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Mental Health > Exam #3 > Flashcards

Exam #3 Flashcards

1
Q

what are positive symptoms of schizophrenia?

A

delusions, hallucinations, disorganized speech, grossly disorganized(hyperactive)

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2
Q

does schizophrenia have periods of remission?

A

yes

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3
Q

what is the symptom criteria for schizophrenia?

A

must have delusions, hallucinations, disorganized speech, with catatonic, disorganized, and negative symptoms for at least one month

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4
Q

what are the stages of schizophrenia?

A

premorbid, prodromal, active psychotic, and residual phase

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5
Q

what happens during the premorbid phase?

A

symptoms like shy, withdrawn, antisocial, poor school performance

hard to diagnose in this stage

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6
Q

what happens during the prodromal stage?

A

psychotic symptoms are frank, functional impairment, deterioration in role, social withdraw, sleep disturbance, anxiety, irritability, depression, fatigue, and poor concentration

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7
Q

what happens during the active psychotic phase?

A

positive and negative symptoms will be present…..delusions, hallucinations, disorganized speech, catatonic behavior….in this stage the patient should be admitted into the psychiatric unit

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8
Q

what are predisposing factors for schizophrenia?

A

genetics, biochem, viral infections, anatomical abnormalities in the brain, psychological factors, environmental influences, and theoretical integration

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9
Q

how can viral infections cause schizophrenia?

A

pre natal exposure to the flu virus

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10
Q

how can biochem cause schizophrenia?

A

too much dopamine activity

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11
Q

what anatomical abnormalities can cause schizophrenia?

A

reduction in the gray matter and size of hippocampus

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12
Q

what psychological factors can cause schizophrenia?

A

childhood trauma

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13
Q

what environmental factors can cause schizophrenia?

A

sociocultural factors, stressful life events, cannabis use in patients who are predisposed

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14
Q

what are the schizophrenic delusional disorders?

A

grandiose, jealous, persecutory, somatic, and mixed

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15
Q

what does the delusional disorder grandiose mean?

A

irrational ideas regarding worth, talent, knowledge, and power

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16
Q

what does the delusional disorder jealous mean?

A

irrational idea that their partner is unfaithful

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17
Q

what does the delusional disorder persecutory mean?

A

that they are being mistreated or spied on

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18
Q

what does the delusional disorder somatic mean?

A

irrational belief that he or she has some physical defect, disorder, or disease

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19
Q

what does the delusional disorder mixed mean?

A

it follows no single theme

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20
Q

what is brief psychotic disorder?

A

sudden onset of psychotic symptoms that last less than one month

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21
Q

what can cause brief psychotic disorder?

A

sudden psychosocial stressor or traumatic even

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22
Q

what is the treatment for brief psychotic disorder?

A

antipsychotics

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23
Q

what is substance and medication induced psychotic behavior?

A

prominent hallucination and delusions that can attributed to the effects of a drug

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24
Q

what do you to treat substance and medication induced psychotic behavior?

A

drug screen, give them fluids, and sedate

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25
Q

what is psychotic disorder due to another medical condition?

A

prominent hallucination and delusions that can attributed to a medical condition

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26
Q

what is the most common population to get medication induced psychotic disorder?

A

elderly

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27
Q

what can cause medication induced psychotic disorder?

A

labs being off or UTI

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28
Q

what is schizophreniform disorder?

A

same symptoms as schizophrenia and lasts between 1 and 6 montsh

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29
Q

what is schizoaffective disorder?

A

schizophrenia disorder accompanied with a mood disorder like mania, depression, bipolar

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30
Q

what are positive symptoms?

A

delusions, hallucinations, disorganized thought/speech, and bizarre behaviors

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31
Q

do atypicals treat positive or negative symptoms?

A

positive symptoms and negative

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32
Q

do typicals treat positive or negative symptoms?

A

negative symptoms

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33
Q

what are negative symptoms?

A

flat affect, reduced social interaction, anhedonia, avolition, alogia, catatonia

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34
Q

what are some examples of alterations in thought?

