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Mental Health > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Most common stimulant

A

Meth

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2
Q

Signs of intoxication of stimulants

A

Pupil dilation, paranoia, ammonia smell

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3
Q

Withdrawal for stimulants

A

Suicidal ideation due to impulsiveness

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4
Q

Why are opioids the most common addiction

A

Easy access

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5
Q

Signs of overdose of opioids

A

Shallow breathing, respiratory arrest, change in consciousness

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6
Q

Withdrawal of opioids

A

N/V, muscle aches, runny nose, watery eyes, sweating, fever

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7
Q

Withdrawal symptoms look like the flu for what drug

A

Opioids

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8
Q

What type of opioid is most common to be addicted to? (Heroin or pain pills)

A

Pain pills

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9
Q

Why is there a high abuse potential for alcohol?

A

It is legal

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10
Q

Withdrawal of alcohol

A

Tremors, sweating, elevated BP

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11
Q

When does withdrawal start for alcohol?

A

4-12 hours after last drink

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12
Q

When can withdrawal of alcohol progress to delirium tremens?

A

Day 2-3

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13
Q

Why might patients going through withdrawal try to manipulate you?

A

They have a control problem

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14
Q

Where should you put patients experiencing DT’s?

A

In a quiet area

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15
Q

What should you do when assessing patients coping skills?

A

Find out what worked in the past

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16
Q

What is the only drug that the withdrawal can directly kill you?

A

Alcohol

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17
Q

What is the key symptom to watch for when withdrawing from alcohol?

A

Hallucinations
Means its progressing to DT’s
Emergency!

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18
Q

What should you do if you think a coworker has a substance use disorder?

A

Must report it

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19
Q

What happens to coworker if they get reported for substance use?

A

Won’t lose license, they just have to complete rehab treatment before returning to work

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20
Q

What is most important when suspecting substance use in a coworker?

A

Keep the coworker anonymous

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21
Q

When dealing with someone with substance use disorder always…

A

Be empathetic
Set firm limits
Be consistent

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22
Q

Therapeutic communication: what NOT to do

A

Agree or disagree
Ask why
Give advice

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23
Q

Addiction

A

When the use of a substance interferes with fulfilling role obligations at work, school, or home

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24
Q

Assessment tools for withdraw

A

Clinical institute withdrawal assessment

CAGE questionnaire

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25
Q

CAGE

A

Cut: have you ever felt you should cut down on your drinking
Annoyed: have people ever annoyed you by criticizing your drinking
Guilt: have you ever felt bad or guilty about your drinking
Eye-opener: have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover

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26
Q

Wernicke’s encephalopathy

A

Deficiency in vitamin B and thiamine

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27
Q

How can thiamine replacement be given?

A

IV or IM

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28
Q

Wernicke’s leads to…

A

Korsakoff syndrome: irreversible

Wernicke’s: reversible

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29
Q

Alcohol withdraw should be treated with?

A

Ativan

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30
Q

Methadone

A

Cheapest
Mimic effects of opioid
Causes slight high
Some people stay on it forever

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31
Q

What might be a side effect of methadone

A

QT syndrome

Must get EKG to start

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32
Q

What is cheaper? Methadone or suboxone

A

Methadone

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33
Q

Suboxone

A

Less addictive

Less risk of overdose

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34
Q

Vivitrol

A

Used as once monthly injection for opioid withdrawal

Can also be used to stop alcohol cravings

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35
Q

Revia (naltrexone)

A

Used as once daily pill for opioid withdrawal or to stop alcohol cravings

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36
Q

Ativan

A

Acute withdrawal of alcohol
Very addictive
Works instantly

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37
Q

Antabuse

A

Blocks enzyme that metabolizes alcohol

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38
Q

Why is education important for antabuse?

A

Can’t use any products with alcohol in it because it will be absorbed through the skin and can cause side effects such as vomiting

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39
Q

Librium

A

Used after ativan

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40
Q

Serax

A

Works like ativan and librium

Cannot be processed in liver

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41
Q

Who are people often abused by?

