Exam 1 Flashcards by Sara Durbin

Mental health:
*Ability to recognize _________
*Cope well with ______ _____
*Work ___________
*Contribute to _____________

*recognize your own potential
*normal stress
*productively
*the community

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Definition of Diathesis

the biological predisposition (genetic)

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Biological predisposition + stress =

= mental illness/dysfunction

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Behavior can be changed through?

Conditioning

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What therapy: Replace negative thoughts with positive thoughts which leads to changed behavior

CBT. Our thoughts determine our emotions then actions.

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Thoughts that contribute to depression/anxiety:
- ____________
-Negative thinking…
-Mind…
-Discounting…
-All…

-Personalizing
-Negative thinking as a default
-Mind reading even when you can’t
-Discounting positives
-All or nothing thinking

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The quantitative study of the distribution of mental disorders in human populations

Epidemiology

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The number of new cases of mental disorders, in a healthy population within a given period of time, usually annually

Incidence

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The total number of cases, new and existing, in a given population during a specific period of time regardless of when they become ill

Prevalence

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What is the Diagnostic and Statistical Manual (DSM-5)?

It is the official guideline for diagnosing psychiatric disorders published by the APA

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Automatic coping styles that protect people from anxiety and enable them to maintain their self- image by blocking feelings, conflicts, and memories

Defense mechanisms

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Aaron Beck developed what therapy?

Cognitive Behavioral Therapy (CBT)

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Maslow developed what therapy?

Humanism/hierarchy of needs

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Piaget theorized what development?

Cognitive development (sensorimotor, pre-operational, concrete, formal)

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Erikson theorized what development?

Psychosocial development (trust/mistrust, autonomy/shame…)

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Freud theorized what development?

Psychosexual development (oral, anal, phallic…)

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The first stage, which occurs from birth to 18 months, where infants learn to trust others or develop a distrust of their environment

Trust vs mistrust

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The second stage struggles to gain control over themselves and separate from others to develop a sense of independence

Autonomy vs shame/doubt

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The third stage, which occurs during preschool age, where children learn to make decisions through play and social interaction

Initiative vs guilt

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The fourth stage, where children learn new skills, build confidence, and figure out what they are good at

Industry vs inferiority

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A stage where people learn about their different social roles and may experience an identity crisis

Identity vs role confusion

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The sixth stage, which occurs during young adulthood, where people form intimate relationships with other

Intimacy vs isolation

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A stage where adults create or nurture things that will last, such as having children or making positive changes in the world

Generativity vs stagnation

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The final stage, where people reflect on their lives and decide if they feel like they’ve lived a good life

Integrity vs despair

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Transference

Patient displaces onto the nurse feelings/behaviors related to significant figures in patient's past

Countertransference

Nurse displaces feelings onto patient

What part of Peplau's model of NS-pt relationship: prepare, research, recognize own feelings

Preorientation phase

What part of Peplau's model of NS-pt relationship: 1st time meeting, establish rapport, specify contract, explain confidentiality

Orientation phase

What part of Peplau's model of NS-pt relationship: data gathering, provide education, evaluate progress, identify and explore pt needs and coping skills

Working phase

What part of Peplau's model of NS-pt relationship: summarizing goals, reviewing education, exploring ways to incorporate coping skills, exchange memories

Termination phase

What personal nursing characteristics promote patient growth?

Genuiness, empathy, and positive regard

3 factors affecting communication?

personal factors, environmental factors, and relationship

An MSE's purpose is to evaluate what? and aids in collecting and organizing ______ information.

An individual’s current cognitive processes and aids in collecting and organizing objective information. It is part of the assessment in all areas of medicine.

What are the 3 parts of a nursing diagnosis?

Problem, probable cause, and supporting data

5 RN interventions (standards) for the mental health RN

-Coordination of care -Health teaching + promotion -Pharmacological, biological, & integrative therapies -Milieu therapy -Therapeutic relationship + counseling

Additional APRN interventions in mental health

-Consultation -Prescriptive authority -Psychotherapy

A state of being constantly on guard for danger, even when there's little to no risk

Hypervigilant

Train of thought wanders, shows lack of focus, never returning to the initial topic of conversation

Tangenitial

A thought process or speech pattern where someone includes unnecessary details that make it hard to follow the main point; full of detail

Circumstantial

Unpredictable shifts of emotional state

Labile

A rapid, continuous succession of superficially related thoughts and ideas, manifest as hurried speech

Flight of ideas

Patient loses train of thought; frequent cessation of speech

Thought blocking

An association of words by similarity of sound rather than meaning; pathological disturbance in states & schiz

Clang association

an often highly personal idea or belief system, not endorsed by one’s culture or subculture, that is maintained with conviction in spite of irrationality or evidence to the contrary

Delusion

Goals in psychcare (3)

Prevent relapsing & hospitalizations Medication compliance Promote an optimal/functioning life

Mental illness is considered a ______ _____ __ ___ _____.

physical disorder of the brain

Psychotropic drugs: - not always ________ - optimal outcomes typically occur when... - May be used by patients/clinicians to... - can have significant or life-threatening ____ _____ - Finding the right drug can be ___-___-____

- not always warranted - other interventions are implemented - avoid the hard work of getting better - life-threatening side effects - trial-and-error

GABA is an __________ target cell

inhibitory target cell

Glutamate is an ________ target cell

excitatory target cell

Decreased GABA can cause

anxiety, schizophrenia, & mania

Increased GABA can cause

Sedation, drowsiness, & depressed vital signs

Do Benzos promote or inhibit the production of GABA?

promote GABA

The hypofunction of NMDA receptors increases or decreases dopamine?

