ati book Flashcards by britt rank

phase where the NURSE:

Introduce self to the client and state purpose

Set the contract: meeting time, place, frequency, duration, and date of termination

Discuss confidentiality

Build trust by establishing expectations and boundaries

Set goals with the client

Explore the clients ideas, issues, and needs

Explore the meaning of testing behavior

Enforce limits on testing or other inappropriate behavior

orientation

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is the expression of psychological stress through physical manifestation.

The physical manifestations of somatic symptom disorder cannot be explained by underlying pathology

spend a significant amount of time worrying about their physical manifestations to the point where it assumes a central role in the clients life and relationship

Somatization

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MALADAPTIVE USE:

A person who learns he has a terminal illness focuses on creating a will and financial matters rather than acknowledging his grief

Intellectualization

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interactions that occur with ________

Concurrent use with MAO’s can cause severe hypertension.

Concurrent use with antihistamines and other anticholinergic agents can result in additive
anticholinergic effects.

Concurrent use with direct-acting sympathomimetics can result in increased effects of these
medications, because uptake is blocked by TCAs.

Concurrent use with indirect-acting sympathomimetics can result in decreased effect of these medications

Concurrent use with alcohol, benzodiazepines, opioids, and antihistamines can result in additive CNS
depression.

Tricyclic antidepressants

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Communication that occurs between two or more people in a small group.

allows the nurse to discuss a change in the clients behavior with the health care team or discuss concerns with clients during a group therapy session

Small-group communication:

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Members who take on these roles tend to help maintain the purpose and process of the Group.

For example, the harmonizer attempts to prevent conflict in the group

Maintenance roles:

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COMPLICATIONS:

seizures
supression of appetite
headache
drymouth
GI distress
constipation
increased heart rate
nausea
insomnia
restlessness

Atypical antidepressants

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A therapist or others serve as role models for a client, who imitates this modeling to improve behavior

help clients improve interpersonal skills

modeling

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MALADAPTIVE USE:

A person who dislikes her neighbor tells others what a great neighbor she is

Reaction formation

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This examination is used to obtain a baseline assessment of a clients level of consciousness, and for ongoing assessment Eye, verbal, and motor response is evaluated, and a number value based on that response is assigned. The highest value possible is 15, which indicates that the client is awake and responding appropriately

Glasgow Coma Scale

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is short term memory losss and confusion normal after and ECT?

yes

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these agents, known as serotonin norepinephrine reuptake inhibitors (SNRIs), increase the amount of these neurotransmitters available in the brain for impulse transmission. SNRIs have little effect on other neurotransmitters and receptors

Venlafaxine, duloxefine, desvenlafaxine, levomilnacipran

Atypical antidepressants

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These medications block reuptake of norepinephrine and serotonin in the synaptic space, thereby intensifying the effects of these neurotransmitters

THERAPEUTIC USES:
Depressive disorders 
Neuropathic pain 
Fibromyalgia 
Anxiety disorders 
Insomnia 
Bipolar disorder

Tricyclic antidepressants

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level of anxiety that

Slightly reduced perception and processing of information occurs, and selective inattention can occur

Ability to think clearly is hampered, but learning and problem-solving can still occur

concentration difficulties, tiredness, pacing, change in voice pitch, voice tremors, shakiness, and increased heart rate and respiratory rate

somatic manifestations including headaches, backache, urinary urgency and frequency, and insomnia

usually benefits from the direction of others

Moderate

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is one in which all members share a certain chosen characteristic, such as diagnosis
or gender

homogeneous group

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uses electrical current to induce brief seizure activity while the client is anesthetized

ECT

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ADAPTIVE USE:

A student puts off thinking about a fight she had with her friend so she can focus on a test

Suppression

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Abdominal pain 
Back pain 
Pain in the extremities/joints 
Menstrual problems or cramps 
Headaches 
Chest pain 
Dizziness 
Fainting 
Heart pounding or racing 
Dyspnea 
Problems or pain with sexual intercourse 
Problems with bowel elimination (constipation/diarrhea) 
Nausea, indigestion, or gas 
Lethargy

are all most common ___________ symptoms

somatic symptom disorder

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•
experiencing a sudden event with little or no time to prepare

Perception of the event as ovemhelrning or life-threatening

Loss or decrease in communication with significant others

Sense of displacement from the familiar

An actual or perceived loss

ARE ALL COMMON ________CHARACTERISTICS

CRISIS

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Phenelzine
Isocarboxazid
Tranylcypromine
Selegiline: transdermal patch

are what kind of medictions

Monoamine oxidase inhibitors

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This therapy uses various techniques to control pain, tension, and anxiety

