CHP 29: PSYCH EMERGENCIES

Question 1

overt vs covert behaviors

Answer 1

overt: open and generally understood by surrounding people

covert: hidden meanings or intentions understood only by person displaying the behavior

Question 2

delusions vs hallucinations

Answer 2

delusions: false beliefs

hallucinations: sensory perceptions not founded on objective reality

Question 3

behavioral vs psychiatric emergencies

Answer 3

behavioral: person’s behavior is interfering with activities of daily living

psychiatric: behavior threatens person’s health/safety or another person’s health/safety

Question 4

definition of serious mental illness

Answer 4

diagnosis of psychiatric disorder with serious functional impairment

Question 5

4 categories of causes for abnormal behavior

Answer 5

1. biologic or organic
2. person’s environment
3. acute injury/illness
4. substance-related

Question 6

2 ways people cope with environmental caused behavior

Answer 6

find ways to alter the situation or alleviate discomfort by escaping from stress

Question 7

what is affect

Answer 7

outward expression of a person’s inner feelings such as happy, sad, angry

Question 8

what are stereotyped movements

Answer 8

repetition of movements that do not seem to serve any useful purpose

Question 9

what are compulsions

Answer 9

repetitive actions that are carried out to relieve the anxiety of obsessive thoughts

Question 10

what is the pressure of speech

Answer 10

pouring out of words liked water escaping under pressure

Question 11

what are neologisms

Answer 11

words invented by patients

Question 12

what is echolalia

Answer 12

patient echoes words they hear

Question 13

what is mutism

Answer 13

patient does not speak at all

Question 14

what is flight of ideas

Answer 14

accelerated thinking in which mind skips very rapid from one thought to the next

Question 15

what is perseveration

Answer 15

repetition of same idea over and over again

Question 16

what circumstantial thinking

Answer 16

inclusion of many irrelevant details

Question 17

what is inappropriate affect

Answer 17

emotion out of sync with situation

Question 18

what is flat affect

Answer 18

absence of emotion

Question 19

what is confabulation

Answer 19

inventing experiences to fill gaps in memory

Question 20

what is catatonic

Answer 20

lacking expression or movement, appearing rigid

Question 21

what is labile

Answer 21

rapidly shifting among different emotional states

Question 22

what mnemonic is used for mental status exam

Answer 22

COASTMAP - consciousness, orientation, activity, speech, thought, memory, affect and mood, perception

Question 23

in what patients may scars be found and why

Answer 23

self-mutilation in patients with borderline personality disorder

Question 24

what is hobble tie

Answer 24

tying feet together

Question 25

what patients do you have to be cautious in giving droperidol and haloperidol to

Answer 25

suspected electrolyte imbalances, cardiac abnormalities, and pt's taking drugs that affect QT interval

Question 26

antipsychotic to use for pediatrics

Answer 26

haloperidol

Question 27

what is loosening of associations

Answer 27

logical connection between one idea and the next becomes obscure

Question 28

what is thought broadcasting

Answer 28

belief that thoughts are broadcast aloud and can be heard by others

Question 29

what is thought insertion

Answer 29

belief that thoughts are being thrust into the patient's mind by another person

Question 30

what is thought withdrawal

Answer 30

belief that thoughts are being removed

Question 31

what does delirium present with

Answer 31

disorientation, hallucinations, or delusions

Question 32

three types of delirium

Answer 32

hyperactive - periods of agitation and restlessness hypoactive - inactivity usually associated with CNS depressants, fever, or liver/kidney failure mixed delirium - hyperactive and hypoactive delirium

Question 33

what does dementia present with

Answer 33

chronic that produces deficits in memory, abstract thinking, and judgement

Question 34

what is excited delirium and its S/S

Answer 34

potentially fatal state of extreme agitation and delirium acute onset of agitation, aggressiveness, high pain tolerance, psychotic behavior, bizarre behavior, noncompliance with police and EMS, profuse sweating, incoherent speech, superhuman strength, hyperactivity, respiratory arrest and death

Question 35

what is bipolar mood disorder

Answer 35

patients who alternate between mania and depression

Question 36

what is manic behavior

Answer 36

"elated, on top of the world", tangential thinking, flight of ideas, delusions of grandeur

Question 37

what are delusions of grandeur

Answer 37

inflated belief about one's own fame, wealth, power, or intelligence

Question 38

what is tangential thinking

Answer 38

skipping rapidly from one topic to another

Question 39

what determines chronic depression

Answer 39

S/S of depression for most days over at least two years

Question 40

what mnemonic is used for depression

Answer 40

GAS PIPES - guilt, abnormal appetite, sleep disturbance, paying attention, interest decrease, psychomotor abnormalities, energy low, suicidal thoughts

Question 41

symptoms of schizophrenia

Answer 41

delusions, hallucinations, apathy, mutism, flat affect, lack of interest in pleasure, erratic speech, overly emotional responses, extreme motor behavior

Question 42

what are neurotic disorders

Answer 42

collection of psychiatric disorders without psychotic symptoms and lacking intense psychopathology of other mood disorders

Question 43

how is generalized anxiety disorder diagnosed

Answer 43

symptoms present more days than not for at least 6 months and hard to control

Question 44

what is a simple phobia

Answer 44

focuses all anxieties on one class of objects or situations like spiders or heights

Question 45

what is agoraphobia

Answer 45

fear of going into public places

Question 46

S/S of panic disorders

Answer 46

palpitations, sweating, chest discomfort, paresthesia, hyperventilation

Question 47

substance use, intoxication, use disorder, dependence

Answer 47

use: moderate amounts (social drinker) intoxication: use of substance that results in impaired thinking and motor function use disorder: disrupts activities of daily living dependence: addiction to a substance

Question 48

side effects of eating disorders

Answer 48

electrolyte imbalances, cardiac conditions, seizures, renal failure, erosion of dental enamel, salivary gland enlargement

Question 49

what is a somatoform disorder

Answer 49

people overly concerned with their physical health and appearance to where it dominates their life

Question 50

what is hypochondriasis

Answer 50

patients have extreme fear that they may have serious disease

Question 51

what is another name for factitious disorder and what is it

Answer 51

Munchausen syndrome - person intentionally produces or feigns physical/psychological S/S. pt wishes to be sick to gain attention or avoid legal responsibilities

Question 52

what is Munchausen syndrome by proxy

Answer 52

parent or caregiver intentionally makes child sick to get attention or pity

Question 53

what are impulse control disorders

Answer 53

lack ability to resist temptation or can't avoid acting on a drive - pyromania, pathologic gambling, kleptomania

Question 54

what are personality disorders

Answer 54

way of thinking/behaving that deviates from cultural expectations causing distress or problems functioning - usually another psych illness is also present

Question 55

how do antidepressants work

Answer 55

alter levels of neurotransmitters (serotonin, norepi, dopamine) in autonomic nervous system

Question 56

what is an acute dystonic reaction and what is the treatment

Answer 56

side effect from antipsychotic agents causing muscle spasms of neck, face, and back - IV Benadryl 25-50mg

Question 57

antipsychotic meds can have effects similar to what drug like what

Answer 57

atropine-like (anticholinergic) dry mouth, blurred vision, urinary retention, cardiac dysrhythmias

Question 58

when are amphetamines prescribed

Answer 58

attention-deficit disorder with hyperactivity

Question 59

3 main effects post war

Answer 59

musculoskeletal ailments, mental disorders, illnesses

Question 60

4 categories of symptoms of PTSD

Answer 60

intrusive thoughts, avoiding reminders, negative thoughts/feelings, arousal/reactive symptoms