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Exam 1 Flashcards

1
Q

Peplau

A

Mother of psych nursing
Created the nursing process
Applied interpersonal theory to nursing practice and nurse-client relationship
Nurses acts s maturing force

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2
Q

Acetylcholine

A

Cholinergic
Location: Autonomic Nervous System
Function: implicated in sleep, arousal, pain perception, modulation & coordination of movement & memory
Implications: Parkinson’s, Huntington’s, Alzheimer’s,increased levels of depression

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3
Q

Norepinephrine

A

Monoamine
Regulation of mood, cognition, perception, cardiovascular function, sleep & arousal
Implications: Increased in mania, anxiety states, schizophrenia, and decreased in depression

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4
Q

Dopamine

A

Monoamine
Reg. Of movements & coordination, emotions, decision making, pleasure & pain reward centers
Implications: decreased levels in depression & Parkinson’s; increased levels in mania & dyregulation in schizophrenia

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5
Q

Serotonin

A

Monoamine
Cognition, sleep, arousal, libido, appetite, mood, aggression, & pain perceptions
High concentrations in GI w nausea w SSRIs
Implications: increased levels in mania and decreased levels in dyregulation anxiety

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6
Q

Gamma-Aminobutyric Acid

GABA

A

Amino Acid
Inhibitory
Widespread in CNS
Interrupts prog of electrical impulse @ synaptic junction, slow down body activity
Implications: decreased level in anxiety, movement disorders & epilepsy

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7
Q

Glutamate

A

Amino Acid
Excitatory
Pyramidal cells in cortex, cerebellum & primary sensory afferent systems
Relays sensory info & reg. Of motor and spinal reflexes
Implications: etiology of certain neurogenic disorder & schizophrenia

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8
Q

Endorphins & Enkephalins

A

Opioid peptides
Location: Hypothalamus, thalamus, lambic structures, midbrain, brain stem, enkephalins founds in GI tract
Pain modulation and Pleasure
Implications: addict tigons, schizophrenia

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9
Q

Id

A

Instinctual drives, immediate gratification, impulsive & irrational

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10
Q

Ego

A

Rational self, develops at 4-6 MO
Experiences the reality of the external world, adapts to it, and responds to it
Role to maintain harmony among external world, the id & superego

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11
Q

Superego

A

The perfection principle

Developers b/w 3-6 yrs, internalize the values and morals set forth by primary caregivers

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12
Q

Oral Stage

A

Birth - 18 MO
Infant feels attach & unable to differentiate self from mothering
4-6 MO, infant starts to view self as separate from mothering fig.
Sense of security & ability to trust others derived from gratification of fulfilling basic needs during this stage

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13
Q

Phallic Stage

A 
3-6 Yrs
Superego development
Sexual ID w parent 
Oedipus complex
Electra complex
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14
Q

Latency Stage

A

6-12 Yrs
Elementary school yrs
Change from egocentricism to more interest in group activities, learning & social w peers
Sexuality is obscure & imperceptible to others
Preference for same-gender relationship, even rejecting members of opposite gender

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15
Q

Anal Stage

A

18MO - 3yrs
Toilet training
Gain independence & control
Stubbornness, stinginess, controlling

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16
Q

Genital Stage

A

13-20 Yrs
Mature of genital organs from reawakening of libidinal drive
Focus on opp gender & prep for mate
Sexual maturity evolves from self-grat. To behaviors deemed accepted by societal norms
Interpersonal relation. Based on genuine pleasure, not child associations.

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17
Q

Compensation

A

Covering up a real or perceived weakness by emphasizing a trait one considers more desirable.

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18
Q

Rationalization

A

Attempting to make or formulate logical reasons to justify unacceptable feelings or behaviors

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19
Q

Denial

A

Refusing to acknowledge the existence of a real situation or feelings associated with it.

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20
Q

Reaction Formation

A

Preventing unacceptable or undesired thoughts or behaviors from being expressed by exaggerations opposite thoughts or types of behaviors

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21
Q

Displacement

A

Transfer of feelings from one target to another that’s considered less threatening or neutral

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22
Q

Regression

A

Retreating is response to stress to an earlier level of development & comfort measures associated w that level of functioning

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23
Q

Repression

A

involuntary blocking of unpleasant feelings and experiences from one’s awareness

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24
Q

Intellectualization

A

An attempt to avoid expressing emotions associated w a stressful situation by using the intellect