A nurse can teach diaphragmatic breathing to a client having a panic attack, or to a female client in labor

Meditation, guided imagery, diaphragmatic breathing, muscle relaxation, and biofeedback

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A nurse or other health professional trained in this method uses a sensitive mechanical device to assist the client to gain voluntary control of such autonomic functions as heart rate and blood pressure

Biofeedback

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These roles tend to prevent teamwork, because individuals take on roles to promote their own agenda

Examples include the dominator, who tries to control other members, and the recognition seeker, who
boasts about personal achievements

Individual roles

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is based on the cognitive model, which focuses on individual thoughts and behaviors to solve
current problems. It treats depression, anxiety, eating disorders, and other issues that can improve by changing a clients attitude toward life experiences

Cognitive therapy

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Communication that addresses an individual's spiritual needs and provides interventions to meet those needs used when the nurse assists the client with meditation as a means of relaxation

Transpersonal communication:

Emphasizing strengths to make up for weaknesses

Compensation

MALADAPTIVE USE: A person who is shy works at computer skills to avoid socialization

Compensation

Teaching a client, when negative thoughts or compulsive behaviors arise, to say or shout, 'stop," and substitute a positive thought The goal over time is for the client to use the command silently

Thought stopping:

INTERACTIONS Concurrent use with MAO's, such as phenelzine, can increase the risk for toxicity. There is an increased risk of seizures with concurrent use of SSRls.

Atypical antidepressants

Transcrania/ magnetic stimulation is used for pateints with ____

depression

Dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression

Sublimation

phase of major depressive disorder where: Remission of manifestations * This phase can last for year * Prevention of future depressive episodes is the goal of treatment

Maintenance phase:

Communication that occurs within an individual

Intrapersonal communication:

This agent increases the release of serotonin and norepinephrine, thereby increasing the amount of these neurotransmitters available for impulse transmission

Mirtazapine

Monitor for cardiac dysrhythmias, which are an indication of toxicity Administer at bedtime due to sedation and risk for orthostatic hypotension

