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mental health > week 5 > Flashcards

week 5 Flashcards

1
Q

What is Somatization?

A
  1. Psychological distress is expressed as physical symptoms
  2. Symptoms are not intentional or under conscious control

ANXIETY BASED

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2
Q

What are the different types of somatic disorders?

A
  1. Somatic symptom disorder
  2. illness anxiety disorder
  3. functional neurological disorder
    4.Factitious disorder
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3
Q

Why do individuals who have somatic symptoms disorder refuse psychiatric care?

A

because they believe they have a physical problem not an anxiety problem.

they believe its medical even with negative test findings

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4
Q

What is illness anxiety disorder also known as?

A

“Hypochondriasis”

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5
Q

What are the two types of hypochondriacs?

A
  1. They constantly go to the doctor, they have a headache but think they have brain cancer
  2. Other person just doesn’t go to the doctor they’re “fine”
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6
Q

What symptoms does someone experience with illness anxiety disorder?

A
  1. anxiety symptoms
  2. hyperventilate
  3. chest pain
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7
Q

What is the difference between illness anxiety symptoms and somatic symptoms disorder?

A

Somatic symptoms=PHYSICAL

illness anxiety=ANXIETY

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8
Q

What is functional neurological disorder knows as?

A

conversion disorder or hysteria

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9
Q

Describe what functional neurological disorder is?

A

sudden loss of function

all of the sudden their arm isn’t working or they become blind but there aren’t any medical findings that support that loss of function

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10
Q

Describe Munchausen syndrome.

A

The Act!!

mom intentionally fakes that the daughter is sick when the daughter isn’t actually sick

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11
Q

What is Munchausen syndrome motivated by?

A

attention

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12
Q

What are examples of factitious disorders?

A

munchausen syndrome

Malingering

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13
Q

Describe malingering

A

same as munchausen but it has a benefit

homeless pts need shelter in winter so they get food, shelter…theres an OBVIOUS benefit

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14
Q

What will we look for in an assessment in somatic symptoms disorders?

A
  1. full assessment
  2. if any dramatic terms are used
  3. ability to meet their own needs
  4. family and workplace dynamic
  5. childhood trauma
  6. ability to express feelings and needs
  7. dependence on medication
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15
Q

What are some expected outcomes in somatic symptom disorders?

A
  1. MAIN GOAL:live a normal life as possible
  2. pt will articulate feelings
  3. pt will resume performance of work-role behaviors
  4. pt will identify ineffective coping patterns
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16
Q

what are some nursing implementations in somatic symptom disorders?

A
  1. DO NOT IMPLY THAT THE SYMPTOMS ARE NOT REAL
  2. spend time with pt when they are not expressing a physical complaint
  3. show concern but avoid dependency
  4. reinforce their strengths
  5. teach stress reduction techniques
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17
Q

are there any pharmacological therapies for somatic symptom disorders?

A

No specific meds but they may have an SSRI

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18
Q

Define personality

A

the individual differences in characteristic patterns of thinking, feeling, and behaving.

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19
Q

Define personality disorders

A

enduring pattern of inner experience and behavior that deviates from the individuals culture

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20
Q

are traits inflexible and unpredictable in individuals with personality disorders?

A

yes

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21
Q

Explain the coping mechanisms for someone with personality disorder. How do they act?

A

coping mechanisms are primitive and immature

they act like a child

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22
Q

Explain the “patterns” of someone with personality disorders.

A

maladaptive patterns in behavior, lack of insight, and tendency to blame others.

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23
Q

Do those with a personality disorder tend to seek help?

A

Naur

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24
Q

What causes personality disorders?

A
  1. genetics
  2. neurobiological
  3. psychological influences
  4. cultural considerations
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25
Q

what kind of trauma is usually always experienced for those with personality disorder?

A

childhood trauma in which is rapid and severe

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26
Q

explain what projective identification is

A

ex: you hate your teacher but you believe its because they hate you

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27
Q

what in the “clinical picture” for someone with a personality disorder?

A
  1. Frequently use splitting or protective identification
  2. symptoms begin in early adulthood
  3. less intense symptoms in middle-age and older
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28
Q

what is cluster A described as?

A

odd and eccentric

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29
Q

What 3 disorders are part of cluster A?

A
  1. Schizotypal
  2. Paranoid
  3. Schizoid
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30
Q

What are some characteristics of someone who is schizotypal?

