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Nur 422 > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

common traits of people with schizophrenia (5)

A

-asocial
-isolative
-psychotic
-impoverished
-poor relationships

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2
Q

schizophrenia: symptoms (5)

A

-thought disorder
-distortion of reality
-adding thing, taking things away
-poor health outcomes
-positive and negative sx

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3
Q

positive symptoms:

A

add something to a person’s perception of reality

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4
Q

2 types of positive sx

A

-hallucinations
-delusions

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5
Q

types of hallucinations (5)

A

-audiovisual
-gustatory
-olfactory
-tactile
-command

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6
Q

types of delusions (3)

A

-paranoid
-religious
-persecutory

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7
Q

negative sx:

A

subtract something from a person’s perception of reality

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8
Q

ex of negative sx (6)

A

-alogia (poverty of speech)
-anhedonia (lack of pleasure)
-avolition (loss of motivation)
-asociality (social isolation, lack of socialization)
-attention deficit
-flat, blunted affect

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9
Q

assessing pts. w/schizophrenia

A

-top priority: safety
-med compliance
-side effects
-thought content
-+ and - sx
-recurrent pschotic breaks/degeneration of mental status

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10
Q

safety and schizophrenia concerns (2)

A

-command a/v hallucinations
-suicidal ideation

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11
Q

schizophrenia nursing actions (6)

A

-assess for thought content and command
-rapport and trust building
-validation of feelings
-med compliance and encouragement
-advocacy
-disposition planning

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12
Q

DO NOT DO (schizophrenia) (5)

A

-feed in to delusions, hallucinations
-challenge thoughts and feelings
-forcing language
-discipline negative behaviors
-force socialization

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13
Q

observation (schizophrenia) (8)

A

-mood
-affect
-actions
-pacing
-interactions
-self-dialoguing
-responding to internal stimuli
-isolation

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14
Q

questions for verbal assessment (schizophrenia) (4)

A

-“Are you seeing anything that isn’t really there?”
-“Are you hearing voices telling you to do anything?”
-“Are you having any thoughts to harm yourself or others?”
-“Are you feeling safe?”

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15
Q

how to ensure safety (schizophrenia) (6)

A

-frequent observation
-be reasonable
-1:1 constant observation
-offer support
-encourage med compliance
-build rapport and trust

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16
Q

client insight (schizophrenia) (4)

A

-variable
-awareness of dx
-spectrum of awareness
-therapeutic communication techniques adapt to pt’s insight

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17
Q

therapeutic environment

A

-welcoming
-group therapy
-normal energy level
-risk reduction (violence, agitation, outbursts)

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18
Q

Limits/boundaries of therapeutic mileu (6)

A

-established rules
-adherence to policies and procedures
-redirection if needed
-identifying unsafe behaviors for the client and others
-reducing risk
-impulse control

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19
Q

evaluating outcomes (schizophrenia) (6)

A

-improvement in thought process and content
-med adherence
-elimination or reduction of safety concerns
-improvement in both positive and negative sx
-appropriate dispo planning
-prevention of readmission

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20
Q

schizophrenia quick tx guide (7)

A
  1. always evaluate for safety
  2. assess both + and - sx
  3. utilize therapeutic communication techniques
  4. maintain therapeutic environment
  5. establish limits and boundaries as needed
  6. ensure medication plan adherence
  7. always consider client rights
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21
Q

aspects of healthy eating

A

-variety of foods
-response to hunger
-stop when full
-no guilt or anxiety

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22
Q

eating disorders (5)

A

-disruption of healthy eating
-binge eating
-not eating enough
-only eating certain foods
-experiencing guilt or anxiety related to eating

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23
Q

types of abuse (6)

A

-physical
-emotional
-sexual
-economic
-neglect
-abandonment

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24
Q

anger is (3)

A

-emotional response
-can be appropriate or inappropriate
-poor control=negative effects