Tricyclic antidepressants

``` Appearance Posture Gait Facial expressions Eye contact Gestures Sounds Territoriality Personal space Silence ```

things to look at with nonverbal communication

Conscious or unconscious assumption of the characteristics of another individual or group

Identification

type of anxiety that: A healthy life force that is necessary for survival, normal anxiety motivates people to take action For example, a potentially violent situation occurs on the mental health unit, and the nurse moves rapidly to defuse the situation

Normal

the spontaneous, uncensored verbalization of whatever comes to a clients mind

Free association

type of loss that: Losses normally expected due to the developmental processing of life

Maturational loss:

Tricyclic antidepressants are conrtaindicated in patients with _____________

seizure disorder

ADAPTIVE USE: An adolescent boy says, "she must already have a boyfriend" when rejected by a girl

Rationalization

enhance the emotional climate of the therapeutic milieu by promoting: interaction and communication between staff and clients Decision making skills of clients A feeling of self-worth among clients Discussions of common unit objectives, such as encouraging clients to meet treatment goals and plan for discharge Discussion of issues of concern to all members of the unit, including common problems, future activities, and the introduction of new clients to the unit Meetings may be structured so that they are client-led with decisions made by the group as a whole

commuinty meetings

Dealing with anxiety by reaching out to others

Altruism

ADAPTIVE USE: A young child temporarily wets the bed when she learns that her pet died

Regression

stage of rettribution treatment that: Work with the provider and client to develop a treatment plan that allows for regular follow-up visits

Stage 4: Negotiating further treatment:

stage of rettribution treatment that: Use therapeutic communication to acknowledge the lack of a physical cause for the manifestations while allowing the client to maintain self-esteem

Stage 3: Making the link:

is a noninvasive therapy that uses magnetic pulsations to stimulate the cerebral cortex of the brain

Transcrania/ magnetic stimulation

Separation of emotions and logical facts when analyzing or coping with a situation or event

Intellectualization

ADAPTIVE USE: | A man who is trying to quit smoking repeatedly talks to adolescents about the dangers of nicotine

Reaction formation

ADAPTIVE USE A person who has feelings of anger and hostility toward his work supervisor sublimates those feelings by working out vigorously at the gym during his lunch period

Sublimation

Collaborate with client to identify interventions while in an acute crisis that promote safety

Secondary care

phase of major depressive disorder where: Increased ability to function * Treatment is generally 4 to g months in duration * Relapse prevention through education, medication therapy, and psychotherapy is the goal of treatment

Continuation phase:

selectively block reuptake of the monoamine neurotransmitter serotonin in the synaptic space, thereby intensifying the effects of serotonin • First line treatment for depression

Selective serotonin reuptake inhibitors

This therapy is the planned, progressive, or graduated exposure to anxiety-provoking stimuli in real-life situations, or by imagining events that cause anxiety During exposure, the client uses relaxation techniques to suppress anxiety response

Systematic desensitization

a short period of _____ may occur after ECT

hypertension

is the way the group behaves during sessions, and, over time, it provides structure for the group

Group norm

A form of depression that occurs seasonally, usually during the winter, when there is less daylight Light therapy is the first-line treatment

Seasonal affective disorder

MALADAPTIVE USE: A person experiences deafness after his partner tells him she wants a divorce

Conversion

Sudden use of childlike or primitive behaviors that do not correlate with the person's current developmental level

Regression

type of anxiety that This level of anxiety is precipitated by an imminent loss or change that threatens one's sense of security

Acute (state)

Flat, blunted, labile affect Tearfulness, crying Lack of energy Anhedonia: loss of pleasure and lack of interest in activities, hobbies, sexual activity Physical reports of discomfort/pain Difficulty concentrating, focusing, problem-solving Self-destructive behavior, including suicidal ideation Decrease in personal hygiene Loss or increase in appetite and/or sleep, disturbed sleep Psychomotor retardation or agitatio are all_________ characteristics

depressive characteristics of bipolar disorder

Misinterprets physical manifestations as evidence of a serious disease process. Illness anxiety disorder, previously known as hypochondriasis, can lead to obsessive thoughts and fears about illness Physical manifestations can be minimal or absent

illness anxiety disorder

assists clients in addressing specific problem. It can improve interpersonal relationships, communication, role-relationship, and bereavement

Interpersonal psychotherapy

Members are often consistent, the focus of the group is on growth, external influences are limited, and the leader can allow members an opportunity in determining the group's direction

Outpatient setting:

are based on clients' level of functioning and personal needs, such as adverse effects of medication

Psychoeducational

type of crisis that: Often unanticipated loss or change experienced in everyday, often unanticipated, life events

Situational/ external:

is characterized by scheduled sessions with a mental health provider to address specific mental health concerns, such as depression

Individual therapy

Pretending the truth is not reality to manage the anxiety of acknowledging what is real

Denial

``` sexual dysfunction anxiety, aggitation, insomnia weight changes serotonin syndrome withdrawal syndrome hyponatremia rash sleepiness, faintness, lightheadedness GI bleed ``` are all complications of ___________ meds

Selective serotonin reuptake inhibitors

is an acute, time-limited (usually lasting 4 to 6 weeks) event during which a client experiences an emotional response that cannot be managed with the clients normal coping mechanism

A crisis

MALADAPTIVE USE: A young adult explains he had to drive home from a party after drinking alcohol because he had to feed his dog

Rationalization

Members can vary on a daily basis, and the focus of the group is on relief. Unit activities will directly impact the group, and the leader must provide a higher level of structure

Acute mental health setting:

phase of major depressive disorder where: Severe clinical findings of depression * Treatment is generally 6 to 12 weeks in duration * Potential need for hospitalization * Reduction of depressive manifestations is the goal of treatment * Assess suicide risk, and implement safety precautions or one-to-one observation as needed

