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Exam 1 Flashcards

1
Q

Freud

A

Id
Ego
Superego

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2
Q

Id

A

Pleasure-pain principle

Immediate gratification

Instinctive and primitive mind is dominant

Birth-1 1/2 years

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3
Q

Ego

A

Behaviors

Problem solving skills
Perception
Ability to mediate id impulses

1 1/2-3 years

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4
Q

Superego

A

Perfection principle

Unconscious

Reward and punishment principle

Incorporating moral values, ideals, judgments from right and wrong that are held by parents

3-7 years

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5
Q

Skinner

A

Operant conditioning

Punishment causes behavior to recur again

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6
Q

Erin beck

A

Negative and self critical thinking causes depression

Cognitive behavioral therapies assist to identify negative thought patterns and replace with rational ones (involves hw)

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7
Q

Maslow hierarchy of needs

A
  1. Physiological
  2. Safety
  3. Love and belonging
  4. Self esteem
  5. Self actualization
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8
Q

Dopamine

A

Cognitive
Motivation
Movement

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9
Q

Serotonin

A

Mood
Attention
Body temp

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10
Q

Norepinephrine

A

Mood
Cognition
Perception

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11
Q

GABA

A

Excitement

Anxiety

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12
Q

Orientation phase

A

Assessment

Getting to know patient and their history

Sort of like job orientation

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13
Q

Working phase

A 
Doing work 
Setting goals
Nursing diagnosis 
Nursing intervention
Nursing plan of care
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14
Q

Termination phase

A

Reflect on relationship

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15
Q

Nurse-client relationship/partnership

A

Patient centered

Patient has control over healthcare decisions

Don’t discuss things about yourself

Understanding nurse is safe, reliable, consistent, info is private

Ex. Bipolar patient/ won’t know boundaries

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16
Q

Social relationships

A

Each person gets something out of relationship

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17
Q

Psych RN

A

Cannot medically diagnose

Promote autonomy

Cannot run personal therapy- can group

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18
Q

Advanced practice provider

A

Focused on therapy and medical diagnosis

MH and disease management/ traditional medicine

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19
Q

Developing goal/outcome

A

SMART

Specific e
Measurable 
Attainable
Realistic 
Timely
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20
Q

Mental health

A

Sense of well- being

Ability to adapt to stress

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21
Q

Mental illness

A

Diagnosis

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22
Q

MSE

A

Mental status exam

Physical behavior, nonverbal comm, appearance (weight, BMI), speech, mood and affect, thought content, perception, cognitive ability, insight, judgement

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23
Q

Empathetic

A

Understanding feelings

“I understand your feelings…”

