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class 2-3 Flashcards

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1
Q

what is a stress reponse

A

physiologically the body reacts to anxiety and fear by arousal of the sympathetic nervous system

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2
Q

S&S of a stress response

A

rapid heart rate, increased BP, diaphoresis, peripheral vasoconstriction, restlessness, repetitive questioning, feelings of frustration, and difficulty concentrating

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3
Q

perceived stress scale

A

scores range from 0-40, higher # =higher stress
most widely used psychological instrument for measuring the perception of stress, gives clinician insight

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4
Q

somatic symptom scale for stress

A

15 item pt questionnaire of physical symptoms (PHQ-15) that assess the domain of somatic symptoms
-completed prior to HCP visit
-score reflects lvl of somatic symptom severity

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5
Q

why do children as young as 3 have difficulting coping

A

-worrying about school
-repsonsibilities
-bullying, peer group pressures
-housing problems or homelessness
-self negative thoughts
-parental concerns
-no coping skills instilled

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6
Q

profile for high-risk adolescents

A

-engaging in problematic high-risk behaviour
-engage with peers who partake in problematic risk taking

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7
Q

HEEADSS acronym questions to assess for high risk youth

A

H- home
E-education
E-eating
A- activities, acquaintances, abuse
D- drugs
S- sexuality/sleeps
S-suicide/safety

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8
Q

personality definition

A

a complex pattern of characteristics, largely outside the person’s awareness, that comprise the individuals distinctive pattern of:
-perceiving
-feeling
-coping
-thinking
-behaving

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9
Q

positive personality concepts

A

-positive self concept
-positive body image
-self worth
-wide range of coping responses(during stress)

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10
Q

personality disorders definition

A

long-term , maladaptive and often self defeating behaviours
essential element of the diagnosis: fixed, enduring quality
can challenge the ability to cope
different from personality traits

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11
Q

characteristics of personality disorders

A

-inflexable
-negative self concept
-maladaptive behaviour
-impaired social & occupational function
-impaired/limited coping=increased stress
-most difficult disorder to treat and cause is unknown
persistent pattern of internal experiences & behaviour which manifests in 2 or more the following areas: thinking, feeling, interpersonal relationships, impulse control

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12
Q

Cluster B personality disorders

A

collection of disorders
unpredictable, dramatic, increased emotional response
a pattern of behaviors is only a disorder if it causes them to struggle in “normal” situations

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13
Q

borderline personality disorder

A

described as living with “constant emotional pain”
is a serious, long-lasting, and complex mental health disorder that impacts the way a person thinks and feels about themselves

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14
Q

when is BPD usually diagnosed?

A

late adolescence, early adulthood

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15
Q

signs and symptoms of BPD

A

-are a result of their efforts to cope
-intense fear of abandonment/instability
-may have difficulty tolerating being alone
-short lived periods of depression/anger/anxiety
-inappropriate anger
-frequent mood swings/paranoid thoughts
-impulsiveness/risk taking behaviour
-self injury

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16
Q

causes of BPD

A

biology but not genetics, environment, personality/temperamental characteristics from birth, certain areas of the brain being affect may cause it, trauma/neglect

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17
Q

interventions for BPD

A

1 always; safety/risk for self harm

DBT/CBT
provide safe environment
stress management
medications for concurrent diagnosis

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18
Q

what is antisocial personality disorder

A

pervasive pattern of disregard for the rights of other people - often manifests in hostility/aggression
charming/masking on the surface, but no empathy or remorse

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19
Q

signs and symptoms of APD

A

-deceit
-manipulation
-lack of genuine remorse for the harm they cause others
-take little to no responsibility for their actions(blames victim)
-depression, schizophrenia, ADHD may be concurrent dx

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20
Q

what is a precursor to APD?