Acute phase:

``` A single episode or recurrent episodes of unipolar depression resulting in a significant change in a clients normal functioning (social, occupational, self-care) accompanied by at least five of the following specific clinical findings, which must occur almost every day for a minimum of 2 weeks, and last most of the day: ``` ``` Depressed mood Difficulty sleeping or excessive sleeping Indecisiveness Decreased ability to concentrate Suicidal ideation Increase or decrease in motor activity inability to feel pleasure Increase or decrease in weight of more than 5% of total body weight over 1 month ```

Major depressive disorder

assists clients to identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self-talk

Cognitive reframing

type of loss that: Any loss of a valued person or item

Actual loss:

ADAPTIVE USE: An adolescent who is physically unable to play contact sports excels in academic competitions

Compensation

type of loss that: Part of the cycle of life: anticipated, but can still be intensely felt

Necessary loss:

restraints * Age 18 years and older: __ hr * Age 9 to 17 years: __ hr * Age 8 years and younger: __ hr

* Age 18 years and older: 4 hr * Age 9 to 17 years: 2 hr * Age 8 years and younger: 1 hr

type of loss that: Unanticipated loss caused by an external event

Situational loss:

contraindications to ECT?

There are no absolute contraindication. However, the nurse should assess for medical conditions that place clients at higher risk of adverse effect: - cardivascular disorders - cerebrovascular disorders

is a cognitive-behavioral therapy for clients who have a personality disorder and exhibit self-injurious behavior This therapy focuses on gradual behavior changes and provides acceptance and validation for these clients

Dialectical behavior therapy

Explores the clients life goals or motivations by presenting a hypothetical situation in which the client no longer has the mental health disorder

Presupposition questions:

stage of rettribution treatment that: Provide acknowledgment of the clients concerns and provide feedback about assessment findings

Stage 2: Broadening the agenda:

provides electrical stimulation through the vagus nerve to the brain through a device that is surgically implanted under the skin on the clients chest believed to result in an increased level of neurotransmitters Indicted for depression

vagus nerve stimulation

Thirty minutes prior to the beginning of the ECT procedure, an 1M injection of ________ or _________ is administered to decrease secretions that could cause aspiration and to counteract any vagal stimulation effects, such as bradycardia A muscle relaxant, such as____________, is then administered to paralyze the clients muscles during the seizure activity, which decreases the risk for injury

atropine sulfate or glycopyrrolate succinylcholine

The quality of doing good: can be described as charity

beneficence

Overcompensating or demonstrating the opposite behavior of what is felt

Reaction formation

Four or more episodes of hypomania or acute mania within 1 year

Rapid cycling

type of crisis that: Achieving new developmental stages, which requires learning additional coping mechanisms

Maturationa/ linternal

Shifting feelings related to an object, person, or situation to another less threatening object, person, or situation

Displacement

Concurrent use with indirect-acting sympathomimetic medications (ephedrine, amphetamine) can promote the release of norepinephrine and lead to hypertensive crisis. Concurrent use with TCAs can lead to hypertensive crisis. Concurrent use with SSRls can lead to serotonin syndrome. Concurrent use with antihypertensives can cause additive hypotensive effects. Concurrent use with meperidine can lead to hyperpyrexia. ``` Hypertensive crisis (severe hypertension as a result of intensive vasoconstriction and stimulation of the heart) can result from intake of dietary tyramine. ``` concurrent use with vasopressors interactions of _________ med

Monoamine oxidase inhibitors

Uses "what if" or similar questions to assist clients in exploring feelings and to gain greater understanding of problems and possible solutions

Projective questions:

THERAPEUTIC USES: * Depression * Bulimia nervosa * First-line treatment for atypical depression

Monoamine oxidase inhibitors

First-degree relative who has somatic symptom disorder Decreased levels of neurotransmitters: serotonin and endorphins Depressive disorder, personality disorder, or anxiety disorder Childhood trauma, abuse, or neglect Learned helplessness Female gender (especially age 16 to 25) ARE ALL RISK FACTORS FOR ____________

somatic symptom disorder

MALADAPTIVE USE: A person who has a fear of the dentist continually forgets to go to his dental appointments

Repression

``` Asking irrelevant personal questions Offering personal opinions Giving advice Giving false reassurance Minimizing feelings Changing the topic Asking "vvhy" questions Offering value judgments Excessive questioning Responding approvingly or disapprovingly ```

barriers to effective communication

phase where the NURSE: Discuss the clients previous experience with separations and loss Elicit the clients feelings about the therapeutic work in the nurse-client relationship Summarize goals and achievements Review memories of work in the session Express own feelings about sessions to validate the experience with the client Discuss ways for the client to incorporate new healthy behaviors into life Maintain limits of final termination

termination

Anxiety disorders: These disorders are comorbid in approximately 70% of clients who have a depressive disorder This combination makes a clients prognosis poorer, with a higher risk for suicide and disability Psychotic disorders, such as schizophrenia Substance use disorders: Clients often use substances in an attempt to relieve manifestations of depression or self-treat mental health disorders Eating disorders Personality disorders ARE ALL COMORIBDITIES OF _______

