Final Flashcards
(140 cards)
1
Q
interventions include using a directive approach, taking control of the situation, using a calm, firm voice for giving directions, directing the client to take a time-out in a quiet place, offering PRN medication, and making a “show of force.”
A
escalation phase,
2
Q
experienced, trained staff can use the techniques of seclusion or restraint to deal quickly with the client’s aggression.
A
crisis phase,
3
Q
, interventions include helping clients to relax, assisting them to regain self-control, and discussing the aggressive event rationally.
A
recovery phase
4
Q
Wide perceptual field Sharpened senses Increased motivation Effective problem solving Increased learning ability Irritability
Restlessness Fidgeting GI "butterflies" Difficulty sleeping Hypersensitivity to noise
A
Mild anxiety
5
Q
Perceptual field narrowed to immediate task
Selectively attentive
Cannot connect thoughts or events independently
Increased use of automatisms
Muscle tension Diaphoresis Pounding pulse Headache Dry mouth High voice pitch Faster rate of speech GI upset Frequent urination
A
Moderate anxiety
6
Q
Perceptual field reduced to one detail or scattered details
Cannot complete tasks
Cannot solve problems or learn effectively
Behavior geared toward anxiety relief and is usually ineffective
Doesn’t respond to redirection
Feels awe, dread, or horror
Cries
Ritualistic behavior
Severe headache Nausea, vomiting, and diarrhea Trembling Rigid stance Vertigo Pale Tachycardia Chest pain
A
Severe Anxiety
7
Q
Perceptual field reduced to focus on self Cannot process any environmental stimuli Distorted perceptions Loss of rational thought Doesn't recognize potential danger Can't communicate verbally Possible delusions and hallucination May be suicidal May bolt and run OR Totally immobile and mute Dilated pupils Increased blood pressure and pulse Flight, fight, or freeze
A
Panic
8
Q
: characterized by persecutory (feeling victimized or spied on) or grandiose delusions, hallucinations, and, occasionally, excessive religiosity (delusional religious focus) or hostile and aggressive behavior
A
Schizophrenia, paranoid type
9
Q
: characterized by grossly inappropriate or flat affect, incoherence, loose associations, and extremely disorganized behavior
A
Schizophrenia, disorganized type
10
Q
characterized by marked psychomotor disturbance, either motionless or excessive motor activity. Motor immobility may be manifested by catalepsy (waxy flexibility) or stupor. Excessive motor activity is apparently purposeless and is not influenced by external stimuli. Other features include extreme negativism, mutism, peculiarities of voluntary movement, echolalia, and echopraxia.
A
Schizophrenia, catatonic type:
11
Q
characterized by mixed schizophrenic symptoms (of other types) along with disturbances of thought, affect, and behavior
A
Schizophrenia, undifferentiated
12
Q
: characterized by at least one previous, though not a current, episode; social withdrawal; flat affect; and looseness of associations
A
Schizophrenia, residual type
13
Q
: Holding seemingly contradictory beliefs or feelings about the same person, event, or situation
A
Ambivalence
14
Q
: Fragmented or poorly related thoughts and ideas
A
Associative looseness
15
Q
: Fixed false beliefs that have no basis in reality
A
Delusions
16
Q
: Imitation of the movements and gestures of another person whom the client is observing
A
Echopraxia
17
Q
Continuous flow of verbalization in which the person jumps rapidly from one topic to another
A
Flight of ideas:
18
Q
: False sensory perceptions or perceptual experiences that do not exist in reality
A
Hallucinations
19
Q
: False impressions that external events have special meaning for the person
A
Ideas of reference
20
Q
: Persistent adherence to a single idea or topic; verbal repetition of a sentence, word, or phrase; resisting attempts to change the topic
A
Perseveration
21
Q
: Tendency to speak very little or to convey little substance of meaning (poverty of content)
A
Alogia
22
Q
: Feeling no joy or pleasure from life or any activities or relationships
A
Anhedonia
23
Q
: Feelings of indifference toward people, activities, and events
A
Apathy
24
Q
Restricted range of emotional feeling, tone, or mood
A
Blunted affect
25
