Exam #3 Flashcards
(119 cards)
1
Q
Why is adequate sleep required?
A
- restore brain tissue
- conserve energy
- regulate immune function
- regulate hormones
- provide thermoregulation
2
Q
How much sleep do infants need?
A
14- 17 hours of sleep a day
3
Q
How much sleep do school aged children need?
A
9 - 11 hours
4
Q
How much sleep do adults need?
A
7-9 hours
5
Q
What factors can contribute to someone developing insomnia?
A
- Hx of anxiety or depression
- various medical/ psychiatric disorders
- high levels of stress
- poor sleeping habits
6
Q
What is narcolepsy?
A
Frequent and uncontrollable periods of deep sleep
7
Q
What is thought to be the cause of narcolepsy?
A
- deficiency of the brain chemical hypocretin which regulates sleep because the immune system mistakenly attacks parts of the brain that produces hypocretin
8
Q
What medication is used to treat narcolepsy?
A
Stimulants such as dextroamphetamine
9
Q
What is hypersomnolence disorder?
A
- excessive daytime sleepiness that persists for more than 3 months even with 9+ hours of sleep
10
Q
What is restless leg syndrome?
A
Uncomfortable sensation in the legs accompanied by the urge to move
11
Q
What is the treatment for restless leg syndrome?
A
- dopamine receptor agonist such as ropinrole or pramipexole
12
Q
What are the risk factors for developing sleep apnea?
A
Obesity
13
Q
What are non- REM sleep arousal disorders?
A
Sleep walking and sleep tremors
14
Q
What are potential treatments for nightmare disorder?
A
-hypnosis
15
Q
What is REM sleep behavior disorder?
Djouldé
A
Characterized by physically act out vivid dreams ( talking, physical movements)
16
Q
What actions promote proper sleep hygiene?
A
- decreased caffeine
- don’t watch tv or use your phone right before sleeping
- calm/ quiet environment
- avoid daytime napping
- exercise
17
Q
What are three classifications for neurocognition?
A
- delirium
- mild neurocognitive disorders
- major neurocognitive disorders
18
Q
What is delirium?
Reverse able
A
An acute disturbed state of mind characterized by restlessness, illusions, incoherence of thought and speech
19
Q
What are the most common causes of delirium?
A
- UTI
- dehydration
- intoxication
20
Q
What are some manifestations of delirium?
A
- labile mood
- anger/ agitation
- pull IV’s
- self care deficits
- hyper or hypo activity
- changes in sleep wake
- abnormal vital signs
21
Q
What are mild neurocognitive disorders ?
A
- a decline from previous cognitive functioning, doesn’t impact daily functioning
22
Q
What are major neurocognitive disorders?
A
Impairments interfere with daily function and the ability to be independent
23
Q
What are the risk factors of developing Alzheimer’s disease?
A
- family member has dementia
- age
- cardiovascular disease
- poor diet and social isolation
- head injury/ traumatic brain injury
24
Q
What is thought to be the cause of Alzheimer’s?
A
Genetics- if fam member has dementia
25
What are some ways we can teach our pt’s to reduce the risk for Alzheimer’s?
- staying physically active
- stop smoking
- maintain healthy weight
- drink mod or not at all
- adequate sleep
- avoid chronic stress or depression
26
What are the different stages of Alzheimer’s disease?
M, M, S
- Mild
- moderate
- severe
27
How is mild Alzheimer’s characterized ?
Stage 1
- memory lapse occurs but the pt can still function independently
28
How is moderate Alzheimer’s characterized?
Stage 2
Symptoms become noticeable and behavior is markedly changed
29
How is severe Alzheimer’s characterized ?
Stage 3
May have difficulty w/ communication and needs 24hr care
30
What is confabulation?
Trump
Creation of stories to maintain self esteem
31
What is preservation?
Religion of phrases or gestures
32
What is agnosia?
Loss of sensory ability to recognize objects
33
What is the treatment used for Alzheimer’s?
