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Definitions |
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Fatigue
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Extreme Tiredness
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Milieu Therapy-Communication:
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-open,honest,appropriate
-no retaliation for expression of thoughts & feelings
-staff listens w/o feeling threatened
-comm skills role-modeled by staff
-respect for dignity of all
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Proranolol
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what med relieves akasthesia?
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To be visited
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Patient rights 10
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Sterotypy
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Disorganized behavior: Repetitive purposeless mvmnts.
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Functions of Serotonin(5-HT)?
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-inhibition of activity
-calmness,contentedness
-regulation of temp & sleep
-precursor to melatonin which plays a role in circadian rhythms
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Functions of Dopamine(DA)?
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-abstract thinking,decision making
-pleasure and reward system
-integration of thoughts & emotions
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Wernicke-Korsakoff’s syndrome
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Wernicke's encephalopathy is a degenerative brain disorder caused by the lack of thiamine (vitamin B1). It may result from alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy. Symptoms include mental confusion, vision impairment, stupor, coma, hypothermia, hypotension, and ataxia.
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Benzos
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They are short-acting, with rebound anxiety. Withdrawl symptoms could include seizures, if the dose if too high and the ______is stopped abruptly. Not intended for use longer than 3 months due to dependence and tolerance
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Environment
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The sum total of your surroundings.
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Milieu therapy-activities w/therapeutic goals(balanced to provide a variety)
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-daily therapeutic community meetings
-group therapy
-ADL training
-physical activity
-art/play therapy
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What is ECT?
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Electroconvulsive therapy is considered when drug therapy is ineffective or is contraindicated
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a mental disorder characterized by feelings of deep sadness, hopelessness, and worthlessness
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depression
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Mental Status Exam
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Includes judgement, insight, memory and intellect.
3 key aspects are:
Behavior
Emotion
Cognition
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atypical antipsychotics, thymoleptics(mood stabilizers) antidepressants
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Drugs used for schizoaffective d/o?
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• Conversion Disorder
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the client develops an unusual physical symptom in order to avoid anxiety and deal with an inner psychic conflict. Repressed (unconscious) emotional conflicts are changed into sensory, motor, or visceral symptoms with no underlying organic cause. Conversion symptoms include: sensory symptoms such as numbness, blindness, or deafness, motor symptoms such as paralysis, tremors or mutism, visceral symptoms such as urinary retention, headaches, or difficulty breathing. Usually treated with psychotherapy. Client may exhibit La Belle Indifference.
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Are self-injury patients borderline personality disorder patients or bipolar?
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No, not always
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Psychological Fatigue
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Extreme tiredness caused by your mental state.
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Prevention of aggression?
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-Talking about feelings
-Finding ways to manage anger
-Physical outlets
-Time out
-Behavioral contracts
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What is A slow, progressive, organic mental disorder characterized by chronic personality disintegration, deterioration of intellectual capacity and function, and memory loss that leads to confusion, disorientation, and stupor?
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Dementia
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What is bulimia nervosa commonly known as?
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Binging
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To appeal to the Supreme Court
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Patient rights 13
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Nihilistic
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Type of delusion marked by belief that one is dead or a calamity is impending?
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WHat is "Inability to recognize a name objects despite intact sensory abilities"?
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Agnosia
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Milieu Therapy:Activities w/ Therapeutic Goals(Assignment to activity depends on level of function)
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-Insight?
-Understands the goals of tx?
-In contact w/ reality?
-Motivated?
*Planned to meet needs of persons in group
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What does the GAF look at?
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psychological,social & occupational functioning on a continuum of mental health illness.
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Which type of schizophrenia is flat or inappropriate affect, incoherence; prognosis is poor?
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Disorganized
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mental illness that mainly affects a persons moods
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affective disorder
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pressured speech
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Speaking as tho the words are being forced out.
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Biological reasons to self-injure are:
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neurotransmitters are chemicals used to transmit messages in the brain. Neurotransmitters linked to self-injurious behavior are: Serotonin, Dopamine & Endorphins.
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bromocriptine (Parlodel) relives muscle rigidity caused by antipsychotic meds by what action?
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activating dopamine recepotrs in the CNS.
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Milieu therapy-Hildegard Peplau(1952):
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-described role of nurse in the therapeutic milieu
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Experiences modify ____ connections & ______.
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experiences modify neural connections & neurochemistry.
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What is DSM-IV-TR?
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It is a multiaxial system that classifies mental disorders and is used by most hospitals and health care professionals in the United States. It consists of the physical, psychiatric, and social factors affecting the individual.
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Dystonia- side effect of antipsychotics
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Muscle contractions especially of the neck, mouth and tongue. (Torticollis, oculogric crisis)
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What meds help self-injury patients?
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depends on the underlying disorder, SSRI to address serotonin & depression. If it's bipolar or borderline.
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The nurse is aware that antipsychotic medications may cause which of the following adverse effects? A. Increased production of insulin B. Lower seizure threshold C. Increased coagulation time D. Increased risk of heart failure
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B Rationale: Antipsychotic medications exert an effect on brain neurotransmitters that lowers the seizure threshold and can, therefore, increase the risk of seizure activity. Antipsychotics don't affect insulin production or coagulation time. Heart failure isn't an adverse effect of antipsychotic agents
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What is the Baker Act Reform?
