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Mental Health > Exam 3 > Flashcards

Exam 3 Flashcards

(60 cards)

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1
Q

any mental disorder that manifests as physical symptoms that suggest illness or injury, but cannot be explained fully by a general medical condition, mental disorder, or substance abuse

Physical symptoms as a result of psychological stress (no physical explanation for the pain) commonly found in patients with depression, anxiety, and drug abuse.

Most common in women, rural areas, poorly educated, non whites

(Dr shopping is common)

Symptoms include , TMJ, grinding, HTN, tension headache

A

Somatoform disorders

12-3) (12-4

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2
Q

Somatoform highest nursing interventions and secondary gains

A

1 ensure patient safety and observation and assess secondary gains such as gaining attention, lack of work responsibility

Get feelings out, so the symptoms are not there anymore

Offer explanations during testing to reduce anxiety

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3
Q

condition in which a person is excessively and unduly worried about having a serious illness for at least 6 months

A

Hypochondriasis

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4
Q

Hypochondriasis s/s

A

Misinterpreted physical sensations and physical illness

May present somatic symptoms , often avoid healthcare and constantly check problems

May misinterpret normal sensations such as abd cramps, sweating as a disease

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5
Q

Functional neurological disorder that affects voluntary motor or sensory function. No physiological basis can be found. Such a paralyzed for no reason)

A

Conversion disorder

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6
Q

Conversion disorder interventions

A

Make sure to use straight forward approach, support them, be assertive

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7
Q

Happens after a traumatic event

Person forgets who they are and start a new life, abrupt departure from home

A

Dissociative fugue

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8
Q

Never truly look perfect or normal

(Usually one part of body that doesn’t look normal)

Example: Nose is abnormal misshaped and needs fixed when it’s looks fine

Feel shame and withdrawn, plastic surgery is used but still feel dissatisfied

A

Body dysmorphic disorder

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9
Q

Body dysmorphic disorder care plan/ highest priority

A

Highest priority is safety

Suicide ideation/self violence is high for these people

Safety checks/precautions should be implemented

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10
Q

Traits are exaggerated.

Cause dysfunction in relationships

Hard to be around

Do not view their behavior as wrong

They believe they do not have an issue , you are the one that is wrong and needs to change

A

Personality disorders

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11
Q

Unstable, frequent mood changes, challenging everything, lots of self-mutilation, high suicidal ideation, don’t typically follow through though.

Self destructive , impulsive , erratic emotions, sexual extreme intensity, always in a crisis

A

Borderline personality disorder

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12
Q

Borderline personality disorder interventions?

A

Set limits, be very consistent, avoid staff, splitting, avoid power struggle

Identify needs and feelings following the act, discuss current and previous impulse acts, identify triggers

Table 13-2 and 13-3

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13
Q

Believe they are incapable of surviving when left alone

Always in a relationship, need to be taken care of, fear of separation, clinging and obedience

A

Dependent personality

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14
Q

Very manipulative

Over Dramatic and charming behavior, attention seeking, relationships are superficial and shallow

A

Histrionic personality

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15
Q

Histrionic personality interventions

A

interventions are all staff set clear limits,
be firm,
avoid power struggle,
avoid engaging in personal discussion that can escalate,
staff splitting,
keep secrets,
accepting gifts

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16
Q

Deceitful, manipulative, revenge , they harm others with no remorse for what they do. Serial killers.

Usually a man, lack of conscience or remorse, even towards friends and family

Aggressive, ruthless, clever con artist

A

Antisocial personality

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17
Q

See themselves as fat all the time but are skinny.

Starvation, fear of weight gain, disturbance in self evaluation of weight and it’s importance

Amenorrhea(no periods)

Use laxatives or diuretics to lose weight

May purge food

Exercise variously and still eat small portions

A

Anorexia

14-4

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18
Q

What to assess with anorexia

A

Blood work
Sodium, potassium, calcium (electrolytes)

If medical or mental condition needs hospitalization

Weight loss of more than 30% in 6months

Hypothermia (below 96.8)

Assess level of understanding, of their family understands, physical exam, family/patient group therapy

Heart dysrhythmias

Laxative, diuretic, emetic, or street drug use

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19
Q

Black and white.