- cholinesterase inhibitor which doesn’t cure but helps delay or prevent symptoms from becoming worse
34
What are some possible intervention for a pt experiencing Alzheimer’s?
- transportation
- suppor groups
- home health services
35
What is dyscalculia?
Persistent difficulty in mathematics
36
What is dysgraphia?
Persistent difficulty in written expression
37
What is an intellectual disability?
- deficits in intellectual, social, and daily functioning
38
What is autism spectrum disorders?
A neurobiological and developmental disability that typically appears during a child first three years of life
39
What are the clinical manifestations of Autism spectrum disorders?
- deficit in social/ emotional interactions
- repetitive speech and or behaviors
- sensory processing issues
- difficulty w/ changes to routines
40
What are common manifestations of ADHD?
- child shows inappropriate level of inattention, impulsivity, and hyperactivity
- low frustration tolerance and labile moods
41
What drug class are used to treat ADHD?
Dextroamphetamine sulfate
Stimulants adderall
42
What should be encouraged in a patient taking a ADHD medications?
Drug holidays and parents should properly store and administer stimulant medications
43
What are the common side effects of taking stimulants?
WL/A, WT, HTN, IS, T, I
- weight loss
- anorexia
- worsen tics/ tremors
- HTN
- impaired sleep
- tachycardia
44
What is intermittent explosive disorders?
- inability to control aggressive impulses
- verbal or physical aggression
45
What is conduct disorder?
- rights of others are violated and societal normal or rules are disregarded
- if left untreated it will develop into antisocial personality disorder
46
What are some interventions that can be used for pt experiencing an impulse control disorder?
- ensure a safe enviormental
- set clear limits and expectations
- provide structure and boundaries
47
How is cluster A personality disorders characterized by?
- odd
- eccentric
48
What personality disorders fall under cluster A?
PSS.. do you know the government is watching us??
- Paranoia PD
- Schizoid
- schizotypical
49
What are the clinical manifestations of Cluster A paranoid PD?
- distrust/ suspicion of others that’s unsupported by evidence
- hyper vigilance
- often provoke a hostile response
- tend to have difficulty in relationships due to jealousy, controlling, and unwillingness to forgive
50
What nursing intervention is appropriate for Cluster A paranoid PD?
- stick to the schedule and don’t change it
- avoid being nice w/ the pt
- be consistent
51
What are some treatment options for paranoid PD?
- psychotherapy
- group therapy
- anti anxiety and antipsychotics
52
What are the clinical manifestations of Cluster A schizoid PD?
- lifelong pattern of social withdrawal, limited emotional expression, they tend to confine in imaginary friends/ fantasies
53
What nursing interventions should be considered of Cluster A paranoid PD?
- avoid being too nice/ friendly
- DO NOT increase socialization
- focus on coping/ anxiety
54
What are the treatment options for Cluster A paranoid PD?
- psychotherapy
- individual therapy then move to group therapy
- antidepressants and antipsychotics
55
What are the clinical manifestations of Cluster A schizotypical PD?
Magical thinking- they think something happen because they thought it or manifested it
- tend to ramble w/ lengthy unclear, overly detailed, and abstract content + paranoia
- odd/ eccentric behavior w/magical thinking
56
What are the nursing considerations for a pt with cluster A schizotypical PD?
- respect the need for iso
- adhere to schedule
- be respectful to religious practices, thought, and beliefs
57
What are the treatment options for a pt with cluster A schizotypical PD?
- psychotherapy
- antipsychotic
- antidepressants
- anti anxiety
58
How is cluster B personality disorders characterized by?
- dramatic
- emotional
- erratic
59
What personality disorders fall under cluster B?
BANH
- borderline
- narcissistic
- antisocial
- histrionic
60
How is cluster C personality disorders characterized by?
- fearful
- anxious
61
What PD’s fall under cluster C?
- avoidant
- dependent
- obsessive compulsive
62
What are the clinical manifestations of cluster B borderline personality disorder?