DEPRESSION

phase where the NURSE: Perform ongoing assessment to plan and evaluate therapeutic measure Facilitate the clients expression of needs and issue Encourage the client to problem-solve Promote the clients self-esteem Foster positive behavioral change Explore and deal with resistance and other defense mechanism Recognize transference and countertransference issue Reassess the clients problems and goals, and revise plans as necessary Support the clients adaptive alternatives and use of new coping skills Remind the client about the date of termination

working

MALADAPTIVE USE: A person who has a disagreement with a co-worker begins throwing things at her office

Regression

employs the same tools as psychoanalysis, but it focuses more on the clients present state, rather than his early life

Psychodynamic psychotherapy

is a therapeutic process of assessing unconscious thoughts and feelings, and resolving conflict by talking to a psychoanalyst Clients attend many sessions over the course of months to year unlikely to be the sole therapy of choice

Classical psychoanalysis

RISK FACTORS for __________ Genetics: having an immediate family member who has a bipolar disorder Psychological: stressful events or major life changes Physiological: neurobiological and neuroendocrine disorders Substance use disorder: alcohol or cocaine use disorder

bipolar disorder

stage of rettribution treatment that: Use therapeutic communication, active listening, and empathy to obtain a thorough history of manifestations while focusing on the clients perception of the manifestations and their cause. This stage also includes a brief physical assessment

• Stage 1: Feeling understood:

MALADAPTIVE USE: A married woman who is attracted to another man accuses her husband of having an extramarital affair

Projection

Responding to stress through the unconscious development of physical manifestations not caused by a physical illness