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24
Q

Sympathetic response

A

Feel the feelings

Your experience can relate

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25
Beneficence
Act or promoting good to others
26
Negligence
Malpractice Breeching act resulting in injury
27
Autonomy
Nurse being able to make own decisions
28
Justice
Distributing resources equally
29
Fidelity
Maintaining loyalty to patient No wrong
30
Veracity
Truthful in documentation, report, speaking truthfully
31
Patients rights
Informed consent Right to refuse (trtmt, med)
32
Involuntary admission
Right to hold Can refuse meds and have informed consent Can’t leave
33
Duty to warn: inpatient
Warn treatment team and staff members
34
Duty to warn: advanced practice nurse
Let victim know they were threatened
35
HIPAA
Health insurance portability and accountability act Confidentiality
36
Psychopharmacology
Tools for chemical imbalances NOT a “cure all” Used to function properly
37
Social relationship
Friendship Socialization Environment Accomplishment Mutual needs met Little emphasis on evaluation of interaction
38
Therapeutic relationship
Nurse maximizes their comm skills Understand human behavior Personal strengths Enhance patient growth Address concerns Respect patient as partner in decision making Language straight forward
39
Clinical competence
principles of knowledge for specific situation Awareness and incorporation of latest knowledge (EBP)
40
Delaying judgment
Avoid transferring own values and beliefs to others
41
Supervision
More experienced clinician or team member overlooks Essential to develop competence
42
Assessment of children
Gather data from variety of sources Best source of determining feelings is by parents Can describe behavior, performance, conduct of child INTERVIEW AND OBSERVATION position yourself at child’s level
43
Assessment of adolescents
Substance abuse and sexual abuse are confidential Threats of suicide or homicide, use of illegal drugs must be shared with professionals and parents HEADSSS interview
44
Assessment of older adult
Sensory condition Motor condition Medical condition Possible cause of increased anxiety, stress, physical discomfort Assess mental and emotional needs
45
HEADSSS
``` Home environment Education and employment Activities Drugs, alcohol, tobacco use Sexuality Suicide risk Savagery (violence or abuse) ```
46
Dopamine and illness
Decrease Parkinson’s, depression Increase schizo and mania
47
Norepinephrine and illness
Decrease depression Increase anxiety
48
Serotonin and illness
Decrease depression Increase anxiety
49
Histamine and illness
High levels associated with anxiety and depression
50
Gamma-amino butyric acid (GABA) and illness
Decrease anxiety, schizo, mania, Huntington chorea Increase reduction of anxiety, schizo, mania
51
Glutamate and illness
Excitatory signals in CNS Cognition Memory Learning
52
Pharmacokinetic
Effects of drugs on plasma concentrations of each other
53
Pharmacodynamic
Combined effects of drugs
54
Acetylcholine and illness
Increase depression Decrease Alzheimer’s, Huntington chorea, Parkinson’s
55
Supstance P
Regulation of mood and anxiety Pain management
56
Somatostatin and illness
Decrease Alzheimer’s Increase Huntington
57
Neurotensin and illness
Decrease levels of spinal fluid of patients with schizo
58
Monoamines
Organic Neurotransmitters divide into subgroups Catecholamines Indolamines
59
Catecholamines
Norepinephrine Epinephrine Dopamine
60
Indolamines
Serotonin
61
Monoamine oxidase (MAO)
Enzyme destroys monoamines
62
Monoamine oxidase inhibitors (MOAIs)
drugs that increase concentrations of monoamines Inhibit MAO
63
EMSAM (delegitimization transdermal system)
Delivers MAOIs through skin
64
Hypertensive crisis
``` Patient ingests tyramine found in OTC meds Beer Wine Aged cheese Organ meats Avacados ``` RESTRICTION should be maintained 2 weeks after stopping MAOIs
65
Antidepressant drugs
``` TCAs SSRIs SNRIs (serotonin noripenephrine) SNDIs (disinhibitors) NDRIs SARIs NRIs ```
66
TCAs drugs
Amitriptyline (elavil) Nortriptyline (pamelor)
67
TCAs use and SE
Increase norepinephrine SE: anticholinergic, dizziness, hypotension Taper slowly 6-8 weeks full effect
68
SSRIs drugs
Fluoxetine (Prozac) Sertaline (Zoloft) Paroxetine (paxil)
69
SSRIs use and SE
Increase serotonin SE: some anticholingeric, nausea, vomiting, serotonin syndrome Watch for suicidal tendencies
70
SNRIs use and SE
Increase serotonin and norepinephrine SE: few anticholinergic
71
SNDIs use and SE
Increase serotonin and norepinephrine Added to SSRIs to increase effectiveness (augment)
72
NDRIs
Norepinephrine dopamine reuptake inhibitors Bupropion (Wellbutrin)
73
NDRIs use and SE
Don’t act on serotonin system Inhibit nicotin acetylcholine receptors to reduce additive effects
74
SARIs
Serotonin antagonist reuptake inhibitors Trazadone (Desyrel)
75
SARIs
Not first choice as antidepressant Good for insomnia SE: priapism (prolonged erection)
76
NRIs
Selective norepinephrine reuptake inhibitors Atomoxetine (strattera)
77
NRIs use
ADHD when stimulants not tolerated No significant antidepressant effects
78
Anxiety drugs/ anxiolytics | BENZO
Diazepam (Valium) Clonazepam(klonopin) Alprazolam (Xanax) Lorazepam (Ativan) and Xanax reduce anxiety without insomnia Insomnia: flurazepam (dalmane) and triazolam (halcion)
79
Anti anxiety and hypnotic | NONBENZO
Busiprone (buspar) X-hypnotics Melatonin receptor agonist
80
Busiporne (buspar)
Less potential for dependence
81
Z-hypnotics
Short acting sedatives and hypnotic sleep agents
82
Melatonin receptor agonist
Ramelteon (rozerem) Acts similar to melatonin Regulate circadian rhythms
83
Mood stabilizers meds
Lithium (eskalith, lithobid) Valproate (depakote/ depakene) Carbamazepine (Tegretol) Lamotrigine (lamictal)
84
Mania
Bipolar disorder
85
Lithium SE
Toxicity can include tremor, ataxia, confusion, convulsions, nausea, vomiting
86
Valproate (depakote/depakene)
Managed impulsive aggression
87
Carbamazepine (Tegretol)
Acute mania
88
Lamotrogine (lamictal)
Maintenance therapy Stevens-Johnson’s
89
Off label mood stabilizers
Oxcarbazepine (trileptal) Gabapentin (neurontin) Topiramate (topamax)
90
Antipsychotics first generation (FGA)
Chloropromazine (thorazine) Fluphenazine (prolixin) Haloperidol (haldol)
91
Extrapyramidal side effects
Caused from dopamine blocking ``` Dystonia (muscle stiffness) Akathisia (restlessness) Tarditive dyskinesia (TD) -involuntary mvmts (tremors) Drug induced Parkinsonism Neuroleptic malignant syndrome (NMS) Ortho hypo ```
92
Blocking muscarinic cholinergic receptors?
Blurred vision
93
Second generation antipsychotics
Atypical Fewer extrapyramidal side effects Target neg and positive symptoms of schizo SE: increase weight, BG, triglyceride, insulin resistance
94
Psychiatrist
Medical physician
95
Role of psychiatric nurse on inpatient unit
Maintain therapeutic milieu
96
Psychoanalytic theory
Freud Unconscious thoughts and psychosexual development
97
Erickson’s stages: adolescence
12-20 Identity vs role confusion Temporary identity diffusion Integrate all tasks previously
98
Erickson’s stages: young adult
20-30 Intimacy vs isolation Fear of losing identity or relationship Forming intense long relationships
99
Erickson’s stages: middle adult
30-65 Generatively vs self absorption Achieving goals
100
Goals of therapeutic relationships
1. Facilitate comm of distressing thoughts and feelings 2. Assist patients with problem solving for ADLs 3. Help patients examine self defeating behaviors and test alternatives 4. Promote self care and independence
101
Restraining orders by age
4 hrs (18+) 2 hrs (9-17) 1 hr (under 9 years) Assess every 15-30 min and DOC!
102
Serotonin syndrome
``` Fever Agitation Increased reflexes Tremor Sweating Dilated pupils Diarrhea Siezures ```

Mental health (7 decks)

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