Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Community Mental Health Nursing > Exam 3 > Flashcards

Exam 3 Flashcards

(81 cards)

Start Studying
1
Q

Bipolar I Disorder

A

Most severe form
Highest mortality rate
At least 1 manic episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bipolar II Disorder

A

At least 1 hypomanic episode

At least 1 major depressive episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cyclothymic Disorder

A

Alternate with symptoms of mild to moderate depression for at least 2 years

Rapid cycling possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Epidemiology of Bipolar Disorder

A

Up to 21% of patients with major depression may actually have undiagnosed bipolar disorder

Bipolar I–more common in males

Bipolar II–more common in females

Cyclothymia–usually begins in adolescence or early adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk Factors for Bipolar Disorder

A

Biological factors: genetic, neurobiological, neuroendocrine (hypothyroidism)

Psychological factors

Environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Assessment for Bipolar Disorder

A

Mood

Behavior

Thought processes and speech patterns

Cognitive functioning (decreased attention span, distracted easily)

Speech patterns (pressured speech, circumstantial speech, tangential speech, loose associations, flight of ideas, clang associations)

Thought content (grandiose delusions, persecutory delusions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Self-Assessment for Bipolar Disorder

A

Manic patient (manipulative, demanding, splitting)

Staff member actions (frequent staff meetings to deal with patient behaviors and staff response, set limits consistently)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Assessment Guidelines for Bipolar Disorder

A 
Danger to self or others
Need for protection from uninhibited behaviors
Need for hospitalization
Medical status
Coexisting medical conditions
Family's understanding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Planning for Bipolar Disorder

A

Medical stabilization

Maintaining safety

Nursing care (managing medications, decreasing physical activity, increasing food and fluid intake, ensuring sleep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Planning for Acute Manic Phase

A

Medical stabilization

Maintaining safety

In-hospital nursing care

Seclusion, restraint, or ECT may be considered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Implementation for Depressive Episodes

A

Hospitalization for harmful thoughts

Medication concerns about bringing on a manic phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Implementation for Manic Episodes

A

Hospitalization for acute mania

Communicating strategies and challenges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lithium Carbonate

A

Mood stabilizer; decreased mania

Therapeutic level: 0.8-1.4
Maintenance blood level: 0.4-1.3
Toxic blood level: 1.5 and above

Takes 10-21 days to get levels stabilized

Give with meals, drink adequate fluids, monitor for weight gain, check renal and thyroid function before giving and monitor those levels throughout due to nephrotoxicity/thyroid toxicity

Contraindications: renal disease, thyroid disorders, brain injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lithium Toxicity

A
  1. 5-2.0: mental confusion/sedation, poor coordination/coarse tremors, GI distress
  2. 0-2.5: tinnitus/blurred vision/ataxia, slurred speech/seizures/polyuria, hypotension

Level > 2.5: coma, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anticonvulsant Mood Stabilizers

A

Valproate (Depakote)

Carbamazepine (Tegretol)

Lamotrigine (Lamictal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Other Treatments for Bipolar

A 
ECT
Teamwork and safety
Seclusion protocol
Support groups
Health teaching and health promotion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Persistent Depressive Disorder

A

Formerly known as dysthymia

Low-level depressive feelings through most of each day, for the majority of days

Two or more of the following: decreased appetite, overeating, insomnia or hypersomnia, low energy, poor self-esteem, difficulty thinking, hopelessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Premenstrual Dysphoric Disorders

A

Symptom cluster in last week prior to onset of a woman’s period; include mood swings, irritability, depression, anxiety, feeling overwhelmed, difficulty concentrating

Symptoms decrease significantly or disappear with the onset of menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Major Depressive Disorder

A

Five or more of the following in a 2 week period: weight loss, appetite changes, sleep disturbances, fatigue, worthlessness or guilt, loss of ability to concentrate, recurrent thoughts of death

PLUS depressed mood or loss of interest or pleasure (anhedonia)

Persistent for 2 weeks to 6 months

Lasts more than 2 years

Recurrent episodes common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Epidemiology of Depression

A

Leading cause of disability in the US

Comorbidities include schizophrenia, personality disorders, eating disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Etiology of Depression

A

Biological Factors: genetic, biochemical, alterations in hormonal regulation, inflammatory process

Psychological factors: cognitive theory, learned helplessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Assessment of Depression

A 
Depressed mood and anhedonia
Anergia
Anxiety
Psychomotor agitation or retardation
Vegetative sides
Chronic pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Depression Recovery Model

A

Focus on patient’s strengths

Treatment goals mutually developed

Based on patient’s personal needs and values

Planning geared towards patient’s phase of depression, particular symptoms, personal goals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Phases of Depression

A

Acute Phase (6-12 weeks)

Continuation Phase (4-9 months)