A
  1. odd speech, thinking, and beliefs
  2. Magical thinking
  3. Ideas of reference
  4. Inappropriate affect
  5. Suspicious of others
  6. Social anxiety
  7. Peculiar ideas
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31
Q

What are some characteristics of someone who is paranoid?

A
  1. distrust of others
  2. Reluctance to confide in others
  3. perceives attacks
  4. inability to forgive perceived insults

hostile to weak individuals

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32
Q

What are some characteristics of someone who is schizoid?

A
  1. unable to establish relationships
  2. restricted range of emotions
  3. take pleasure in few things
  4. emotional coldness
  5. solitary
  6. little desire to help others

no desire for humans but attached to animals

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33
Q

Do people with schizotypal have delusions or hallucinate?

A

no

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34
Q

What can category B be known as?

A

the all about me

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35
Q

what four disorders fall under cluster b?

A
  1. antisocial
  2. borderline
  3. narcissistic
  4. histrionic
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36
Q

Describe someone who has antisocial disorder.

A
  1. sense of entitlement (they tx people unfairly)
    2.** lack of remorse**
  2. disregard for safety for others
  3. impulsive
  4. fail to plan ahead
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37
Q

What may have happened to someone with antisocial disorder as a child?

A
  1. parents used substances
  2. disciplined harshly
  3. no supervision
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38
Q

What are some other characteristics of someone who has antisocial disorder?

A
  1. increased chance of DUI
  2. Very charming and use that to manipulate
  3. they make poor financial decisions
  4. they don’t take responsibility
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39
Q

Describe someone who has borderline disorder.

think of Mario

A
  1. they have mood instability
  2. unstable self image
  3. unstable sense of relationships
  4. Frantic efforts to avoid abandonment-will do anything to avoid abandonment
  5. recurrent suicide
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40
Q

what is the key to know someone is borderline?

A

they have unstable and intense relationships

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41
Q

what disorder is borderline often confused with?

A

Bipolar disorder

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42
Q

What are other characteristics of someone with borderline?

A
  1. very clingy
  2. thoughts are intense and dramatic
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43
Q

Describe someone who has narcissistic disorder.

A
  1. Grandiose
  2. Arrogant
  3. Require excessive admiration
  4. lack empathy
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44
Q

Describe someone who has histrionic disorder.

A
  1. Self dramatization
  2. theatrical (main character, drama queen)
  3. use physical appearance
  4. labile
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45
Q

What is the difference between someone who is narcissistic or histrionic?

A

narcissistic want attention but also think they are better than everyone else while histrionic JUST wants attention

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46
Q

What disorders are in cluster C?

A
  1. Avoidant
  2. Obsessive compulsive personality disorder
  3. dependent
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47
Q

Describe avoidant disorder.

A
  1. Hypersensitive to criticism
  2. reluctant to take personal risks
  3. feelings of inadequacy

avoids relationships but DESIRES them/connections

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48
Q

Describe obsessive compulsive personality disorder.

A
  1. Preoccupied with rules and details
  2. rigid perfectionism
  3. Financially stingy

-high achievers
-cannot bend rules
-devote entire life to work

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49
Q

Describe dependent disorder

A
  1. clingy
  2. excessively submissive
  3. difficulty making everyday decisions

-they don’t like conflict
-they lack confidence
-tend to tolerate abusive tx

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50
Q

What should be included in an assessment for those with personality disorder?

A
  1. primitive defenses
  2. suicide/self harm
  3. aggressiveness
  4. substance use
  5. past abuse
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51
Q

For borderline and antisocial what would we implement?

A

limit settings

they’re very manipulative or abusive as far as language so set those limits a bitch

52
Q

For dependent and histrionic what would we implement?

A

Modeling

when you do something and they copy you like a role model

53
Q

for schizoid and schizotypal what should we implement?

A

Respect need for isolation

54
Q

what is dialectal behavioral therapy?

A

addresses strategies for extreme mood swings

55
Q

Which substance is the MOST used in substance use? Second most used?

A
  1. alcohol
  2. marijuana
56
Q

What are some psychiatric comorbidities in someone with substance use and addictive disorders?

A
  1. anxiety disorder
  2. PTSD
  3. depressive disorders
  4. mania
  5. Schizophrenia
57
Q

Are those with a substance use or addiction disorder at higher risk for suicide?

A

yuh

58
Q

Describe cross tolerance.

