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NURS308 > Exam #2 > Flashcards

Exam #2 Flashcards

1
Q

S.E. of dopamine blockage

A

decreased psychosis
psychomotor agitation
PARKINSONIAN EFFECTS
EPS (i.e. dystonia, akathisia, tardive dyskinesia)

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2
Q

S.E. of histamine blockage

A

sedation
weight gain
cognitive impairment
orthostasis

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3
Q

dystonia

A

acute contractions of tongue, face, neck, and back

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4
Q

akathisia

A

motor-driven inner restlessness

e.g., tapping foot incessantly, rocking forward and backward in chair, shifting weight from side to side

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5
Q

tardive dyskinesia

A

facial: protruding and rolling tongue, to years blowing, LIP SMACKING, licking, spastic facial distortion, smacking movements
Trunk: neck and shoulder movements, dramatic hip jerks and rocking, twisting pelvic thrusts

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6
Q

neuroleptic malignant syndrome

A

Severe muscle rigidity with confusion, agitation, increased temperature, pulse, and blood pressure suggest a serious condition
the acute reduction in brain dopamine activity
tx: consists of early detection, discontinuation of the antipsychotic agent, management of fluid balance, reduction of temperature, and monitoring for complications

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7
Q

serotonin syndrome

A

r/t over-activation of the central serotonin receptors, caused either by too high a dose or by interaction with other drugs
sx.’s include abdominal pain, diarrhea, sweating, fever, tachycardia, elevated B.P., altered mental state (delirium), myoclonus (muscle spasms), increased motor activity, irritability, hostility, and mood change
- severe manifestation can induce hyperpyrexia (excessively high fever), cardiovascular shock, or death
risk of this syndrome seems to be the greatest when an SSRI is administered in combo. with a 2nd serotonin- enhancing agent, such as an MAOI

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8
Q

SCHIZOPHRENIA: psychosis

A

it is not a diagnosis but a sx.
refers to a total inability to recognize reality via hallucinations and delusions
may present as recurrent acute exacerbations
w/ each relapse of psychosis, there is an increase in residual dysfunction and deterioration

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9
Q

SCHIZO.: schizophrenia

A

it is a severe mental illness
s a result of a combination of inherited genetic factors and extreme non-genetic factors (e.g., virus infection, birth injuries, nutritional factors
suicide is the leading cause of premature death in pt.’s w. schizo.
it is treatable but not curable
individuals have varying degrees of neurocognitive impairments evidenced by disorganized thinking and disorganized speech

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10
Q

SCHIZO.: what are the neurobiological causes of schizo.?

A

dopamine hypothesis
- there’s a hyperactivity of the neurotransmitter dopamine in the limbic regions of the brain
glutamate hypothesis
serotonin theory

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11
Q

SCHIZO.: what are the neuroanatomical causes of schizo.?

A

disruptions in the connections and communication within neural circuitry (communication pathways) are thought to be severe in schizophrenia
:. it is conceivable that structural cerebral abnormalities cause disruption to the entire circuitry of the brain

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12
Q

SCHIZO.: what are key sx.’s in schizo.?

A

positive sx.’s [psychotic sx.’s]
- delusions, hallucinations, and perceptions that are not based on reality
- least imp. sx.’s, prognostically, and can be treated w/ antipsychotic med.’s
negative sx.’s
- poverty of thought, loss of motivation, inability to experience pleasure or joy, feelings of emptiness, and blunted affect
cognitive sx.’s
- inability to under- stand and process information, trouble focusing attention, and problems with working memory
affective sx.’s
- dysphoria, suicidality, hopelessnes

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13
Q

SCHIZO.: what are the phases of schizo.?

