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Mental Health part #3 Flashcards

1
Q

the habitual use of a substance that falls outside of medical necessity or social acceptance for the single purpose of altering ones mood, emotion, or state of consciousness and resulting in adverse effects to the abuser or to others

A

abuse

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2
Q

a habitual psychological and physiological dependence on the substance beyond ones voluntary control

A

addiction (dependence)

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3
Q

when the body adapts to the substance and gradually requires increasing amounts of the substance to reproduce the effects originally produced by smaller ones

A

tolerance

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4
Q

transitory recurrences of perceptual disturbance caused by a persons earlier use of a hallucinogenic drug when in a drug free state

A

flashback

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5
Q

combination of drugs can intensify or prolong the effect

A

synergistic effects

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6
Q

combination of drugs to weaken or inhibit the effect of one of the drugs

A

antagonistic effects

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7
Q

people who are co dependent often exhibit over responsible behavior (doing for others what others could just as well do for themselves)

A

codependence

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8
Q

what are some co dependent behaviors

A

attempting to control someone else’s drug use
finding excuses for the persons use
covering up the persons drinking/drug use
feeling responsible for the persons use
eliciting promises for change

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9
Q

a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one or more of the following, occurring within a 12 month period

A

substance abuse

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10
Q

addiction is characterized by

A

loss of control and tendency to relapse

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11
Q

what plays a major role in all addictions

A

dopamine

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12
Q

how do drugs work in the body system

A

they effect the limbic system, the brain circuits allow pleasure, which increase the response to dopamine, the 1st time of use, neurons release an abnormally high amount of dopamine, eventually the user needs increase amounts to achieve the same feeling

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13
Q

name CNS depressants

A

alcohol
barbiturates
benzodiazepines

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14
Q

barbiturates

A

sedative hypnotic
slight overdose can cause coma or death
addictive

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15
Q

benzodiazepines

aka date rape drug

A 
sedative hypnotic
minor tranquilizer
addictive
produces sedation, muscle relaxation, and lowers anxiety levels
combined with alcohol can be lethal
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16
Q

examples of benzodiazepines

A

versed, Xanax, Ativan, Librium, valium

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17
Q

over dose on benzodiazepines/barbiturates

A

cardiovascular or respiratory depression, coma shock, convulsion, death

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18
Q

withdraw effects of benzodiazepines/barbiturates

A

N/V, tachy, diaphoresis, anxiety, tremors, grand mal seizures, delirium

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19
Q

the body burns how much alcohol in an hour

A

0.5 oz

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20
Q

alcohol intoxication

A

slurred speech, incoordination, unsteady gait, drowsiness, decreased blood pressure

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21
Q

excessive etoc interferes with storage of new memories in hippocampus, lost from memory within minutes of its occurrence

A

alcoholic blackouts

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22
Q

when does alcohol withdraw develop

A

4-12 hours after cessation or reduction of use

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23
Q

when does alcohol withdraw peak

A

24-48 hours

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24
Q

S/sx of alcohol withdrawal

A

tachy, sweating, increase BP, tremors, insomnia, psychomotor agitation, anxiety, N/V, malaise, grand mal seizures, transient visual hallucinations

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25
Q

intervention for alcohol withdraw

A

support measures, benzo’s (Librium for WD S/SX)

if they have a Hx of WD seizures: clonodine

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26
Q

alcohol withdraw delirium

A

MEDICAL EMERGENCY
death is usually due to sepsis, MI, fat embolism, peripheral vascular collapse, electrolyte imbalance, aspiration pneumonia, or suicide

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27
Q

S.Sx of alcohol withdraw delirium

A

disorientation, tachy, diaphoresis, increase BP, perceptual disturbances, fluctuating LOC

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28
Q

Sx of overdose

A

cool or clammy skin, respirations less than 10/min, cyanosis, emesis while semiconscious, or conscious, seizure

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29
Q

Tx for overdose

A

AIRWAY
if awake induce vomiting, VS Q15 minutes
if coma clear airway, IV fluids, gastric lavage with activated charcoal

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30
Q

most serious form of thiamin deficiency, paralysis of ocular muscle , diplopia, ataxia
death if thiamine tx not implemented

