exam 3 Flashcards
(85 cards)
1
Q
OCD and stress
A
it can wax and wane depending on stress levels
2
Q
do people with OCD know their behavior is unreasonable
A
yes
3
Q
first line meds for ocd
A
SSRI
4
Q
what is response prevention theory
A
delay or avoid performing ritual
5
Q
initial ntervention for compulsions
A
dont stop them, but instead have person identify stressors and involve them in ADLs
6
Q
schizo is a _______
A
brain illness/brain syndrome
7
Q
when is schizo dx
A
when someone shows positive ss for 6 months
8
Q
preservation
A
adhering to a single topic or word
9
Q
alogia
A
speaking little
10
Q
anhedonia
A
no joy or pleasure
11
Q
catatonia
A
immobility
12
Q
clang associations
A
ideas relating based on sound and rhyming - jill kill
13
Q
neologisms
A
inventing words
14
Q
verbigeration
A
repetition of words
15
Q
stilted language
A
flowery language
16
Q
echollia
A
copying nurse or others words or actions
17
Q
schizoaffective disorder
A
psychotic and mood disorder ss
18
Q
schizophreniform disorder
A
acute reactive psychosis less than 6 months
19
Q
delusional disorder
A
non bizzare delusions
lasts 1 day to 1 month
20
Q
what to do if someone is hearing voices
A
are the voices making you do anything
21
Q
how to deal with innnapropriate client
A
redirect
22
Q
loss of ego boundaries
A
loss of sense where someone body mind and influence is
23
Q
3 social implications of schizo
A
isolation, no trust, low self esteem
24
Q
what to do if someone is delusional
A
clarify but do not agree
25
interventions for delusions
keep stimulation low and say things like" i find that hard to believe" or "I have seen no evidence of that" - presenting reality and voicing doubt
26
recognize signs of relapse
27
how to dx MDD
2 or more weeks of sad mood and 4 other ss
28
dysthmic disorder
MDD but milder
29
BP 1 vs 2
1: one or more manic accompanied with depression
2: hypomania
30
cyclothymic disorder
mood swings but milder
31
how to treat SAD
light therapy
32
why do people do nonsuicidal self injury
avert suicidal thoughts
33
4 nursing interventions for ECT
NPO, no polish, void before, start IV
34
vegetative signs of depression
lethargy, low energy, apathy
35
lability in mania vs dep
mania too fast, dep too slow
36
3 goals of psychotherapy
reverse neg thoughts, improve self image, gain competence and self mastery
37
education about diet for pt taking lithium
adequate Na and fluids
38
suicide precautions
C - current plan -are you having thoughts of suicide?
P- pain - do you have unbearable pain?
R- resource - do you feel you have any resourses?
39
examples of 1,2,3 gen antipsychotics
1:zines and haloperidol
2: pines
3: prazole
40
acute dystonic -
muscle spasms in deiscrete muscle groups
41
pseudoparkinsonism
muscle stiffness, cog wheeling, drooling, slow muscle start
42
akasthisia and tx
restlessness - propanolol Beta blocker
43
when to use AIMS
tardive dyskinesia (ss like involuntary movemens)
44
neuroleptic malignant syndrome
board like rigidity
45
3 meds to treat EPS
benadryl, benzotropine, trihexphenidryl (Antihistamines and anticholinergics)
46
MOA of antipsychs
blocks dopamine
47
3 TCA meds
imipramine
amitriptyline
clomipramine
48
moa of tca
block neph reuptake
49
2 ed for TCA
reposiiton slowly and works in 4-6 weeks
50
7 SE of TCA
ortho hypo, urinary retention, sedation, anticholinergic, wt gain, sweet craving, sex dysfunction, tachycardia
51
which drugs can be lethal in overdose
MAOis and TCA
52
SSRI clinical course
3-4 days insomnia decreases
5-7 apeitire returns
4-7 energy returns
7-10 mood concentration improve
53
4 interventions for SSRI
surgar free bevs or candy
fluids
monitor for hyponatremia
contact HCP if sexual difficulties
54
3 MAOi meds
phenelzine
isocarboxacid
tranylcypromine
55
what can happen if someone eats tyramine with MAOI
HTN crisis
56
serotonin syndrome occurs when
no wash out period between MAOI and SSRI
57
4 atypical antidepressanta
venlafaxine SNRI
duloxetine SNRI
buproprion NDRI
tranzodone
58
2 causes of lithium toxicity
renal impairemnt and low Na due to diuretics, dehydration or diarrhea
59
intervention and education for pt on lithium
monitor blood levels
60
3 anticonvulsants
lithium, valpropic acid, lamotrigine
61
AE of lamotrigine
stevens johnsons so report rash
62
A client is hospitalized on a psychiatric unit secondary to a suicide attempt. The client has been diagnosed with depression and is consistently depressed. When assessing the client, which finding would alert the nurse that the client's suicidal risk has increased?
