Exam 1 Flashcards
(141 cards)
1
Q
Cognition impairment may signify _______
A
Alzheimer’s disease
2
Q
A state of well-being in which an individual is able to realize his or her own potential, cope with the normal stresses of life, work productively, and make a contribution to the community is considered ________ ________
A
Mental health
3
Q
_____ _____ refers to all mental disorders with definable diagnoses manifested in significant dysfunction that may be related to development, biological, or psychological disturbances in mental functioning
A
Mental illness
4
Q
Emotions may be affected by _____
A
Depression
5
Q
Behavioral alterations may be apparent with _____
A
Schizophrenia
6
Q
Projective questions usually start with _______?
A
What if
7
Q
Presupposition questions usually discuss ______?
A
Future goals
I.e. Suppose you woke up in the morning is a miracle happened and this probably had gone away. What would be different? How would it change your life?
8
Q
_____ is associated with physical characteristics, such as body movements in past years. Facial expressions, I contact or lack there of, the way someone holds the head, legs, and shoulders, and so on convey a multitude of messages
A
Kinesics
9
Q
_____ refers to the study of personal space and the significance of physical distance between individuals.
A
Proxemics
10
Q
_____ distance is 0-18 inches
A
Intimate
11
Q
_____ distance is 18-40 inches
A
Personal
12
Q
_____ distance is 4-12 feet
A
Social
13
Q
_____ distance is 12 or more feet
A
Public
14
Q
What are the three stages of General adaptation syndrome (GAS)?
A
Alarm,
Resistance/Adaptation,
Exhaustion
15
Q
_____ is a negative, draining energy that results in anxiety, depression, confusion, helplessness, hopelessness, and fatigue.
A
Distress
16
Q
_____ is a positive, beneficial energy that motivates and results in feelings of happiness, hopefulness, and purposeful movement.
A
Eutress
17
Q
For the short term effects of stress related to cortisol and corticoids in the hypothalamus?
A
Fluid loss, increased glucose by gluconeogenesis, decreased inflammation, decreased brain norepinephrine
18
Q
For the long term (chronic) effects of stress related to cortisol and corticoids in the hypothalamus?
A
Immune system compromise, atherosclerosis, depression, high blood pressure, insulin insensitivity, obesity, high blood lipid, protein breakdown
19
Q
For the short term effects of stress related to epinephrine and norepinephrine in the central nervous system?
A
Increased heart rate, increased respiration, increased triglycerides, increase platelet aggregation, decreased kidney clearance, increase blood to skeletal muscles, increased muscular tension
20
Q
For the long term (chronic) effects of stress related to cortisol and corticoids in the hypothalamus?
A
High resting heart rate, heart disease, platelet aggregation, reactive high blood pressure, high cholesterol, high triglycerides, Renal/hepatic problems, glucose intolerance, chronic muscle tension, hyperventilation, digestive problems, chronic anxiety/anger
21
Q
What are the overall effects of stress on the body?
A
Hypertension, heart disease/heart attack, stroke, atherosclerosis, diabetes, cancer, ulcers, chronic G.I. problems, allergies, autoimmune diseases, arthritis, headaches, reduced immunity, kidney and liver disease
22
Q
_____ is the progressive deterioration of cognitive functioning and global impairment of intellect with no change in consciousness.
A
Dementia
23
Q
_____ is the most common type of dementia, accounting for 60% to 80% of all dementias.
A
Alzheimer’s
24
Q
_____ is memory loss that interferes with one’s activities of daily living.
A
Alzheimer’s
25
What are the risk factors for Alzheimer's disease?
Cardiovascular disease,
social engagement and diet,
head injury and traumatic brain injury
26
What are some of the defense mechanisms with Alzheimer's?
Denial,
confabulation,
perseveration,
avoidance of questions
27
What are the symptoms of Alzheimer's disease?
```
Memory impairment,
Disturbances in executive functioning,
Aphasia (loss of language ability),
Apraxia (loss of purposeful movement),
Agnosia (loss of sensory ability to recognize objects)
```
28
What are the three stages of Alzheimer's disease?
Preclinical,
Mild cognitive impairment (MCI) due to Alzheimer's disease,
Dementia due to Alzheimer's disease
29
Contributing factors of delirium?