Conversion

``` Amitriptyline Imipramine Doxepin Nortriptyline Arnoxaplne Trimiprarnine ``` are all types of ___________ medications

Tricyclic antidepressants

3 indications for ECT

Acute manic episodes: • Clients who have bipolar disorder with rapid cycling, unresponsive to treatment with lithium and antipsychotic medications Schizophrenia spectrum disorders: • Clients who have schizophrenia with catatonic manifestations, schizoaffective disorder pregnant and have a schizophrenia spectrum disorder Major depressive disorder: • Clients for whom the risks of other treatments first trimester of pregnancy, not responsive to pharmacological treatment, suicidal or homicidal and for whom there is a need for rapid therapeutic response psychotic manifestations

CONTRAINDICATIONS/ PRECAUTIONS: Bupropion is a Pregnancy Risk Category B medication This medication is contraindicated in clients who have a seizure disorder This medication is contraindicated in clients taking MAOIs Bupropion is contraindicated in clients who have anorexia nervosa or bulimia nervosa

Atypical antidepressants

The client receives positive rewards for positive behavior (positive reinforcement) client receives tokens for good behavior, and he can exchange them for a privilege or other items

Operant conditioning

ADAPTIVE USE: A person initially says, "No, that can't be true" when told they have cancer

Denial

what is a rare but potential complicaation of TMS

seizure

• Instruct the client to take antidepressant medication as prescribed on a daily basis to establish therapeutic plasma levels • Assist with medication regimen compliance by informing the client that therapeutic effects might not be experienced for 1 to 3 vveeks Full therapeutic effects can take 2 to 3 months • Instruct the client to continue therapy after improvement in manifestation• Sudden discontinuation of the medication can result in relapse or major withdrawal effects Advise the client that therapy usually continues for 6 months after resolution of manifestations, and it can continue for 1 year or longer

Atypical antidepressants

ADAPTIVE USE: A person preparing to give a speech unconsciously forgets about the time when he was young and kids laughed at him while on stage

Repression

type of anxiety that This level of anxiety is one that usually develops over time, often starting in childhood The adult might display that anxiety in physical manifestations, such as fatigue and frequent headaches

Chronic (trait)

Labile mood with euphoria Agitation and irritability Restlessness Dislike of interference and intolerance of criticism Increase in talking and activity Flight of ideas: rapid, continuous speech with sudden and frequent topic change Grandiose view of self and abilities (grandiosity) Impulsivity: spending money, giving away money or possessions Demanding and manipulative behavior Distractibility and decreased attention span Poor judgment Attention-seeking behavior: flashy dress and makeup, inappropriate behavior Impairment in social and occupational functioning are all_________ characteristics

manic characteristics of bipolar disorder

stage of grief that The client accepts what is happening and plans for the future

Acceptance:

Also known as functional neurological disorder, conversion disorder results when a client exhibits neurologic manifestations in the absence of a neurologic diagnosis

conversion disorder

is the verbal and nonverbal communication that occurs during group sessions, including how the work progresses

Group process

MALADAPTIVE USE: A person who is angry about losing his job destroys his child's favorite toy

Displacement

ADAPTIVE USE: A law enforcement officer blocks out the emotional aspect of a crime so he can objectively focus on the investigation

Intellectualization

nursing interventions for what kind of anxiety: Use active listening to demonstrate willingness to help, and use specific communication techniques Provide a calm presence, recognizing the client's distress. Evaluate past coping mechanisms. Explore alternatives to problem situations Encourage participation in activities, such as exercise that can temporarily relieve feelings of inner tension.

Mild to moderate anxiety

A milder form of depression that usually has an early onset, such as in childhood or adolescence, and lasts at least 2 years for adults (1 year for children) contains at least three clinical findings of depression and can, later in life, become major depressive disorder

Dysthymic disorder:

Communication that occurs within large groups of people. commonly occurs during educational endeavors where the nurse is teaching a large group of individuals.

Public communication:

Voice changes due to the proximity of the implanted lead on the vagus nerve to the larynx and pharynx hoarseness, throat or neck pain, dysphagia Dyspnea, especially with physical exertion are all common complications from______

vagus nerve stimulation

Attributing one's unacceptable thoughts and feelings onto another who does not have them

Projection

type of loss that: Any loss defined by a client that is not obvious to others

Perceived loss

The client enters the mental health facility against her will for an indefinite period of time. the admission is based on the clients need for psychiatric treatment, the risk of harm to self or others, the inability to provide self-care

Involuntary admission:

mood disorders with recurrent episodes of depression and mania

bipolar disorders

level of anxiety that occurs in the normal experience of everyday living increases one's ability to perceive reality identifiable cause of the anxiety vague feeling of mild discomfort, restlessness, irritability, impatience, and apprehension The client can exhibit behaviors such as finger- or foot-tapping, fidgeting, or lip-chewing as mild tension- relieving behavior•

Mild

Creating reasonable and acceptable explanations for unacceptable behavior

Rationalization

This agent has moderate selective blockade of serotonin receptors, thereby increasing the amount of that neurotransmitter available for impulse transmission

Trazodone

The clients right to make her own decision

Autonomy

allows the nurse to perform a self-assessment of her values or beliefs prior to caring for a client whose diagnosis can trigger an emotional response

intrapersonal communication

Chronic anxiety or panic attacks Depression, chronic pain, sleep disturbances Weight gain or loss Increased risk for myocardial infarction, stroke Poor diabetes control, hypertension, fatigue, irritability, decreased ability to concentrate Increased risk for infection

PROLONGED STRESS (MALADAPTIVE RESPONSE)

ADAPTIVE USE: A parent blocks out the distracting noise of her children in order to focus while driving in

Dissociation

is characterized by scheduled sessions for a group of clients to address common mental health issues, such as substance use disorder

Group therapy

Bupropion This medication acts by inhibiting dopamine uptake Treatment of depression * Alternative to SSRIs for clients unable to tolerate the sexual dysfunction side effects * Aid to quit smoking * Prevention of seasonal pattern depression

Atypical antidepressants

Demonstrating an inability to reconcile negative and positive attributes of self or others

Splitting

MALADAPTIVE USE: | A person who has lost his job states he will worry about paying his bills next week

Suppression

: Assists clients to identify what requires priority, such as devoting energy to pleasurable activities

Priority restructuring

: A less severe episode of mania that lasts at least 4 days accompanied by three or more manifestations of mania

Hypomania

stage of grief that The client negotiates for more time or a cure

Bargaining:

THERAPEUTIC USES: Major depression Obsessive compulsive disorder Bulimia nervosa Premenstrual dysphoric disorders Panic disorders Posttraumatic stress disorder (PTSD) Bipolar disorder

Selective serotonin reuptake inhibitors

Communication that occurs one-on-one with another individual In nursing, is used when the nurse obtains a psychosocial history from a client or when listening to a client discuss his feelings

Interpersonal communication:

commonly prescribed daily for a period of 4 to 6 weeks can be performed as an outpatient procedure procedure lasts 30 to 40 min A noninvasive electromagnet is placed on the clients scalp, allowing the magnetic pulsations to pass through The client is alert during the procedure Clients might feel a tapping or knocking sensation in the head, scalp skin contraction, and tightening of the jaw muscles during the procedure

Transcrania/ magnetic stimulation

These medications block MAO in the brain, thereby increasing the amount of norepinephrine, dopamine, and serotonin available for transmission of impulse. An increased amount of those neurotransmitters at nerve endings intensifies responses and relieves depression

Monoamine oxidase inhibitors

complications of ______________ ``` orthostatic hypotension sedation toxicity decreased seizure threshold excissive sweating increased appetite anticholinergic effects ```

Tricyclic antidepressants

stage of grief that Anger is directed toward self, others, or objects

anger

type of crisis that: * The occurrence of natural disasters, crimes, or national disasters * People in communities with large-scale psychological trauma caused by natural disasters

Adventitious

Specific mental health issues include disclosing ________, the duty to warn and protect third parties, and the reporting of child and vulnerable adult abuse

HIV status

level of anxiety that: * characterized by markedly disturbed behavior * The client is not able to process what is occurring in the environment and can lose touch with reality * The client experiences extreme fright and horror * The client experiences severe hyperactivity or flight * Immobility can occur • Other characteristics can include dysfunction in speech, dilated pupils, severe shakiness, severe withdrawal, inability to sleep, delusions, and hallucinations

Panic-level

nursing interventions for what kind of anxiety: Provide an environment that meets the physical and safety needs of the client. Remain with the client. Provide a quiet environment with minimal stimulation. Use medications and restraint, but only after less restrictive interventions have failed to decrease anxiety to safer levels. Encourage gross motor activities, such as walking and other forms of exercise. Set limits by using firm, short, and simple statements. Repetition may be necessary. Direct the client to acknowledge reality and focus on what is present in the environment

Severe to panic-level anxiety

Members take on various tasks within the group process An example is the recorder, who takes notes and records what occurs during each sessiorn

Task roles:

Voluntarily denying unpleasant thoughts and feelings

Suppression

cns stimulation orthostatic hypotension hypertensive crisis local rash ARE ALL COMPLICATIONS OF ______________

Monoamine oxidase inhibitors

stage of grief that: The client has difficulty believing a terminal diagnosis or loss

denial

includes opportunities for the nurse and other staff to observe clients as they interact spontaneously within the milieu

Unstructured, flexible time

has been used successfully to treat clients who have phobias, substance use or addictive disorders, and other issues

• Behavioral therapy