A

Dx of conduct disorder
hostile/aggressive and decietful behaviours exhibited during childhood

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21
Q

what makes APD distinct

A

aggressive features

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22
Q

interventions for APD

A

drugs to help with aggression, depression, erratic moods concurrent with APD
CBT
family therapy
no set TX, tx of concurrent dx or s&s

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23
Q

what is histrionic personality disorder

A

-intense, unstable emotions and a distorted self-image
-a self-esteem that depends on the approval of others
-an overwhelming desire to be noticed and often behave dramatically or inappropriately for attention

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24
Q

signs and symptoms of histrionic personality disorder

A

-attention seeking
-entertaining others
-reputation for drama
-discomfort when ignored
-exaggerated emotions, using clothes for attention, inappropriate seduction, suggestibility, vulnerability to persuation
-need for approval
-genetic, childhood trauma, parenting styles

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25
interventions for histrionic personality disorder
1st intervention: psychotherapy: -group therapy, psychodynamic therapy, supportive therapy, cognitive behavioural therapy no meds Tx: meds for concurrent dx
26
main behaviours that characterize narcissistic personality disorder
dramatic and exaggerated emotional and intense erratic and unpredictable
27
s&s of narcissistic personality disorder "SPECIAL ME"
S:sense of self-importance P:preoccupation with power, beuaty, or success E:entitled C:can only be around people who are important or special I:interpersonal exploitive for their own gain A:arrogant L:lack of empathy M:must be admired E:envious of others/believing others are envious of them
28
interventions for narcissistic personality disorder
1.psychotherapy: DBT, CBT, group or family therapy 2.setting boundaries 3.medication to tx s&s
29
cluster B commonalities:
self-centeredness lack of perspective-taking and empathy lack of insight lack of individual accountability manipulative and exploitative behaviour unhappiness distorted or superficial understanding of self and others' perceptions concurrent mental disorders socially maladaptive no hallucinations, delusions or thought disorders(exception of severe BPD)
30
interventions for cluster B personality disorders
#1 safety teamwork: consistency, limit setting and boundaries medications for s&s case management counselling: DBT, CBT
31
3 primary s&s of anorexia nervosa
1.Restricition of energy intake in the context of age, gender, developmental trajectory, and physical health 2.intense fear of weight gain or being "fat" even though underweight 3.disturbance in the experience of body weight or shape
32
warning signs of anorexia nervosa
-dramatic weight loss -preoccupation with weight, food,calories, fat grams and dieting -resistance to eating certain foods, progressing to restrictions against whole categories of food (e.g no carbs) -freq comments about feeling "fat" or overweight despite weight loss -anxiety about gaining weight to being "fat" -denial of hunger -development of food rituals -consistent excuses to avoid eating -withdrawl from usual friends/activities
33
co-morbidity of anorexia nervosa
depression, OCD, PD, Hx of sexual abuse
34
physical exam findings of anorexia nervosa
bradycardia & low bp; osteoporosis , lanugo, fainting/fatigue, weakness, decreased ability to focus
35
lab findings in anorexia nervosa
leukopenia, anemia, increased LFT's, BUN, Cholesterol, decreased estrogen, electrolyte imbalances, decreased bone density hypokalemia
36
etiology of anorexia nervosa
deficits in hypothalamus(hunger regulation center) -decreased serotonin=decreased appetite -decreased dopamine may decrease eating -hereditary disposition(sister & mothers) -self esteem link -maladaptive coping
37
criteria for admission of anorexia nervosa
decreased BP bradycardia (40 or less) BMI under 18
38
nursing process with anorexia nervosa
-interpersonal therapy -cognitive behavioural interventions -educations -diet of ~3500cal -nutrition stabilization therapy -dealing with feelings of isolation, supporting interactions -family involvement -group therapies -milieu -medications -must maintain approx 80% of BW -1:1 meals
39
3 primary s&s of bulimia nervosa
1. regular intake of large amounts of food 2.regular use of inappropriate compensatory behaviours 3.extreme concern with body weight and shape
40
warning signs of bulimia nervosa