Hypoglycemia, fever, dehydration, hypotension, infection, ever struggle reaction, head injury, change in environment, pain, emotional stress
30
This neurocognitive disorder presents with altered levels of consciousness
Delirium
31
These neurocognitive disorder's may also present with sundowning
Delirium and dementia
32
______ can't present with rapid mood swings, fearfulness, anxiety, suspicious thoughts, aggressiveness, hallucinations and or delusions
Delirium
33
These symptoms may occur in late Alzheimer's disease
Agraphia (inability to read or write),
Hyperorality (The need to taste, chew, and put everything in one's mouth),
Visual agnosia (Lost ability to recognize familiar objects),
Hypermetamorphosis (manifested by touching everything in sight)
34
Which medications are aimed at preventing acetylcholine breakdown in Altheimer's disease patients?
Cholinesterase inhibitors
Tacrine hydrochloride, Donepezil, rivastigmine, galantamine, Memantine (Namenda),
35
This medication treats mild to moderate symptoms of Alzheimer's disease and improves functioning while slowing the progression of the disease
Tacrine (Cognex)
Has significant side effects including elevated liver transaminases levels, gastrointestinal effects, and liver toxicity. As a result it is no longer marketed for used with dementia
36
What classification of medication is used as first-line treatment for depression
Selective serotonin reuptake inhibitors (SSRIs)
37
This nurse/patient relationship phase involves chart review and preparation for first meeting with patient
Pre-orientation phase
38
This nurse/patient relationship phase can last anywhere from a few meeting or over an extended period of time. Initial interview is conducted, nurses role is clarified, confidentiality is discussed, termination is introduced, and patient problems are discussed with mutually agreed upon goals
Orientation phase
39
This nurse/patient relationship phase is where the relationship is maintained, information is shared, further data is gathered, and the promotion of patient problem-solving skills, self-esteem, and behavioral changes begin
Working phase
40
The inability to identify familiar objects or people is called ____
Agnosia
41
The inability to successfully perform simple tasks is called _____
Apraxia
42
The inability to read or write is called _____
Agraphia
43
I need to taste, Chin, and put everything in one's mouth is called _____
Hyperorality
44
Forgetting familiar words, the location of every day objects, coming up with the right word or name, trouble remembering names when introduced to new people, difficulty performing tasks in social and work settings, forgetting material that was just read, misplacing things, trouble planning/organizing, are all signs of which stage of Alzheimer's disease?
Mild cognitive Alzheimer's disease
45
Impaired ability to perform mental arithmetic, difficulty performing complex tasks such as paying bills, becoming moody or withdrawn, gaps in memory, unable to recall ones address or telephone number, becoming confused about location and day, choosing proper clothing, are all part of what stage of Alzheimer's disease?
Moderate or mid stage Alzheimer's disease
No assistance with eating are using the toilet is yet required
46
Personality changes, the need for extensive help with ADLs, loss of awareness of recent experiences and surroundings, I won't remember names, major changes in sleep patterns, needing assistance toileting, wandering, are all part of which stage of Alzheimer's disease?
Severe Alzheimer's disease
47
_____ is the normal, healthy fluctuations in mood
Euthymia
48
_____ is the lack of interest in normal activities
Anhedonia
49
_____ mania feels wonderful in the beginning but turns scary and dark as it progresses toward loss of control and confusion
Euphoric
50
_____ mania is referred to as mixed state or agitated depression, with depressive symptoms along with mania.
Dysphoric
51
The _____ phase of Bipolar disorder focuses on injury prevention
Acute
52
The _____ phase of bipolar disorder lasts for 4-9 months
Continuation
53
The _____ phase of bipolar disorder focuses on prevention of relapse
Maintenance
54
_____ is the primary medication for Bipolar disorder
Lithium
55
What is the therapeutic level for lithium?
0.8 - 1.4 therapeutic
0.6 - 1.2 maintenance blood level
>1.5 is toxic
56
What are the expected side effects for lithium at therapeutic levels of 0.4 to 1.0?
```
Fine hand tremor,
polyuria,
mild thirst,
mild nausea,
general discomfort,
weight gain
```
57
What are the early signs of lithium toxicity?
```
1.5
Nausea,
vomiting,
diarrhea,
thirst,
polyuria,
lethargy,
slurred speech,
muscle weakness,
fine hand tremors
```
58
What are the signs of advanced lithium toxicity?