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new law allows court-ordered outpatient tx for individuals w/ untreated severe mental illness.
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What are negative traits or behaviors?
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Negative behavior includes apathy (avolition), social withdrawal, alogia, blunted emotional responses, and anhedonia.
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Risk for self-directed or other-directed violence
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If a client is hallucinating and agitated what may the client do (what is he at risk for?
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List specific helpful behavioral and communication techniques for the patient with Alzheimer's.
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Supportive Touch, (calm tones that convey caring is helpful when words are not understood) and Reminiscence Therapy is helpful (this is thinking about or relating personally significant past experiences.
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Which of the following statements describes how elderly clients react to medications? A. At risk for increased adverse effects B. Tolerate medication better because they're less active C. Metabolize medications quickly D. Need hig
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A Rationale: As individuals become older, their livers metabolize drugs at a slower rate. Cumulative effects can occur and increase the risk of adverse effects. Elderly clients typically need lower doses not higher. Level of activity typically doesn't affect a person's reaction to medication
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S/S of middle stage demetia of Alzheimers type:
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exacerbated cognitive impairment with obsious personality changes and impaired communication, such as inappropriat conversation, actions adn responses.
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What is the cognitive distortion, Superstitious thinking?
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person believes that some unrelated action will magically influence a course of events.
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Has an intellectual disability
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NOT a mental illness 4 - A person who
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The sociological reason to self injure is:
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has an element of BORDERLINE PERSONALITY. There is an inability to distract themselves from their emotional experiences, and self-injury is as an attempt to modulate or cope with strong emotions.
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A client recently lost an important advertising account and had a flat tire while driving home. That evening, he began to find fault with everyone. Which defense mechanism was the client using? A. Displacement B. Projection C. Regressio
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A Rationale: Displacement is a defense mechanism by which the client discharges anger and rejection in a manner that he perceives as safe in this situation, by displacing anger over work and car problems onto family members. Projection involves attributing one's own emotions to others. Regression is a retreat to earlier levels of developmental behavior to relieve anxiety. Sublimation is the socially acceptable discharge of psychic energy or anger, such as through exercise or some other productive activity.
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A client with agoraphobia experiences severe panic attacks when attempting to leave the house. This client's outpatient treatment plan includes behavioral therapy to systematically decrease the amount of anxiety that occurs when leaving the house. Which s
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A Rationale: Getting the client to leave the house is the goal of therapy. Sweating palms is a sign of tolerable, mild anxiety. Shortness of breath indicates intolerable, moderate- to high-anxiety. Using anxiolytic agents to control anxiety regularly isn't desirable because of their addictive potential. Standing outside the door and holding onto the doorknob may be an early intervention, but it isn't the ultimate goal.
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BA 52(Baker Act-Involuntary Status)
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-can be initiated to bring the pt into the hospital by police,doc,LCSW,licensed PhD, or masters psychiatric nurse. pt must meet one of the Baker Act criteria.
-dangerous to self
-dangerous to others
-refusal to care for self & is likely to suffer 4m neglect
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What is the difference between the mini-mental status exam & the actual mental status exam?
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The mental status exam looks at (judgement, insight, memory & intellect) & the mini mental status exam (includes orientation, registration, attention, memory, language)
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A schizophrenic clinet is taking clozapine (Clozaril) what S/S should the client report?
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A sore throat or fever. These are indication of an infection caused by agranuylocytosis.If the WBC is <3,000/ul the medication must be stopped. <HTN may occur. If medication must be stopped it should be slowly tapered over 1 to 2 weekds and only under supervision.
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During the assessment stage, a client with schizophrenia leaves his arm in the air after the nurse has taken his blood pressure. His action shows evidence of:
A. somatic delusions.
B. waxy flexibility.
C. neologisms.
D. nihilistic delusions.
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B Rationale: The correct answer is waxy flexibility, which is defined as retaining any position that the body has been placed in. Somatic delusions involve a false belief about the functioning of the body. Neologisms are invented meaningless words. Nihilistic delusions are false ideas about self, others, or the world.
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Superego is the component of the personality that...
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is concerned w/ moral behavior & societal rules
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Onset is usually at ________ for self-injury. The ones that seek treatment often have what background?
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puberty. middle to upper class, average to high intelligence, low-self esteem.
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A nurse places a client in full leather restraints. How often must the nurse check the client's circulation?
A. Once per hour
B. Once per shift
C. Every 10 to 15 minutes
D. Every 2 hours
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Rationale: Circulatory as well as skin and nerve damage can occur within 15 minutes. Checking every hour, 2 hours, or 8 hours isn't often enough and could result in permanent damage to the client's extremities.
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What is the goal of crisis intervention?
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to help ppl return to previous level of functioning or move on to a higher level of functioning.
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What is an imp intervention in helping a client with early-stage dementia complete activities of daily living?
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Allow enough time for the client to complete ADLs as independently as possible
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Lithium is similar to what chemical in the body?
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Na. if Ns levels are reduced such as from sweating or diuresis the kidneys will abosrb Lithium and toxicity is a possiblity.
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