Unit 1 Flashcards
a normal biological adaptation to long-term use of a drug.
tolerance
a normal physiological response that most people experience after a week or more of continuous opioid use. If an opioid is discontinued abruptly or if an opioid antagonist such as naloxone (Narcan) is administered, the patient experiences withdrawal syndrome
physical dependence
a disease of the brain that causes the compulsive pursuit of a substance or behavior to obtain reward or relief from craving. Addiction is characterized by poor control over drug use, craving, reduced recognition of problem behaviors, and continued use despite harm.
Addiction or psychological dependence
described in patients who are receiving opioid doses that are too low or spaced too far apartto relieve their pain.
pseudoaddiction
Early stage alzheimer’s
no apparent manifestation
What stage of alzheimer’s is this?
forgetfulness
forgetfullnes of glasses or wallet, no memory problems
Stage 2 alzheimer’s
the followinf is what stage of alzheimer’s
mild cognitive decline
(inability to plan, decreased attention, unable to remember names, difficulty in social or work situations)
Stage 3 alzheimer’s
The following is what stage of alzheimer’s
mild to moderate cognitive decline
(withdrawn, obvious memory loss, limited knowledge, difficulty performing task planning or organzing, depression and social withdral)
Stage 4 alzheimers
the following is what stage of alzheimer’s
moderate cognitive decline
(inability to recall important details such as address, telephone, schools, assistance with adls become necessary, disorientation and confusion as to time and place)
stage 5 alzheimers
the following is what stage of alzheimer’s
moderate to severe cogntive decline (late stage)
(loss of awareness to recent events, can recall name but not hx, significant personality changes, wandering behavior, x1 w/adls, normal sleep cycle is disrupted, increased episode of incontinence
stage 6 alzheimer’s
The following is what stage of alzheimer’s
severe cognitive decline
(inability to respond to enviorment, speak, control movement is lost, unrecongizible speech, incontinence, inability to eat w/o assistance and impaired swallowing, ataxia)
stage 7 alzheimer’s
What can cause problems with older adults and medication doses? What system changes are there?
risk for toxic reactions, risk for adverse drug reaction due to multiple prescribed drugs, everything in older adults diminishes GI, inability to exert drugs.
System changes include- GI, body fat, plasma proteins, hepatic function, renal function.
negative symptoms of schizophrenia
include affective blunting or flattening,alogia, avolition,apathy, anhedonia, and social isolation.
The following are s/s of what:
Patients are usually hospitalized for exacerbation of positive symptoms, which include hallucinations, delusions, disorganized thinking, and disorganized behavior.
Establish a therapeutic rapport with the patient, Convey acceptance and unconditional positive regard for the patient.Assure the patient of his or her safety.
Offer to accompany patient to milieu activities.Acknowledge the patient’s efforts to interact and attend activities.
positive symptoms of schizophrenia
the following are s/s of what?
Pale or flushed face, YELLING, SWEARING, agitated, threatening, demanding, clenched fist, threatening gestures, hostility, loss of ability to solve the problems or think clearly
s/s of excalating behavior
elevated mood, expansive and irritable;
requires hospitilzation,
last for 1 week.
mania
The following are s/s of what?
agitation, reslteness, intolerance of criticism, increase talking and activity, flight of ideas, grandiosity, impulsive, manipulative behavior, decreased attention span, poor judgment, attention seeking behavior, decreased sleep, neglect of adls, delusions/hallucinations, denial of illness
s/s of mania
last 4 days accompanied w/3or more manifestions of mania. No Hospital req.
depressed (hypomania)
flat, blunted labile effect, tearfulness, lack of energy, anhedonia; loss of pleasure and interest activites hobbies sexual activity, reports pain, difficulty concentrating, decrease in personal hygiene, loss or increase of appetite, retardation or agitation.
S/S of depression or hypomania
Fear of gaining weight, disturbance in self-perceived weight or shape, intake restriction leading to low body weight.
anorexia
s/s of anorexia
weight loss/ gain, refusal to eat, hx of dieting, methods of weight control, value attached to shape of body, lack of nurture, low bp, brittle skin and nails, irregular hr, Acidosis or Alkalosis, dehydration, muscle weakness, low energy, bone loss density, GI Issues, irregular periods
Client eats a great deal of calories and follows with purging behaviors of enema, laxatives, diuretics, self-induced vomiting. Binge eating followed by guilt.
bulimia
s/s of bulimia
distress before eating episode, once per weeks for 3 months, weight gain.
inability to concentrate on a single thought.