: Psychologically induced immobility occasionally marked by periods of agitation or excitement; the client seems motionless, as if in a trance
Catatonia
26
Absence of any facial expression that would indicate emotions or mood
Flat affect
27
: Absence of will, ambition, or drive to take action or accomplish task
Lack of volition
28
Mistrust and suspicions of others; guarded, restricted affect
**** NI***
Serious, straightforward approach; teach client to validate ideas before taking action; involve client in treatment planning
Paranoid disorder
29
Detached from social relationships; restricted affect; involved with things more than people
***NI****
Improve client's functioning in the community; assist client to find case manager
Schizoid
30
Acute discomfort in relationships; cognitive or perceptual distortions; eccentric behavior
*** NI ***
Develop self-care skills; improve community functioning; social skills training
Schizotypal
31
Disregard for rights of others, rules, and laws
,**** NI***
Limit setting; confrontation; teach client to solve problems effectively and manage emotions of anger or frustration
Antisocial personality disorder
32
Unstable relationships, self-image, and affect; impulsivity; self-mutilation
*** NI ****
Promote safety; help client to cope and control emotions; cognitive restructuring techniques; structure time; teach social skills
Borderline personality disorder
33
Excessive emotionality and attention seeking
**** NI*****
Teach social skills; provide factual feedback about behavior
Histrionic
34
Grandiose; lack of empathy; need for admiration
*****NI****
Matter-of-fact approach; gain cooperation with needed treatment; teach client any needed self-care skills
Narcissistic personality disorder
35
Social inhibitions; feelings of inadequacy; hypersensitive to negative evaluation
**** NI*****
Support and reassurance; cognitive restructuring techniques; promote self-esteem
Avoidant
36
Submissive and clinging behavior; excessive need to be taken care of
**** NI***
Foster client's self-reliance and autonomy; teach problem-solving and decision-making skills; cognitive restructuring techniques
Dependent
37
Preoccupation with orderliness, perfectionism, and control
**** NI ****
Encourage negotiation with others; assist client to make timely decisions and complete work; cognitive restructuring techniques
Obsessive-
| compulsive
38
Pattern of depressive cognitions and behaviors in a variety of contexts
**** NI****
Assess self-harm risk; provide factual feedback; promote self-esteem; increase involvement in activities
Depressive
39
Pattern of negative attitudes and passive resistance to demands for adequate performance in social and occupational situations
*****NI****
Help client to identify feelings and express them directly; assist client to examine own feelings and behavior realistically
Passive-aggressive
40
nursing interventions include speaking calmly and nonthreateningly, conveying empathy, listening, offering PRN medication, and suggesting retreat to a quiet area
triggering phase
41
causes EXCESSIVE production of DOPAMINE
Schizophrenia
42
- hard time making decisions
Ambivalence
43
- fragmented or poorly related thoughts & ideas
| - When you & the pt are talking about one topic & the pt goes off on a tangent with one word
Associative looseness
44
-fixed false beliefs
Delusions
45
- repetition of MOVEMENTS & GESTURES of another person the client is observing
Echopraxia
46
- repeating WORDS
Echolalia
47
- client jumps from one topic to another
• Many ideas in your head that all come out at once
Flight of ideas
48
- false impressions that external events have special meaning for that
person
• You believe everything refers to you
Ideas of reference
49
- verbal repetition of a sentence, word, or phrase
• Repetitive thought
Perseveration
50
- absence of will or drive to take action to accomplish tasks
Avolition
51
- acute, reactive psychosis for
Schizophreniform disorder
52
one or more bizarre delusions & the focus of the delusion is believable
• Delusion may be persecutory, erotomanic, grandiose, jealous, or somatic in content
Delusional disorder
53
- allows clients to practice & develop social skills
• Designed to help clients remediate or improve client’s deficits such as attention, memory, & information processing