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25
Sublimation
The diversion of energy of a sexual or other biological impulse from its immediate goal to one of a more acceptable one
26
Undoing
Symbolically negating or canceling out an experience that one finds intolerable
27
Projection
Attributing unacceptable feelings or impulses to another person
28
Trust v Mistrust
Birth-18MO develop a basic trust in the mothering fig & to gen it to others Self confidence, optimist, hope for future Non achievement: emotional dissatisfaction with others, suspiciousness, & difficulties w interpersonal relationships
29
Autonomy v Shame
18MO-3 yrs Gain self-control & independence w/in environ. Delay gratification, self confidence in ability to perform Autonomy achieved when parent encourage & provide opportunity for independent activities Non achievement: lack of self confidence, lack of pride in ability to perform, feeling of being controlled by others, primary caregiver restriction of independent behavior both physically and verbally.
30
Initiative v Guilt
3-6 Yrs develop a sense of purpose & ability to initiate & direct own activities Able to exercise restraint & self control Creativity encouraged Non achieve: feelings of inadequacy & guilt and sense of defeat
31
Industry v Inferiority
6-12 Yrs Achieve self confidence by learning, competing, performing successfully, and receiving recognition from significant others & peers Satisfaction & pleasure in interactions involved w others. Master reliable work habit, trust & pride in achieve Non achieve: difficulty interpreting relationships because feelings of inadequacy. Inability to cooperate or compromise, problem solve successfully
32
Identity v Role Confusion
12-20 Yrs Sense of confidence, emotional stability & view of self esteem as unique individual Values system, career choice, relationship with both gender Parents relinquish control
33
Intimacy v Isolation
20-30 Yrs Form lasting relationships or commitments to person, cause, institution, or creative effort. Capacity for mutual love & respect b/w people Non achieve: social isolation; aloneness
34
Generativity v Stagnation/ Self-absorption
30-50 Yrs Achieve life's goals established for oneself while considering welfare and future generation Sense of gratification from personal and professional achieve & meaningful contributions to others Non achieve: lack of concern or welfare of others & total preoccupation w self with dawn, isolated, self-indulgent
35
Ego Integrity v Despair
65-Death Review one's life & derive meaning from both + & - events while achieving positive sense of self Self worth/achievement Non achieve: disgust with how life progressed, want to start over; want 2nd chance
36
"Good Me"
Part of personality that develops in response to positive feedback from primary caregiver, a positive response as it becomes incorporated into self-system
37
"Bad Me"
Part of personality that develops in response to negative feedback from primary caregiver. Alter behavior in response to negative feelings
38
"Not Me"
Part of personality that develops in response to situations that produce intense anxiety in a child, denial of feelings in an effort to relieve anxiety, withdrawal from emotions
39
Symptoms of Manic Episodes
``` Inflated self-esteem/grandiosity decreased need for sleep Talkative/pressured speech Flight of ideas/racing thoughts Distractibility Increase in goal directed activity Excessive involvement in activities with increased potential for painful consequence Agitation, irritability, aggression ```
40
Bipolar Disorder
Mood swings from profound depression to extreme euphoria w intervening periods of normalcy delusions may be present Onset of symptoms may follow seasonal pattern
41
Hypomanic Episode
4 day period of increased, expansive, or irritable mood episode is change in behavior Disturbance in mood and change in function are observed by others Not sever enough to cause marked impairment in function Not attributed to substances/meds or medical condition
42
Cyclothymic Disorder
Chronic, fluctuating mood disturbance of @ least 2 yr duration Numerous periods of elevated mood (doesn't meet crit for hypomanic episode) Numerous period of depressed mood (insuff crit to meet MDD) Never w/o sump for +2MO
43
Mood
Pt's internal & sustained emotional state
44
Affect
Emotional rxn associated with an experience Expression of mood or what pt's mood appears to be to the clinician Congruent/incongruent
45
Abstract Reasoning
Ability to shift back & forth b/w general concepts & specific examples Can pt interpret proverbs Cultural & educ. limits need to be kept in mind
46
Insight & Judgement
Ability to solve prob & make decisions Knowledge about self Adaptive / maladaptive use of coping mech.
47
Psychosis
Loss of contact w reality Disorganization of the personality Deterioration of social function
48
Delusions
Fixed false beliefs Persecutory: ppl out to get them Referential: everything refers to them Grandiose: Think they're God Somatic: Bodily delusions (think something's wrong with them)