- instability ( moods, relationships)
- impulsive
- distorted self image/ identity
- labile
- splitting
- separation anxiety
- self harm
63
What are some nursing interventions of cluster B borderline personality disorder?
- therapeutic relationship is essential
- monitor for manipulation and splitting
- monitor for self harm behaviors
64
What are some treatments for cluster B borderline personality disorder?
- DBT
- antidepressants and mood stabilizers
65
What are the clinical manifestations of antisocial personality disorder?
- disregards the right of others and frequently violates
- deceitful, manipulative, and hostile when they can’t manipulate the person
- no remorse / guilt
- criminal misconduct and substance misuse are common
66
What are some nursing interventions for cluster b antisocial PD?
- direct and clear language to avoid manipulation
- monitor for violence
- usually not hospitalized
67
What are some treatment options for cluster b antisocial PD?
- mood stabilizers
- antidepressants
- benzodiazepines
- therapy
68
What are the clinical manifestations of cluster B histrionic personality disorder?
- extroversion and flamboyance
- emotional seeking behavior
- impulsive
- may act flirtatiously
69
What are some nursing care interventions for cluster B histrionic personality disorder?
- professional communication
- monitor for exaggerated symptoms
-
70
What are some treatment options for cluster B histrionic personality disorder?
- individual therapy
- group therapy
- antidepressant
- anti anxiety
71
What are the clinical manifestations of cluster B narcissistic PD?
- feelings of entitlement
- exaggerated belief in ones importance
- lack of empathy
- poor self esteem and hypersensitive to criticism
72
What are some nursing intervention for a person with cluster b narcissist PD?
- remain neutral
- model healthy communication/ empathy
- do not engage in power struggles
73
What are treatment options for a person with cluster b narcissist PD?
- CBT
- group therapy
- lithium
- antidepressants
74
What are the clinical manifestations of cluster c avoidant PD?
- extreme sensitivity to rejection
- feelings of inadequacy
- socially inhibited
- low self esteem
75
What are some nursing interventions used for cluster C avoidant pd?
- friendly/ reassuring approach
- ease into social situations
- provide assertiveness training
76
What are some treatment options used for cluster C avoidant pd?
- individual and group therapy
- antidepressants
- anti anxiety
77
What are the clinical manifestations of cluster C dependent PD?
- overwhelming need to be cared for
- submissive and clingy behavior
- intensive fear of separation
78
What are some nursing interventions used for Cluster C dependent PD?
- identify stressor
- teach assertiveness training
- beware of countertransference
79
What are some treatment options used for Cluster C dependent PD?
- CBT
- antidepressants
- anti anxiety
80
What are the clinical manifestations of cluster C obsessive compulsive PD?
- limited emotional expression
- stubbornness
- indecisive
- perfectionist
- always think they are right
81
What are some nursing interventions used for Cluster C obsessive compulsive PD?
- avoid power struggle
- provide structure
- help identify ineffective coping
82
What are some treatment options used for Cluster C obsessive compulsive PD?
- group and individual therapy
- antidepressants (specifically SSRIs)
83
What are paraphiliac disorder?
Sexually aroused by things that are outside of societal norms
84
What are the risk factors for developing SDD?
- hormonal
- vascular issues
- cognitive factors
85
What are some nursing interventions used for pt’s with sexual disorders?
- be non judgmental
- maintain and reinforce appropriate interpersonal boundaries
- explain consequences of actions
86
What are risk factors for developing anxiety?
- psychological factors
* negative life events
- genetics
- neurobiological
* low levels of GABA
87
What are the different levels of anxiety?
M, M, S, P
- mild
- moderate
- severe
- panic
88
How is mild anxiety characterized?
- they are able to perceive what’s happening around them
- restlessness, irritability, psychomotor agitation
( foot tapping, fidgeting)
89
How is moderate anxiety characterized?