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25
aggression is: (3)
-outwardly violent behavior -intent to cause harm -physical, emotional, etc.
26
risk factors for aggression (7)
-history of violence -history of mental health disorder including substance abuse -being a victim of a crime -witnessing abuse or violence -poor self-esteem and inadequate coping skills -no presence of positive role models throughout childhood -adverse childhood experiences
27
warning signs for aggression (7)
-declining to eat or drink -attempting to leave area before discharge -verbally antagonistic toward staff or visitors -harming self -staring -pacing -destroying inanimate objects
28
perpetrator behavior (3)
-excuses, raionalizations -noncommunicative -sexual aggression/ poor coping skills
29
victim behavior (4)
-blames self -no resolution to behaviors -feels emotionally / financially trapped -poor sexual boundaries
30
childhood traumatic events have _______ term effects leading to ___________ adaptation
long; poor
31
childhood trauma can lead to:
-aggressive behavior -attention-seeking behavior -bullying
32
teenage aggression (3)
-start seeing intimate partner violence -issues with self-control -overt signs of aggressions
33
elder abuse
-dependence for basic needs -risk for neglect, physical, emotional, financial abuse -isolation
34
nursing role (4)
-be aware -document thoroughly -know the law -know your responsibility
35
stages of grief
1. denial 2. anger 3. depression 4. bargaining 5. acceptance
36
TEAR Model of Grief
To accept reality of loss Experience pain of grief Adjust to change Reinvest into new reality
37
Prolonged Grief Disorder (4)
-Sx of grief become prolonged, pervasive, and persistent -preoccupied w/ deceased -experiencing separation distress -ability to function in daily life is disrupted
38
grief sx (9)
-sleep disruption -headaches -appetitie changes -sadness/fear -anxiety -depression -confusion -issues with concentration -anger
39
anticipatory grief
-occurs concurrently w/ loss process -not always death related
40
childhood loss (babies, young children, adolescents)
-babies: more irritation, clinginess -young children: regression -adolescents: withdrawal; adult like responses
41
Stress def.
mental, emotional, or physical response and adaptation to real or perceived changes and challenges or condition in which the body responds to changes affecting its normally balanced state
42
3 types of causes of stress
physical/physiological emotional psychological
43
physical/physiological causes of stress (2)
-illness -injury
44
emotional causes of stress (3)
-loss of a loved one -school/professional setbacks -divorce
45
psychological causes of stress
-trauma (PTSD?) -altered mental status -psychological disease process
46
types of stress
-acute -episodic acutes stress -chronic stress
47
acute stress defined/described (3)
-most common and frequent -usually brief and can be positive or negative -causes an immediate reaction (fight or flight)
48
episodic acute stress defined/described (3)
-acute stress experienced episodically, repeatedly -occurs when someone experiences frequent bouts of acute stress -over time can negatively impact relationships, work, overall health
49
chronic stress defined
-disabling condition -constant prolonged stress -requires careful tx
50
effects of chronic stress (4)
-declined mental health -PTSD (or acute stress disorder in acute episodic stress) -poor physical health -declining relationship quality
51
acute stress disorder def.
intense, unpleasant, and dysfunctional reaction beginning shortly after an overwhelming traumatic event and lasting less than one month
52
PTSD defined
intense, unpleasant and dysfunctional reaction beginning shortly after a traumatic event and lasting longer than one month
53
physical stressors:
-hot -cold -wet -noisy -messy
54
physiological stressors
injury illness pain fatigue
55
psychological stressors
anxiety fear behavioral health d/o
56
Transactional Theory of Stress and Coping
-process by which a person interprets a stressor as a threat or a challenge -influences their stress response -2 stages: primary appraisal and secondary appraisal
57
Primary appraisal
event evaluated with respect to what is at stake
58
secondary appraisal
consideration of possible coping strategies or resources available to help
59
General Adaptation Syndrome (GAS) stages
Stage 1: alarm Stage 2: resistance Stage 3: exhaustion
60
GAS occurs whether ________ or _________
eustress distress
61
Goal of GAS
-body's return to homeostasis to maintain optimal fx
62
GAS alarm stage features stimulation of _________nervous system
sympathetic
63
GAS alarm stage causes adrenal medulla to release 2 hormones:
-epinephrine -norepinephrine
64
physiological response to GAS alarm stage (5)
dilation of pupils and increased: -HR -BP -blood glucose -mental activity, alertness
65
GAS resistance stage physiological events
stabilization of -hormones -BP -HR
66
GAS exhaustion stage
-body not able to maintain response to stressor -inability to adapt -ends in death or recovery
67
Local Adaptation Syndrome (LAS)
-includes inflammatory response and repair processes at local site of tissue injury
68
Local Inflammatory Response (LAS): 2 local adaptation responses
-reflex pain responses: response of CNS to pain -inflammatory response: local response to injury or infection
69
cardiovascular effects of stress on health
-HTN -Coronary artery disease
70
respiratory effects of stress
asthma
71
GI effects of stress (4)
-Esophageal reflux -constipation -diarrhea -ulcerative colitis
72
Autoimmune disorders associated with stress (4)
-Graves disease (hyperthyroidism) -rheumatoid arthritis -psoriasis -systemic lupus erythematous
73
stress assessment: objective findings: appearance
-observed irritability, anxiety, tension -sleep, appetite, weight -eye contact, verbal/motor/cognitive status
74
stress assessment: objective findings: physical assessment (2)
-V/S -clinical manifestations
75
stress assessment: objective findings: lab data (1)
stress-induced hyperglycemia
76
Stress Assessment: subjective findings
questions focus on: -present stressors (life changes?) -Coping skills (how dealt with stress in past?) -Sx of stressors -support network (who do you talk to/get help from?)
77
Nurse role for clients experiencing stress (3)
-conduct comprehensive assessment -establish rapport and trusting relationsip -be aware of S/S of stress, anxiety, educate pt.
78
Common stressors in elderly (3)
-loss of independence (declines in vision, cognition, and hearing -relocation -loss of partner
79
caregiver burden def.
-caring for a family member for a long period of time -caregivers often need assistance to adapt to difficult situation
80
caregiver burden sx (6)
-chronic fatigue -sleep problems -increase in stress related illness -ineffective coping/defense mechanisms -difficulty with job, relationship -poor self-esteem
81
coping def:
strategies an individual uses to deal w/ stressors; highly influenced by psychological, sociological, and cultural factors
82
examples of healthy coping strategies
-eating nutritious foods -daily exercise -building personal resistance -implementing self-care activities
83
types of defense mechanisms (6)
-denial -rationalization -projection -suppression -regression -compartmentalization
84
anxiety def:
stress response that causes apprehension or uncertainty; manifests as nervousness or feeling of dread
85
chronically suppressed anger can lead to: (3)
-HTN -GI upset -Depression
86
psychological stress response
-depression from a loss, professional failure, diminished physical appearance
87
nursing priority for stress:
safety
88
suicide precautions: (3)
- 1:1 constant observation - safety assessment - remove hazardous objects from vicinity
89
Coping skills: time management
-prioritize tasks -set goals -decrease distractions -avoid procrastination -set boundaries -maintain self-discipline
90
Coping skills: anger management
-express feelings in a calm and nonconfrontational manner -exercising -identifying potential solutions -take a time-out -forgiving -diffusing the situation with humor -"owning" the negative feelings -deep-breathing exercises
91
Coping Skills: support groups
-reduce stress-related to specific life circumstances -meeting with others who share a common disease or loss -support from knowing that the person is not alone -online support groups
92

Nur 422 (5 decks)

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