``` Fluoxetine Citalopram Escitalopram Paroxetine Sertraline Vilazodone ``` are __________ kind of meds

Selective serotonin reuptake inhibitors

uses both cognitive and behavioral approaches to assist a client with anxiety Management

Cognitive-behavioral therapy

Clinical findings of depression that are associated with the use of, or withdrawal from, drugs and alcohol

Substance-induced depressive disorder:

Preventing a client from performing a compulsive behavior with the intent that anxiety will diminish

Response prevention:

A depressive disorder associated with the luteal phase of the menstrual cycle. Primary manifestations include emotional lability and persistent or severe anger and irritability Other manifestations include a lack of energy, overeating, and difficulty concentrating

Premenstrual dysphoric disorder

ADAPTIVE USE: | A nurse who lost a family member in a fire is a volunteer firefighter

Altruism

Creating a temporary compartmentalization or lack of connection between the person's identity, memory, or how they perceive the environment

Dissociation

First-degree relative who has illness anxiety disorder Previous losses or disappointments resulting in feelings of anger, guilt, or hostility Childhood trauma, abuse, or neglect Depressive disorder or anxiety disorder Major life stressor Low self-esteem ARE ALL RISK FACTORS FOR ___________

illness anxiety disorder

ADAPTIVE USE: A girl who has a chronic illness pretends to be a nurse for her dolls

Identification

The client is admitted for emergent mental health care due to the inability to make decisions regarding care The medical healthcare provider may initiate the admission which is then evaluated by a mental healthcare provider often is not to exceed 15 days

Temporary emergency admission

stage of grief that The client mourns and directly confronts feelings related to the loss

Depression:

Advise clients to take these medications in the morning to minimize sleep disturbance Advise clients to take these medications with food to minimize gastrointestinal disturbance Obtain baseline sodium levels for older adult clients taking diuretic• Monitor these clients periodically

SSRIS

level of anxiety that * Perceptual field is greatly reduced with distorted perceptions * Learning and problem-solving do not occur * Functioning is ineffective • Other characteristics include confusion, feelings of impending doom, hyperventilation, tachycardia, withdrawal, loud and rapid speech, and aimless activity • The client who has severe anxiety usually is not able to take direction from others

Severe

This examination is used to objectively assess a clients cognitive status by evaluating the following: * Orientation to time and place * Attention span and ability to calculate by counting backward by seven * Registration and recalling of objects * Language. including naming Of objects. following Of commands. and ability to Mite

mini mental status exam

Interactions: Concurrent use with MAO's, TCAs, or St. John's wort increases the risk of serotonin syndrome. Concurrent use with warfarin can displace warfarin from bound protein and result in increased warfarin Concurrent use with tricyclic antidepressants and lithium can result in increased levels of these medications. Concurrent use with NSAlDs and anticoagulants can further suppress platelet aggregation, thereby increasing the risk of bleeding.