• Help the client take the perspective of another person, rather than focus entirely on themselves
Cognitive enhancement therapy
54
- ideas that are related to another based on rhyming
• Ex:“IwilltakeapillifgoupthehillbutnotifmynameisJill,Idon’twanttokill”
Clang associations
55
- new words that have meaning to the pt
Neologisms
56
- repetition of words or phrases that may/may not have meaning to the listener
Verbigeration
57
- combination of jumbled words & phrases that are disconnected & make no sense
to the listener
Word salad
58
-client is talking & stops in the middle of a sentence & remains silent
Thought blocking
59
- fixed, false beliefs with NO basis in reality
Delusions
60
- FALSE sensory perceptions or perceptual experiences that DON’T exist in
reality
Hallucinations
61
Mature or aged cheeses: lasagna, pizza
Aged meats: pepperoni, salami, mortadella, summer sausage, beef logs, meat extracts
Fava beans, tofu, banan peel, overripe fruit, avocado
Tap beers & microbrewery beer
Sauerkraut, soy sauce/soybean condiments
Yogurt, sour cream, peanuts, brewers yeast, MSG
Tyramine
62
- developmental issue, predictable events in normal course of life
• Ex: leaving home for the 1st time, getting married, beginning career
Maturational
63
- unanticipated or sudden events
• Ex: you lose your job & can’t afford to pay the bills, significant other death
Situational
64
- uncontrolled event
• Ex: natural disasters, violent crime, rape, mugging, murder
Adventitious
65
looks HOLISTICALLY (mind, body, spirit)
• Focuses on the client’s cognitive abilities
• Includes orientation, time, place, date, season, & day of the week
• The FEWER tasks the client completes accurately, the GREATER the cognitive deficit
MSE- mental status examination
66
- overall appearance, including dress, hygiene,
& grooming
• Observe the clients posture, eye contact, facial expression, unusual tremors or tics
General appearance & motor behavior
67
- rapidly changing mood
LABILE
68
- 5 senses- visual hallucination, auditory hallucination (hearing voices- who's voice are they hearing & what is it saying?), gustatory (tasting something), olfactory(smelling something), tactile (bugs crawling on you)
Sensorium & intellectual process
69
- having understanding
• Ex: psych pts. have good insight about their illness when they know they have to take
their meds & go to a program b/c if they don’t they’re going to decompensate & go
back into the hospital
Insight
70
the way one views themselves in terms of personal worth & dignity
• RN can assess this by asking about the pts. coping strategies
Ex: “What do you do when you have a problem? How do you solve it? What usually works to deal with anger or disappointments?”
Self- concept- self esteem
71
- emotional problems can affect eating & sleeping
patterns.
Physiologic self care concerns
72
- parity law; Timothy’s family fought for parity & equality dealing with the amount of days allowed for psych pts
• If someone has a medical illness & they can get extra days so can psych patients
Timothy’s law
73
-mandatory out patient treatment known as AOT (assisted out patient
treatment)
*AOT- pt who has hx of VIOLENCE & when he/she leaves psych hospital they follow up
visit is NECESSARY* *NO follow up = LEGAL risk!*
Kendra's law
74
• NOT guilty by reason of insanity
M’ Naughten rule
75
- relationship between interpersonal rejection & aggression
• If your ego is wounded you may get mad & handle it the wrong way (basis of domestic
violence issues)
Wesselman
76
Agoraphobia
Panic disorder
Generalized anxiety disorder
Anxiety disorder
77
0.5-1.5
Lithium
78
```
Severe diarrhea
Vomiting
Drowsiness
Muscle weakness
Lack of coordination
----> renal failure, coma, death
```
Lithium
79
```
Facial/body flushing
Throbbing headache
Sweating
Dry mouth
Nausea
Vomiting
Dizziness
Weakness
Chest pain
Dyspnea
Severe hypotension
Confusion
```
Disulfiram
80
is part of one's nature that reflects basic or inmate desire is such as pleasure seeking behavior, aggression, and sexual impulses. seeks instant gratification, causes impulsive unthinking behavior, and has no regard for rules or social convention
***** Devil
The ID
81
is the balancing our mediating force between the ID and the super ego. represents mature and adaptive behavior that allows a person to function successfully in the world.
