week 5 notes Flashcards
depersonalization/derealization disorder is when
a client experiences feeling detached from themselves or that the outside world is unreal
client has a new diagnosis of dissociative identity disorder. which meds should the nurse expect the doctor to prescribe
fluoxetine (ssri)
bensodiazepenes
beta blockers
somatization
physical manifestations that cannot be explained medically
*not under conscious control
illness anxiety disorder is treated with..
*hypochondriac
antidepressants (ssri’s-fluoxetine)
factitious disorder
gypsy rose
*** conscious control
falsifying symptoms to oneself or others even w/o reward
malingering
intentional reporting of symptoms for personal gain
drug seeking
dissociation
mental state of discnnecting from one’s thoughts memories or feelings
positive dissociative symptoms
identity
depersonalization, derealization, & division of identity
negative dissociative symptoms
mental issues
lack of control/access to mental functions, amnesia
functional neurologic disorder
neurological manifestations are present (blindness, paralysis, inability to swallow) w/o identifiable medical causes
grounding techniques
shower, exercising, holding an object & focusing, 5 x see, 4x feel, 3x hear, 2x smell, & 1x taste
withdraw from alcohol is usually treated with and includes
benzodiazepenes
agitation, high temp, increased respirations, irritability, & confusion
stage 2 withdraw of alcohol may include
anxiety
diaphoresis
increased BP & body temp
tachypnea
mood disturbances
stage 3 withdrawl of alcohol includes
hallucinations
disorientation
SEIZURES
sets of lab data that indicates chronic use of alcohol
liver panel
compressive metabolic panel
BAL/BAC
magnesium
hallucinogen withdrawal symptoms
headaches
increased appetite
sleepiness
depression
opiod withdrawal symptoms
*occurs 12 hrs after
n/v/d
generalized body pain
insomnia
low energy
irritability
hot & cold sweats
restlessness
muscle & bone pain
stimulant withdrawal symptoms
vivid dreams
slowness
restlessness
insomnia
depression
fatigue
increased appetite
screening tool to determine severity of alcohol withdrawal
CIWA-AR
score > 19 = severe
cluster A personality disorders
ODD & ECCENTRIC behavior
- Paranoid
- Schizoid
- Schizotypical
focus on relationships
cluster B personality disorders
*DRAMATIC, ERRATIC, & EMOTIONAL behavior
- Antisocial
- Borderline
- Histrionic
- Narcissistic
focus on boundaries
Cluster C personality disorders
*ANXIOUS & FEARFUL behavior
- Avoidant
- Dependent
- Obsessive-Compulsive
focus on decreasing anxiety
paranoid personality disorder
suspicious & distrustful of others
holds grudges
unwilling to forgive
social withdrawal
cluster a
Schizoid Personality Disorder
AVOID
**solitud preferred
**animals > humans
socially withdrawn w/ little to no interest in close relationships
emotional coldness
enjoy math
depersonalization
does not occur with schizophrenia
*nurse should respect need for isolation – cluster a
Schizotypical Personality Disorder
eccentric & peculiar thoughts, behaviors & speech
*blames others for social isolation
suspicious
supernatural powers
trouble w relationships
*nurse should respect need for isolation – cluster a
Antisocial Personality Disorder
- lack of remorse
- dismiss rules & disregard others
- reckless disregard for safety
- do not fear rejection and believe they are correct
MEN – cluster b
**biggest concern is harm to others
Borderline Personality Disorder
*PSYCHOTIC
*women
poor boundaries
excessive emotions
impulsive & fears abandonment
*self harm & suicide
begins w rejection or trauma in childhood
cluster b
Histrionic Personality disorder
attention seeking – SEDUCTIVE, provocative, dramatic, & emotional
superficial & shallow
*THEATRICAL
nurse should model behavior– cluster b
Avoidant Personality Disorder
fears criticism
inferior to other
anxious & embarrassed
feels inadequate
*cluster c
nursing intervention if suspecting factitious disorder by proxy
do not leave client alone
be unpredictable
no cluster care – limit ability to cause harm
expected outcomes for patients with somatic symptom disorders
*live a normal life
*articulate feelings
*resume performance
*can identify ineffective coping patterns
Obsessive Compulsive Disorder presents as
cant bend/break rules
high achiever
financially stingy
implementing the nursing process with Borderline & Antisocial personality disorders consists of
limiting abusive language
addressing negative behavior
do not bargain
substance induced disorders include
intoxication
withdrawal
psychosis / delirium
CAGE Assessment tool
screen for high tisk of substace abuse **alcohol
C = have you ever felt like you should CUT down on drinking/drug use
A= have people ANNOYED you by criticizing your use
G = ever felt GUILTY for your drug use
E= eye opener
yes to 2+ = need for further evaluation
Wernicke-Korsakoff’s syndrome
vitamin D deficiency
delirium
cant learn new things
Alcohol withdrawal delirium
medical emergency that can last 2-5 days
peaks 48 to 72 hours after cessation/reduction
*high risk for seizures
– rails
– aspiration equipment
symptoms of opioid overdose
respiratory depression
decreased level of consciousness
pinpoint pupils
CNS stimulants include
cocaine & meth
*homeless population
*kept warm
symptoms of CNS stimulants
*cocaine & meth
dryness of nasal cavity
dilated pupils
heart issues
increased alertness, energy, & sexual arousal
a nurse is caring for a client who has avoidant personality disorder. which of the following statements is expected from a client who has this disorder?
- “Im scared that you are going to leave me.”
- “I’ll go to group therapy if you let me smoke.”
- ” I need to feel that everyone admires me.”
- ” I sometimes feel better if I cut myself.”
- “Im scared that you are going to leave me.”
a client has antisocial personality disorder. which of the following findings should the nurse expect?
- demonstrates extreme anxiety when placed in a social situation
- Often engages in magical thinking
- attempts to convince other clients to relinquish their belongings
- becomes agitated if personal area is not neat an orderly
- blames others for personal, past, & current problems
- attempts to convince other clients to relinquish their belongings
- blames others for personal, past, & current problems
a nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. which of the following findings should the nurse expect? sap
- bradycardia
- fine tremors of both hands
- hypotension
- vomiting
- restlessness
- fine tremors of both hands
- vomiting
- restlessness
a nurse is planning care for a client who is experiencing a benzodiazepine withdrawal. which of the following intervention should the nurse identify as priority?
- orient the client frequently to time. place. and person
- offer fluids and nourishing diet as tolerated
- Implement seizure precautions
- Encourage participation in group therapy sessions
- Implement seizure precautions
a nurse is caring for a client who has alcohol use disorder. the client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol?
- Chlordiazepoxide
- Buproprion
- Disulfiram
- Carbamazepine
- Disulfiram
a nurse is providing teaching to the family of a client who has substance use disorder. which of the following statements by a family member indicates an understanding of the teaching? sap
- “we need to understand that our sibling is responsible for their disorder.”
- “eliminating codependent behavior will promote recovery.”
- “our sibling should participate in the Al-anon group to assist with recovery.”
- “the primary goal of treatment is abstinence from substance use. “
- “our siblings need to discuss personal feelings about substance use to help with recovery.”
- “eliminating codependent behavior will promote recovery.”
- “the primary goal of treatment is abstinence from substance use.”
- “our siblings need to discuss personal feelings about substance use to help with recovery.”