Increase dopamine

Decreased glutamate can cause?

Psychosis (a rebound effect r/t NMDA causing an increase in dopamine)

Increased glutamate can cause?

Alzheimer's

Monoamines (serotonin, dopamine, NE, histamine) affect

attention, cognition, & emotion

Serotonin affects

sleep, hunger, cognition, & emotion

Decreased serotonin causes

depression

Dopamine affects

emotions, movement, decision-making, and reward-system

Decreased dopamine causes

Parkinson's and increase in EPSEs

Increased dopamine causes

Psychosis & schizophrenia

Norepinephrine affects

Mood, attention, fight-or-flight

Increased norepinephrine causes

anxiety, mania, & possibly schiz

Decreased norepinephrine causes

Depression

Histamine affects

alertness, inflammation, and GI secretions

Decreased histamine causes

Sedation & wt gain

Cholinergics acts on what receptors?

Muscarinic & nicotinic receptors

Acetylcholine affects

learning & memory (Alzheimer's), aggression/sexual behaviors, mood & mania, stimulates PNS

Decreased serotonin causes: DOMAINS

Depression Obsession (thinking + intrusive thoughts) Migraines Anxiety Intestine upset Nausea Sexual dysfunction (loss of libido)

Excessive dopamine causes: DOPAMINE

Drug addiction psychOsis Prolactin inhibition (tx antipyschotics which may have rebound effect that increases prolactin and cause gynecomastia/galactorrhea) Attention (ADHD) Motivation Involuntary movements (restlessness) Nausea Energy (excessive)

Selective serotonin reuptake inhibitors (SSRIs): - most often used/prescribed _________ - ________ the amount of serotonin available in synaptic cleft - full efficacy isn't reached until ____ weeks - also helps with GAD, OCD, & PTSD

- antidepressant - increases amount of serotonin - 4-6 weeks

Side effects of SSRIs in the: - spinal cord - mesocortical area - brainstem - and overall _______ ____!

- inhibits orgasm - apathy & low libido - GI side effects - suicide risk!

Serotonin norepinephrine reuptake inhibitors: - _______ energy, _____/motivation, antidepressant effects - higher doses of Venlafaxine has side effect of _________ - Duloxetine can treat both _______ & ______ ____ through "dulling" effect

- increases energy & focus (antidepressant) - side effect of HTN - treats both depression & chronic pain

A Norepinephrine and serotonin specific antidepressant

Mirtazipine (Remeron)

A nonrepinephrine dopamine reuptake inhibitor

Bupropion (Wellbutrin, Zyban)

When should Bupropion (NEDRI) not be used/contraindicated for?

- Don't use in patients with seizure risk - Contraindicated for pts with bulemia/anorexia

Serotonin antagonist reuptake inhibitor.

Trazodone (Desyrel)

What antidepressant has fewer GI issues but increases sedation & wt gain? Often used in nursing homes

Mirtazipine (Remeron)

Can be used for smoking cessation and has no sexual side effects. Lacking serotonin but effective in treating depression.

Bupropion

"Sorry" antidepressant but excellent sleep-aid. Emergent side effect: priapism

Serotonin antagonist reuptake inhibitor Trazodone (Desyrel)

1st gen antipsychotic: - blocks ______ - treats ______ symptoms of schizophrenia - ____ & ______ side effects

- blocks dopamine - treats positive sx - motor & neurological SEs

2nd gen antipsychotic: - less affinity for D2 receptors & increases _____ - treats ______ symptoms of schizophrenia - serious _________ side effects

- increases serotonin - treats +/- sx - serious metabolic issues

Benzodiapines promote ____ activity (overabundance may cause _____) - opens ______ channels which reduces cellular activity - causes ______ - helpful for _____ activity, sx of _____ ____ and neuronal ___-____ & aggression - combined with other CNS depressant = ___ RR/LOC

- GABA, ataxia - opens chloride - causes sedation - helpful for seizure activity, alcohol withdrawal, neuronal over-excitation, & aggression - decreases RR/LOC

Lithium, anticonvulsants, antipsychotics, and antidepressants are all ____ ______

mood stabilizers

Best mood stabilizer for mania. May help depression in lower doses.

Lithium

MOA of lithium is unknown but it is involved in the electrical conductivity of _____ and decreases ______

Na/K+, glutamate

Anticonvulsants are useful in tx of ______ _____ - reduce _____ _____ - reduce firing of of ____ frequency neurons

bipolar disorders - mood surge - high frequency neurons

Antipsychotics have ___ _______ properties - useful in acute tx of _______ ______ & ______ - works ______ than others

mood stabilizing - tx of bipolar disorder & depression - works quicker

Exam 1 Flashcards

(88 cards)