A

prodromal phase
- sx.’s: social withdrawal and deterioration in function and depressive mood, followed by perceptual distur· bances, magical thinking, and peculiar behavior, perceptual difficulties; increased stress, depression, anxiety, and sleep disturbances, declined functional ability
acute phase
- periods of positive, negative, and cognitive sx.’s
stabilization phase
- acute sx decrease in severity, particularly the positive sx
maintenance phase
- sx.’s are in remission, although there might be milder persistent sx.’s

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14
Q

SCHIZO.: alogia

A
  • sx.
    poverty of speech
    poverty of content of speech
    blocking
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15
Q

SCHIZO.: avolition

A
  • sx.
    general lack of drive, or motivation to pursue meaningful goals; physical anergia
    e.g. impaired grooming and hygiene, lack of persistence at school or work
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16
Q

SCHIZO.: associative looseness

A

+sx.

thinking becomes haphazard, illogical, and confused

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17
Q

SCHIZO.: neologisms

A

+ sx.

these are made-up words that have special meaning to the person

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18
Q

SCHIZO.: echolalia

A

+ sx.
echolalia is the pathological repeating of another’s words by imitation and is often seen in people with catatonia
- echolalia is the counterpart of echopraxia, mimicking of the movements of another, which is also seen in catatonia

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19
Q

SCHIZO.: clang association

A

+ sx.

it is the meaningless rhyming of words, often in a forceful manner

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20
Q

SCHIZO.: personal boundary difficulties

A

+ sx.
people with schizo. often lack a sense of where their bodies end in relationship to where others begin. Patients might say that they are merging with others or are part of inanimate objects
- depersonalization is a nonspecific feeling that a person has lost his or her identity; the self is different or unreal
- derealization is the false perception by a person that the environment has changed

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21
Q

SCHIZO.: affect [flat, inappropriate, bizarre]

A
  • sx.
    flat
  • immobile facial expression or a blank look
    inappropriate
  • an emotional response to a situation that is not congruent with the tone of the situation
    bizarre
  • includes grimacing, giggling, and mumbling to oneself
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22
Q

SCHIZO.: catatonia

A
  • sx.
    an essential feature of catatonia is extreme abnormal motor behavior
    pt.’s may exhibit bizarre postures, waxy flexibility, stereotyped behavior, echolalia, echopraxia
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23
Q

SCHIZO.: defense mechanism of ideas of reference

A

frequently misinterpreting the messages of others or giving private meaning communications of others

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24
Q

SCHIZO.: 1st generation/ conventional antipsychotic agents

A

these are teh D2 receptor antagonists [DRA’s]

target the + sx.’s [e.g. hallucinations, delusions]

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25
Q

SCHIZO.: 2nd generation/ atypical antipsychotic agents

A

these are the serotonin-dopamine antagonists [SDA’s]
first-line
they have a higher risk for metabolic syndrome
- glucose dysregulation, hypercholesterolemia, HTN
benefits of 2nd’s:
- have better tolerability with patients than the 1st generation antipsychotics
- provide reduction of - sx.’s
- improve the neurocognitive defects associated w/ schizo.
- may decrease affective sx.’s (e.g. anxiety & depression)
- thought to decrease suicidal behavior
- reduce neuroanatomical changes/enlargement of the lateral ventricles
- improve cognition
- associated with lower relapse rates

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26
Q

LEGAL: beneficence

A

the duty to act so as to benefit or promote the good of others

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27
Q

LEGAL: autonomy

A

respecting the rights of others to make their own decisions

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28
Q

LEGAL: justice

A

the duty to distribute resources or care equally, regardless of personal attributes

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29
Q

LEGAL: fidelity or nonmaleficence

A

maintaining loyalty and commitment to the patient and doing no wrong to the patient

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30
Q

LEGAL: veracity

A

one’s duty to communicate truthfully

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31
Q

LEGAL: writ of habeas corpus

A

literally means a formal, written letter to free a person

it is the procedural mechanism used to challenge unlawful detention by the government.

