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3920: Mental Health > Week 7 & 8 > Flashcards

Week 7 & 8 Flashcards

1
Q

MDD DSM-5 Diagnosis

A
  • 5+ symptoms including depressed mood/anhedonia
  • Most of the day, nearly everyday, 2+ weeks
  • History of 1+ depressive episodes
  • No history of mania
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2
Q

MDD Symptoms

A
  • Increase/decrease appetite (5% weight change in month = significant)
  • Sleep changes (insomnia/hypersomnia)
  • Psychomotor aggression/retardation
  • Fatigue/energy loss
  • Feelings of worthlessness or excessive guilt
  • Poor concentration (indecisiveness)
  • Recurrent suicidal ideations or past attempt
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3
Q

MDD Pharm Interventions

A
  • SSRIs
  • SNRIs
  • TCAs
  • MAOIs
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4
Q

MDD Non-Pharm Interventions

A
  • Psychotherapy: CBT, group
  • Electroconvulsive therapy ECT
  • Transcranial magnetic stimulation TMS
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5
Q

Bipolar I Disorder

A

1+ manic episodes with depressive component

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6
Q

Bipolar II Disorder

A

Periods of major depression accompanied by 1+ incidence of hypomania

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7
Q

Cyclothymic Disorder

A
  • Mild form bipolar disorder where mood swings from short period of mild depression
  • Hypomania 2+ years
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8
Q

Manic Episode DSM5

A
  • Abnormally/persistently increased goal-directed activity or energy
  • 3+ symptoms
  • Marked impairment in social/occupational functioning
  • Episode not attributable to psychological effects of substance
  • Episode lasts 7+ days
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9
Q

Manic Episode Symptoms

A
  • Inflated self-esteem or grandiosity
  • Decreased need for sleep
  • More talkative than usual/pressured speech
  • Flight of ideas
  • Distractibility
  • Increase in goal-directed activity/psychomotor agitation
  • Excessive involvement in activities that have high potential for painful consequences
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10
Q

Hypomanic Episode

A
  • Same categorization as manic episode
  • Episode lasts 4+ days
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11
Q

Depressive Episode DSM5

A

5+ symptoms in 2-week period

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12
Q

Depressive Episode Symptoms

A
  • Depressed mood most of day, nearly everyday
  • Loss of interest/pleasure in activities
  • Significant weight loss, decrease/increase in appetite
  • Engaging in purposeless movements
  • Fatigue or loss of energy
  • Feelings of worthlessness or guilt
  • Diminished ability to think, concentrate, indecisiveness
  • Recurrent thoughts of death, recurrent suicidal ideation without specific plan, suicide attempt
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13
Q

Minor Depressive Episode

A

2-4 symptoms in a 2-week period

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14
Q

Mood Disorder Care Priorities

A
  • Safety
  • Monitor electrolytes & thyroid function
  • Assess effects of meds & adherence
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15
Q

Pharm Treatment

A
  • Prevent mood cycling
  • Lithium
  • Treat symptomology
  • Antipsychotics
  • Anticonvulsants
  • Antianxiety
  • Antidepressants can precipitate manic episodes
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16
Q

Non-Pharm Interventions

A
  • Decrease stimuli
  • Monitor sleep, promote routine
  • Nutrition & hydration
  • Limit setting, restricting behaviors
  • Maintain safety
  • Psychotherapy
  • ECT as last resort
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17
Q

Delirium

A
  • Medical emergency
  • Preventable & reversible
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18
Q

Delirium Screening

A
  1. Acute onset & fluctuating course
  2. Inattention
  3. Disorganized thinking
  4. Altered LOC
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19
Q

Positive Confusion Assessment Method (CAM)

A
  • Positive = presence of delirium
  • Altered mental status & fluctuating course
  • Inattention
  • Disorganized think OR altered LOC
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20
Q

Delirium Non-Pharm Interventions

A
  • Ambulate early
  • Reorient to surroundings
  • Sleep hygiene
  • Fluids, nutrition, oxygen
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21
Q

Delirium Pharm Interventions

A
  • Antipsychotics
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22
Q

Dementia

A

Umbrella term used to describe collection of brain diseases & symptoms

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23
Q

Anosognosia

A
  • Deficit in awareness about themselves, their losses, impact of illness
  • Poor insight & judgement
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24
Q