Maintenance Phase (1 year or more)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How to Choose an Antidepressant
``` Symptom profile of the patient Side-effect profile Ease of administration History of past response Safety and medical considerations ```
26
Antidepressants
SSRIs (first-line therapy, rare risk of serotonin syndrome) SNRIs Tricyclic Antidepressants (anticholinergic adverse reactions) MAOIs (effective for unconventional depression)
27
Other Treatments for Depression
ECT TMS Vagus nerve stimulation Deep brain stimulation Light therapy St. John's Wort Exercise
28
Electroconvulsive Therapy
The most effective depression treatment; also used for psychotic illnesses Used for lengthy depression, delusional depression, schizophrenia with catatonia
29
Transcranial Magnetic Stimulation
Noninvasive Uses MRI-strength magnetic pulses to stimulate focal areas of the cerebral cortex Presence of metal is only contraindication
30
Adverse Reactions to TMS
Headache and lightheadedness No neurological deficits or memory problems, seizures rarely, scalp tingling, discomfort
31
Vagus Nerve Stimulation
Originally used to treat epilepsy Decreases seizures and improves mood Electrical stimulation boosts the level of neurotransmitters
32
Side Effects of Vagus Nerve Stimulation
Voice alteration Neck pain, cough, paresthesia, dyspnea
33
Deep Brain Stimulation
Surgically implanted electrodes in the brain Stimulates those regions identified as underactive in depression More invasive than VNS
34
Light Therapy
First-line treatment for SAD Efficacy due to influence of light on melatonin Effective as medication for SAD Negative effects include headache and jitteriness
35
St. John's Wort
Flower processed into tea or tablets Thought to increase serotonin, norepinephrine, anti-dopamine in the brain Useful in mild to moderate depression
36
Trauma-Related Disorders in Children
Posttraumatic stress disorder in preschool children Reactive attachment disorder Disinhibited social engagement disorder
37
Comorbidities of Trauma-Related Disorders in Children
Learning disorders Increased stress
38
Biological Factors of Trauma-Related Disorders in Children
Genetic: how individuals react to trauma Neurobiological: trauma dysregulates neural pathways that integrate emotional regulation and arousal; triggers hyperaroused state leading to dissociation; polyvagal theory Psychological factors: attachment theory Environmental factors: dependence on adults and systems; external factors that support stress
39
Intervention Stages for Trauma-Related Disorders in Children
Stage 1: provide safety and stabilization Stage 2: reduce arousal and regulate emotion through symptom reduction Stage 3: catch up on developmental and social skills; develop a value system
40
Interventions for Child with PTSD
Establish trust and safety Use developmentally appropriate language Teach relaxation techniques Use art and play to promote expression of feelings Involve caretakers in 1:1s, unless they are the cause of trauma Educate child and caretakers about grief process Assist caregivers in resolving personal distress
41
Posttraumatic Stress Disorder
Re-experiencing of the trauma Avoidance of stimuli associated with trauma Persistent symptoms of increased arousal Alterations in mood
42
Acute Stress Disorder
Immediately after a highly traumatic event Symptoms persist for 3 days Diagnosis made within month After 1 month: resolution or becomes PTSD
43
Diagnosis of Acute Stress Disorder
Alterations in concentration Anger Dissociative amnesia Headache Irritability Nightmares
44
Implementation for Acute Stress Disorder
Establish therapeutic relationship Assist to problem solve Connect person to supports Collaborate for coordination of care Ensure and maintain safety Refer to a licensed mental health provider Monitor response and/or adherence to treatment
45
Adjustment Disorder
Trauma-related disorder in adults Precipitated by stressful events Debilitating cognitive, emotional, and behavioral symptoms that negatively impact normal functioning Responses to stressful event may include combinations of depression, anxiety, and conduct disturbances
46
Dissociative Disorders
Occur after significant adverse experiences/trauma Individuals respond to stress with severe interruption of consciousness Unconscious defense mechanism Protects individual against overwhelming anxiety through emotional separation
47
Depersonalization Disorder
Focus on self
48
Derealization Disorder
Focus on outside world
49
Dissociative Amnesia
Inability to recall important personal information Often of traumatic or stressful nature Dissociative fatigue
50
Dissociative Identity Disorder
Presence of two or more distinct personality states Each alternate personality has own pattern of perceiving, relating to, and thinking about the self and environment
51
Dissociative Disorders Assessment
History Moods Impacts on patient and family Suicide risk Self-assessment
52
Dissociative Disorders Planning
Phase 1: establishing safety, stabilization, and symptom reduction Phase 2: confronting, working through, and integrating traumatic memories Phase 3: identity integration and rehabilitation
53
Oppositional Defiant Disorder
Angry and irritable mood Defiant and vindictive behavior Experience social difficulties, conflicts with authority figures, academic problems
54
Risk Factors for Oppositional Defiant Disorder
Genetic component Numerous neurobiological causes identified Family dysfunction can play a role
55
Intermittent Explosive Disorder
Inability to control aggressive impulses Adults 18 years or older Leads to problems with interpersonal relationships, occupational difficulties, criminal difficulties
56