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32
Q

LEGAL: voluntary admission

A

voluntarily admitted patients have the right to demand and obtain release
many states require that a patient submit a written unconditional release, or discharged, notice to the facility staff, who reevaluate the patient’s condition for possible conversion to involuntary status according to criteria established by state laws

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33
Q

LEGAL: informed consent

A

based on a person’s right to self-determination, as enunciated in the landmark case of Canterbury v. Spence [1972]
patients must be informed of the nature of their problem or condition, the nature and purpose of a proposed treatment, the risks and benefits of that treatment, the alternative treatment options available, the probability that the proposed treatment will be successful, and the risks of not consenting to tx
neither voluntary nor involuntary admission to a metal facility determines whether patients are capable of making informed decisions about the health care they may need

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34
Q

LEGAL: contraindications to seclusion and restraints

A

extremely unstable medical and psychiatric conditions
delirium or dementia leading to inability to tolerate decreased stimulation
severe suicidal tendencies
severe drug reactions or overdoses or need for close monitoring of drug dosages
desire for punishment of patient or convenience of staff

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35
Q

LEGAL: duty to warn

A

a psychotherapist has a duty to warn a pt.’s potential victim of potential harm

36
Q

LEGAL: tort

A

it is a civil wrong for which money damages may be collected by the injured party (the plaintiff) from the wrongdoer (the defendant)
the injury can be to person, prop- erty, or reputation

37
Q

LEGAL: elements to prove negligence

A

(1) duty, (2) breach of duty, (3) cause in fact [e.g. “Except for what the nurse did, would this injury have occurred?”], (4) proximate cause [legal cause, may be evaluated by determining whether there were any intervening actions or individuals that were, in fact, the causes of harm to the pt.], and (5) damage

38
Q

LEGAL: breach of duty

A

it is the conduct that exposes the pt. to an unreasonable risk of harm, through either commission or omission of acts by the nurse

39
Q

STRESS: eustress vs. distress

A

eustress is beneficial stress; it motivates people to develop the skills they need to solve problems and meet personal goals
distress is a negative experience that can drain our energy

40
Q

STRESS: stress response

A

amygdala
- the component of the limbic system that contributes to emotional processing
hypothalamus
- functions as the command-and-control center when receiving stressful signals
- responds to signals of stress by engaging the autonomic nervous system
– the ANS is comprised of the sympathetic (fight-or-flight response) and parasympathetic nervous systems (relaxation response)
adrenal glands
- receives signals from the AND, then releases epi.
– circulating epi. increases, oxygenation to all tisssues [esp. brain > alertness] increases H.R., elevates B.P., increases blood flow to the skeletal muscles, and increases muscle tension
HPA [hypothalamus, pituitary gland, adrenal glands] axis
- stimulated by hypothalamus pc initial rush of epi. subsides
- prolonged stress > hypothalamus to produce corticotropin-releasing hormone [CRH] > stimulates pituitary gland to produce adrenocorticotropic hormone [ACTH] > stimulates adrenal glands to release cortisol
cortisol
- helps to supply cells with amino acids and fatty acids for energy; as diverts glucose from muscles for use by the brain to maintain vigilance
- as the threat passes, the parasympathetic branch of the ANS, the part that helps maintain homeostasis and relaxation, takes over
– cortisol levels drop
* the chemicals produced by the stress response can have damaging effects on the body, causing physical diseases e.g. a substantial negative effect on the immune system, leaving individuals vulnerable to autoimmune disease

41
Q

STRESS: effects of brain from repeated trauma/ stress

A

it not only alters the release of neurotransmitters but also changes the anatomy of the brain-neuroimaging shows that the size of the hippocampus is actually reduced

42
Q

STRESS: tx for PTSD

A

both CBT and selective serotonin reuptake inhibitors (SSRls) have become first-line treatment options

43
Q

STRESS: compassion stress

A

this describes the emotional effect that nurses and other health care workers may experience by being indirectly traumatized when helping or trying to help a person who has experienced primary traumatic stress

