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Mental Health > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

How much weight do you want your anorexic patient to a gain a week

A

1-2 lbs

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2
Q

If an anorexic patient is gaining more than 1-2 lbs a week what could it possibly be…

A

Pulmonary edema

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3
Q

What is the legal intoxication limit.. you are considered intoxicated at this point

A

0.08-0.1

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4
Q

If they are above the legal limit (above .08) and they don’t show signs of intoxication what could that mean..

A

They are tolerant

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5
Q

What are 2 characteristics of nursing that are involved in manipulation and substance abuse..

A

They will always want to pass meds

Their patient will ask for pain meds a lot because the meds are never actually making it to them

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6
Q

What could happen to your body if you go off depressants..

A

You could rebound and your personality will shoot up into an overly happy person

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7
Q

Someone who does not feel guilt and is full of excuses might reflect what personality disorder

A

Antisocial

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8
Q

Someone who is highly manipulative is going to be able to acknowledge when other people are..

A

also highly manipulative

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9
Q

Why are weekly staff meetings important

A

so that all the nurses are on the same page about the clients and what they can and cannot do

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10
Q

What should you do when clients are verbally abusing others

A

You have to stop verbal abuse

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11
Q

When a client is doing this they are just trying their best to attempt to cope with the situation

A

Self mutilating

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12
Q

Its a good idea for a person with an eating disorder to..

A

Write down their foods/keep a food journal

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13
Q

Long term drinking can lead to..

A

Liver failure

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14
Q

An 84 year old with sleep disruptions is going to experience..

A

Aches & pain

Getting up to go to the bathroom

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15
Q

If you sleep better when it is dark outside, what season are you going to have the most trouble sleeping

A

Summer

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16
Q

Problems with their sleep cycle could be because the person is..

A

In different time zones

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17
Q

Russel signs are associated with..

A

Bulemia

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18
Q

What is a hallucination

A

These are false sensory stimuli
They are not actually there
Ex.) Bugs in the bed

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19
Q

What is an illusion

A

This is when objects that are actually there are wrongly perceived as something else

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20
Q

Someone with an eating disorder might secretly do this in their room

A

Exercise

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21
Q

This is given to people to help them to quit drinking and it will get them sick if mixed with alcohol

A

Antabuse

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22
Q

With these disorders, thoughts are emotions are everywhere, participation in interpersonal relationships is difficult, they don’t manage impulses well such as spending money, harming themselves or others

A

Personality disorders

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23
Q

This cluster of personality disorders display odd and eccentric behaviors, they have an unusual level of suspiciousness, they have magical thinking, and they are cognitively impaired

A

Cluster A

  • paranoid
  • schizoid
  • schizoidtypal
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24
Q

This personality disorder displays a large amount of distrust, it is very hard for them to trust others
They are always suspicious of others
They use projection, placing emotions on others
They think others want to harm them
They are hypervigilant and hostile
They don’t bond well with others
They are jealous, controlling, and unwilling to forgive

A

Paranoid

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25
Q

This personality type has a poor ability to function
They are viewed as loners
Friends and dating relationships are rare
Depersonalize and detach from others and emotions
They are often raised in a cold/neglectful environment

A

Schizoid

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26
Q

This personality type is rare
It is more common in men than women
They show severe social and interpersonal deficits
They have extreme anxiety in social situations
They tend to ramble and are unclear with their words
They have odd beliefs, magical thinking, and delusions, but they can probably be talked out of their delusions

A

Schizotypal

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27
Q

This cluster of personality is dramatic, emotional, shows erratic behavior, and they have problems with impulse control

A

Cluster B personality disorders

  • antisocial
  • borderline
  • histrionic
  • narcissistic
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28
Q

This personality is dramatic, the life of the party, and flirtatious, they need and love to have attention
They are self centered
They have a low frustration tolerance, get frustrated easily
They have an attachment to the opposite sex parent
Many do not think they need help, they also will not harm themselves
Psychotherapy may help

