eating, anxiety, personality disorders

Question 1

self-concept

Answer 1

the personal perception of self that forms in response to interactions with others and the environment throughout the course of an individual’s lifetime
identity, body image, role performance, self-esteem, self-awareness

Question 2

anorexia/bulimia s/s

Answer 2

hypotension, bradycardia, hypothermia
lanugo (AN)
acrocyanosis: purple mottled skin on hands and feet
low bone density
muscle weakness
insomnia
refeeding syndrome
cathartic colon with laxative abuse

Question 3

malnutrition s/s

Answer 3

impaired hepatic function
edema covers muscle wasting
dry, raw, yellow skin
split nails
muscle atrophy
immunodeficiency

Question 4

bulimia nervosa

Answer 4

normal BMI
binge eating behaviors
self-induced vomiting, laxative use, or diuretic use after binge
possible chemical dependency
between binges, they often eat normally or slightly restrict calories
complications of vomiting

Question 5

complications of vomiting

Answer 5

loss of HCl and K
elevated serum bicarbonate levels
pharyngitis
esophageal tears 
enamel erosion
stomach rupture
aspiration pneumonia
burst blood vessels
cardiomyopathy

Question 6

eating disorder interventions

Answer 6

daily vitals if inpt; temp only at home.
weigh pt consistently
exercise should be monitored
discuss triggers to the binge-purge cycle

Question 7

eating disorder admission criteria

Answer 7

rapid weight loss of ≥ 30% of body weight in underweight client
inability to gain weight
failure to adhere to treatment contract
severe hypothermia < 89.6
bradycardia at or < 40 bpm
systolic BP at or < 70
hypokalemia < 3 mEq/L 
renal output < 30 cc/hour
EKG changes
suicidal behavior

Question 8

personality disorders

Answer 8

a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving
believed to be 2/2 childhood trauma

Question 9

personality disorder dx

Answer 9

inappropriate response to stress
poor impulse control
difficulties in relating to others
cause others to react with extreme annoyance or irritability
tendency to provoke interpersonal conflict

Question 10

paranoid personality disorder

Answer 10

suspicious of others based on unfounded beliefs that they are out to harm, exploit or deceive them
feel they are always being watched

Question 11

schizoid personality disorder

Answer 11

characterized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism

Question 12

schizotypal personality disorder

Answer 12

characterized by odd beliefs leading to interpersonal difficulties, an eccentric appearance, and magical thinking

Question 13

antisocial personality disorder

Answer 13

(sociopath, psychopath)
an aggressive personality type that disregards the rights of others
repeated unlawful/deceitful actions
above average intelligence
manipulative, no conscience
most violent personality disorder

Question 14

borderline personality disorder

Answer 14

straddle the border between sanity and psychosis

splitting: portrays people as all good or all bad
manipulation
unstable affect, relationships
impulsive
fear of abandonment
self-injury, frequent hospitalizations

Question 15

narcissistic personality disorder

Answer 15

characterized by arrogance, grandiose views of self-importance, the need for constant admiration, and a lack of empathy for others that strains most relationships

Question 16

histrionic personality disorder

Answer 16

characterized by emotional attention-seeking behavior

seductive and flirtatious

Question 17

avoidant personality disorder

Answer 17

characterized by social inhibition and avoidance of all situations & relationships due to extreme fear of rejection; often very anxious in social situations

Question 18

dependent personality disorder

Answer 18

characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends

Question 19

OCD

Answer 19

characterized by perfectionism with a focus on orderliness and control to the extent that the individual may not be able to accomplish a given task
type a personality

Question 20

stressor

Answer 20

external influence that threatens to disrupt the equilibrium that is needed to maintain homeostasis

Question 21

anxiety

Answer 21

a feeling of apprehension that develops when the self or self-concept is threatened

distinct from fear which is a response to an identifiable external threat

Question 22

anxiety psychopathology

Answer 22

GABA functions as the body’s natural antianxiety agent by reducing cell excitability
decreases in GABA will increase anxiety

Question 23

generalized anxiety disorder

Answer 23

chronic disorder characterized by excessive worry and uncontrollable anxiety
3 of the following must be present:
ADLs provoke anxiety, restlessness, indecision, fatigue, avoidance, poor focus, irritability, muscle tension, sleep disturbance, need for constant reassurance