44
Q

ANXIETY: anxiety vs. fear

A

anxiety: can be defined as a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat whose actual source is unknown or unrecognized
fear: it is a reaction to a specific danger, and more often the body reacts

45
Q

ANXIETY: mild level of anxiety

A

this level can be found in a normal person on an average day
perceptual field
- may have heightened perceptual field
ability to learn
- able to work effectively toward a goal and examine alternatives
physical characteristics: slight discomfort, attention-seeking behaviors, restlessness, irratibility

46
Q

ANXIETY: moderate level of anxiety

A

perceptual field
- has narrow perceptual field; grasps less of what is occurring; can attend to more if pointed out by another (selective inattention)
ability to learn
- able to solve problems but not at optimal ability; benefits from guidance of others
physical characteristics
- voice tremors, difficulty concentrating, repetitive questioning, increased H.R. & resp. rate & muscle tension

47
Q

ANXIETY: severe level of anxiety

A

perceptual field
- focuses on details or one specific detail; attention scattered; completely absorbed with self; env’t. is blocked out
ability to learn
- unable to see connections between events or details; has distorted perceptions
physical characteristics
- feelings of dread, confusion, hyperventilation, tachycardia, withdrawal, threats and demands

48
Q

ANXIETY: panic level of anxiety

A

perceptual field
- unable to focus on the environment; experiences the utmost state of terror and emotional paralysis; in panic, may have hallucinations or delusions that take the place of reality
ability to learn
- may be mute or have extreme psychomotor agitation leading to exhaustion; shows disorganized or irrational reasoning
physical characteristics
- experience of terror; immobility or severe hyperactivity; dilated pupils; unintelligible communication or inability to speak; severe shakiness; sleeplessness

49
Q

ANXIETY: interventions for mild to moderate levels of anxiety

A

the nurse can help the patient focus and solve problems with the use of specific communication techniques, such as employing open-ended questions, giving broad openings, and exploring and seeking clarification.

50
Q

ANXIETY: interventions for severe to panic levels of anxiety

A

anxiety reduction measures may take the form of moving the person to a quiet environment in which there is mini· ma! stimulation and providing gross motor activities to drain some of the tension
firm, short, and simple statements are useful

51
Q

ANXIETY: properties of defense mechanisms

A

defenses are a major means of managing conflict and affect
defenses are relatively unconscious
defenses are discrete from one another
although defenses are often the hallmarks of major psychiatric syndromes, they are reversible
defenses are adaptive as well as pathological

52
Q

ANXIETY: defense of altruism

A

a healthy defense mechanism

emotional conflicts and stressors are addressed by meeting the needs of others

53
Q

ANXIETY: defense of sublimation

A

a healthy defense mechanism
it is an unconscious process of substituting constructive and socially acceptable activity for strong impulses that are not acceptable in their original form
e.g. a man with strong hostile feelings may choose to become a butcher, or he may participate in rough contact sport

54
Q

ANXIETY: defense of suppression

A

a healthy defense mechanism

it is the CONSCIOUS denial of a disturbing situation or feeling

55
Q

ANXIETY: defense of displacement

A

a healthy defense mechanism
transfer of emotions associated with a particular person, object, or situation to another person, object, or situation that is nonthreatening
e.g. boss yells at the man, the man yells at his wife, the wife yells at the child, and the child kicks the cat
spousal, child, and elder abuse are often cases of displaced hostility

56
Q

ANXIETY: defense of reaction formation

A

a healthy defense mechanism
unacceptable feelings or behaviors are kept out of awareness by developing the opposite behavior or emotion
e.g. a person who harbors hostility toward children becomes a Boy Scout leader

57
Q

ANXIETY: defense of somatization

A

a healthy defense mechanism

transforming anxiety on an unconscious level into a physical symptom that has no organic cause

58
Q

ANXIETY: defense of undoing

A

a healthy defense mechanism
compensates for an act or communication
e.g., giving a gift to undo an argument