Ego
82
Part of the persons nature that reflects moral and ethical concepts, values, and parental and social expectations
**** Angel
Superego
83
Substituting a socially unacceptable activity for an impulse that is unacceptable
--- smoking
Sublimation
84
Acting the opposite of what one thinks or feels
| --doesn't want kids becomes super mom
Reaction formation
85
Excepting another person's attitude believes and values as one's own
Dislikes guns becomes avid hunter
Intronjection
86
Separation of the emotions of a painful event or situation from the facts involved acknowledging the facts but not the emotion
-- no expression when discussing car accident
Intellectualization
87
Is the ability to express positive and negative ideas and feelings in an open, honest, and direct way. It recognizes the rights of both parties and is useful in a variety of situations such as resolving conflicts
- works best when the speaker is calm makes specific factual statements and focuses on "I" statements
Assertive communication
88
1. Re-experience events through dreams, recurrent, intrusive thoughts
• Ex: may be at work a few weeks later & all of a sudden relive the event
• 2. Emotional numbing- feeling detached, on guard, irritability, hyperarousal
3. Flashbacks- reliving the event; feeling of the flashback is the same intensity & levels when the event actually occurred
PTSD
89
• Occurs right after the traumatic event but you eventually get over it
• May go for crisis intervention & be okay (happens & resolves= SHORT TERM) • One technique is CBT (change the thinking we can change the behavior)
• Sometimes we don’t get better & it progresses to PTSD
Acute stress disorder
90
Panic disorder, social & specific phobias have - COULD BE
passed down through genes
MODERATE heritability
91
GAD, OCD - DEFINITELY passed down through genes
INCREASED heritability
92
: anxiety generated from problems in interpersonal relationships
• If you’re not getting along with someone that is causing your anxiety
Sullivan
93
- turning negative messages into positive ones
• Ex: instead of thinking “My heart is pounding. I think i’m going to die! the client thinks “I can
stand this. This is just anxiety. It will go away.”
Positive reframing
| Anxiety d/o
94
- involves therapists use of questions to more realistically appraise the situation
What is the worst thing that could happen? Is it likely? Could you survive that? is it as bad as you imagine
Decatastrophizhing
| Anxiety d/o
95
CBT, deep breathing, relaxation, anxiolytics
Treatment of Anxiety d/o
96
- anxiety is being transferred into a PHYSIOLOGICAL problem
• You believe you have a physiological problem BUT when the doctors try to do tests they come
up negative
• Problem is really in your head
• You have anxiety & somatisizing anxiety physiologically
Somatic symptom disorder
97
world backward
Serial 7
Repeat days of week backward
Ability to concentrate
98
Cognitive abilities and intellectual functioning
Intelligence test
99
Self concept impulse control reality testing and major defense
Personality tests
100
Observe clients eating, drinking, & elimination patterns
Assess & monitor the clients sleep patters; prepare for bedtime by DECREASING stimuli & providing comfort
LT- after discharge client utilized Tai Chi class successfully to help alleviate anxiety
Applying nursing process/ OCD
101
Pin rolling, mask-like face, stiff,shuffling gait, crooked walk
Pseudo Parkinson's s/e of 1st generation antipsychotics
102
- absence of will or drive to take action to accomplish tasks
Avolition
| Hard symptom
103
- acute, reactive psychosis for
Schizophreniform disorder
104
client experiences sudden onset of at least 1 psychotic symptom such as delusions, hallucinations, or disorganized speech which lasts from 1 day- 1 month
Brief psychotic disorder
105
- known to diminish negative effects of schizophrenia & REDUCE relapse rate
Education group/family education
106
- client feels detached from his or her behavior
• Most extreme form of disorientation
• Although the client can state their name correctly, they feel as if their body belongs to
someone else or that their spirit is detached from the body
Depersonalization
107