A

Histrionic

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29
Q

This personality type makes up excuses for everything
They feel no guilt, are deceitful, manipulative, and will exploit others whenever they get the chance
They have a disregard for responsibility
Lack of empathy
More common in men, by age 40 symptoms may improve
Usually in adults but symptoms can be evidenced in mid teens
They can show cruelty to animals and can be child perpetrators
Sociopaths, most likely in jail

A

Antisocial

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30
Q

What are things to focus on when caring for a client with antisocial personal disorders

A

Safety
Boundary and limit setting
The whole team should be consistent and on the same page
Watch for them trying to sneak in objects
Use therapeutic communication, no blaming–they will shut down

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31
Q

This is one of the least occurring personality disorders
They think everyone is less than them
They have an arrogant over inflated view of themselves
They need constant admiration
They lack empathy
They feel entitled and will exploit others
They have a fear of abandonment and shame
The cause could be childhood neglect and criticism
There is no medication for this disorder but cognitive behavioral therapy (CBT) is used

A

Narcissistic

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32
Q

This personality disorder starts when they are young
Most come out of foster homes because they have been abandoned, feel neglected from their families
There is a good chance they will get better as they get older
Borderline parents produce borderline kids
Impulsiveness
Most well known and most dramatic
Mostly women
Emotionally unstable: unstable moods and relationships
They have a fear of separation and social rejection
They don’t know who they are
They lie very easily
They cut and they can overdose as well—high mortality
They have a splitting behavior, its all or nothing
They are unpredictable

A

Borderline

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33
Q

This cluster of personality disorders are anxious, fearful, and have rigid patterns of social shyness

A

Cluster C

  • avoidant
  • dependent
  • obsessive compulsive
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34
Q

This personality disorders is excessively clingy
Self sacrificing
They try to get others to care about them
They are needy and need a new relationship

A

Dependent

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35
Q 
This personality disorder has a need for control and they are not flexible at all
Perfectionists
Rigid, highly critical of others
Preoccupied with details
Cant do something unless its perfect
A

Obsessive compulsive

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36
Q

OCD uses what defense mechanisms

A 
Intellectualization
Rationalization
Reaction formation
Isolation
Undoing
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37
Q

This personality disorder is fairly common
They have low self esteem
They are reluctant to engage in new activities
They respond well do antidepressants

A

Avoidant

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38
Q

When symptoms or problematic behavior become more pronounced in the evening or night
Nocturnal delirium
They may need PRNs and someone there with them

A

Sundowning

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39
Q

Making things up to talk about, creating stories or answers in place of actual memories to maintain self esteem

A

Confabulation

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40
Q

Loss of speech or language ability, difficulty finding the right word, then they are reduced to fewer words, finally they are reduced to babbling

A

Aphasia

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41
Q

Loss of purposeful movements, cant move and there is no cause of it, cant perform once familiar tasks such as putting on clothes

A

Apraxia

42
Q

Loss of ability to recognize objects, cant recognize a pen or what you do with it, cant recognize the ringing of the phone, cant recognize a spouse

A

Agnosia

43
Q

Cant read or write, more end stage of dementia

A

Agraphia

44
Q

Testing things by putting them in your mouth, tasting, or chewing them, like babies do

A

Hyperorality

45
Q

Touching everything in sight

A

Hypermetamorphosis

46
Q

The repetition of words, phrases, or behaviors

A

Perservation

47
Q

False sensory stimuli

A

Hallucinations

48
Q

When patients are extraordinarily alert, their eyes are constantly moving or scanning the room, they have difficulty falling asleep, they are agitated at night

A

Hypervigilance

49
Q

The ability to focus on environmental cues without distraction

A

Attention

50
Q

Immediate recall

A

Short term memory

51
Q

Determining what is appropriate for the environmental context

A

Social cognition

52
Q

What are the 5 drugs for dementia and what do these drugs do

A 
Tacrine (Cognex) --> no longer used
Donepezil (Aricept) --> drug of choice
Rivastigmine (Exelon)
Galantamine (Razadyne)
Memantine (Namenda) --> for moderate to severe
Increase acetylcholine (stop acetylcholinesterase)
They slow down the disease progression
53
Q