59
Q

ANXIETY: defense of passive aggression

A

an immature defense mechanism
these people deal with emotional conflict or stressors by indirectly and unassertively expressing aggression toward others
aggression toward others is expressed through procrastination, failure, inefficiency, passivity, and illnesses that affect others more than oneself

60
Q

ANXIETY: defense of dissociation

A

an immature defense mechanism
a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment
e.g. “I really don’t remember what happened. The last thing I remember is going out the door to check on Johnny.”
- at that moment, to protect herself from an unbearable situation, she separated the threatening event from awareness until she could begin to deal with her feelings of devastation

61
Q

ANXIETY: defense of devaluation

A

an immature defense mechanism
occurs when emotional conflicts or stressors are handled by attributing negative qualities to self or others
when devaluing another, the individual then appears good by contrast

62
Q

ANXIETY: defense of idealization

A

an immature defense mechanism

emotional conflicts or stressors are addressed by attributing exaggerated positive qualities to others

63
Q

ANXIETY: defense of splitting

A

an immature defense mechanism

the inability to integrate the positive and negative qualities of oneself or others into a cohesive image

64
Q

ANXIETY: defense of projection

A

an immature defense mechanism
a person unconsciously rejects emotionally unacceptable personal features and attributes them to other people, objects, or situations
it is the hallmark of blaming, scapegoating, prejudicial thinking, and stigmatization
projection of anxiety can often be seen in systems (family, hospital, school, business, politics]

65
Q

ANXIETY: anxiety disorders

A

anxiety becomes a problem when it interferes with adaptive behavior, causes physical symptoms, or exceeds a tolerable level
the common element in anxiety disorders is that individuals experience a degree of anxiety that is so high that it interferes with dysfunction at work, social, and family functions
anxiety disorders are common and chronic, tend to be persistent, and are usually disabling
anxiety can be some of the first symptoms of a medical disorder

66
Q

ANXIETY: neurobiological theories of anxiety

A

certain anatomical pathways (the limbic system) provide structure for electrical impulses that either receive or send anxiety-related responses
the part of the limbic system [consists of the amygdala, septum, cingulate, and hippo· campus] most associated with anxiety disorders as well as the obsessive-compulsive disorders is the cingulate, where the neural pathways connect to the limbic system and prefrontal lobes that result in the regulation of emotions
other parts of the brain that cause anxiety
- frontal cortex
– cognitive interpretations (e.g., potential threat)
- hypothalamus
- activation of the stress response (fight-or· flight response]
- hippocampus
– associated with memory related to fear responses
- amygdala
– fear, especially related to phobic and panic disorders

67
Q

ANXIETY: anxiety and the mediator serotonin

A

serotonin (5-HT)

  • thought to be decreased in anxiety disorders
  • SSRI’s, increase serotonin levels in the brain, are often first-line medications for the treatment of many anxiety disorder
68
Q

ANXIETY: anxiety and the mediator norepi.

A

mediates arousal
when a person feels threatened (real or perceived) the level of norepinephrine (adrenaline) increases and can cause hyperarousal and increased anxiety
it is thought that the noradrenergic system is poorly regulated and can cause bursts of activity
- noradrenergic drugs such as propranolol (which blocks adrenergic receptor activity) and clonidine (which stimulates a-adrenergic receptors) are used to help lower anxiety

69
Q

ANXIETY: anxiety and the mediator GABA

A

it is an inhibitory neurotransmitter in the brain
the release of GABA slows neural transmission, which has a calming effect
binding of the benzodiazepine medications to the benzodiazepine receptors facilitates the action of GABA
- antianxiety agents, sedative-hypnotics, general anesthetics, and anticonvulsant drugs are the targets of the GABA receptor system thus slowing neural trans- mission and lowering anxiety

70
Q

ANXIETY: behavioral theory of anxiety

A

behavioral psychologists conceptualize anxiety as a learned response that can be unlearned
e.g. modeling, systematic desensitization, response prevention, thought stopping