A

If someone has a high tolerance of alcohol they will need a higher dose for benzos because they’re cross tolerable

59
Q

describe synergistic effects

A

When you have two CNS depressants together the effect become more significant like death

60
Q

describe cross dependance

A

when you substitute the dependance or addiction of a drug with another so if you want to get someone off opioids you replace it with methadone

61
Q

describe antagonistic effects

A

when you give someone an antidote like narcan

62
Q

describe flashbacks

A

when someone has a recurrence of a perceptual disturbance that was caused by an earlier hallucinogenic

someone has flashbacks from when they were high when they’re sober

63
Q

Describe dual diagnosis

A

when someone has a mental health condition and substance use disorder

64
Q

describe codependance

A

One person enables this compulsive behavior

Drug dealer enabling addict

65
Q

Define substance use disorder

A

Cluster os cognitive, behavioral, and physiological symptoms

continues to use substance even if it causes problems

66
Q

What disorders may be induced by substance use disorder?

A
  1. intoxication
  2. withdrawal
  3. psychosis or delirium
67
Q

is addiction a brain disease

A

yes

68
Q

define addiction

A

a chronic relapsing brain disease characterized by compulsive disorder

69
Q

What is addiction disorder strongly motivated by?

A

cravings

70
Q

What is the neurobiology of addiction?

A
  1. brainstem
  2. limbic system
  3. cerebral cortex
71
Q

What does the brainstem control?

A

HR
RR

72
Q

What does the limbic system control?

A

responsible for reward circuit

73
Q

What is the cerebral cortex responsible for?

A

judgment, problem solving

74
Q

What are some CNS depressants?

A
  1. alcohol
  2. Benzos
  3. barbiturates

*all cross tolerant of each other**

75
Q

Define alcohol use disorder.

A

when someone has a problematic pattern of alcohol that leads to impairment or distress

taking larger amounts over a longer period that was intended

76
Q

What does CAGE stand for?

A

C= Cut
A = annoyed
G= guilty
E= eye opener

77
Q

What is the CAGE assessment tool?

A

to screen if there is a potential alcohol abuse

if you answer yes to at least two then you have a probability of having substance or alcohol use

78
Q

What are the four questions in a
CAGE assessment tool?

A
  1. Have you ever felt you should CUT down on your drinking or drug use?
  2. Have people ANNOYED you by criticizing your drinking or drug use?
  3. Have you ever felt bad or GUILTY about your drinking or drug use?
  4. Have you ever had a drink or used a drug first thing in the morning to steady your nerves or to get rid of a hangover? EYE OPENER
79
Q

What are some medical issues that can be caused by alcohol?

A
  1. Gastrointestinal medical problems
  2. Cardiovascular problems
  3. Wernicke-Korsakoff syndrome
  4. Nervous system and brain damage
80
Q

What cardiovascular issues can be caused by alcohol?

A

Dysrythmias and stroke

81
Q

Describe Wernicke-korsakoffs syndrome

A

Deficiency of Vitamin B
-confused and can’t learn new things
-irreversible

82
Q

How do you measure alcohol intoxication?

A

measure the blood alcohol level

not by how they feel

83
Q

What is the legal Blood alcohol level?

A

0.08%

84
Q

What can alcohol intoxication effect?

A
  1. decreased reflexes
  2. impaired judgement
85
Q

What can alcohol withdrawal syndrome syndrome effect?

A
  1. Autonomic
  2. motor
  3. awareness
  4. psychiatric
86
Q

What autonomic symptoms will be experienced in alcohol withdrawal syndrome?

A
  1. Elevated BP
  2. Diaphoresis
  3. n/v/d

elevated vitals in general

87
Q

What motor symptoms will be experienced in alcohol withdrawal syndrome?

A
  1. Tremors
  2. Dysarthria-slurred speech
  3. Seizures- BIG CONCERN
88
Q

What awareness symptoms will be experienced in alcohol withdrawal syndrome?

A
  1. agitation
  2. Irritability
  3. Insomnia
  4. Disorientation
89
Q

What psychiatric symptoms will be experienced in alcohol withdrawal syndrome?

A
  1. Anxiety
  2. hallucinations
  3. paranoia
90
Q

When does alcohol withdrawal delirium peak?

A

peaks 48-72 hours after cessation/reduction

91
Q

how long does alcohol withdrawal delirium last?