This is disturbances in consciousness and a change in cognition so its possible to have hallucinations and illusions present
It has a fast onset and can occur in young or old patients
It is transient meaning it can come and go
Its always secondary to another physiological condition
–infection, UTI, medication reaction
Goal is to treat the underlying condition, if this disorder is not treated the patient could die because this destroys neurons

A

Delirium

54
Q

What is ALWAYS a diagnosis of delirium

A

Risk for falls: safety is important

–no area rugs, use bath mats and safety devices

55
Q

The 4 cardinal features of delirium

A

Acute onset & fluctuating course: meaning they can abruptly develop a change in consciousness

Inattention: a reduced ability to direct, focus, or keep their attention so conversations may be difficult because you may be repeating a lot of questions

Disorganized thinking

Disturbances of consciousness: their disorientation and confusion are usually worse at night and early morning

56
Q

Why might a delirious patient be at risk for injury

A

They could have illusions and hallucinations that cause them to do things such as pull off tubes, IVs, or O2, or try to run away from things
Good lighting is important to avoid illusions and glares

57
Q

Why might a delirious patient be at risk for confusion

A

They have hallucinations, illusions, disorientation, agitation, restlessness, and misperception of things
–Clocks, calendars, and maps can be used to help with reorienting them

58
Q

Why might a delirious patient be at risk for fluid volume deficit

A

They could have a fever and dehydration and because as they get older their thirst trigger diminishes

59
Q

Why might a delirious patient be at risk for insomnia or sleep deprivation

A

Their disorientation and confusion are usually worse at night so it interferes with their sleep/wake cycles
You should not let them sleep during the day or they will be up all night

60
Q

Why might a delirious patient be at risk for impaired communication

A

They are disoriented and are in and out of consciousness so conversations may be difficult

61
Q

Why might a delirious patient be at risk for fear

A

This is very common related to their hallucinations, illusions, or delusions

62
Q

What 4 outcomes are we looking for with delirious patients

A

That they will return to their premorbid level of functioning
They will remain safe and free from injury while in the hospital
They will be oriented to time, place, and person (x3)
They will be free from falls, injuries, and skin breakdown

63
Q

This is a deterioration of cognitive functioning and global impairment of intellect with no change in consciousness
They are not usually in and out of consciousness, they just are not processing information correctly
This has a very slow onset, from diagnosis to death is usually 7 years
More likely in women because they live longer
Alzheimers disease is the most common cause of this

A

Dementia

64
Q

This is the most common type of dementia constituting 50-60% of all dementias
Physical and mental activities help to prevent this
Most cases are 65 years or older

A

Alzheimers

65
Q

Plaques and tangles in the brain
Neuronal degeneration that starts in the hippocampus (recent memory) then spreads to the cerebral cortex (problem solving and cognitive functioning)
Genetics play a large role
Only definitive way to diagnose is with an autopsy

A

Alzheimers

66
Q

In this stage of alzheimers: someone cant balance their check book anymore, cant do math, cant pay bills, cant manage finances, cant plan dinner, moody or withdrawn in harder situations

A

Mild

67
Q

In this stage of alzheimers: inability to recall your address or phone number or high school you graduated from, gaps in memory, confused with date and time, trouble with any arithmetic, cant choose clothes for the weather, don’t need assistance with eating or bathroom yet, they can still remember themselves and families

A

Moderate

68
Q

In this stage of alzheimers: they don’t remember spouse or caregiver (AGNOSIA), cant remember how to get dressed (APRAXIA), might put shoes then socks, changes in sleep patterns, cant control bladder or bowels, might need help going to the bathroom, still walking in severe stage, hard to swallow, muscles rigid, laying in bed, force fed

A

Severe

69
Q

In this stage of alzheimers: they frequently die of pneumonia, need help with much of their daily personal care such as eating and toileting, lose ability to smile, cant sit without support, cant hold heads up, reflexes are abnormal, AGRAPHIA, HYPERORALITY, HYPERMETAMORPHOSIS, they pretty much need help with everything

A

Late

70
Q

As dementia progresses, so does the need for..