A

wernickes encephalopathy

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31
Q

chronic use of alcohol can have effects on what organs

A

heart: increase BP, produces deterioration of heart muscle
liver: fatty liver, cirrhosis, portal HTN, ascites, hepatic encephalopathy
pancreas: blockage of pancreatic ducts, pancreatic insufficiency (malnutrition, weight loss, DM)

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32
Q

Tx used for alcoholism

A

Naltrexone, acamprosate, Disulfiram, acupuncture AA

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33
Q

Naltrexone

A

used for craving, blocks opiate receptors to reduce ETOH craving

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34
Q

Acamrosate

A

helps to abstain from alcohol

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35
Q

disulfiram

A

a drug that makes drinking painful

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36
Q

NDX for alcoholism

A

altered nutrition
denial
ineffective coping

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37
Q

CNS stimulants

A

cocaine, crack, amphetamines, methamphetamines

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38
Q

Meth

A

releases excessive dopamine in the brain, smoked, injected, snorted
highly addictive, destroys brain cells that contain dopamine and serotonin

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39
Q

Prolonged use of meth (effects)

A

weight loss, severe tooth decay (meth mouth), skin sores, dry mouth

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40
Q

amphetamines

A

sniffed swallowed, snorted, injected

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41
Q

S/Sx of meth or amphetamine

A

increased energy, resembles paranoid schizophrenia, paranoia with delusions, psychosis, hallucinations, panic levels of anxiety, potential for violence

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42
Q

cocaine

A

made from leaf of coca bush, fine white powder, schedule II, produces an imbalance of the neurotransmitters dopamine and norepinephrine

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43
Q

the high in cocaine is obtained when

A

snorted: 3 minutes
injected: 30 seconds
smoked: 4-6 seconds (crack)

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44
Q

how long does the high last with cocaine

A

15-30 minutes for cocaine, and 5-7 for crack

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45
Q

S/Sx of cocaine

A

tachy, dilated pupils, elevated BP, N/V, insomnia, assertiveness, grandiosity, impaired judgment, impaired social and occupational functioning

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46
Q

overdose Tx for stimulants

A

antipsychotics, manage convulsions, resp distress, cardiovascular shock

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47
Q

caffeine

A

stimulant, most commonly used psychoactive drug in the world

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48
Q

how much caffeine is too much

A

200 stimulates mental activity

300 tremors, insomnia

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49
Q

sources of caffeine

A

coffee, tea, soft drinks, choc. OTC (analgesics, stimulants, cold relief preparations

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50
Q

what effects does caffeine have

A

stimulates brain, heart, kidneys, and increases acid production in stomach

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51
Q

withdraw from caffeine

A

tiredness, HA, irritability
onset is 12-24 hours after abstinence
peaks 20-51 hours

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52
Q

nicotine

A

stimulates central, peripheral and autonomic nervous system

causes increased alertness, concentration, attention, appetite suppression

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53
Q

Heroin

A

addictive, ranges from white to dark brown, cut with other substances, can be sniffed, snorted, smoked, injected (most common)

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54
Q

what happens when someone becomes addicted to heroin

A

spend more time and energy obtaining and using the drug, may become the primary purpose in life

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55
Q

intoxication of heroin

A

constricted pupils, decrease RR/BP, slurred speech, drowsiness, psychomotor retardation, initial euphoria followed by dysphoria and impairment of judgment and momory

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56
Q

overdose Sx of heroin

A

dilation of pupils, Resp arrest, cardiac arrest, coma, shock, convulsions, death,

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57
Q

Tx for overdose of heroin

A

narcan (reverses CNS depression)

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58
Q

withdraw from heroin Sx

A

yawning, insomnia, irritability, runny nose, panic, diaphoresis, cramps, N/V, “bone pain”, fever, lacrimation, diarrhea

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59
Q

Tx for withdraw of heroin

A

methadone, trexan, clonidine

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60
Q

marijuana

A

cannabis sativa, tetrahydrocanniol, hashish (strongest form)

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61
Q

initial effects of marijuana takes place when

A

within minutes, last for 3 to 4 hours

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62
Q

effects of marijuana

A

euphoria, inappropriate laughter, grandiosity, sedation, impaired cognition/motor skills, sensation of prolonged time sequences, blood shot eye, increase appetite, tachy, dry mouth