1.5-2.0
```
Course hand tremor,
persistent gastrointestinal upset,
mental confusion,
muscle hyperirritability,
incoordination,
sedation
```
59
what are the signs of severe lithium toxicity ?
```
Ataxia,
Blurred vision,
Clonic movements,
Large output of dilute urine,
Seizures,
stupor,
severe hypotension,
coma
```
60
What are the two major long-term risks of lithium therapy?
Hypothyroidism,
| impairment of the kidneys ability to concentrate urine
61
When is lithium therapy contradicted?
```
Cardiovascular disease,
Brain damage,
Renal disease,
Thyroid disease,
Myasthenia Gravis
```
62
Which assessment tools are used to screen for depression?
```
Beck depression inventory,
Hamilton depression scale,
Zing depression scale,
Geriatric depression scale,
Patient health questionnaire (PHQ 2 or 9),
```
63
The _____ phase of major depression is during weeks 6-12
Acute
64
The _____ phase of major depression is during months 4-9
Continuation
65
The _____ phase of major depression is greater than 1 year
Maintenance
66
A lack of energy is called _____
Anergia
67
What are the factors to therapeutic relationships?
```
Elicit data and understand core problems,
Listening,
Promote patient comfort/safety,
Balancing Control,
Trust and active participation,
Genuineness, empathy, positive regard
```
68
A lack of feeling, emotion, or interest is called _____
Apathy
69
What factors contribute to mental health?
Culture,
Resilience,
Ethnicity
70
What is the stage of development (Erikson) for an infant age 0-1 year?
Trust vs. Mistrust
Trusting or suspicion and fear
71
What is the stage of development (Erikson) for early childhood age 1-3?
Autonomy vs Shame
Self control and adequacy vs Shame and doubt
72
What is the stage of development (Erikson) for an preschool age 3-6?
Initiative vs Guilt
Self starter/Independent vs Guilt and inadequacy
73
What is the stage of development (Erikson) for an school age age 6-12?
Industry vs Inferiority
Learning how things work and organizing vs Lack of understanding and feeling inferior
74
What is the stage of development (Erikson) for an adolescence age 12-19?
Identity vs Confusion
Seeing self as unique person vs Unsure of personal identity
75
What is the stage of development (Erikson) for an early adulthood age 20-25?
Intimacy vs Isolation
Establishing relationships vs Lack of relationships
76
What is the stage of development (Erikson) for an middle adulthood age 35-65?
Generativity vs Self-Absorption
Concern for family and others vs Concern for self
77
What is the stage of development (Erikson) for an later years age 65-death?
Integrity vs Despair
Feeling fulfilled vs Disappointed with life
78
What attributes to caregiver stress?
```
Change in roles within the family,
Change in living arrangements,
Financial strain,
Time/energy demands,
Family conflict,
Lack of help
```
79
What are the physical responses to caregiver stress?
```
Weakened immune system,
Obesity,
Chronic disease,
Depression/anxiety,
Hypersomnia
```
80
Signs/symptoms related to caregiver stress
```
Denial,
Anger,
Social withdrawal,
Depression,
Exhaustion,
Sleeplessness,
Irritability,
Health problems,
Anxiety
```
81
What is the primary role of the caregiver?
Assist with ADLs,
Provide emotional and social support,
Manage health care services
82
What are some ways to cope with caregiver stress?
```
Deep breathing,
Meditation,
Yoga,
Regular exercise,
Music,
Sex,
Maintain social relationships/support,
Eat well,
Adequate sleep
```
83
What resources would you provide to support caregivers for positive outcomes?
```
Provide resources (home health),
Seek help from others,
Meals on wheels,
Speak to church,
Government/local assistance
```
84
Things that contribute to therapeutic communication?
Open ended questions,
Reflecting (rewording),
Restating (exact words),
Clarifying (additional questions to clarify)
85
Things that contribute to non-therapeutic communication?
Giving advice,
False reassurance,
Asking "why" questions,
Using excessive medical terms
86
What are some signs/symptoms of impaired cognition?
```
Short-term memory loss,
Confusion,
Poor hygiene,
Poor motor function,
Reappearance of health related symptoms (not taking meds)
```
87
What are signs and symptoms of depression?
```
Tired,
Weight loss,
Social isolation,
Irritable,
Frustrated
```
88
What are signs and symptoms of bipolar disorder (manic phase)?
