Week 3 & 4 Flashcards
Define mood
Subjective feeling that a person experiences.
It is on a continuum (constantly changes)
Define disinhibition
Inability to withhold an inappropriate or unwanted behaviour e.g spending copious amounts of money
Define seclusion
The individual is placed in a small room without any restraints e.g person is under assessment order
Define bipolar as a mood disorder
It is a mental health condition that causes severe disturbances of mood
Identify and explain the two types of bipolar
- Bipolar I: characterised by episodes of severe mania and severe depression
- Bipolar II: characterised by episodes of hypomania (not requiring hospitalisation) and severe depression
What are the key features of bipolar?
- Mania: persistent elevated, expansive, irritable mood coupled with a lack of need for sleep and engagement of goal directed activity (must last at least 1 week)
- Hypomania: a period of mania characterised by mood elevation and similar to mania, yet lacks the need for hospitalisation and presence of psychotic features.
- Mixed episodes: the person experiences symptoms of mania and depression at the same time (e.g agitation, restlessness, and decreased need for sleep, which is typically seen in mania, coupled with depressed mood
What are the signs and symptoms of mania?
-increased energy/hypervigilance/feeling weird
-racing thoughts and flight of ideas
-more talkative than usual (pressured speech)
-inflated confidence/self esteem
-distractibility
-decreased need for sleep
-engaging in risky behaviours
-increase in goal directed behaviour
feelings of euphoria or extreme irritation
-impaired judgement and decision-making ability
-impulsivity
-disinhibition +/- symptoms of psychosis
What are the treatment options available for BPAD
-Pharmacological treatments
-Mood stabilisers (e.g sodium valproate, lithium, lamotrigine and carbamazepine)
-Antipsychotics
-Antidepressants (risk of triggering a manic episode)
-Nonpharmacological treatments (e.g CBT, ACT, behavioural strategies, mindfulness cognitive therapy)
What are the signs and symptoms of major depressive disorder?
-depressed mood most of the day
-diminished interest in pleasure in all or almost all activities
-significant weight loss or weight gain
-insomnia or hyper insomnia nearly every day
-psychomotor agitation or retardation
-fatigue/loss of energy
-feelings of worthlessness or inappropriate guilt
-recurrent thoughts of death, recurrent suicidal ideation
What are the treatment options for clinical depression?
- Pharmacological treatments:
Antidepressants:
-selective serotonin reuptake inhibitors
-tricyclic
-serotonin-noradrenaline reuptake inhibitors
-monoamine oxidase inhibitors - Non-pharmacological treatments:
-CBT
-ACT
-behavioural strategies
-mindfulness based cognitive therapy - Physical treatments
-electroconvulsive therapy (ECT)
-transcranial magnetic stimulation (TMS)
What are the physical signs/effects of anxiety
-increased respiratory rate (shallow)
-increased heart rate
-increased blood pressure
-sweating (diaphoresis)
-dry mouth
-trembling/shaking
-tensions/stress
-headaches
-dizziness
-hyperventilation
-nausea
What are the psychological/cognitive signs/effects of anxiety?
-negative thoughts
-overthinking
-cataphrophise
-irrational thoughts
-lack of concentration
-low mood
-irritability
-worry/apprehension
-stressed
What are the behavioural signs/effects of anxiety
-agitation
-restlessness
-disassociation
-shutting down
-procrastination (avoidance behaviour)
-isolation or withdrawal
What are the causes of anxiety disorders?
-overprotective parenting styles
-physical health issues (chronic illness)
-substance abuse (addiction)
-life circumstances e.g grief, pressure of ongoing stressors
Explain the specific anxiety disorder of panic disorder
Involves panic attacks; intense and sudden overwhelming anxiety, chest pain, hyperventilation
-shortness of breath
-person develops anxiety around thoughts regarding having another panic attack
-person may develop agoraphobia (not wanting to leave the house)
What are the treatment options for anxiety disorders?
- Pharmacological treatment:
long term treatment; antidepressants (sertraline, fluoxetine) and beta blockers (propranolol and atenolol)
short term treatment; benzodiazepines such as diazepam - Non-pharmacological treatment:
-graded exposure: aims to help a person break the pattern of avoidance to feared objects or situations
-CBT
-ACT
Explain the specific anxiety disorder of phobias
Persistent excessive fear towards a particular trigger or stimulus
-“Irrational fear”
-when the stimulus is not around/present they will not experience anxiety, however if they think about this then this could trigger anxiety
Explain the specific anxiety disorder of generalised anxiety disorder
Persistent and intense anxiety/worry all day most of the day, impacting the person’s daily functioning
-symptoms last 6 month in order for as diagnosis
Explain the specific anxiety disorder of social anxiety
Experienced discomfort in certain social situations
-the person could come across as rude or demonstrate avoidant behaviour
-perceived threat causing a person to avoid a certain social interaction/situation
Explain the specific anxiety disorder of obsessive compulsive disorder (OCD)
Obsessions and compulsions that interfere with daily activities
Obsessions: unwanted, intrusive, and persistent thoughts
Compulsions: urges to do certain rituals or actions/behaviour
What is the role of the nurse in caring for someone with a specific anxiety disorder?
-supportive interventions, therapeutic communication and education
-based on principle of promoting a sense of emotional and physical safety
-administration of PRN medication, promote the use of deep breathing/relaxation techniques
-decreasing the amount of stimulation, sitting with the consumer
-strengths based approach
Outline the steps involved in the management of panic attacks
- Outline the steps that you could consider in managing a panic attack
-get the client to control their breathing
-being calm with the client
-removing the stimulus (sensory modulation) - Outline the management of GAD and the role of the nurse on the ward
-implementation of pt. care plans
-asking the pt. preference of their own treatment
-education regarding empowerment (strength based approach) and medication options - Psychotherapeutic approaches in managing anxiety disorders
-CBT
-Exposure therapies
-relaxation methods - Develop three goals of psychoeducation for a consumer with GAD
-provide strategies a pt. can use when feeling anxious
-increase their understanding of pt. anxiety (origin of anxiety)
-to promote relapse promotion
What are the early warning signs of aggression?
-agitation
-restlessness
-pt. raising voice
-changes in behaviour
-avoidant eye contact
-minimal conversation
-demanding
-aggressive body language
-impatient behaviours
What are early intervention strategies to minimise the likelihood of aggression
- Aware of triggers for aggression
- Validating the pt. feelings
- Avoid negative talk
- Identify pt. goals of care
- Active listening