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63
Q

how does marijuana work

A

fat soluble, absorbed rapidly after being smoked or taken orally, binds with opioid receptors in the brain, can be stored for weeks in fat tissue and in brain, dependence does develop

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64
Q

what can happen if you have long term use of marijuana

A

accumulation in frontal cortex, limbic areas, brains auditory and visual perception centers

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65
Q

what are the medical uses for marijuana

A

chemo induced nausea, decrease intraocular pressure in glaucoma, appetite stimulate in AIDS wasting syndrome

66
Q

hallucinogens

A

LSD (acid)

effects last btwn 3-6 hours, causes confusion, depression, sleep problems, paranoia

67
Q

LSD

A

binds to serotonin receptor sites, causing a greater than normal activation of the receptor

68
Q

seeing a particular sight may cause the user to perceive a sound and hearing a sound may cause him to perceive an odor

A

synesthesia

69
Q

expansion of consciousness

A

trips

70
Q

what effect will the hallucinations have on mood

A

they usually intensify whatever mood the user is in when the drug is taken

71
Q

Sx of use of hallucinations

A

visual hallucinations, disorientation, confusion, paranoid delusions, panic, increased pulse

72
Q

what is life threatening with hallucinogens

A

the hallucinations

73
Q

what do you need to do for overdose Tx of hallucinogens

A

low stimuli, attempt to talk down pt, speak slowly and clearly in low voice

74
Q

Ecstasy (MDMA)

A

takes 20-40 minutes to take effect, table or capsule

75
Q

inhalants “huffing, backing”

A

cause euphoria, sedation, emotional liability, impaired judgment
intoxication occurs within 5 minutes, last 60-90, large dose = death

76
Q

inhaled fumes take the place of oxygen in the lungs causing suffocation

A

sudden sniffing death

77
Q

SE of inhalants

A

similar to alcohol

slurred speech, euphoria, dizzy, drunkenness, violent behavior

78
Q

overdose of inhalants can effect

A

liver and brain damage, heart failure, resp arrest, coma, death

79
Q

long term use of inhalants can effect

A

myelin sheath of nerve fibers, muscle spasms and tremors, difficulty with basic movements

80
Q

what is the active ingredient in fake cocaine

A

MDPV methylenediozpyrocalerone “bath salts”

an active alkaloid found in the khat plant, it is a CNS stimulant

81
Q

MDPV “bath salts”

A

powder similar to cocaine, snorted

82
Q

S/Sx of MDPV

A

excessive HR, HTN, sweating, prolonged panic attacks psychosis, agitation, hallucinations

83
Q

what is the 10th leading cause of death nationally

A

suicide

84
Q

what is the leading cause of premature death

A

schizophrenia

85
Q

risk factors for suicide

A

previous suicide attempts, depression, substance abuse, impulsiveness, barriers to help, loss, isolation

86
Q

levels of suicidal behavior

A 
suicidal ideation
suicide threat
suicide gesture: cry for help
suicide attempt
completed suicide
87
Q

SAD PERSONS scale

A

S: sex: 1 if male
A: age: 1 if 25-44 or over 65
D: depression: 1 if present
P: previous attempt: 1 if present
E: ethanol use: 1 if present
R: rational thinking lost: 1 if psychotic for any reason
S: social supports lacking: 1 if lacking
O: organized plan: 1 if plan with lethal method
N: no spouse: 1 if widowed, separated, etc.
S: sickness: 1 if severe or chronic

88
Q

points for SAD PERSONS scale

A

0-2: send home with follow up
3-4: closely follow up, consider hospitalization
5-6: strongly consider hospitalization
7-10: hospitalize or commit

89
Q

soft methods of suicide

A

inhaling gas, pills, cutting wrists

90
Q

hard methods of suicide

A

gun, jumping, hanging, staging a car crash

91
Q

NDx suicide

A

risk for self directed violence, ineffective coping

92
Q

nursing interventions for suicide

A

establish a therapeutic relationship, communicate the potential for suicide, stay with the person, listen to the pt, secure a no-suicide contract, give the pt a message of hope, provide meaningful activities that release tension and anger

93
Q

PT teaching for suicide

A

have hobbies, adapt to loss, positive attitude, focus on accomplishments, increase self-esteem, share sad feelings with support person

94
Q

ADHD

A

misfiring in the brains executive function mediated through the prefrontal cortex