If I gain weight, I’ll blow up like a balloon or if I don’t win, I’ll be a looser

A

All or nothing thinking - cognitive distortions

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20
Q

Cardiovascular collapse due to addition of electrolytes

Depleted electrolyte

Replenishing those electrolytes and system can not compensate for that

The system can not handle that

Becomes a crisis and the cardiac muscle has a hard time functioning

Catastrophic causing a cardiovascular collapse

A

Refeeding syndrome

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21
Q

Highest priorities/interventions for bulimia (binge and purge)

A

Safety is number one
Assess suicide ideation

Assess vs ABCs

Blood work

Monitor before and after meals/purging

encourage to Keep a journal

Monitor dysfunctional thoughts

Health teaching and health promotion

(14-2)

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22
Q

Comorbidities of anorexia

A

Depression/anxiety or mood disorders

personality disorders/OCD or borderline

substance use disorder,

Impulse control disorders

BDD

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23
Q

Reminiscing is very important for them. Helps with self expression and with reality

Reinforces accomplishments they have done and gives them meaning to what they have done

A

Memory care

18-5,7,8

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24
Q

Dementia family teaching and education

A

Be sure family has realistic understanding of the diagnosis, prognosis, disease progression, can maintain own self care

Caregiver needs to be able to care for self and know where to get help if needed

Support family if grieving

Educate family of strategies for communication

Give guidelines for safe care

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25
Lose of sensory ability to recognize objects Looking at a toothbrush and not knowing what it’s for
Agnosia
26
Happens because of something such as a medication or UTI. Take away the reason for it and it goes away.
Delirium -
27
What is the best thing to do for delirium patients?
Reorientate the patient to the here and the now (best thing for them)
28
Visual and tactile hallucinations priority nursing dx?
Priority is always safety for them and anyone around them The mind makes it up and can not talk them out of it
29
Nursing interventions for visual and auditory illusions
Sensory defecate “The window Blinds looks like snakes” Orientate them to what the object is and clarify for them what is going on and that they are safe
30
Medications given for behavioral Symptoms/combativeness in Alzheimer’s patients and how to start them?
Start low with meds and go slow Risperdal, seroquel, viprexa Monitor closely
31
Caregiver fatigue nursing interventions
Make sure they know where to go for help Counseling, disease progression education , refer to community based group, make sure they have phone numbers for them prior to discharge. Health teaching and promotion : ``` Nutritious diet Exercise Adequate sleep Relaxing activities Addressing spiritual needs ```
32
Alcohol dependence health teaching?
Relapse prevention plan (19-5) Basics - keep the program simple - review instruct with health team members - use notebook and record important information Skills CBT-figure our what helps you cope Relapse prevention groups - rehearse stressful situations using a variety of techniques - find ways to deal with current problems - provide role models to help you make changes
33
PCP overdose nursing interventions (table 19-7 or 10) What to do for it?
Speak slow, clear, in low voice Don’t talk down to them Minimalize Stimuli /safety Give benzodiazepine it or haldol High BP tachycardia, resp distress , paranoid , strong and violent
34
S/s of opioid overdose
Constricted pupils Anoxia (little to no oxygen) Resp distress /decrease respiration’s Decreased blood pressure Low temp Drowsiness Slurred speech Cardiac arrest Convulsions
35
Heroin overdose s/s (19-6)
Similar as Opioids Respiratory depression is most severe
36
What Is narcan Why is it given Side effects? What to monitor
Reversed the effect of opioids Monitor vs Pulse, bp , resp, ABCs S/e- nausea, vomiting , diarrhea Give every few hours until non toxic
37
Alcohol withdrawal delirium s/s What can it lead to if untreated How serious?
Medical emergency Usually occurring 2-3 days following alcohol withdrawal and lasts 2-3 days Can cause sepsis and lead to MI or death if not treated Sepsis , MI, fat embolism, electrolyte imbalance , aspiration, pneumonia, suicide, tachycardia, diaphoresis, disorientation, hallucinations, agitation, fever. Paranoia , disorientation, delusions , visual hallucinations, vomiting , diarrhea, sweating (delirium tremens)
38
CNS stimulants withdrawal s/s
Cocaine and meth increase normal function of the body Fatigue, depression, lethargy, apathy, disorientation Similar to depression
39
How are cocaine and alcohol use related?
cocaine is a Stimulant and alcohol is a depressant Usually these people have abuse with each other They balance each other out
40
Alcohol withdrawal-symptoms and when they peak?