A

Someone they know

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42
Q

Victim profile

A 
Often accepts blame
Low self esteem
Feels guilty
Anger, fear, shame
Isolated from family and friends
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43
Q

Victimizer profile

A 
Low self esteem
Jealous
Poor coping skills
Dual personality
Sees others as possessions 
Threatened by signs of independence
Controlling
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44
Q

Honeymoon phase of abuse

A

Abuser may show jealousy

No abuse taking place

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45
Q

Tension building phase of abuse

A

Minor incidents occur such as criticizing, yelling, and blaming
Victim is “walking on eggshells”
Victim tries to prevent violence

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46
Q

Explosive phase of abuse

A

Tension released and typically gets worse over time
Victim will be hurt and may go to hospital
Police may be called

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47
Q

Reconciliation phase of abuse

A

Abuser apologizes and begs the victim to believe the violence won’t happen again
Blames the victim for the abuse

48
Q

Why don’t the victims of abuse leave?

A 
Fear of losing custody
Fear for family members including children
Fear of retaliation
Physical or financial dependence
Lack of support network
49
Q

Homicide of the victim of abuse or homicide-suicide

A

74% of all murder-suicides involved intimate partners

50
Q

Risk factors that the violence will escalate

A

Guns in the home (5-8 more likely)
Battering during pregnancy
Extreme jealousy/control
Substance abuse

51
Q

When is the most dangerous period for abuse?

A

After the victim leaves

52
Q

Sexual assault has to do with…

A

Has nothing to do with sex and everything to do with power, control, and humiliation

53
Q

Rape

A

Penetration of vagina, anus, or oral penetration by a sex organ of another person

54
Q

Sexual assault

A

Any type of sexual contact or behavior that occurs without consent
(Sex, child molestation, incest, fondling, attempted rape)

55
Q

Expressed response pattern of rape

A 
Fear
Anxiety
Anger
Crying
Tension
56
Q

Controlled response pattern for rape

A

Masked or hidden feelings

Calm and composed

57
Q

Compounded rape reaction

A

Additional symptoms such as depression, suicide, psychotic behavior

58
Q

Silent rape reaction

A

Tells no one
Burden may be unbearable
Unresolved feeling may manifest in other sexual crisis

59
Q

Sexual assault is usually done by…

A

Someone you know

60
Q

Why don’t people seek care after rape?

A 
Fear of having to report
Not wanting someone to touch you
Fear of court
Not wanting to admit it to yourself
Fear of pain
61
Q

What is the most common form of child abuse?

A

Neglect

62
Q

Physical abuse

A

Non accidental physical injury ranging from minor injury to death

63
Q

Physical signs of abuse

A

Wounds in different healing stages
Old scars
Poor skin turgor
Growth patterns

64
Q

Emotional abuse of a child

A

Pattern of behavior from caretaker resulting in serious impairment of child’s social, emotional or intellectual functioning

65
Q

Neglect of child

A

Can be physical or emotional

66
Q

Physical neglect

A

Refusal or delay in health care, abandonment, inadequate supervision

67
Q

Emotional neglect

A

Chronic failure to provide hope, love, and support needed for healthy personality

68
Q

Sexual abuse of a child

A

Employment, use, persuasion, inducement, enticement, coercion of child to engage in sexually explicit conduct

69
Q

S/S emotional abuse of child

A

Extremes in behavior
Innapropriately adult or infantile behavior
Delays in physical or emotional development

70
Q

S/S neglect of children

A 
Dirty
Lacks medical/ dental care
Begs or steals food or money
Abuses alcohol or drugs
Not dressed for weather
71
Q

S/S of sexual abuse of child

A 
Not changing for gym
Nightmares or bedwetting
Sudden change in appetite 
Bizarre or unusual sexual knowledge or behavior
Runs away
Attachment issues
72
Q

Physical signs of sexual abuse in child

A

Erosion of hymen
Reflex anal dilation
Petechiae to pharynx
Soft tissue ecchymosis to thighs

73
Q

S/S of child abuse offenders

A

Limits contact with others and overly protective of child
Often victims in early life and have impaired attachment with own child
Jealous and controlling
Secretive and isolated

74
Q

Is non-sexually abusing parent usually aware of the incest occuring?