49
Hallucinations
Perception like experiences that occur w/o an external stimulus Vivid, clear w full force & impact Occur in sensory: auditory, visual, olfactory, tactile, gustatory
50
Disorganized Thinking
``` Thought Disorder Inferred from person's speech Loose associations/derailment Tangential speech Word Salad ``` Must be severe enough to substantially impair effective communication
51
Negative Symptoms of Psychosis
``` Diminished emotional expression Avolition (lack of motivation) Alogia (inability to speak) Anhedonia (inability to feel pleasure) Asociality (lack of motivation in social interactions) ```
52
Positive Symptoms of Schizophrenia
``` Hallucinations Delusions Illusions Disorganized Thinking Bizarre behavior ```
53
Negative Symptoms of Schizophrenia
``` Flat Affect Anhedonia Avolition Social isolation Diminished self care ```
54
Waxy flexibility
Person maintains the body position into which they are placed (catalepsy)
55
Posturing
Strange, fixed & bizarre bodily positions (catatonic posturing)
56
Anergia
Lack of energy
57
Side Effects of Typical Antipsychotics
``` EPS: Extra Pyramidal Side Effects Cog wheeling Dystonia Akathesia Tardive dyskinesia Parkinsonianism ``` Neuroleptic Malignant Syndrome Orthodontic hypotension
58
Tardiness Dyskinesia
Syndrome characterized by abnorm involuntary movements of pt's face, mouth, trunk or limbs Monitor symptoms with AIMS scale
59
Vascular Dementia
Secondary to CV disease Fluctuating pattern of prog R/t interruption of vascular flow Mult sm. strokes
60
Picks Disease
Frontotemporal NCD | Language, behavioral and motor subtypes
61
Lewy Body Dementia
Dementia accompanied by delirium, visual hallucinations, & Parkinsonism. Symptoms: syncope, falls, sleep disorder & depression Amyloid plaques, deficiencies in dopamine & acetylcholine
62
Pseudo dementia
Can be reversed w appropriate treatment | not caused by organic disease
63
Kubler-Ross Stages of Grief
``` I. Denial II. Anger III. Bargaining IV. Depression V. Acceptance ```
64
John Boulby Stages of Grief
I. Numbness/Protest II. Disequilibrium III. Disorganization & despair IV. Reorganization
65
George Engel Stages of Grief
``` I. Shock & disbelief II. Developing awareness III. restitution IV. Result ion of loss V. Recovery ```
66
Tasks to be Reconciled | William Worden
I. Accepting reality of the loss II. Processing pain of grief III. Adjusting to world w/o lost entity IV. Finding an enduring connection w lost entity in midst of embarking on new life
67
Anticipatory Grief
Experiencing feelings/emotions associated w normal grief before loss occurs Becomes more intense as loss becomes more imminent Defense mechanism
68
Delayed/Inhibited Grief
A sense of Grief | Fixed in denial
69
Distorted (exaggerated) Grief Response
Symptoms exaggerated Dysfunc in managing ADLs Fixed in anger phase; depression may result
70
Chronic/prolonged Grieving
Disabling behavior that prevents bereaved from ADLs
71
Major Depressive Disorder
Depressed mood/loss of interest in activities for @ least 2 wks Evidence of impaired social & occupational function No hist of manic behavior Symptoms not attributed do to substance/medical condition Decrease/increase in weight (significantly) Insomnia/hyperinsomnia Psychomotor agitation SSRI,SNRI
72
Side effects of SSRIs and SNRIs
``` Headache Nausea Insomnia/anxiety Weight gain/loss Sexual dysfunction Serotonin syndrome ```
73
Serotonin Syndrome
Most commonly drug-drug interaction Symptoms: diarrhea, restlessness, agitation, hyperreflexia, autonomic instability, myoclonus, seizures, delirium, coma, status epileptius, cardiovascular collapse Fix by remove agent; meds to block serotonin receptors
74
Autism Spectrum Disorder
``` Wide range of impairment in 2 domains Social communication Restricted & repetitive behavior Onset first 3 yr life Seizure disorder common co-morbidity ```
75
ADHD
Persistent pattern of inattention &/or hyperactivity-impulsivity that interferes w func or development Types: Hyperactive-impulse Inattentive Combined
76
Stimulant Side Effects
``` Restlessness Overstimulation Insomnia Anorexia Tolerance Dependence ```
77
Clozapine (Clozaril)
1st effective antipsychotic w decrease EPS Associated w risk of agranulocytosis & risk for myocarditis Monitor WBC closely Used for severely ill pt who fail to respond to standard treatment
78
Lamotrigine (Lamictil)
Anticonvulsant Side effects: Steven Johnson's Syndrome
79
Lithium
Mood stabilizer Acute mania: 1.0-1.5 mEq/L Maintenance: 0.6-1.2 mEq/L Side effect: drowsiness, dry mouth/ thirst, GI upset, hand tremor, polyuria, dehydration, weight gain, acne, lithium toxicity
80
Valproic Acid (Depakote)
Anticonvulsant Side effects: sedation, weight gain, hepatotoxicity w liver fail, pancreatitis, prolonged bleed time
81
Carbamazepine (Tegretol)
Anticonvulsant Side effects: Steven Johnson syndrome, aplastic anemia, hyponatremia

Acute Psych (1 decks)

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