
c. Existence of 2 or more personalities within 1 person
d. Don’t recognize it until someone else points it out
cause of dissociative identity disorder (DID)
a. Socialization
b. Support
c. Task completion
d. Camaraderie
e. Informational
f. Normative
g. Empowerment
h. governance
8 functions of group therapy
a. Initial: getting acquainted, clarifying goals, dependency on leader
b. Working: communicate freely in problem solving, conflict and cooperation emerge, less dependent on leader
c. Termination: evaluation of group experience, explore feelings regarding separation
stages of group development
a. Size: 7-8 is ideal, otherwise too many personalities, opinions, voices, etc
b. Homogeneity/heterogeneity: age, gender, diagnosis help them feel like they’re not alone, someone understands them
c. Cohesiveness: ability to create a bond
d. Stability: respect and recognize others, helps with creating bond
e. Purpose: ability to understand a specific topic
f. Focus: expected outcome and goal
g. Leadership Styles (list all three): 1) Autocrative 2) Democratic 3) Laissez-faire (least amount of structure)
h. Conformity to norms:
i. Member roles: complete task, maintain group promises, fulfill personal/individual needs
characteristics of group
a. Instillation of hope, university, the imparting of information, altruism, the corrective recapitulation of the primary family group, the development of socializing techniques, imitative behaviors, interpersonal learning, group cohesiveness, catharsis, existential factors
Yalmon’s curative factors
a. 1st: initial exposure
b. 2nd: problem solving techniques utilized to try to relieve stress
c. 3rd: internal and external resources are called upon to relieve discomfort
d. 4th: tension builds itself up to a breaking point
4 phases in crises
a. Perception of event: is it stressful? Are they looking at it realistically?
b. Support systems: available? Unavailable? Helpful?
c. Coping mechanisms: appropriate vs. inappropriate coping skills
Paradigm of balancing factors
a. Goal: bringing back to equality, emphasis focus on their strengths, what got them through
b. Directive approach: actively problem solves, collaborates with person and his/her support group, conveys hope that crisis will be resolves, assess suicide optional and intervene if necessary
goal of crisis intervention
how does interventionist take a directive approach
a. Assist patient to effectively express and resolve anger
b. Give space/time
c. Decrease stimuli
d. Verbal interventions and limit setting
e. Do not engage in a power struggle
f. Offer PRN meds
interventions for aggressive/angry patients
Cluster A personality disorders
Schizoid
Paranoid
Schizotypal
Cluster B personality disorders
Histrionic
Antisocial
Borderline
Narcissistic
Cluster C personality disorders
Avoidant
Dependent
Doesn’t belong personality disorders
Passive aggressive
personality disorders NOS
Odd, excentric behaviors
cluster a
dramatic, emotional, irritic
cluster b
anxious or fearful, unspecified: maladaptive behaviors, passive aggressive: comply with others but passively don’t do it
cluster c
- The nurse is working with a client with a narcissistic personality disorder, the nurse would use which of the following approaches.
matter of fact
- Which of the following underlying emotions is commonly seen in an avoidant personality disorder?
insecurity
- The nurse is working with a client with antisocial personality disorder and would expect which of the following behaviors?
exploitation of others
withdrawal from social activities
social smile, recognition of mother, touching face, hair, jewelry
differentitation 4-10 months
locomotion allows some control over closeness and distance, mirrors excitement of cheerleading, “refuel” by checking in with mom, feels on top of the world
practicing 10-18 months
clingy, demands consistent mother involvement, emotional fulfilled
boardline personality disorder occurs here due to mothers lack of fostering healthy seperation
rapprochement 15-30 months
has image of mother while away image of good and bad mom
object constancy 3-4 years
on time , inability to enjoy leisure time, completive, prone to coronary heart disease
personalitiy a
perform under pressure, can enjoy leisure time without gilt, time urgency, think decisions through, lower risk of heart disease
personalitiy B
suppression of anger puts others needs before own, holds grudges, prone to cancer
personality C
learning of behavioral change occurs because of Condit which results in conditioned response learning
i. Fear of injections may be conditioned by the combined sight of nurses uniform and the presence of the needle/syringe
classical conditional Pavlov
: belief that behavior is strengthened or weakened by consequences which consit of positive or negative reinforcers
operant condition
automatic thoughts, replacing irrational or distorted thought or feelings/behaviors with logical thinking
cognitive therapy
learn by positive or negative behaviors “role model”
modeling
stress reduction, thinking of visualizing something to relax
imagery
role play, mostly with child/adolesent
behavior rehersal
slow intro of a low fear and slowly working it up to a high fear
systematic desensitization
decreasing behavior by introducing more adaptive behaviors
i. Focusing of breathing, rather than the stressor itself
reciprocial inhibition
passive style, desire to please others at own expense, want to be likedq
nonassertive
communicate effectively, respected by others, stand up for own rights, taking responsibility for own chores, words and actions
assertive
defend basic right but violate rights of others, expresses feelings of dishonesty/inappropriately, puts down others (bully)
aggressive
“forgot” use humor to abuse highly critical and sarcastic, resisting social and occupational demands
passive aggressive
a. Supportive: patient encourages, change or share a supported, safe environment (short term)
b. reconstructive: utilizing knowledge and applying it to all aspects of life (2-5 years)
types of psychotherapy
Tension build up
i. Increase verbal, minor physical abuse, increase tension/anxiety, decrease effective communication
phase 1 of abuse cycle
Battering incident
i. Abuse occurs, most violent phase, shortest phase, “teach them a lesson”
ii. Initiator victim or victimizer, excuses for the marks, denies abuse, distraction from abuse, S/S, at risk for most serious injuries
phase 2 of abuse cycle
promises, “it won’t happen again”, untrue apologies, buys things, makes them happy, relive the original dream, CALM, LOVING, HONEYMOON PHASE
phase 3 abuse cycle
a. Private area to discuss battering, to help the victim recognize choices and regain control over life, discuss available resources, limit the amount of caregivers
intervention for rape
a. Independent acts: things RN can, should and must do on her own initiative
i. Side rails, support group info
b. Dependent acts: dependent on orders of someone else
i. Meds, dressing
nurse practice acts
a. Memory: short term memory decreased
b. Intellectual functioning: problem solving becomes more difficult
c. Learning ability: takes longer, but can still learn new things
psychological changes in normal aging process
a. Health promotion strategies are tied to lifestyle choices that impact present and future health
b. Primary Prevention: prevention of illness before it occurs
c. Secondary prevention: early case finding and prompt intervention
d. Tertiary prevention: Rehabilitation to decrease long term disability
public health model of health promotion
a. To assist patient/family to gain, regain, maintain or restore optimal state of health and independence, to minimize and rehabilitate the defects of illness and disability before or after institutionalization, to prevent institutionalization altogether when possible
goals of psychosocial home health care