95
Q

role of resilience

A

adapts to the environment, ability to form nurturing relationships with other adults when a parent is not available

96
Q

role of temperament

A

genetically determined, can be modified with post. or neg. results,

97
Q

general tx for disorders of children

A

art therapy, family therapy, milieu therapy, point system

98
Q

development disorders covering a range of abilities that cause problems with social skills, communication, repeated behaviors, emotional detachment

A

pervasive developmental disorders

99
Q

an abnormal self absorption characterized by lck of response to people and actions and limited ability to communicate, complex neurobiological and developmental disability, typically appears in 1st 3 years of life

A

autistic disorder or autism

100
Q

what have MRI studies showed with autistic disorder

A

markedly decreased activity in the parietal area and corpus callosum

101
Q

corpus callosum

A

connects the left and right hemispheres, its role is to pass information from the left hemisphere and vice versa

102
Q

parietal lobe

A

receives and processes sensory information from the body, also have language functions

103
Q

what impairments might a child show

A

delay/absence of language, failure to imitate, lack of spontaneous make believe play, lack of eye contact, lack of interest in others, rocking, responds catastrophically to minor changes, preoccupied with objects, toe walking

104
Q

average IQ score for “normal”

A

100

105
Q

2/3 of autistic children have an IQ of what

A

70 or less

106
Q

unusual talents that appear at an early age, exceptional memory, lightening quick calculations, musical talent, drawing ability

A

savant syndrome

107
Q

NDx for autistic

A

delayed growth and development, disturbed personal identity, ineffective impulse control, risk for injury, ineffective relationship, impaired verbal communication

108
Q

Nursing intervention for autistic

A

1:1, protect from self mutilated behaviors, assign limited number of caregivers, positive reinforcement, anticipate needs, NO MEDICATION to Tx autism

109
Q

what medications might be given to a child with autism

A

NO MEDICATION TO TX AUTISM
antipsychotic to tx aggression, temper tantrums
beta blockers tx lower side effects
SSRI may be used for OCD behaviors

110
Q

restricted and respective patterns of behavior and idiosyncratic interest, appears to have later onset, familial pattern, problems with social relationships, no significant delay in cognitive and language development

A

asperger’s disorder

111
Q

disorder characterized by inattention, hyperactivity, impulsivity, some may have attention deficit without hyperactivity

A

attention deficit hyperactivity disorder

112
Q

Sx for ADHD

A

inattention, hyperactivity (fidgets, talks excessively, acts without thinking), impulsivity (blurts out answers, diff. waiting their turn, impatient)

113
Q

Tx for ADHD

A

Rx for hyperactivity impulsive behaviors, inattention, behavior modification, family counseling

114
Q

causes of ADHD

A

adverse influences during prenatal period (drugs), perinatal influences (low birth weight), postnatal period (trauma or infections)
*brain scan show underdeveloped and inactive frontal lobes

115
Q

Ritalin

A

targets the slugglish frontal lobe, risk of abuse and misuse

SE: insomnia, HA, abd. pain, lethargy, growth retardation

116
Q

Adderal

A

calms pt, increases motor activity, mental alertness, suppresses appetite
SE: talkativeness, increased motor activity, mild euphoria

117
Q

Strattera

A

non stimulant selective norepinephrine reuptake inhibitor, eliminates the risk of abuse, decreases daydreaming, aggression, mood swings
SE: GI disturbance, reduced appetite, weight loss, dizzy, insomnia, fatigue, small increase in BP & HR
**Dose needs to be titrated slowly to achieve the lowest satisfactory dose

118
Q

what nursing interventions need to be done with Rx given for ADHD

A

assess mental status, level of activity, aggressiveness, degree of stimulation, keep stimuli low, reduce anorexia by administering immediately before meals and weigh weekly, administer 6 hours prior to bedtime to prevent insomnia, avoid OTC Rx, should not be withdrawn abruptly

119
Q

a persistent pattern of negativistic, disobedient, hostile, defiant behaviors toward authority figures, which happen more persistently and more frequently

A

oppositional defiant disorder

120
Q

Sx of oppositional defiant disorder

A

frequent temper tantrums, annoys other people deliberately, academic difficulties, blames others for mistakes or misbehavior