Selective serotonin reuptake inhibitors

MALADAPTIVE USE: A child who observes his father be abusive toward his mother becomes a bully at school

Identification

developed by Sigmund Freud toresolve internal conflicts which, he contended, always occur from early childhood experience • Past relationships are a common focus for therapy

Classical psychoanalysis

: A type of admission that is similar to temporary commitment but must be imposed by the courts. time of commitment varies, but is usually 60 to 180 day. Sometimes, there is no set release date

Long-term involuntary admission

The typical course of ECT treatment is byo to three times a week for a total of _____-_____ treatments

six to 12

``` Apprehension Unhappiness or sorrow Decreased appetite Increased respiratory rate, heart rate, cardiac output, blood pressure Increased metabolism and glucose use Depressed immune system ```

ACUTE STRESS (FIGHT OR FLIGHT)

The shortest, simplest communication is usually most effective

Clarityl brevity

MALADAPTIVE USE: A woman forgets who she is following a sexual assault

Dissociation

This agent is usually used with another antidepressant agent Sedation can be an issue, so it can be indicated for a client who has insomnia caused by an SSRI Advise the client to take at bedtime Priapism can be a serious adverse effect Instruct to seek medical attention immediately if this occur This medication should be used with caution in clients who have cardiac disease

Trazodone

Exposing a client, while in the company of a therapist, to a great deal of an undesirable stimulus in an attempt to turn off the anxiety response

Flooding:

Unconsciously putting unacceptable ideas, thoughts, and emotions out of awareness

Repression

Pairing of a maladaptive behavior with a punishment or unpleasant stimuli to promote a change in the behavior use unpleasant stimuli, such as bitter taste or mild electric shock, as punishment for behaviors such as alcohol use disorder, violence, self-mutilation, and thumb-sucking

Aversion therapy

• Provide clients with a list of foods containing tyramine to reduce the risk of hypertensive crisis • Instruct the client to avoid taking any other prescription or nonprescription medications unless approved by the provider

MAOIS

ADAPTIVE USE: An adolescent angrily punches a punching bag after losing a game

Displacement

is based on the theory that behavior is learned and has consequence Abnormal behavior results from an attempt to avoid painful feeling. Changing abnormal or maladaptive behavior can occur without the need for insight into the underlying cause of the behavior

Behavioral therapy

Advise clients who have seasonal pattern depression to begin taking bupropion in autumn each year and gradually taper dose and discontinue by spring • Avoid concurrent use with MAOIs

ATYPICAL ANTIDEPRESSANTS

An abnormally elevated mood, which can also be described as expansive or irritable: usually requires hospitalization episodes last at least 1 week

mania

Collaborate with client to identify potential problems: instruct on coping mechanisms: and assist in lifestyle changes

Primary care

``` Substance use disorder Anxiety disorders Borderline personality disorder Oppositional defiant disorder Social phobia and specific phobias Seasonal affective disorder ``` ARE ALL COMORBIDITIES of __________

bipolar disorder

MALADAPTIVE USE: A parent who is informed that his son was killed in combat tells everyone one month later that he is coming home for the holidays

Denial

Collaborate with client to provide support during recovery from a severe crisis that include outpatient clinics, rehabilitation centers, and workshops

Tertiary care

MALADAPTIVE USE: A client tells a nurse that she is the only one who cares about her, yet the following day, The same client refuses to talk to the nurse

Splitting

* Phenelzine is a Pregnancy Risk Category C medication * clients taking SSRIs * clients who have pheochromocytoma, heart failure, cardiovascular and cerebral vascular disease, or severe renal insufficiency * Use cautiously in clients who have diabetes or seizure disorders, or those taking TCAs * Transdermal selegiline is contraindicated for clients taking carbamazepine or oxcarbazepine CONTRAINDICATED WITH _________ MEDS

Monoamine oxidase inhibitors

ati book Flashcards

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