evidence of binge eating evidence of purging behaviours:parotid gland enlargement, russell's sign, loss of dental enamel excessive,rigid exercise regimen despite weather, fatigue, illness or injury unusual swelling of the cheeks and jaw(parotid gland)
41
co-morbidity's with bulimia nervosa
substance misuse, personality disorders, depression, OCD
42
physical exam findings for bulimia nervosa
cardiac changes d/t increased potassium menstration irregularities parotid swelling esophageal tearing
43
lab findings for bulimia nervosa
leukopenia, anemia, increased LFT's, BUN, cholesterol, decreased estrogen, electrolyte imbalance, decreased bone density hypokalemia
44
etiology of bulimia nervosa
genetics decreased serotonin stressful transitions/life changes Hx trauma decreased self esteem & body image
45
nursing process for bulimia nervosa
self awareness, empathetic non-judgemental attitude SSRI's outpatient or inpatiend tx
46
medications for eating disorders
antidepressants antipsychotics anxiolytics calcium supplements multivitamin
47
co-morbidity with binge eating disorder
depression, anxiety
48
physical exam findings for binge eating disorder
associated with being overweight medical complications (diabetes, dyslipidemia, HTN, sleep apnea,Pain conditions)
49
treatments & interventions for binge eating disorder
research ongoing, use of SSRI's and CBT Bariatric surgery may be an option with psychotherapy monitor eating patterns(binges can last 1-2h & go up to 5000cal, psychotherapy, education, assist person to deal w stress, offer support
50
examples of feeding disorders
restrictive food intake pica rumination disorder
51
what is a feeding disorder
inability or difficulty with eating starts in early childhood - continues into adulthood
52
what is restrictive food intake
eating very little/avoiding certain foods=malnutrition/delayed growth
53
what is pica
eating things with no nutritional value can be d/t iron deficient anemia
54
what is rumination disorder
undigested food returns to a persons mouth after swallowing unconsciously/involuntarily cause isn't known but is usually concurrent with anxiety, depression, or other psych disorders tx:behavioural therapy + PPI's to protect the esophagus
55
3 types of crisis
1.maturational 2.situational 3.adventitious
56
maturational crisis
d/t lifestyle changes & challenges coping with them i.e. someone has to retire but is not ready
57
situational crisis
comes from another source sudden and unexpected
58
adventitious crisis
something not expectant in the realm of everyday life
59
what is trauma
an event that threatens the life or integrity of the individual or a loved one
60
what % of canadians report trauma
76% but only 9.2% have PTSD s&s
61
what does trauma feel like
could cause mild disruption to a debilitating response varies from person to person feelings of: helplessness, powerlessness,anxiety,flashbacks
62
how does trauma impact the person
safety, sense of self, self efficacy all impacted effects regulations of emotions & relationships
63
trauma-informed care
shifts focus from blame on the person "whats wrong with you" to blame on the situation "what happened to you" shifts from individual being sick to what happened being an injury
64
acute stress disorder
mimics PTSD s&s but manifests 2days-4weeks after event dissociative s&s, amensia, depersonalization **will go on to develop PTSD**
65
dissociative identity disorder
"multiple personality disorder" -very stigmatized, often develops after trauma 1.disruptions in processes related to memory, identity, & preceptions 2.emotion detachment & disconnection 3.disconnection from reality & surroundings -persistent, causes stress, may impede functioning in the world is a coping mechanism to a traumatic event
66
s&s of dissociative identity disorder
primarily recognized by the presence of alternate identities or personality states -dissociative amnesia -dissociative fugue state -blank spaces in memory -sense of depersonalization -sense of body taking on different sizes and shapes -vauge, dreamlike memories of experiences -feeling like your body, thoughts, & feelings are not theirs and cannot be controlled -noticable changes in speech, behaviour, and personal preferences
67
causes of dissociative identity disorder
-physical, sexual, or emotional abuse -mistreatment or neglect -childhood medical trauma -war or terrorism
68
interventions for dissociative identity disorder
Rx to help with anxiety and depression cognitive behavioural therapy dialectical behavioral therapy

mental health (10 decks)

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