Elevated mood,
Grandiose delusions,
Excessive behavior (spending, sexual partners),
Flight of ideas
89
What are signs and symptoms of bipolar disorder (depressive phase)?
```
Decreased interest in typically pleasurable activities (Anhedonia),
Fatigue,
Suicidal ideation,
Sadness,
Isolation
```
90
What are the implications, mechanism of action, adverse effects and nursing considerations for SSRIs?
Prozac, Paxil, Zoloft, Lexapro, Celexa
For depression;
Inhibits reuptake of serotonin (making it more available);
Sexual dysfunction, drowsiness, nausea, vomiting, anxiety, sleep disturbance, agitation;
Don't give with MAOIs, Can cause mania (serotonin syndrome)
Takes 2-4 weeks to become effective, wean off
91
SSRIs typically have a generic name extension of _____ or _____ and becomes effective after ______ (period of time)
~ine or ~pram,
2-4 weeks
Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Vilazodome (Vibryd)
Escitalopram (Lexapro), Citalopram (Celexa)
92
Side effects such as; Mania, serotonin syndrome (mental status changes, sweats/fever, tachycardia, seizures, motor skills changes), insomnia, weight gain, and sexual dysfunction are associated with which class of drugs?
SSRIs
93
What is the mechanism of action for SSRIs?
Serotonin Reuptake Inhibitor
Makes serotonin more available, resulting in elevation of mood
First line Antidepressant
94
SNRIs typically have a generic name extension of _____
~ine
Duloxetine (Cymbalta), Venlafaxine (Effexor), Desvenlafaxine (Pristiq)
95
Side effects such as; Headache, Nausea, Insomnia, Diaphoresis, Anticholinergic effects (dry mouth, blurry vision) can occur with which classification of drugs?
SNRIs
96
What is the mechanism of action for SNRIs?
Inhibits reuptake of serotonin and norepinephrine
Makes serotonin and norepinephrine more available, resulting in elevation in mood
Antidepressant
97
What are the nursing considerations for SSRIs?
Evaluate for serotonin syndrome (abdominal pain, diarrhea, sweating, fever, tachycardia, elevated blood pressure, altered mental state, myoclonus, increase motor activity, irritability, hostility, mood change); wean off drug slowly; can cause mania
98
Tricyclic Antidepressants usually have a generic name extension of _____ and become effective in ______ (time period)
~ine
Can take 10-14 days to begin working and 4-8 weeks to establish full effects
99
Side effects such as: anticholinergic effects (dry mouth, blurred vision, tachycardia, constipation, urinary retention, esophageal reflux); weight gain; hypotension may present with which classification of drugs?
Tricyclic Antidepressants
Third line
100
What are the nursing considerations for Tricyclic Antidepressants?
Caution use for elderly (quick accumulation if liver/kidney issues); caution with cardiovascular disorders, BPH, and glaucoma; can cause seizures; not recommended with MAOIs; start with low dose, gradually increase
101
SSRIs, SNRIs, Tricyclics, and MAOIs treat which condition(s)?
Depression
102
This class of antidepressant is used only after attempting to use SSRIs and Tricyclics?
Atypical antidepressants
Bupropion (Wellbutrin), Mirtazapine (Remeron), Trazadone (Oleptro)
Can also be used for smoking cessation
103
This type of antidepressant has strict dietary requirements (need fresh fruits, meat, and fish: avoid beer, yeast, and cheese) and is used for unconventional depression (characterized by mood reactivity, oversleeping and overeating) as well as panic disorder, social phobia, generalized anxiety disorder, OCD, PTSD, and bulimia
MAOIs
104
What is the mechanism of action for MAOIs?
Inhibits breakdown of serotonin, norepinephrine, dopamine, and tyramine
Allows more of these neurotransmitters to be present in the body
105
Side effects such as: weight gain, edema, hypertension, muscle twitch/weakness, and sexual dysfunction may present with which drug class?
MAOIs
106
What are the nursing considerations for MAOIs?
Hypertension crisis (especially with tyramine foods), avoid over the counter drugs
107
_____ is used to treat Bipolar disorder, acute mania, and can be used for depression
Lithium
First line drug for bipolar and acute mania
108
What is the mechanism of action for lithium?
Alters sodium transport in nerve and muscle cells, inhibits release of norepinephrine and dopamine
109
What are the nursing considerations for lithium?