A

ideas of thought, persecution, grandeur, somatic delusions, jealousy, being controlled, thought broadcasting, thought withdrawal, religiosity, and magical thinking

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35
Q

what does alterations in ideas of thought mean?

A

misconstrues trivial events and attaches personal significance to them

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36
Q

what does alterations in persecution mean?

A

feels singled out for harm by others

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37
Q

what does alterations in grandiosity mean?

A

thinks they are powerful and important

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38
Q

what does alterations in somatic delusions mean?

A

thinks that their body is changing in an abnormal way…..growing a third arm

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39
Q

what does alterations in jealousy mean?

A

thinks that their partner is sexually involved with someone

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40
Q

what does alterations in being controlled mean?

A

that their thoughts are being controlled by someone else

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41
Q

what does thought broadcasting mean?

A

thinks that their ideas can be heard by others

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42
Q

what does thought withdrawal mean?

A

thinks their thoughts have been removed from their brain

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43
Q

what does religiosity mean?

A

obsessed with religious beliefs

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44
Q

what does magical thinking mean?

A

thinks that their actions can control a situation…wearing a hat makes them invisible

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45
Q

what is associative looseness?

A

inability to concentrate on a single though

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46
Q

what is noelogisms?

A

make up words

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47
Q

what is echolalia?

A

the client repeats specific words that they have heard

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48
Q

what is clang association?

A

meaningless rhyming of words

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49
Q

what is tangentiality?

A

inability to get to the point of communication due to the introduction of many new topics

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50
Q

what is word salad?

A

words jumbled together with little meaning or significance to the listener

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51
Q

what are auditory hallucinations?

A

hallucinations you can hear

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52
Q

what are visual hallucinations?

A

hallucinations that you can see

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53
Q

what are tactile hallucinations?

A

hallucinations that you can feel

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54
Q

what are gustatory hallucinations?

A

hallucinations that you can tast

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55
Q

what are olfactory hallucinations?

A

hallucinations that you can smell

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56
Q

illusions???

A
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57
Q

what is echopraxia?

A

copying what they observe

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58
Q

what is depersonalization?

A

feelings of unreality….lost identity

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59
Q

what is derealization?

A

perception that the environment has changed

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60
Q

what is identification and limitation?

A

taking on the form of behavior that they observed someone doing….copy cat

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61
Q

what does apathy mean?

A

lack of interest in their environment

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61
Q

what alteration in behavior do schizophrenics experience?

A

flat affect, apathy, agitation, pacing, robot like, stupor, catatonia, impaired impulse control, avolition, anhedonia, and deteriorated apperance

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62
Q

what does stupor mean?

A

motionless coma-like state

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63
Q

what does catatonia mean?

A

inability to move normal

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64
Q

what does avolition mean?

A

inability to initiate a plan to reach a goal

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65
Q

what does anhedonia mean?

A

inability to experience pleasure

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66
Q

how are some things schizophrenics do socially?

A

isolate, withdraw, not trust

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67
Q

what do you do when your patient is experiencing hallucinations/dellusions?

A

be accepting but orient back to reality

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68
Q

in regard to violence, what interventions can do for schizophrenics?

A

low stimulus, removing dangerous objects, intervene when signs appear

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69
Q

in general, what are some goals for schizophrenic patients?`

A

decrease anxiety, build trust, define reality, interact with others, safety, hygiene, and adaptive family coping

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70
Q

what are SMART goals

A

Specific, measurable, attainable, realistic, and have a time``

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71
Q

what type of therapies might schizophrenics attend?

A

individual, group and behavioral

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72
Q

what training might schizophrenics be apart of to help them socially?

A

social skills training, family therapy, and assertive community treatment

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73
Q

what is social skills training?

A

use of role play to help the patient understand eye contact, personal space, voice notation, posture etc

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74
Q

what is family therapy for schizophrenics?

A

helps family members cope and understand the illenss

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75
Q

what is assertive community treatment for schizophrenics?

