Psych Flashcards
1
Q
1 problem in abuse is
A
denial
2
Q
Denial
A
- Refusal to accept the reality of their problem
- Treatment
- Confront it by pointing out to the person the difference between what they say and what they do.
3
Q
Wernicke’s (Korsakoff’s Syndrome
A
- Psychosis induced by vitamin B1 (thiamine) deficiency
- Symptoms
- Amnesia (memory loss)
- Confabulation (make-up stuff)
- Preventable (take vitamin)
- Irreversible (kills brain cells)
4
Q
Alcoholism treatment
A
- Antabuse/Revia (Aversion Therapy)
- Onset and duration of effectiveness - 2 weeks
- Avoid all forms of alcohol to avoid nausea, vomiting, death
- Alcohol avoidance
- Mouth wash, cologne, perfume, aftershave, elixir, most OTC liquid medicines, insect repellant, vanilla extract, vinaigrettes (red wine vinaigrettes acceptable), hand sanitizer
5
Q
Alcohol Withdrawal Syndrome vs. Delirium Tremens
A
- AWS
- Every alcohol goes through this
- semiprivate room
- regular diet
- up ad lib
- Give anti-HTN meds
- Give tranquilizer
- Give multivitamin to prevent Wernicke’s
- DT
- can kill you
- Danger to self and others
- Private room near nurse’s station
- Clear liquid or NPO
- bedrest w/o bathroom privileges
- vest or 2 point restraints
- Give anti-HTN meds
- Give tranquilizer
- Give multivitamin to prevent Wernicke’s
6
Q
Non-psychotic vs. psychotic
A
- Non-psychotic
- has insight (reality based)
- know they’re sick and that it’s affecting them
- has insight (reality based)
- Psychotic
- no insight (non-reality based)
- therapeutic communication can’t be used
- Delusions
- Paranoid/Persecutory Delusion - false, fixed belief that people are out to harm you
- Grandiose - false, fixed belief that you are superior
- Somatic - False, fixed belief about a body part
- Hallucinations
- Auditory, Visual, Tactile, Gustatory, Olfactory
- Illusion
- Misinterpretation of reality → sensory experience
7
Q
Types of Psychotics
A
- Types of Psychotics
- Functional Psychotics
- Schizophrenia, Schizoaffected, Major depression, Manic
- Teaching reality
- Acknowledge feelings
- Present reality
- Positive - what is reality
- Negative - what is not reality
- Set a limit
- Enforce the limit
- Psychosis of Dementia
- Brain damage
- Alzheimer’s, Wernicke’s, Organic Brain Syndrome, Dementia
- Can’t learn reality
- Treatment
- Acknowledge feelings
- Redirect - get them to express the fixation that they are expressing inappropriately to appropriately
- Psychotic delirium
- Temporary episodic sudden onset loss of reality due to chemical imbalances
- UTI, thyroid imbalance, electrolyte imbalance, adrenal crisis
- Treatment
- Acknowledge feelings
- Reassure them of safety and temporariness
- Functional Psychotics
8
Q
Loosening of association
A
- Flight of ideas
- Stringing phases together (loosely associated phrases; tangentiality)
- Word salad
- Throw words together
- Neologisms
- Making up new words
9
Q
ABN - Abnormal Personality Disorders
A
- Antisocial, Borderline, Narcissistic
- most severe personality disorders
10
Q
All psych drugs cause…
A
- Hypotension
- Weight changes (primarily weight gain)
11
Q
Phenothiazines
A
- 1st gen anti-psychotics (typical)
- All end in -zine (“zines for the zany”)
- Thorazine, compazine
- Reduces symptoms
- Actions
- large doses - antipsychotic
- small doses - antiemetic
- major tranquilizers
- S/E
- A = anticholinergic (dry mouth)
- B = blurred vision and bladder retention
- C = constipation
- D = drowsiness
- E = EPS (tremors, parkinsonisms)
- F = “f”otosensitivity (skin burns)
- G = aGranulocytosis (low WB count)
- Treat Side Effects
- Teaching
- Teach patient to report sore throat and symptoms of infection to PCP
- Never stop the zine
- # 1 diagnosis is safety
- Deconate or … D
- Long-acting IM form given to non-compliant patients
12
Q
Tricyclic Antidepressants (NSSRI)
A
- “Mood elevators” to treat depression
- Must take for 2-4 weeks before beneficial effects
- Ex. Elavil, Trofranil, Aventyl, Desyrel
- S/E
- A = Anticholinergic (dry mouth)
- B = blurred vision
- C = constipation
- D = drowsiness
- E = euphoria
13
Q
Benzodiazepines
A
- Antianxiety meds (considered minor tranquilizers)
- Always have “pam/lam” in name
- Indications
- induction of anesthetic
- muscle relaxant
- alcohol withdrawal
- seizures (status)
- facilitates mechanical ventilation
- Work quickly
- Must not take for more than 6 weeks → 3 months
- Keep on valium until elavil kicks in
- # 1 nursing diagnosis is safety
- S/E
- A = anticholinergic
- B = blurred vision
- C = constipation
- D = drowsiness
14
Q
Monoamine Oxidase (MAO) Inhibitors
A
- Antidepressants
- Prevent breakdown of norepinephrine, dopamine, and serotonin
- Ex. MARplan, NARdil, PARnate
- S/E
- A = anticholinergic
- B = blurred vision
- C = constipation
- D = drowsiness
- Teaching
- Must avoid foods containing tyramine to avoid hypertensive crisis
- “BAR” - Bananas, Avocados, Raisins (any dried fried)
- avoid things made from active yeast
- No organ meats
- no preserved meats (smoked, dried, cured, pickled, hot dogs)
- No cheese except mozzarella and cottage cheese (no aged cheese)
- No yogurt
- No alcohol, elixirs, tinctures (iodine/betadine), caffeine, chocolate, licorice, soy sauce
- Avoid OTC meds
- Must avoid foods containing tyramine to avoid hypertensive crisis
15
Q
Lithium
A
- Used for bipolar disorder (decreases mania)
- S/E (3 Ps)
- Peeing
- Pooping
- Paresthesia
- Toxic S/Es
- Tremors
- Metallic taste
- Severe diarrhea
- # 1 intervention → good fluid hydration
- If sweating, give sodium (or other electrolyte) as well as fluid
- Don’t give water
- →give gatorade or other electrolyte drink
- Monitor Na+ levels
- high sodium will cause lithium to not work
- low sodium will make lithium toxic