71
Q

ANXIETY: panic disorders [PD]

A

sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom
normal function is suspended, the perceptual field is severely limited, and misinterpretation of reality may occur
occur suddenly (not necessarily in response to stress), are extremely intense, last 1 or 2 minutes (occasionally lasting up to 30 minutes), and then subside
major depression may co-occur
tx
- high-potency benzodiazepines
– e.g. alprazolam, clonaz- epam, and lorazepam
- antidepressants
– e.g. tricyclics and SSRI’s
- monoamine oxidase inhibitors (MAOis)
- utilization of cognitive and behavioral therapy in conjunction with medications has been effective in treating some people with panic attacks

72
Q

ANXIETY: phobias

A

it is a persistent, intense irrational fear of a specific object, activity, or situation that leads to a desire for avoidance, or actual avoidance, of the object, activity, or situation
behavioral therapy seems to be the only therapy effective with specific phobias

73
Q

ANXIETY: social anxiety disorders

A

a form of phobia
characterized by severe anxiety or fear provoked by exposure to a social situation or a performance situation, resulting in humiliation or embarrassment
believed to be influenced by psychological factors such as the quality of early attachments, the development of appropriate social skills, inadequate experi- ences interacting with others, and other negative environmental influences
tx
- the beta-blocker propranolol reduces the physiological symptoms of anxiety, although not the cogni- tive (e.g., worry
- more pervasive social anxiety may respond to monoamine oxidase inhibitors (MAOI’s) and selective serotonin reuptake IIlhibitors (SSRis)
- cognitive therapy interventions along with social skills training are helpful for many

74
Q

ANXIETY: agoraphobia

A

a form of phobia
it a is an intense, excessive anxiety about or fear of being in places or situations where help might not be avail- able and escape might be either difficult or embarrassing
it is perhaps the most limiting and debilitating of all of the phobias
complications ensue when individuals attempt to decrease anxiety or depression through self-medication with alcohol or drugs
tx
- responds well to cognitive behavioral therapy (CBT) and SSRI medications to help reduce the anxiety as well as treat the depression

75
Q

ANXIETY: generalized anxiety disorder [GAD]

A

it is a chronic psychiatric disorder associated with severe distress different from other anxiety disorders in that there is pervasive cognitive dysfunction, impaired functioning, and poor health-related outcomes
may contract co-morbid MDD which may lead to substance or alcohol abuse
it is characterized by excessive, persistent, and uncontrollable anxiety, and by excessive worrying
a diagnosis of GAD is made if at least three of the following symptoms are present: restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbance
tx
- buspirone and 5-HT serotonin antagonists (SSRis) are effective in reducing the “what ifs” and worrying in GAD patients

76
Q

OCD: obsessive compulsive disorder

A

seems to occur more often in patients with other neurological disorders, such as in Huntington’s chorea epilepsy, Sydenham’s chorea, or brain trauma
obsessions are thoughts, impulses, or images that persist and recur so that they cannot be dismissed from the mind which often seem senseless to the individual who experiences them, although they still cause the individual to experience severe anxiety
compulsions are ritualistic behaviors that an individual feels driven to perform in an attempt to reduce anxiety
the primary gain is achieved by compulsive rituals, but because the relief is only temporary, the compulsive act must be repeated many times
suicide can be a risk for these individuals, especially in the presence of a co-occurring depression

77
Q

OCD: body dysmorphic disorder

A

diagnosis includes preoccupation with an imagined “defective body part”; obsessional thinking and compulsive behaviors and Impairment of normal social activities related to academic or occupational functioning
individuals with BDD have higher rates of suicidal ideation, suicide attempts, and completed suicides than individuals who did not meet criteria for BDD
tx
- The pharmacological agents of choice for treating people with BDD are selective serotonin reuptake inhibitors (SSRis), antidepressants, and clomipramine (a tricyclic antidepressant]