Can progress to flight of ideas in which client speech moves rapidly. Incoherent thoughts.
associative looseness
made up words that have meaning only to client “I tranged and flittled”
neogolisms
repetition of words spoken to them
echolalia
meaningless rhyming of words “ oh fox, box, lox”
clang association
words jumbled together with little meaning to the listener. “hip hooray, the flip is cast and wide sprinting in the forest”
word salad
words jumbled together with little meaning to the listener. “hip hooray, the flip is cast and wide sprinting in the forest”
word salad
multiple and unneeded details during a conversation; such as detail the weather and clothes they are wearing when asked what their plan for the day is.
circumstantiality
talks about trivial information rathr than focus on the main topic of conversation; such as talking about what they are having for lunch when the topic is about medications.
tanglentially
risk factors for ADHD
Familial Tendency Exposure to toxins or medicines Chronic otitis media Meningitis Head trauma
(Ph greater than 7.45) - Vomiting, NG TUBE Suctioning, Bulimia, Renal disease.
metabolic acidosis
(Ph under 7.35) – diarrhea, renal disease, small intestine, surgery, laxative abuse.
metabolic acidosis
(PH greater than 7.45) – Hyperventilation
respiratory alkalosis
(PH under 7.35)- COPD, sleep apnea, opioid toxicity, asthma, anesthesia
respiratory acidosis
The following are symptoms of what:
Fear (usually of dying, losing control of self, or “going crazy”)
Feelings of impending doom
Dissociation (feeling that it is happening to someone else or not happening at all)
Nausea
Diaphoresis
Chest pain
Palpitations
Shaking
Can be confused w/ a heart attack by a pt in an ER.
Panic attacks
positive s/s of schzophrenia
hallucinations and delusions
negative s/s of schizophrenia
apathy, flat affect, anhedonia
client is responsive and able to fully respond would be considered what LOC
Alert
the client is able to open eyes and respond but drowsy and falls asleep would be considered what LOC
lethargic
client requires vigorous or painful stimuli, might not be able to respond verbally. (pinching a tendon or rubbing sternum) would be considered what LCO
Stuporous
unconscious and does not respond to painful stimuli would be used to describe a patient in what LOC
Comatose
Weight loss, lack of interest in play w/ age group in a preschooler could be classified as
depression
School-aged child with trouble concentrating at school, paying attention, making decision, recalling information, less confident, stating “ I cant do anything right”
could be diagnosed with
depression
Adolescents with poor hygiene, stop communicating w/friends, lose interest in teen activites, risk for suicidal thoughts, depression more common in girls than boys.
could be diagnosed with
depression
unconsciously staying away from events or situations that might open feelings of aggression or anxiety
avoidance
Making up for something we percieve as an inadequacy bby developing some other dsirable trait
compensation
Anxiety is channeled into physical syptoms (symptoms disapear soon after the threat is over)
conversion reaction
Unconscious refusal to see reality. Usually the first defense learned and used. Is not consiously lying
denial
Transferring anger and hostility to another person or object that is percieved to be less powerful: the “kick-the-dog syndrome:
displacement (transferrence)
painful events or situationsare separated or dissaociated from from the consious mind. Patients will often say, “I had an out of body experience” or “it happened to someone else, but it felt lik eit happened to me”
dissociation
A person takes on the ideas or personality traits of someone that he or she fears or respects
Identification
Separates self from uncomfortable emotions by focusing facts and logic. When her husband dies, the wife relieves her pain by saying “it’s better this way because he was suffering so much
Intellectualization
Emotion that is separated from the original feeling
Isolation
Not acknowledging or accepting the significance of one’s own behavior, making it seem less important
MInimization
Use of a logical-sounding excuse to cover up true thoughts and feelings. THe most frequently used defense mechinism
Rationalization
Similar to compensation, except the person usually develops the exact opposite trait
Reaction formation/overcompensation
Emotionally rreturning to an earlier time in life when there was far less stress. Most commonly seen in hospitalized pt’s
regression
An unconscious “burying” or “forgetting” mechanism excludes or witholds from our conscious events or situations that are unbearable; a step deeper than denial
repression/stuffing
Making amends for a behavior one thinks is unacceptable. Making an attempt at reducing guilt.
Restitution
Unacceptable traits or characteristics are diverted into acceptable traits or characteristics
sublimation
Lithium levels
NR 0.5-1.5 for acute
NR 0.6-1.2 for long term
For pt’s taking lithium what diet and fluid recommendations?
Advise patient to drink 2000–3000 mL fluid each day and eat a diet with consistent and moderate sodium intake.
Symptoms to report with litium
Fainting
Irregular pulse
Difficulty breathing
Fever, nausea, vomiting.
How often should litium levels be taken
twice a week during initiation of therapy and every 2 months during chronic therapy