Amnesia

A
  • Memories impacted
  • Short term: new learnings & ability to learn new information
  • Long term: experiences memories & emotions, tasks
  • Memories are laid down in order which they are acquired
25
Agnosia
- Inability to recognize things through 1+ of the 5 sense that were familiar - Misunderstand noises, confuse objects, unable to recognize familiar people
26
Aphasia
- Inability to utilize language - Speaking, reading, writing & the understanding - Broca's - expressive - Wernicke's - receptive
27
Apraxia
- Ability to purposefully move is lost - Unable to understand directions - Planning, sequencing, executing multi-step activities affected
28
Altered Perception
- Loss of awareness of their lack of knowledge about themselves, illness - Misperception of objects - Loss of depth perception
29
Apathy
- Unable to initiate action to participate in activities - Little to no emotion/interest associated with loss of initiation - Loss of empathy towards others' views - Patient refuses to complete task but agrees after demonstration/cueing
30
Attention Deficits
- Inability to sustain/shift attention - Increased distractibility in conversations - Loss of ability to store information in memory/acquire new learning
31
Dementia Non-Pharm Interventions
- Correct sensory deficits - Physical exercise - Environmental modifications - Recreational therapy
32
Anorexia DSM 5
- Restriction of energy intake - Low body weight for age/sex - Developmental trajectory - Physical health - Intense fear of gaining weight - Disturbance in way body weight/shape is experienced
33
Anorexia Severity
- Mild: BMI>17kg/m2 - Moderate: BMI 16-16.99 - Severe: BMI 15-15.99 - Extreme: BMI <15
34
Anorexia Restricting Type
- Has not engaged in recurrent episodes of binge eating/purging *During last 3 months
35
Anorexia Binge/Purge Type
- Has engaged in recurrent episodes of binge-eating/purging *During last 3 months
36
Bulimia DSM-5
- Recurrent episodes of binge eating - Eating significantly large amount of food - Loss of control over eating - Recurrent inappropriate compensatory behavior to prevent weight gain - Binge eating & compensatory behaviors occur at least 1x/week for 3 months - Self-evaluation solely influenced by body shape & weight - Disturbance does not occur exclusively during episodes of anorexia nervosa
37
Bulimia Severity
- Mild: 1-3x/week inappropriate compensatory behaviors - Moderate: 4-7x/week - Severe: 8-13x/week - Extreme 14+/week
38
Binge Eating Disorder DSM 5
- Recurrent episodes of binge eating - Binge eating associated with 3+ symptoms - Marked distress regarding biinge eating - Binge eating occurs 1x/week for 3 months - Associated with recurrent compensatory behavior - Does not occur exclusively during course of bulimia/anorexia nervosa
39
Binge Eating Disorder Symptoms
A. Eating much more rapidly than normal B. Eating until feeling uncomfortably full C. Eating large amounts when not feeling physically hungry D. Eating alone due to embarrassment of how much one is eating E. Feeling disgusted with oneself, depressed, guilt afterwards
40
Binge Eating Disorder Severity
- Mild: 1-3x/week binge episodes - Moderate: 4-7x/week - Severe: 8-13x/week - Extreme 14+/week
41
AFRID
- Limit amount/type of food eaten - Do not have distorted body image or fear of gaining weight
42
Pica
Repeatedly eat things that are not considered food & have no nutritional value
43
Rumination Disorder
- Food is repeatedly regurgitated (chewed/partially digested food) - No apparent nausea, involuntary retching, disgust
44
Unspecified Feeding/Eating Disorder
- Describe symptoms of feeding/eating disorder - Causes distress & impaired functioning - Does not meet criteria for any other eating disorders
45
Eating Disorder Subjective Data
- Health history - Psychosocial history
46
Eating Disorder Objective Data
- Physical (BMI, LOC, head to toe) - Labs - ECG - Bone density scans
47
Anorexia Assessment Findings
- Low weight - Muscle wasting/weakening - Peripheral edema - Cardiovascular abnormalities - hypotension, bradycardia, heart failure - Abnormal labs - hypokalemia, anemia - Amenorrhea - Lanugo - Cold extremities - Constipation - Impaired renal function - Decreased bone density
48
Bulimia Assessment Findings
- Normal to slightly low weight - Muscle weakening from electrolyte imbalances - Peripheral edema - Cardiovascular abnormalities - dysrhythmias - Electrolyte imbalances - hypokalemia & hyponatremia - Tooth erosion/dental carrier - Parotid swelling - Positive Russell's sign - calluses/scars on hand - Seizures
49
Eating Disorder Treatments
- Psychotherapy (CBT, individual, group) - Nutritional counselling - Meds (SSRI, antipsychotics, mood stabilizers)
50
Inpatient ED Treatment
- Medically & psychiatrically unstable - Suicide risk - Admitted for extreme electrolyte imbalances, weight below 75% of healthy body weight, arrythmias, hypotension
51
Outpatient ED Treatment
- Medically & psychiatrically stable - Symptoms under sufficient control - Able to function in normal social, educational, vocational situations
52
Partial Hospitalization ED Treatment
- Medically & psychiatrically stable - Able to function in normal social, educational, vocational situations - Continues to engage in disordered behaviors
53
Residential ED Treatment
- Medically stable - Psychiatrically impaired
54
Refeeding Syndrome
- Occurs when re-feeding after a period of not eating *Life threatening
55
Refeeding Complications
- Hypophosphatemia - Hypomagnesemia - Hypokalemia - Fluid imbalances - Thiamine deficiency
56
Imbalanced Nutrition & Fluid Volume Interventions
- Focus on restoring weight - TPN/enteral feeds - IV fluids - Monitoring for refeeding syndrome - Encourage oral fluids/intake at scheduled times - Collaborate with dietitian - meal planning - Food logs - Sit with client during meal times - Monitor 30mins-1h for purging behavior
57
Disturbed Body Image/Low Self-Esteem Interventions
- Promote feelings of control - Help client realize perfection is unrealistic - Help develop realistic perception of client's body image & food relationship
58
Ineffective Coping Interventions
- Establish trusting & therapeutic relationship - Acknowledge feelings of anger, anxiety, loss of control - Encourage free expression of feelings - Establish clear boundaries

3920: Mental Health (7 decks)

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