78
Q

SUICIDE: traumatic brain injury

A

refers to any type of trauma to the head that affects brain functioning
It is believed that those who tested positive for TBI were more likely to be diagnosed with depression, anxiety disorders, PTSD, adjustment disorders, psychosis, and bipolar disorders

79
Q

SUICIDE: sub-intentioned suicide

A

identified by Shneidman as self-destructive behaviors (e.g., compulsive use of drugs, hyperobesity, gambling, self-harmful sexual behaviors, and medical noncompliance

80
Q

SUICIDE: neurobiological aspects of suicide

A

scientists have identified a strong association b/w suicide and the molecular genetics of the neurotransmitter serotonin
- e.g. people who attempted suicide have lower serotonin functioning
– those who have completed suicide have the lowest levels
studies of the brains of those who have completed suicide show abnormalities of the serotonin system in parts of the prefrontal cortex in an area of the brain called the ventral medial prefrontal cortex
the noradrenergic system is a mediator of acute stress responses and over-activity of that system has been associated with both severe anxiety or agitation and higher suicidal risk
the HPA axis is associated with major depression and suicide victims often exhibit HPA axis abnormalities

81
Q

SUICIDE: psychological aspects of suicide

A

there is a trio of psychological-emotional factors often present when people become suicidal: hopelessness, helplessness, and feelings of worthlessness

  • hopelessness refers to lack of purpose in life
  • helplessness refers to lack of social supports
  • worthlessness refers to low self-esteem or lack of love for self
82
Q

SUICIDE: risk factors for adolescents and young adults

A

strongest: substance abuse, aggression, disruptive behaviors, depression, and social isolation
others: frequent episodes of running away, frequent expressions of rage, family loss or instability, frequent problems with parents, withdrawal from family and friends, expression of suicidal thoughts or talk of death or the afterlife when sad or bored, difficulty dealing with sexual orientation, unplanned pregnancy, perception of school, work, or social failure

83
Q

SUICIDE: risk factors for older adults

A

social isolation, solitary living arrangements, widowhood, lack of financial resources, poor health, and feelings of hopelessness
recognition and treatment of depression m the medical setting are promising ways to prevent suicide in older adult

84
Q

SUICIDE: examples of verbal and behavioral clues indicating suicidal ideation

A 
verbal 
- overt statements
-- "I can't take it anymore."
-- "Life isn't worth living anymore." 
- covert statements
-- "It's okay now. Everything will be fine." 
-- "Things will never work out."
behavioral
- giving away prized possessions
- writing farewell notes
85
Q

SUICIDE: interventions to prevent suicide [attempt]

A

restriction of access to means, treatment of depression, assistance with problem-solving skills and other therapies, and prescription of psychotropic medication
interventions to improve a person’s resiliency and act as protective factors
- family and community support
- effective and appropriate clinical care for mental, physical, and substance abuse disorders
- restricted access to highly lethal methods of suicide
- cultural and religious beliefs that discourage suicide and support self-preservation instincts
- acquisition of learned skills for problem solving, conflict resolution, and nonviolent management of disputes
- cognitive behavioral therapy

86
Q

SUICIDE: postvention

A

intervention for family and friends (“survivors”) of a per- son who has committed suicide
natural feelings of denial and avoidance predominate during the first 24 hours after a person has committed suicide
survivors report mental deterioration, with symptoms of depression or post-traumatic stress disorder
- often manifest the following post-traumatic stress reactions: irritability, sleep disturbances, anxiety, exaggerated startle reaction, nausea, headache, difficulty concentrating, confusion, fear, guilt, withdrawal, anger, and reactive depression
family members of the suicide victim exhibit a higher rate of suicide

87
Q

S.E. of norepinephrine blockade

A

decreased depression
tremors
tachycardia
erectile and or ejaculatory dysfunction

NURS308 (4 decks)

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