Takes 7-14 days to be therapeutic, need benzodiazepine or antipsychotic in interim
Monitor for toxicity (nausea, vomiting, diarrhea, thirst, polyuria, slurred speech, muscle weakness, hand tremors, G I upset, confusion, incoordination, sedation, ataxia, blurred vision)
Patient must stay hydrated
110
Side effects such as hypothyroidism, kidney nephropathy, polyuria, weight gain and nausea are associated with which drug?
Lithium
111
Which drug classification is used for cycling bipolar disorder, schizoeffective disorder, and to reduce impulsivity and aggression?
Anticonvulsants
Divalproex (Depakote), Lamotigine (Lamictal), Topiramate (Topomax)
112
What are the nursing considerations for anticonvulsants?
Can cause life threatening rash (Lamictal), watch liver/platelets, watch drug levels
113
This classification of drugs typically has the extension ~ole or ~pine
Second generation antipsychotics
Aripiprazole (Abilify), Quetiapine (Seroquel), Risperidone (Risperdal)
114
Side effects such as: seizures, muscle restlessness, priapism, sedation, nausea, vomiting, weight gain, dry mouth, cough and rash are common is which drug classification
Antipsychotics
115
What drug classification is typically used for schizophrenia?
Antipsychotics
116
What are the nursing considerations for antipsychotics ?
Watch kidney/liver function,
| Hematologic profile
117
Which drug classification has the extension ~pam or ~lam?
Antianxiety medications
Clonazepam (Klonopin), Lorazepam (Ativan), Alprazalam (Xanax)
118
What is the mechanism of action for Antianxiety medication?
Enhances GABA (inhibitory), tranquilizes the central nervous system
119
What are the side effects for anti-anxiety medications?
Sedation, CNS depression, psychosis, neuro changes
120
Which drug classification is used to treat acute mania, psychomotor withdrawal, and anxiety
Anti-anxiety medications
121
What are the nursing considerations for anti-anxiety medication
High abuse potential/tolerance
122
What are the 4 As of Alzheimer's ?
Amnesia (memory)
Aphasia (speech)
Apraxia (purposeful movement)
Agnosia (object recognition)
123
Which part of the brain is linked with emotion?
Amygdala
124
Which part of the brain is linked to memory?
Hippocampus
125
Which part of the brain controls functions such as sleep/rest, temperature, aggression, libido?
Hypothalamus
126
Which part of the brain is the message cortex with motor/sensory fibers?
Thalamus
127
This neurotransmitter is responsible for regulating body temperature, sleep, mood, appetite and pain. Related disorders include depression, impulsive behavior and aggressiveness?
Serotonin
128
This neurotransmitter is responsible for regulating attentiveness, emotions, sleeping, dreaming, learning, and fight/flight response. Related disorders include depression and bipolar disorder?
Norepinephrine
129
This neurotransmitter is responsible for regulating movement, posture, mood and dependency. Related disorders include Parkinson's, chemical dependency, and self injury?
Dopamine
130
This neurotransmitter is responsible for regulating muscle contraction, wakefulness, attentiveness, anger, aggression, sexuality, and thirst. Related disorders include Alzheimer's and certain neurological disorders?
Acetylcholine
131
This neurotransmitter is responsible for regulating the excitatory response associated with learning and memory. Related disorders include Alzheimer's, memory, ETOH withdrawal?
Glutamate
132
This neurotransmitter is responsible for regulating inhibitory response related to anxiety, cortical, vision and motor. Related disorders include epilepsy and neuropathic pain?
GABA
133
Who developed the theory that notes transference and counter-transference?
Freud
134
Who developed the theory relating to the 8 stages of development?
Erikson
135
Who developed the theory relating to interpersonal processes and social framework, helping clients gain insight into their disorders?
Sullivan
136
Who is considered the "Mother of psychiatric nursing" that developed nurse/patient relationships as a foundation?
Peplau
137
Who developed the theory related to conditioning and reinforcement and behavior theory?
Skinner
138
Who developed the theory relating to rational/emotive behavior therapy and CBT?
Ellis, Beck, Maslow
139
_____ are errors in perception of sensory stimuli. The stimulus is a real object misinterpreted as something else
Illusions
140
_____ are false sensory stimuli. They see something that isn't there.
Hallucinations
141
_____ is thinking or believing something that isn't true (people can see you through the walls)
Delusions