A

Family and staff participation in care

As well as patients, creativity, and maturity

71
Q

Primary chronic disease of brain reward, motivation, memory, and related circuitry
A disease of dysregulation in the hedonic (pleasure seeking) or reward pathway of the brain

A

Addiction

72
Q

Cluster of behaviors originally identified through research involving the families of alcoholic patients
Consists of over responsible behaviors, doing for others what they should do for themselves
Define self worth in terms of caring for others to the exclusion of their own needs

A

Codependence

73
Q

Using a substance in excess

A

Intoxication

74
Q

Needing increasing amounts of a substance to receive the desired results in a much diminished effect

A

Tolerance

75
Q

A set of physiological symptoms that begin to occur as the concentration of the chemical decreases in an individuals blood stream

A

Withdrawal

76
Q

Behavioral actions such as gambling rarely have..

A

intoxication, withdrawal, or tolerance

77
Q

A new group of stimulants that can come as tablets, capsules, or powder in sealed envelopes
They are made of MDPV, mephedrone, and methylone
They are a schedule 1 making them illegal to possess
Can cause euphoria, elevated mood, and a pleasurable rush
But can also cause hostility, paranoia, some cases are flesh eating, chest pain, tachycardia, hallucinations, hypertension, peripheral constriction, erratic behavior, inattention, lack of memory of substance abuse, and psychosis

A

Bath salts

78
Q

Those who are highly educated, are employed, and live in nonmetropolitan cities are..

A

Less likely to misuse drugs or alcohol

79
Q

Nurses are at risk for this..since the nature of our job is to provide care to others

A

Codependency

80
Q

For nurses who begin to engage in risk taking behaviors they have non-punitive alternatives to discipline programs in the form of

A

Peer assistance

81
Q

Caused by the use of an earlier hallucinogenic drug, can be pleasant but often times its frightening

A

Flashbacks

82
Q

Within 12 hours of discontinuation can cause diaphoresis, anxiety, hand tremors, and can range from mild to severe
Seizures can occur within the first 48 hours of not having a drink

A

Withdrawal

83
Q

Substance induced delirium

A

Psychosis

84
Q

This medication can be used for mild alcohol detox

A

Ativan

85
Q

This medication can be used for more severe alcohol detox
It decreases seizures and reduces withdrawal agitation
It produces sedation
Stopping may result in seizures

A

Librium

86
Q

Alcohol with depressants will put you to sleep: name 3 depressants

A

Opiates
Benzodiazepines
Barbiturates

87
Q

What assists with bringing down the effects of cocaine

A

Heroin

88
Q

What reverses the respiratory depression that opiates such as heroin could possibly cause

A

Narcan

89
Q

IV drug use can cause..

A

sclerosing (hardening) of the veins

90
Q

Intranasal usage can cause..

A

holes or erosions of the nasal septum

91
Q

What 3 vitals do you not want over 100

A

HR
Temp
B/P (diastolic)

92
Q

Name 3 stimulants

A

Crack cocaine
Caffeine
Nicotene

93
Q

Name 4 opiates

A

Opium
Morphine
Heroin
Codeine

94
Q

2 treatments for opiates

A

Fentanyl patch

Methadone

95
Q

The main ingredient in marijuana that can treat intraocular pressure in glaucoma, appetite stimulation in chemo and AIDS patients

A

THC

96
Q

Name 4 inhalants

A

Spray paint
Glue
Lighter fluid
Gases

97
Q

For friends and family members of alcohol abusers

A

Al-anon

98
Q

For teenage relatives of alcohol abusers

A

Alateen

99
Q

Drugs for the treatment of alcohol addiction

A

Naltrexone (Trexon, Revia) –> drugs also
Acamprosate (Campral)
Benzos: librium, ativan, klonopin

100
Q

Drugs for the treatment of alcohol addiction

A

Naltrexone (Trexon, Revia) –> drugs also
Acamprosate (Campral)
Benzos: librium, ativan, klonopin

101
Q

Daytime sleepiness

A

Primary hypersomnia

102
Q

No cause to not being able to fall asleep

A

Primary insomnia

Mental Health (4 decks)

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