- decreased perception and grasp less information, and has selective attention
- thinking is impaired but learning can still occur
- increased RR/ HR, GI problems, tremors, and headache
90
How is severe anxiety characterized?
- very low perception, unable to learn or problem solve
- nausea, dizziness, confusion, hyperventilation, impending doom
91
How is panic anxiety characterized?
- complete loss of touch of reality
- screaming, shouting, social withdrawal, or hallucinations
92
What is panic disorder?
Sudden onset for extreme apprehension or fear of impending doom
- intense, unpredictable, lasts 10 min.
93
What is generalized anxiety disorder?
Characterized by excessive worrying that is out of proportion for more than 6 months.
- avoids events or puts off things due to anxiety
- difficulty w/ relationships due to need for reassurance and high anxiety levels
94
What is body dysmorphic disorder?
- obsessive focus on a perceived flaw in appearance
- often has a hx of abuse or neglect
95
What are some effective nursing interventions for a pt experiencing anxiety?
- promote self care activities
- health teaching
- encouragement of therapy
96
What are some clinical manifestations of a pt w/ PTSD?
- recurrent dreams or flashbacks
- avoidance of stimuli associated with/ trauma
- numbing response
- persistent symptoms of increased arousal
97
What are some treatment options for a pt with PTSD?
- SSRI like Zoloft and Paxil
98
What is dissociative disorder?
- when the person separates themselves emotionally after significant trauma(s)
- dissociation is an involuntary response that protects individuals from full awareness of trauma
99
What are positive symptoms of dissociative disorder?
- flashbacks
- emotional triggers
100
What are negative symptoms of dissociative disorder?
- lack of self control or control of body parts
- decline in memory
101
What is depersonalization disorder?
The persistent felling of observing oneself from outside their body and that their surroundings aren’t real
- feeling mechanic, dreamy, or detached from body
102
What kinds of survivors experience depersonalization disorder?
- severe acute stress
- childhood sexual abuse
103
What are the different kind of dissociative amnesias?
- localized
- selective
- dissociative
104
What is localized dissociative amnesia?
- inability to remember all event in certain periods
105
What is selective dissociative amnesia?
- some but not all events can be recalled
106
What is dissociative fugue amnesia?
Traveling away and forgetting your identity and past
107
What are the signs of a dissociative disorder?
- change in behavior, voice, or dress
- referring to self by another name or third person
- partial memory or memory gaps
- disoriented X4
- presence of blackouts
108
What are some nursing implementation that can be used for a pt’s struggling with dissociative disorders?
- coping skills for stressor
- establish routine
- encourage expression of feelings
- long term therapy
109
What is somatic symptom disorder?
Extreme focus on physical symptoms such as pain or fatigue because of emotional distress and problems functioning
110
What is the most lethal substance to have a pt withdrawal on?
Alcohol then benzo’s
111
What is the definition of intoxication?
- occurs when the individual use a substance to excess
112
What are drug classes and how are they categorized?
The lower the # the increased risk for abuse
- 5 categories based on acceptable medical use and potential for abuse
113
What are schedule I drugs and some examples?
Street drugs
Not for medical use, high abuse potential
- heroin
- LSD
- Shrooms
114
What are schedule II drugs and some examples?
A, F, D
Acceptable for medical use, tightened regulated, high risk for abuse
- Adderall
- fentanyl
- dilaudid
115
What are schedule III drugs and some examples?
T w/ C, K
Acceptable medical use, less abuse potential than S2
- Tylenol w/ codeine
- Ketamine
116
What are schedule IIII drugs and some examples?
Acceptable for medical use, medium risk for abuse
- Xanax
- Valium
117
What are schedule IV drugs and some examples?
OTC, R
Acceptable medical use, with decrease abuse potential
- OTC
- Robitussin
118
What neurotransmitters are involved in addiction?
- opioid, catecholamine, and GABA
- the dopaminergic neurons in the VTA are implicated
119
What are the common risk factors for developing an addiction?
B, E, S
- biological
- environmental risks
- sociocultural