A

care team comes to the patient home and does treatment there

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76
Q

what medications are used to treat schizophrenia?

A

antipsychotics

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77
Q

what are the two kinds of antipsychotics?

A

typical and atypical

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78
Q

what type of symptoms do typicals treat?

A

positive symptoms

79
Q

do typicals or atypicals have more eps symptoms?

A

typicals

80
Q

do typicals or atypicals increase the risk of seizures?

A

typicals

81
Q

what type of symptoms do atypicals treat?

A

positive and negative

82
Q

do typical or atypicals make you gain weight?

A

atypicals due to the change in your metabolic rate

83
Q

do typicals or atypicals have a sedative effect?

A

atypicals

84
Q

what must you assess before starting your patient on antipsychotics?

A

NSAIDs, dietary supplement, drug use, smoking, drinking, prescription med

85
Q

what are the symptoms of antipsychotics? VERIFY

A

N/V, diarrhea, rash, photosensitivity, orthostatic hypotension, hormone changes, ECG changes, anticholinergic, seizures, hypersalivation, hyperglycemia,

86
Q

what is agranulocytosis?

A

failure of bone marrow to produce adequate white blood cells

87
Q

what medication can cause agranulocytosis?

A

clozapine

88
Q

what is the worst outcome of agranulocytosis?

A

death

89
Q

what should you do when you notice that your patient has agranulocytosis?

A

stop the medication and treat the symptoms

90
Q

what are the symptoms of agranulocytosis?

A

fever, malaise, sore throat

91
Q

what is done for patients with agranulocytosis other than stopping the medication?

A

lab work to monitor wbc

92
Q

what is the dystonic reaction?

A

muscle spasms particularly in the neck, eyes, and tongue

93
Q

what does the patient experience with the dystonic reaction?

A

pain, fear, dysphagia, and compromised airway

94
Q

what should be given to a patient with a dystonic reaction?

A

benztropine and diphenhydramine

95
Q

what is akathisia?

A

inability to sit still

96
Q

what will a patient with akathisia look like?

A

restless, pacing, fidgeting, leg shaking etc

97
Q

when does akathasia typically present?

A

when antipsychotics are started or increased

98
Q

what should be administered when the patient has akathisia?

A

benztropine and diphenhydramine

99
Q

what is pseudoparkinsonism?

A

shuffling gait, muscle stiffness, mask expression, drooling

100
Q

can pseudoparkinsonism be fixed?

A

yes

101
Q

what should be administered for patients with pseudoparkionism?

A

benztropine and diphenahydramine

102
Q

what is tardive dyskinesia?

A

abnormal involuntary movements typically seen on the face

103
Q

what is the patient at risk for socially with tardive dyskinesia?

A

social isolation

104
Q

is tardive dyskinesia permanent?

A

yes

105
Q

what is used to screen for TD?

A

aims

106
Q

what should you do if your patient gets TD?

A

stop the medication

107
Q

what is neuroleptic malignant syndrome?

A

characterized be 104-105 temp

108
Q

what is the patient at risk for if they get malignant syndrome?

A

death

109
Q

what medication is administered for malignant syndrome?

A

dantrolene

110
Q

what are the antiparkinsonian agents?

A

xxxxxx

111
Q

what are the indications for antiparkinsonian agents?

A

treatment of all forms of parkinsonism and for the relief of drug-induced extrapyramidal reactions.

112
Q

what is the MOA of antiparkinsonian agents

A

restores the natural balance of ACH and dopamine

113
Q

what precautions should taken when give antiparkinsonian agents?

A

glaucoma, obstructions, BPH, myasthenia gravis

114
Q

what are the side effects of antiparkinsonian agents?

A

anticholinergic effects, Neausa, Gi upset, sedation, dizzines, exacerbation of psychosis, orthostatic hypotension, sedation,

115
Q

what should patients do when going outdoors if on antiparkinsonian agents?

A

wear sunscreen

116
Q

what should patients taking antiparkinsonian agents not consume?