A

Yes

Fear or relief may be present

75
Q

Intellectual disability disorder (IDD)

A

Onset during developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains

76
Q

Mild IDD

A

IQ 50-70

77
Q

Moderate IDD

A

IQ 35-49

78
Q

Severe IDD

A

IQ 20-34

79
Q

Profound IDD

A

IQ <20

80
Q

What is the main tool to assess IDD

A

Functional assessment

81
Q

Autism spectrum disorder distinguishing features

A

Early onset
Severe social unrelatedness
Evaluated on a spectrum

82
Q

Clinical features of autism spectrum disorder

A

Self stimulating
Impaired communication
Stereotypic behavior
Poor social interactions

83
Q

S/S of autism spectrum disorder

A 
Tantrums
Communication issues (delay, lack of eye contact)
Repetitive hand movements
Toe walking
Developmental delays (toilet training)
Humming
Hypersensitivity to noises and textures
Interests/fixated on things that don't move
Difficulty verbalizing needs
84
Q

Priority for safety for autism spectrum disorder

A

Running off

Do not have the same sensation for pain- hard to recognize when they are in pain

85
Q

Asburgers

A

Highly intelligent
Usually have one aspect they really excel at
Missing other social cues

86
Q

Medications for autism spectrum disorder

A 
Risperdine
Tenex
Clonidine
Propranolol 
Arpiprozole
87
Q

ADHD diagnosis

A

Should not be diagnosed before age 5 - some of this is normal for a child
When diagnosed early, cardiac development is still occurring and being put on a stimulant can disrupt this

88
Q

S/S of ADHD

A 
Motor restlessness
Difficulty concentrating
Trouble sitting still
Acting out behaviors r/t frustration
Impulsivity
89
Q

Medications for ADHD

A 
Stimulants:
Ritalin
Concerta ER
Adderall 
Focalin 
Vyvance
Quillevent SR
90
Q

Non stimulants for ADHD

A

Straterra

Intuniv (similar to tenex)

91
Q

Side effects of ADHD meds

A

Motor ticks
Loss of appetite
Weight loss
Can sometimes have an opposite effect of what is intended

92
Q

Nursing interventions for ADHD meds

A

Often recommended to take a break from these meds
Do not give after 4pm
Take meds with meals

93
Q

Tourette’s disorder

A

Most severe tic disorder

Can diminish with aging

94
Q

Meds for tourette’s

A

Haldol
Clonidine
Tenex

95
Q

Oppositional defiant disorder

A

Occurs early in development
Trouble with authority figures
Defiant

96
Q

Intermittent explosive disorder

A

Unprovoked go into fits of rage

97
Q

Conduct disorder

A 
Reckless behavior, disregard for social norms
Common to turn into antisocial disorder
More boys than girls - older
No guilt or remorse
Manipulation
Theft, vandalism, truancy, running away
98
Q

Why are children with conduct disorder impulsive and do not recognize consequences?

A

Adolescent brain is not fully developed

99
Q

Treatment for conduct disorder

A

CBT
Mood stabilizers
Tenex
Clonidine

100
Q

Separation anxiety disorder

A

Develops after a significant loss

Can include PTSD

101
Q

S/S of separation anxiety

A 
Nightmares
Irritability
Reenactment of the event
Regression
Withdrawal
Trouble concentrating
102
Q

Disruptive Mood Dysregulation Disorder (DMDD)

A

Previously bipolar disorder

103
Q

DMDD features

A

Child will mask depression with things like irritability and refusal to go to school
Somatic complaints
Grades falling
Weight loss

104
Q

Meds for DMDD

A

Tegretol

Prozac

105
Q

Schizophrenia

A

Rarely diagnosed before age 13

Will usually see odd behaviors early on

106
Q

When is the first psychotic break for schizophrenia?

A

Adolescence or early adulthood due to increase and changes in gray matter in the brain

107
Q

Meds for schizophrenia

A

Clozaril

108
Q

Why is lorazepam (ativan) the drug of choice for alcohol withdrawal?

A

Minimizes risk for seizures

109
Q

Distinguishing feature for alcohol withdrawal

A

Diaphoresis

110
Q

Common sign of depression in small children

A

Irritability or refusal to go to school

111
Q

Separation anxiety could be a sign of what in children?

A

Abuse

112
Q

Who is at highest risk for suicide during withdrawal?

A

Cocaine abusers

113
Q

Nursing implications for Tenex (for DMDD)

A

Take BP because drug drops BP

114
Q

What drug makes breath smell like ammonia?

A

Meth

115
Q

A care plan for a child with autism includes:

A

Consistency
Structure
Frequent redirection

116
Q

A patient wants to stop taking venlafaxine (effexor) because of the side effects. What do you do first?

A

Reassure him that side effects are transient and can be treated

Mental Health (2 decks)

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