121
Q

oppositional defiant disorder can lead to what if not treated

A

conduct disorder

122
Q

interventions for oppositional defiant disorder

A

act as a role model, redirect violent behavior, maintain calm attitude, mechanical restraints if necessary

123
Q

characterized by persistent pattern of behavior in which the rights of others are violated and age appropriate societal norms or rules are disregarded

A

conduct disorder

124
Q

complications due to conduct disorder

A

academic failure, school suspension or dropouts, juvenile delinquency, drug or alcohol abuse, juvenile court involvement

125
Q

what psychiatric disorder may co exist with conduct disorder

A

anxiety, depression, ADHD, learning disabilities, substance dependency

126
Q

Sx of conduct disorder

A

destructive behavior, deceitfulness, serious violations of rules

127
Q

significantly sub average general intellectual function and deficits in adaptive behavior

A

mental retardation

128
Q

how is mental retardation measured

A

IQ test

129
Q

4 classifications of mental retardation

A

mild: 50-70
moderate: 35-40
severe: 20-34
profound: below 20

130
Q

mild mental retardation

A

50-70, 6th grade level

131
Q

moderate mental retardation

A

35-49, 2nd grade level, requires supervision, can perform some activities, some limitation in speech

132
Q

severe mental retardation

A

20-34, minimal verbal skills, only able to perform simple tasks under close supervision, poor psychomotor development

133
Q

profound mental retardation

A

below 20, no capacity for independent functioning, little if any speech, no gross or fine motor movement, constant assistance

134
Q

Possible causes of mental retardation

A

hereditary (downs, klinefelter syndrome, tay-sacs, PKU), embryonic development

135
Q

characteristics of mental retardation

A

sit up, crawl, walk later, hard to remember things, trouble thinking logically

136
Q

an individual, person or private sense of identity as female or male

A

gender identity

137
Q

strong and persistent cross gender identification, cross gender activity/interest, relate to opp. sex, boys prefer females and cross dress, don’t consider themselves homosexualy

A

gender identity disorder

138
Q

biological sex differs from gender identity or feelings of unease about ones maleness or femaleness

A

gender dysphoria

139
Q

group of psychosexual disorders characterized by unconventional sexual behaviors as defined by the dominant culture, usually male, learned to associate sexual arousal with some environmental stimulus, which triggers the unusual behavior, OCD

A

paraphilias

140
Q

sexualization of body part or inanimate object feet, shoes, etc.

A

fetishism

141
Q

adult who is sexually aroused by and engages in sexual activity with children, usually with a prepubescent child (13 or younger)

A

pedophilia

142
Q

in pedophilia what is the age difference

A

perpetrator must be at least 16 years of age and at least 5 years older than the victim

143
Q

illegal, intentional display of genitals in a public place aroused by the observers shock and disgust

A

exhibitionism

144
Q

illegal, peeping tom, frequently addicted to porn and strip clubs

A

voyeurism

145
Q

sexual satisfaction achieved by dressing in clothing of the opposite gender, usually heterosexual

A

transvestic fetishism

146
Q

physical/psychological suffering inflicted upon another person

A

sexual sadism

147
Q

rubbing or touching a non consenting person in busy places

A

frotteurism

148
Q

obscene phone calls, don’t know victim

A

telephone scatologia

149
Q

sex with cadaver

A

necrophilia

150
Q

concentration of sex activity on 1 part of the body

A

partialism

151
Q

sex with animal

A

zoophilia

152
Q

being urinated on or urinating on someone

A

urophilia

153
Q

altered state of consciousness 2ndary to hypoxia while experiencing orgasm

A

hypoxyphilia

154
Q

a pattern of coercive control founded on and supported bby physical and or sexual violence or threat of violence of an intimate partner

A

battering

155
Q

who is at the highest risk of domestic violence

A

females 20-40

156
Q

cycling of violence

A

tension building phase, acute battering incident, honey moon phase

157
Q

reasons why ppl stay

A

fear, for children, financial reasons, retaliation, religious, hopefulness

158
Q

for the average victim it takes how many times being abused before leaving

A

7

159
Q

goal of domestic abuse

A

educate the victim to increase awareness of available resources

160
Q

children of battered women often demonstrate what problems

A

behavioral problems, depression, PTSD, living in secrecy

161
Q

homeless are prevalence to what disorders

A

severe depression, bipolar disorder, schizophrenia

school (27 decks)

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