A

2-5 days

92
Q

Is alcohol withdrawal delirium a medical emergency?

A

yes

93
Q

What is important to ask/look for when someone is experiencing alcohol withdrawal delirium?

A
  1. when was their last drink
  2. seizures are crucial watch for this
94
Q

What is the CIWA scale?

A

scale used to assess and diagnose the severity of alcohol withdrawal.

95
Q

What are the medications for alcohol withdrawal?

A
  1. Benzos
  2. Barbituates
  3. Anticonvulsants
  4. Vitamins
96
Q

Why would you give someone with alcohol withdrawal a barbiturate?

A

only give barbs if not responding to benzos

97
Q

What are the medications for alcohol sobriety?

A
  1. Disilfiram (Antabuse)
  2. Naltrexone
  3. Acamprosate
98
Q

Which medication focuses on cravings and should NOT be taken if they’re taking opioids?

A

Naltrexone

99
Q

Which medication is used as an eversion therapy/used everyday for alcohol sobriety?

A

Disulfiram

100
Q

What is important to avoid when taking Disulfiram?

A

avoid things with alcohol in them like hand sanitizer, wine cooked in food etc. if they ingest they can have terrible symptoms

101
Q

What are some examples of opiates?

A
  1. heroin
  2. Oxycodone
  3. Fentanyl
102
Q

When does someone peak with opioid withdrawal?

A

3-5 days but withdrawal can last up to 4 weeks

103
Q

When does opioid withdrawal occur?

A

12 hr after last use

104
Q

What are symptoms of opioid withdrawal?

A
  1. low energy
  2. irritability
  3. flu-like symptoms
  4. hot and cold sweats
  5. severe muscle aches and pains
  6. abdominal cramping
105
Q

What is a key symptom of someone who has an opioid overdose?

A

PINPOINT pupils

106
Q

what are symptoms of opioid overdose?

A
  1. pinpoint pupils
  2. respiratory depression
  3. decreased LOC
107
Q

What are medications for opioid overdose?

A
  1. Nalaxone
  2. Nalmefene
108
Q

How often should naloxone be administered?

A

every few hours and works almost instantly

109
Q

Why don’t we normally give nalmefene?

A

because withdrawal symptoms could last longer

110
Q

What are the medications for opioid withdrawal?

A
  1. methadone
  2. Clonididne
  3. Buprenorphine
111
Q

What medication for opioid withdrawal is given to a pt with unstable vitals?

A

Clonidine

112
Q

What medication for opioid withdrawal is given to a pt that needs help with cravings?

A

Methadone

113
Q

which medication is a long acting opioid and doesn’t give them the high?

A

Methadone

114
Q

Which medication for opioid withdrawal is given as a detox AND to help cravings?

A

Buprenorphine

115
Q

What are some CNS stimulants?

A
  1. Cocaine
  2. Methamphetamine
116
Q

What can CNS stimulants cause?

A
  1. increase alertness
  2. heighten sexual arousal
  3. increase energy
117
Q

If someone is using CNS stimulants what is key to know?

A

they have nose bleeds and dilated pupils

due to OD they can suffer from stroke or heart attack

118
Q

What withdrawal symptoms can someone experience with cocaine and crack?

A
  1. Depression
  2. Paranoia
  3. Lethargy
  4. Anxiety
  5. N/V
  6. Sweating

Euphoria but then sends them into deep depression

119
Q

What can meth cause?

A
  1. a more permanent psychosis
  2. cracked teeth
  3. skin infections
120
Q

Why are those that use meth more prone to skin infections?

A

because their always picking at their skin because they think there’s bugs

aka meth induced psychosis

121
Q

Why is meth used for survival for the homeless?

A
  1. keeps them awake
  2. keeps them warm
  3. Decreases appetite
122
Q

Explain abstinence syndrome.

A
  1. strong cravings
  2. impaired concentration
  3. restlessness
  4. Increased appetite

like withdrawal

123
Q

What are some nicotine based pharmacological aids?

A
  1. Patches
  2. Gums
  3. Lozenges
  4. Nasal sprays
  5. inhalers
124
Q

What are some nicotine free pharmacological aids?

A
  1. Varenicline (Chantix)
  2. Buproprion (Zybran)
125
Q

Why should someone using bupropion as a nicotine free pharmacological aid be cautious?

A

its an antidepressant and can cause SJS and suicidal ideation

mental health (14 decks)

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