Test 1 - Alteration in Mental Health Flashcards
What are some causes of mental illness?
Genetics - 50% chance of depression if parents has had depression
Biological - Coronary artery disease, Certain drugs contribute to depression by altering neurotransmitters
Personality - Shy, non-assertive persons are more predisposed to depression
Environment - Victims of crimes, physical assault, neglect, physical abuse can predispose to mental illness
The mental health exam is what the ______ _____ is to ______ ____________
physical exam is to medsurg
The general description of the mental status exam provides an:
overview or mental image of the patient
What are the components included in the general description of the mental status examination
o Appearance – shows ability to care for themselves, judgment. Note eye contact (can be a sign of culture), facial expressions, posture, gait. Can give you an idea of their general state of health – for ex. Limp when walking. Depressed may have slumped posture. Aggressive personality may stand close to you. May smell of alcohol, can tell if they’re intoxicated.
o Speech – cognitive status. Dysarthria? – Neurological disorder. Nervousness? Fidgety, speaking too quickly or slowly. Slurring their words? Intoxicated or neurological disorder. Culture – speaks with accent. Choice of words – education. Amount of speech.
o Motor activity – refers to physical movement. Fidgety? Restless? Agitated? Catatonic? Unusual gestures?
o Interaction – comfort level during interaction with others? Cooperative? Hostile? Polite?
What are the components included in the emotional state of the mental status examination
o Mood – patient’s description of how they’re feeling. Patient report of emotional state.
Suicidal or homicidal thoughts must be addressed immediately. If they do, ask if they’ve made any plans.
o Affect – the nurse’s observation of the patient’s behavior
Flat (emotionless)
Euphoric (state of inappropriate elation)
Labile (shifting emotions – quickly shifting from one affect to another. Crying one minute – laughing the next)
Expansive (exaggerated sense of ability & importance)
What are the components included in the perceptions of the mental status examination:
o Hallucination – sensory perception that isn’t shared by others. Can be visual or auditory. Command hallucinations – receiving orders from other people. They have false perceptions that commands are made of them that they must obey.
If they’re hearing things ask what the voices are saying.
o Illusion – misrepresentation of real stimuli. They may see lint on their clothing, but it is perceived by the person as insects
What are the components included in the thought content of the mental status examination:
o Obsession – repetitive, intrusive type of thought. Ex. Stalking
o Phobia – unreasonable fear
o Delusion – false belief(s) deeply imbedded & inconsistent with reality. Ex. Thinking you’re a celebrity.
The thought content of the mental status exam describes:
what the person is thinking about
The perceptions of the mental status exam describes:
ability to recognize and interpret your surroundings
The emotional state of the mental status exam describes:
o Mood – patient’s description of how they’re feeling. Patient report of emotional state.
o Affect – the nurse’s observation of the patient’s behavior
The Sensorium & Cognition of the mental status exam describes:
state of wakefulness
What are the components included in the thought content of the mental status examination:
o Level of consciousness
o Orientation – time/place/person
o Memory – ability to recall past experience
o Attention & concentration – level of distractibility
o Comprehension & abstract reasoning – level of intelligence
o Insight & judgment – their understanding of the problem
What is a psychosis?
It is not a disease. A symptom of mental illness. Persons with psychosis cannot comprehend reality. Thoughts and behaviors may be disorganized. Have difficulty communicating with others.
What does ICD-10 stand for?
• International Statistical Classification of Diseases and Related Health Problems, Tenth Edition
What does the ICD-10 include?
o Diseases and morbid entities
o Published by World Health Organization
What does DSM stand for
• Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-V-TR)
The DSM includes:
o Psychiatric diagnosis
o American Psychiatric Association
What is an anxiety disorder?
• A state of tension, dread, or impending doom, arising from external influences that threaten to be overwhelming
True or False
Anxiety disorders are one of the most common psychiatric disorders.
True
What are some examples of anxiety disorders?
o Generalized Anxiety Disorder o Panic attack o Panic disorder o Agoraphobia o Specific Phobia o Social Anxiety Disorder (Social Phobia)
o Characterized by persistent, excessive and unrealistic worry about everyday things.
o Begins in childhood and adolescence but may begin in one’s twenties
o Can be the result of stressful events
o Can develop Panic Disorder
Generalized Anxiety Disorder
o Sudden onset of fear. Comes out of nowhere. Physical symptoms accompany the fear.
Tachycardia
Palpitations
Chest pain
Numb & tingling in hands & feet (paresthesia)
Feeling of doom
Panic disorder
o Fear of being trapped.
o Fear of wide open spaces. Fear of being trapped or having a panic attack in front of others.
o Eventually persons with panic disorder can develop this.
o Ex. Fear of crossing a bridge because the bridge could collapse and they can become trapped
Agoraphobia
o Marked and persistent fear that is excessive and unreasonable, cued by the presence or anticipation of a specific object or situation
Specific Phobias
o Fear of situations in which an individual fears humiliation or embarrassment when under the scrutiny of others.
Social Phobias (social anxiety disorders)
Describe Obsessive-Compulsive and Related Disorders:
- Obsession: unwanted, repetitive thoughts that lead to feelings of fear, anxiety, or guilt. Ex. Germaphobe – obsessed with germs & viruses. Scared they will get sick.
- Compulsion: behavior or thoughts used to decrease the fear or guilt associated with obsessions. Ex. Germaphobe – wash hands compulsively
- Body dysmorphic disorder: Type of OCD. Obsessed with perceived flaws with their body.
- Trichotillomania: compulsively pull hair out.
- Excoriation: compulsively picking at their skin.
Describe Post-Traumatic Stress Disorder
- Preceded by a traumatic event
- Clusters of symptoms
i. Persistent re-experience of traumatic event – flashbacks
ii. Avoidance of stimuli associated with the trauma; experiences a numbing that was not present before the trauma
iii. Experiences symptoms that were not present before the trauma
a. Sleep disturbances
b. Poor concentration
c. Angry outbursts
d. Hypervigilance
• Somatic symptoms plus abnormal thoughts, feelings, and behaviours; may or may not have a diagnosed medical condition.
o Formerly called hypochondriasis
o High health anxiety accompanied by somatic symptoms
Somatic Symptom (soma = body)
High health anxiety without somatic symptoms (no symptoms)
Illness Disorder:
Deliberately falsify their symptoms. Become evasive & angry when questioned. Intentional.
o Munchausen syndrome
Will create own symptoms
Ex. swallowing a safety pin
o Munchausen syndrome by proxy
Deliberately making someone else sick
Mother makes her child sick, nurse makes patient sick
factitious disorder
o Not intentional
o Neurological symptoms not accounted for by neurological disease
o May have involuntary tremors, paralysis, pseudoseizures
Conversion Disorder
o Pain in one or more anatomic sites and causes impairment in one or more areas of functioning
o May be associated with: (1) psychologic factors (2) psychologic and general medical condition
o May be acute or chronic
• Pain disorder
effects person’s feelings, behaviour
Depressive Disorders