Question 24

panic disorder

Answer 24

repeated episodes of full-blown panic; sudden onset of fear associated with feelings of impending doom
palpitations, chest pain, SOB, chills or hot flashes, emotionally painful

Question 25

agoraphobia

Answer 25

intense fear of being in places or situations where help might not be available & escape might be difficult or embarrassing; most limiting & debilitating of all the phobias being alone outside the home, using public transportation, being out in open spaces, being in an enclosed space, being in a crowd

Question 26

obsessive compulsive disorder

Answer 26

obsessions: thoughts, impulses or images that persist & cannot be dismissed from the mind compulsions:ritualistic behaviors an individual feels driven to perform to reduce anxiety caused by the obsession obsessions and compulsions usually occur together together they are called a ritual tx: antidepressants

Question 27

PTSD

Answer 27

occurs in people who have experienced a highly traumatic event, witnessed a traumatic event or been repeatedly exposed to stories about a traumatic event feelings of fear, helplessness or horror flashbacks difficulty with interpersonal, social, or occupational relationships hypervigilance and irritability exposure to reminders of the event can exacerbate symptoms

Question 28

anxiety disorder assessment

Answer 28

caffeine and sugar intake skin assessment especially for broken areas on those patients who are obsessive-compulsive because many rituals revolve around bathing perception of events: if the patient perceives the event as stressful that is all that matters coping patterns may include overuse of medication or substance abuse ritualistic activity is often increased by anxiety

Question 29

relaxation techniques

Answer 29

``` deep breathing exercises progressive relaxation meditation mental imagery calming music expression of feelings ```

Question 30

medication for anxiety disorders

Answer 30

``` benzodiazepines increase GABA [GABA up, anxiety down] chlordiazepoxide (Librium) diazepam (Valium alprazolam (Xanax) lorazepam (Ativan) midazolam (Versed) clonazepam (Klonopin) ```

Question 31

diazepam (valium)

Answer 31

anxiolytic, anticonvulsant, muscle relaxant benzodiazepine caution with opioids, other benzodiazepines, hypnotics, muscle relaxants avoid with pregnancy, lactation, myasthenia gravis, sleep apnea

Question 32

diazepam adverse effects

Answer 32

``` respiratory depression dizziness lethargy hangover constipation addiction ```

Question 33

benzodiazepine antidote

Answer 33

flumanezil

Question 34

alprazolam (xanax)

Answer 34

increases GABA in the CNS caution with CNS depressants, valproate, oral contraceptives, valerian avoid with pregnancy, lactation, angle-closure glaucoma

Question 35

alprazolam (xanax) adverse effects

Answer 35

``` dizziness drowsiness lethargy physical dependence psychological dependence tolerance ```

Question 36

buspirone (buspar)

Answer 36

anxiolytic, also treats sleep disorders binds to serotonin & dopamine receptors in brain caution in hepatic or renal impairment. avoid use with MAOIs, alcohol, grapefruit, valerian

Question 37

buspirone (buspar)

Answer 37

``` headache N/V dizziness chest congestion insomnia fatigue blurred vision tinnitus palpitations ```

Question 38

CBT anxiety techniques

Answer 38

looking at the situation another way (positive reframing) trying not to blow the situation out of proportion (decatastrophizing) snapping a rubber band to stop themselves from dwelling on the negative (thought stopping)

Question 39

anxiety levels

Answer 39

mild: can be productive, senses sharp, automatic responses moderate: agitation, focus on root of anxiety, easily redirected severe: inability to function, ritualistic behavior, tachycardia, diaphoresis, chest pain panic: distorted perception, cannot process environmental stimuli, possibly suicidal, cannot communicate verbally

Question 40

transference

Answer 40

occurs when the client unconsciously projects to the health professional feeling toward another person who has been significant to the client’s personal life

Question 41

countertransference

Answer 41

the tendency of health professionals to displace on to a client, feelings related to another person in the healthcare worker’s personal or professional life

Question 42

voluntary admission

Answer 42

the client or client’s guardian seeks admission to a mental health facility in order to obtain treatment right to refuse tx and meds right to leave AMA

Question 43

involuntary admission

Answer 43

the client enters the mental health facility against their will for a period of time the rationale for commitment is always danger to self or others cannot leave AMA can still refuse meds, but can be overruled with input from two doctors