Withdrawal can happen in a few hours peaks with in 24-48 hours -medical help needed at this time Diaphoresis, tachycardia, tremors, hyper alertness, jerky, movements, irritability, shakiness, diaphoresis. GI upset, anxiety, high BP, high pulse, confusion, high respiratory Delirium tremens: Seizures, disorientation to time, place, person peaks with in 24-48 hours then rapidly and dramatically disappears All leads to seizure
41
Potential meds given for alcohol withdrawal
Subutex and suboxone- for drug related detox Chlordiazepoxide (Librium) Carbamazepine (tegretol) Valproic acid (depakote) Magnesium sulfate (decrease seizure risk) Benzodiazepines
42
Physical and psychological health trauma. Damage to the family Acts of violence involving family members. Thought of as occurring between more powerful (perpetrators) and less powerful victim
Domestic violence
43
Destroys ones spirit and ability to succeed later in life Fails to deeply connect with someone later Name calling, criticism, ignoring accomplishments, yelling and swearing, mocking, isolating, locking the victim in a room, threats and intimidation, denying abuse and blaming the victim
Emotional abuse
44
Nurses legal responsibility for child abuse ?and potential nursing dx: child abuse?
Table 21-2 Nurses are mandated reporters Obligated to report to manager and social worker Ensure proper procedures are followed ——————————————————— Primary: safety and risk for injury Others: disabled family coping, post-trauma syndrome, anxiety, fear, impaired parenting, acute pain
45
Sexual assault nursing interventions?
Table 22-2 When caring for one who has been sexually assaulted do NOT be judgemental, confidential, do not press them to talk, let patient talk, listen and take down info, have someone stay with patient l, get permission to ask questions or take pictures. Make sure they feel safe and secure
46
Act of initiating feelings of hostility that arouses thoughts of attack for physical assault or aggression S/s- rage
S/s of physical aggression
47
Doing harm to a specific person or group. Bullying
Violent behavior
48
Highest risk for violent behavior is what? What to assess first?
Paranoid thinking is highest risk Safety for self and others on unit
49
What to do if someone is Immediate threat to themselves or danger to others/ Violent behavior towards other patients and staff
Least restrictive is always used first Restrain and seclude patient when all else fails Use restraints when pt is a danger to self or others , patient has been legally detained for involuntary tx- risk of seclusion, and patient request to be secluded or restrained Chemical restraints can be used in acute rage and aggression such as benzodiazepines
50
ADHD medication (CNS stimulant) What is most widely used?
``` stimulants: Ritalin - most widely used Daytrona patch Concerti-ER Adderall Lisdexamfetamine (Vyvanse) ``` Non-stimulant: Atomoxetine- strattera Guanfacine- tenex
51
Pervasive developmental disorders/autism s/s
They avoid eye contact, communication delays, upset with routine change, inappropriate facial expressions, no interest in shared activities. difficulty with language, repetitive movements (banging head), severe frustration, weird eating habits, very impulsive
52
Risk for suicide in order adults?
widowhood, acute illnesses, intractable pain, status change, chronic illness, family history of suicide, chronic sleep problems, alcoholism, depression, losses, previous suicidal behavior, Feeling of hopelessness Medical issues or acute illnesses Functional loss intractable pain
53
Interview techniques for older adults?
Use simple choice questions Begin with general questions Be alert for information on the patient’s relationship with others Speak slowly and give more time for interview Choose a quiet and well lite area Assess mental status for deficits in recent or remote memory
54
Risk for abuse for older adults?
Physical, emotional, sexual abuse , financial abuse and neglect Most at risk are those with illness, immobility or ALOC Hx of abuse , caregiver strain, increasing dependence on others Victims may attempt to dismiss injuries, abusers may prevent the abused from getting proper medical care
55
Types of abuse in older adults?
``` Physical abuse Psychological abuse Financial abuse Neglect Sexual abuse ```
56
Difference between objective and subjective data in nursing assessment?
Objective: what is being observed such as physical findings Subjective: what the patient has told you
57
Care plan for patients with dysmorphic disorder
SSRIs, antidepressants, clomipramine (TCA) CBT therapy: talk Atypical antipsychotic + SSRI = severe form
58
Milieu therapy management for Anorexia
Keep a eye on patient so they are not purging after meals Regular weights Monitor all trips to bathroom Adherence to the selected menu Precise meal times
59
Anorexia s/s
Cachectic (severely underweight with muscle wasting) Lanugo (a growth of fine, downy hair on the face and back) Mottled cool skin on the extremities Low blood pressure, pulse and temp readings Self induced vomiting Obsessed with exercising
60
Medications given for alcohol cravings and substance abuse
Campro- for alcohol craving Disulfiram (Antabuse): help prevent relapse Naltrexone (revia): diminish cravings Vivitrol: for alcohol abuse Acamprosate: diminish cravings

Mental Health (4 decks)

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