The client’s behavior makes a marked switch from irritability to calmness
63
A client with bipolar disorder is experiencing a major depressive episode. Which would the nurse expect to assess? Select all that apply.
a.
Flight of ideas
b.
Obsessive rumination
c.
Hypersomnia
d.
Excessive shopping sprees
e.
Difficulty concentrating
bce
64
A client with bipolar disorder is experiencing acute mania. The client is unable to sit still, moving from place to place. Medication therapy has been prescribed but not yet initiated. Which would the nurse include in the plan of care to meet the client's physical needs?
high energy snacks
65
A client has just been diagnosed with a major depressive disorder following recent problems with the client's mood, work performance, and sleep quality. When planning this client's care, the nurse should anticipate what interventions? Select all that apply.
a.
Administration of an monoamine oxidase inhibitor (MAOI)
b.
Administration of a selective serotonin reuptake inhibitor (SSRI)
c.
Repetitive transcranial magnetic stimulation (rTMS)
d.
Cognitive therapy
e.
Phototherapy
bd
66
A client receiving lithium therapy has a plasma blood concentration of 2.2 mEq/L. Which would the nurse expect to assess?
slurred speech
67
A 42-year-old client with major depression is in an inpatient psychiatric hospital. The client has been taking phenelzine for depression. The therapist writes an order to discontinue the phenelzine and begin fluoxetine. Which action by the nurse is indicated?
call hcp for washout period
68
A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine. After educating the client on this medication, the nurse determines that the education was successful when the client states what?
ill notify if i get a rash
69
An inappropriately dressed client has not slept for 3 days and has been making excessive long-distance phone calls. When the client can be heard singing loudly in the examining room, the nurse makes initial plans to focus on what?
food fluid and rest
70
The nurse is preparing to discharge a client from the inpatient facility where the client was treated following an unsuccessful suicide attempt. The priority assessment for the nurse to make is to assess whether or not the client can do what?
Identify a person to whom he or she can turn to for help after discharge
71
A client is admitted to the unit in an acute manic episode. The client has had three major depressive episodes in the past 10 years and two other hospitalizations for mania. Which disorders would reflect the client's symptom profile?
BP 1
72
A client who has a recent diagnosis of bipolar I disorder is scheduled to begin therapy with lithium. Which instruction should the nurse provide to this client?
“Avoid exercise at the hottest times of the day.”
73
education for ECT
“Some people experience mild confusion after ECT. Generally it clears in a few days, though it may take longer.”
74
A nurse is providing psycho-education to a client who has been admitted to the inpatient mental health unit for a manic episode. In order to ensure the teaching is effective, the nurse must first determine which regarding the client?
Ability to concentrate and process the information
75
A client with bipolar disorder has been taking lithium, and today the client's serum lithium level is 1.8 mEq/L. What effects would the nurse expect to see?
nausea, diarrhea, confusion
76
The nurse knows that the most dangerous time period following a previous suicide attempt is what?
first 3 mo
77
A client's depression is being treated in the community with phenelzine. The client has presented to the clinic stating, "I had a few beers and I'm feeling absolutely miserable." What is the nurse's best action?
BP
78
A client who has just been prescribed lithium for bipolar disorder is being given education from the nurse about this medication. Which is important for the nurse to include in teaching?
the higher the Na the lower the lithium
79
A nurse is assessing a client and suspects obsessive-compulsive disorder .The nurse understands that to rule a behavior as obsessive-compulsive disorder (OCD), the obsession or compulsion must meet which criteria?
They take up more than 1 hour/day and cause stress to the client.
80
The nurse is teaching relaxation techniques to a client with obsessive-compulsive disorder (OCD). When does the nurse teach relaxation techniques to the client?
when low anxiety
81
The nurse is evaluating the plan of care for a client with schizophrenia. Which observation best suggests that the plan has been effective?
The client has resumed employment and attends social functions.
82
When teaching a class of nursing students about brief psychotic disorder, the instructor explains that the episode lasts for at least 1 day but less than which time frame?
1 month
83
A client with schizophrenia has returned to the clinic because of an increase in symptoms. The client reports the client stopped taking the medication because the client did not like the side effects. The nurse educates the client about managing uncomfortable side effects. Which is included in the teaching plan? Select all that apply.
a.
Use stool softeners as needed
b.
Decrease the amount of daily fluid intake
c.
Spend at least 30 minutes outside in the sun daily
d.
Suck on hard sugar-free candy as desired
e.
Maintain a balanced calorie-controlled diet
ade
84
A client with schizophrenia is prescribed clozapine. The nurse would monitor the client closely for specific signs of which of the following?
infection
85
education for clozapine
WBC count every week for 6 mo