A

alcohol or other medications without dr knowledge

117
Q

what might the patient need to do weekly when taking antiparkinsonian agents?

A

lab draw

118
Q

is anxiety normal?

A

yes it prepares you for threats and gives motivation

119
Q

what is GABA?

A

a neurotransmitter that is responsible for calming you down

120
Q

is GABA high or low in patients with GAD?

A

low

121
Q

what are risk factors for GAD?

A

genetics, environment, depression, substance abuse

122
Q

what are some symptoms of GAD?

A

restless, on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbance

123
Q

how many symptoms and for how long must a patient experience symptoms in order to be diagnosed with GAD?

A

3 symptoms for 6 months

124
Q

how can regular anxiety lead to panic attacks?

A

if your day to day anxiety is not controlled this leads to GAD and if GAD is uncontrolled this can lead to panic attack

125
Q

do panic attacks have a trigger or is it random?

A

specific triggering event

126
Q

does panic disorder have a trigger or is it random?

A

random

127
Q

what are the symptoms of a panic attack?

A

chest pain, feeling of choking, paresthesia, fear of dying, shaking, sweating, trembling, hyperventilation, depersonalization, derealization, increased HR, and sob

128
Q

what are the symptoms of anxiety?

A

irritability, disturbed sleep, muscle tension, increased HR, SOB,

129
Q

what is hyperventilation?

A

occurs when a patient has a panic attack…characterized by having too high of respirations

130
Q

what are the symptoms of hyperventilation?

A

lightheaded, tachycardia, SOB, numbness, tingling, syncope

131
Q

what is the patient blowing off too much of during hyperventilation?

A

too much CO2

132
Q

what should be done if a patient is hyperventilating?

A

have them breathe into a paper bag

133
Q

should you give a patient who is hyperventilating oxygen?

A

no

134
Q

does a patient who is hyperventilating go into respiratory acidosis or alkalosis?

A

respiratory alkalosis

135
Q

what might the patient receive if they have an active hyperventilation episode?

A

benzo

136
Q

what is panic disorder?

A

a recurrent panic attack that is unpredictable

136
Q

what medications are administered for panic disorder patients?

A

Benzo, SSRI, Betablockers, Anxiolytics, and SNRI

137
Q

what benzo is given to panic disorder patients?

A

alprazolam

138
Q

what patient ed is given to patients taking benzo?

A

they are addictive, has to be tapered off, no caffeine, no smoking, no alcohol, PRN only

139
Q

what SSRI is given to panic disorder patients?

A

paroxetine

140
Q

what patient ed is given to patients taking SSRI?

A

increased SI, sexual dysfunction, weight gain

141
Q

what beta blocker is given to panic disorder patients

A

propranolol

142
Q

what anxiolytic is given to panic disorder patients?

A

buspirone

143
Q

what does anxiolytics mimic?

A

benzo effect without the symptoms

144
Q

can you take buspirone daily?

A

yes

145
Q

what SNRI do panic disorder patients take?

A

venlafaxine

146
Q

what teaching can be given to panic disorder patients to decrease the amount of occurrences?

A

notice when your symptoms begin, breating, imagery,yoga, sleep, exercise, journaling

147
Q

what are phobias?

A

an irrational fear of something

148
Q

what are risk factors for phobias?

A

learned behavior or traumatic event

149
Q

what is agoraphobia?

A

fear of being vulnerable or unable to escape

150
Q

what is social phobia?

A

fear of doing something embarrassing

151
Q

what are the interventions for phobias?

A

safety, explore their perception of fear, discuss reality of avoiding

152
Q

what medications groups are used to treat phobias?

A

benzo, ssri, betablocker, snri

153
Q

what benzo is used to treat phobias?

A

alprazolam

154
Q

What SSRI is used to treat phobias?

A

paroxetine

155
Q

what beta-blocker is used to treat phobias?

A

propanolol

156
Q

what snri is used to treat phobias?