Comorbidities of Intermittent Explosive Disorder
Depressive, anxiety, and substance use disorders Antisocial and borderline personality disorders
57
Risk Factors for Intermittent Explosive Disorder
Neurobiological abnormalities Conflict or violence in family of origin
58
Conduct Disorder
Behavior is usually abnormally aggressive Rights of others are violated and societal norms or rules are disregarded; lack of remorse
59
Complications of Conduct Disorder
Academic failure School suspensions and dropouts Juvenile delinquency Drug and alcohol abuse Juvenile court involvement
60
Personality Disorders
Cluster A (Eccentric): paranoid, schizoid, schizotypal Cluster B (Erratic): borderline, narcissistic, histrionic, antisocial Cluster C (Anxious): avoidant, dependent, obsessive-compulsive
61
Paranoid Personality Disorder
Prevalence: 2% to 4% Characteristics: may be apparent in childhood, social anxiety in childhood, jealous and controlling as adults, unwillingness to forgive and projection of feelings
62
Treatment of Paranoid Personality Disorder
Counteract mistrust by adhering to schedules, avoiding being overly friendly, and projecting a neutral but kind affect Psychotherapy versus group therapy Short-term antidepressants
63
Schizoid Personality Disorder
Prevalence: nearly 5% of population Characteristics: symptoms appear in childhood/adolescence, loners, poor academic performance, increased prevalence of disordered family life, avoid close relationships, depersonalization
64
Treatment of Schizoid Personality Disorder
Avoid being too nice or friendly, do not try to increase socialization, assess for symptoms the patient is reluctant to discuss, protect against group's ridicule Treatment: psychotherapy, group therapy, antidepressants
65
Schizotypal Personality Disorder
Prevalence: varies from 0.64 to 4.6% of population Characteristics: severe social and interpersonal deficits, anxiety in social situations, rambling conversations, paranoia, suspiciousness, anxiety, distrust, intermittent episodes of hallucinations, can be made aware of their own odd beliefs, may be vulnerable to involvement with cults
66
Treatment of Schizotypal Personality Disorder
Respect patient's need for social isolation Be aware of and intervene appropriately with patient's suspiciousness Perform careful diagnostic assessment for symptoms that may need intervention Withhold judgment or ridicule Psychotherapy Low-dose antipsychotics
67
Histrionic Personality Disorder
Prevalence: nearly 2% of population Characteristics: excitable, dramatic, high functioning, bold external behaviors, limited ability to develop meaningful relationships, attention-seeking, self-centered, excessive emotions, may be provocative, no insight into disorder or role in ruining relationship
68
Treatment for Histrionic Personality Disorder
Psychotherapy is treatment of choice Know that seductive behavior is a response to stress Keep interactions professional and ignore flirtations Model concrete language Help patient clarify inner feelings Teach and role-model assertiveness
69
Narcissistic Personality Disorder
Prevalence: 0 to 6% Characteristics: feelings of entitlement, exaggerated self-importance, tendency to exploit others, weak self-esteem and hypersensitivity to criticism, constant need for admiration, less functional impairment
70
Treatment for Narcissistic Personality Disorder
Remain neutral Avoid power struggles or becoming defensive Role model empathy Difficult to treat; patients not likely to seek help Cognitive-behavioral therapy Group therapy Lithium for mood swings
71
Antisocial Personality Disorder
Prevalence: 1.1% Characteristics: antagonistic behaviors, disinhibited behaviors, profound lack of empathy, absence of remorse or guilt
72
Assessment of Antisocial Personality Disorder
Patients tend to not answer assessments honestly Self-assessment
73
Clinical Picture of Borderline Personality Disorder
Severe impairments in functioning Emotional lability Impulsivity Self-destructive behaviors Antagonism Splitting: inability to view both positive and negative aspects of others as part of a whole
74
Borderline Personality Disorder
Prevalence: 1.6% 10% suicide and mortality rate 85% of BPD patients have another mental illness High genetic association Separation-individuation factors
75
Assessment for Borderline Personality Disorder
Semi-structured interview Use of MMPI Self-assessment
76
Treatment of Borderline Personality Disorder
Psychotropics geared toward symptom relief CBT Dialectical behavior therapy Schema-focused therapy
77
Avoidant Personality Disorder
Prevalence: 2.4% Characteristics: low self-esteem, shyness that increases with age, feelings of inferiority, reluctance to engage with new people, subject to depression, preoccupied with rejection and failure
78
Dependent Personality Disorder
Prevalence: 0.5% Characteristics: high need to be taken care of, submissiveness, fears of separation and abandonment, manipulating others to take responsibilities, intense anxiety when left alone
79
Treatment of Dependent Personality Disorder
Help address current stressors Set limits Be aware of strong countertransference Psychotherapy
80
Obsessive-Compulsive Disorder
Prevalence: 2 to 8% Characteristics: inflexible standards for others and self, constant rehearsal of social responses, excessive goal-seeking, strict standards that interfere with project completion, unhealthy focus on perfection
81
Treatment for Obsessive-Compulsive Disorder
Patients tend to seek help for anxiety and depression Group and behavioral therapy Clomipramine or fluoxetine for obsessions, anxiety, and depression

Community Mental Health Nursing (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions