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NURS 3036 - Mental Health Theory > Week 3 and 4 Powerpoint > Flashcards

Week 3 and 4 Powerpoint Flashcards

1
Q

Review:

What are the 5 categories of the MSE?

A
  1. General appearance
  2. Emotional State (mood/affect)
  3. Perception/sensory experience
  4. Thinking (thought content and form)
  5. Sensorium/Cognitive processes
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2
Q

What are three examples of mental disorders or situations whereby a patient might exhibit/experience psychosis?

A
  1. Schizophrenia
  2. Schizoaffective disorder
  3. Bipolar disorder
  4. Major depression
  5. Brief reactive psychosis
  6. ICU psychosis
  7. Post partum psychosis
  8. Drug/substance induced
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3
Q

What are three examples of problems/behaviours that a person with psychosis might be experiencing?

A
  1. Anxiety
  2. Agitation
  3. Difficulty processing information
  4. Difficulty communicating needs
  5. Disturbances in sensory experiences
  6. Many others!
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4
Q

What are the goals of care associated with a psychotic/schizophrenic patient?

A
  • establish safety, security, and trust
  • orient towards reality
  • alleviate high levels of anxiety and agitation
  • Promote action towards: appearance, hygiene, biological needs, social behaviour (appropriate)
  • Increase/maintain self esteem
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5
Q

What are the 5 types of schizophrenia?

A
  1. Paranoid
  2. Disorganized
  3. Catatonic
  4. Undifferentiated
  5. Residual
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6
Q

What is specific to paranoid schizophrenia?

A

Presence of auditory hallucinations or prominent delusional thoughts about persecution or conspiracy

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7
Q

What is specific to disorganized schizophrenia?

A

Disorganization of the thought processes

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8
Q

What is specific to catatonic schizophrenia?

A

Disturbances in movement

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9
Q

What is specific to undifferentiated schizophrenia?

A

Symptoms that are NOT sufficiently formed or specific

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10
Q

What is specific to residual schizophrenia?

A

No longer displays prominent symptoms

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11
Q

What are the 5 negative symptoms of schizophrenia?

A
  1. Affective flattening
  2. Alogia
  3. Avolition/apathy
  4. Anhedonia
  5. Attention problems
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12
Q 
Define alogia
Is it (+) or (-)?
A

Inability to speak

  • b/c of mental defect, mental confusion or aphasia
  • NEGATIVE symptom
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13
Q 
Define avolition/apathy
Is it (+) or (-)?
A

Severe lack of initiative or motivation

- NEGATIVE symptom

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14
Q 
Define Anhedonia
Is it (+) or (-)?
A

Inability to feel pleasure

- NEGATIVE symptom

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15
Q

What are 6 positive symptoms of schizophrenia?

A
  1. Delusion
  2. Hallucinations
  3. Thought form disorders
  4. Disorganized speech
  5. Bizarre behaviour
  6. Inappropriate affect
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16
Q

What is the main neurotransmitter than is related to schizophrenia?

A

Dopamine

17
Q

If a person is schizophrenic/psychotic, do they too much dopamine or not enough dopamine?

A

Too MUCH dopamine

18
Q

What can happen if you have too little dopamine?

A

Unwanted motor side effects

19
Q

What are the 4 EPS (extrapyramidal side effects) of antipsychotic drug use?

A
  1. Acute dystonia
  2. Akathisia
  3. Pseudoparkinsonism
  4. Tardive dyskinesia
20
Q

Explain what acute dystonia would look like and what it is

A

Severe muscle spasms, difficulty swallowing, stiff neck, rotation of eyes upwards, PROTRUSION of tongue
- It’s an extrapyramidal side effect (EPS)

21
Q

What medication can be given if acute dystonia is suspected?

A

Benztropine (Cogentin) (IM)

- extremely powerful muscle relaxant

22
Q

Explain what akathisia would look like and what it is.

A

Extreme restlessness, pacing, jittery, discomfort alleviated with pacing/moving
- It’s an extrapyramidal side effect

23
Q

When does akathisia commonly appear?

A

After the first few days of treatment

  • important to recognize, b/c if not, the antipsychotic drug dosage may be INCREASED to relieve agitiation
  • This would only make it WORSE - it’s a SIDE EFFECT!
24
Q

What are three features of pseudo parkinsonism?

A
  1. Repetitive “pill rolling” movement
  2. Persistent tremors
  3. Shuffling gait/taking small steps
25
Q

Describe the movements of tardive dyskinesia

A
  • Involuntary movements
  • most commonly affects the lower face
  • “delayed and abnormal movement”
26
Q

When does tardive dyskinesia appear during treatment? Very quickly or over a long period of time?

A

Tardive Dyskinesia appears late in treatment

- after the patient has been taking the medication for a long period of time

27
Q

Define mood

A
  • one’s prevailing emotion

- synonymous with emotion and feeling state

28
Q

Define affect

A

Emotional responsiveness

  • observed mood (from nurse’s perspective)
  • described in range, intensity, appropriateness and stability
29
Q

What are three options for treatment of depression?

A
  1. Medication
  2. Electro convulsive therapy (ECT)
  3. Psychotherapy
30
Q

What are the 4 categories of medications for the treatment of depression?

A
  1. SSRI (selective serotonin reuptake inhibitors)
  2. SNRI (serotonin norepinephrine reuptake inhibitors)
  3. TCA (tricyclic antidepressants)
  4. MAOI (monoamine oxidase inhibitors)
31
Q

What is TCA (tricyclic antidepressants) not the first choice of drug for treating depression?

A

Has more side effects than the other categories

32
Q

What is the most effective category of medication for treating depression but it is not the first choice of treatment? Why?

A

MAOI (monoamine oxidase inhibitors)

- can increase BP to dangerous levels if mixed with tyramine (old cheese, wine, cold medication)

33
Q

What happens during ECT?

A

A brief electric current through the brain, while the patient is sedated to induce a seizure

  • used to treat severe depression
  • used when a person is a risk to themselves
34
Q

Describe cognitive behaviour therapy (CBT)

A

How thoughts contribute

35
Q

Describe interpersonal therapy

A

How relationships contribute

36
Q

Describe psychodynmaic therapy

A

How behaviour contributes

37
Q

Describe individual counseling

A

Increase understanding/develop strategies

38
Q

Describe family counseling

A

Helps families learn and heal

39
Q

Describe group counseling

A

Helps connect with others

NURS 3036 - Mental Health Theory (5 decks)

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