A

venlafaxine

157
Q

what medications are used to treat OCD?

A

ssri…Fluoxetine

Paroxetine

Sertraline

Fluvoxamine

158
Q

what is OCD?

A

an obsession with something that is relieved by compulsions

159
Q

what is an obsession?

A

intrusive thoughts that give anxiety

160
Q

what is a compulsion?

A

something that is done to relive anxiety around the obsession

161
Q

what is the OCD cycle?

A

obsession, anxiety, compulsion, relief

162
Q

what are interventions for patients with OCD

A

identify triggers, allow compulsion but slowly limit, replace compulsion with coping skill

163
Q

what are ocd patients at risk for?

A

substance abuse

164
Q

what are the typical antipsychotics?

A

chlorpromazine, haloperidol, Fluphenazine,

165
Q

what are the atypical antipsychotics?

A

Olanzapine, Risperidone, Aripiprazole, Ziprasidone, clozapine

166
Q

what are the predisposing factors to PTSD?

A

the experience, the individual, and recovery

167
Q

what in the experience predisposed someone to getting PTSD?

A

severity, duration, anticipation, death, control of reoccurrence, location

168
Q

what individual attributes predisposed someone to get PTSD?

A

ego strength, coping, MH condition, previous trauma, temperament, demographic

168
Q

what in the recovery stage might predispose someone to getting PTSD?

A

social support, close family, societal attitudes, culture

168
Q

what are potential causes for PTSD?

A

DV, war, abuse, disasters, accidents, bullying, surgery, robbery, death of a loved one, adoption, separation

169
Q

how long must you have symptoms after an experience to have PTSD?

A

1 month

170
Q

what are the intrusion symptoms of PTSD?

A

recurrent memories, nightmares, flashbacks, prolonged distress

171
Q

what are the avoidance symptoms of PTSD?

A

avoiding trauma related to…..thoughts, feelings, people. places, conversations, activities, objects, situations

172
Q

what are cognition symptoms of PTSD?

A

cant recall specific events, negative toward self, survivor guilt, distorted blame, lack of interest, inability to feel positive emotions

173
Q

what are the dissociative symptoms of PTSD?

A

altered sense of reality

174
Q

what are the arousal and reactivity symptoms of PTSD?

A

irritable, aggression, self destruction, hypervigilance, exaggerated startle, problems sleeping and concentrating

175
Q

what are co morb for PTSD?

A

depression, anxiety, and substance abuse

176
Q

what are the interventions for PTSD?

A

stay with them, build trust, encourage verbalization, coping skills

177
Q

what medications are used for PTSD?

A

SSRI, betablocker, anxiolytics, Benzo

178
Q

what SSRI is used to treat PTSD?

A

paroxetine and sertraline

179
Q

what betablocker is used to treat PTSD?

A

propranolol

180
Q

what anxiolytic is used to treat PTSD?

A

buspirone

181
Q

what benzo is used to treat PTSD?

A

alprazolam

182
Q

what therapies are used for PTSD?

A

group CBT, exposure therapy, EMDR, digital therapeutics

183
Q

what is EDMR?

A

patients talks about an event while their eyes follow a swinging object

184
Q

who do you not do EDMR with?

A

active SI, substance abuse, psychosis, and seizure disorder

185
Q

what is adjustment disorder?

A

a response to a stressor that lasts 3-6 months

186
Q

what are the symptoms of adjustment disorder?

A

depressed mood, anxiety, disturbance of conduct, mixed disturbance???

187
Q

what black box warning is associated with antipsychotics?

A

Increased risk of MORTALITY in ELDERLY patients with dementia-related psychosis.

188
Q
A
189
Q

what are the negative symptoms of schizophrenia?

A

flat affect, anhedonia, alogia, avolition, asociality, catatonia

190
Q

what does anhedonia mean?

A

inability to experience pleasure

191
Q

what does alogia mean?

A

lack of speech

192
Q

what does avolition mean?

A

inability to reach gaols

193
Q
A

Mental Health (4 decks)

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