- unrealistic beliefs about clients health status or bodily functions
Somatic
108
Lack of ego boundaries is evidenced by depersonalization, derealization, & ideas of reference
Deterioration of self concept
MAJOR problem
schizophrenia
109
Decision should be based on whether an action is morally right with no regard for the results or consequences
Deontology
110
Theory that bases decisions on the greatest good for the greatest number action would produce the greatest benefit for the most people
Utilitarianism
111
Is a reaction to a stressful event that causes problems for the individuals typically the person has more than the expected difficulty coping with an event into his or her life financial relationship and work related stressors are the most common events symptoms develop within a month lasting no more than six months
Adjustment disorder
112
Occurs before the age of five in response to trauma of child abuse or neglect is called grossly pathogenic care
• inappropriate social be late miss seeking comfort from select group of caregivers resistance to social contact
• unselective socialization
Reactive attachment disorder
113
Is a treatment approach designed to combat the avoidance behavior that occurs with PTSD Help the client face troubling thoughts and feelings and regain a measure of control over his or her thoughts and feelings
Exposure therapy
114
Is a specialized CBT approach developed by the military to offer an intense specific short term therapy for active-duty military personnel with PTSD
Adaptive disclosure
115
Mature or aged cheeses: lasagna, pizza
Aged meats: pepperoni, salami, mortadella, summer sausage, beef logs, meat extracts
Fava beans, tofu, banan peel, overripe fruit, avocado
Tap beers & microbrewery beer
Sauerkraut, soy sauce/soybean condiments
Yogurt, sour cream, peanuts, brewers yeast, MSG
Tyramine
116
S&S- changes in eating habits (weight loss/gain), hypersomnia or insomnia, impaired
concentration, decision-making problems, inability to cope w/ daily life, worthlessness,
hopelessness, guilt, despair, suicide thoughts
Major depressive disorder
117
- when person’s mood fluctuates b/x extremes of mania/depression
• S&S- include inflated self esteem or grandiosity, decreased sleep, excessive & pressured
speech, flight of ideas, INCREASED activity or psychomotor activity
Bipolar disorder
118
Depersonalization
| Derealization
Panic disorder
119
```
Exposure-confront situation and stimuli
Response prevention- focuses on delaying or avoiding performance of rituals
Relaxation
Deep breathing manage anxiety
Keep diary
```
OCD
120
```
Thought blocking
Thought broadcasting
Thought insertion
Thought withdrawal
Waxy flexibility
Word salad
```
Schizophrenia
121
Marked by cycle mortar disturbance either excessive motor activity or virtually immobility and motionlessness
Catatonia
122
```
Acute dystonic reactions
Seizures
Akathisia
Parkinsonism
Tardive dyskinesia
NMS
```
EPS
123
– Spasms in discrete muscle groups – neck muscles (torticollis), eye muscles (oculogyric crisis). May be accompanied by protrusion of the tongue, dysphagia, laryngeal and pharyngeal spasms that can compromise the pts airway. Very frightening and painful for the pt.. Treated with diphenhydramine (IM, IV) or benztropine (IM).
Dystonic Reactions
124
– Restless movement, pacing, inability to remain still, inner restlessness. Makes very clients very uncomfortable, the pt may stop taking meds because of this
Akathisia
125
A serious and frequently fatal side effect of antipsychotic meds characterized by muscle rigidity, high fever, increased muscle enzymes (creatine phosphokinase), leukocytosis (increased leukocytes). Treated by stopping meds.
Neuroleptic Malignant Syndrome:
126
- A late appearing side effect of antipsychotic meds characterized by abnormal movements such as lip smacking, tongue protrusion, chewing, blinking, grimacing and choreiform movements of the limbs and feet. Embarrasses clients, which lead to social isolation. IRREVERISBLE. Decreasing or stopping meds can stop progression
Tardive Dyskinesia
127
* Thought blocking
* Thought broadcasting – others can hear their thoughts
* Thought insertion – Others are placing thoughts in their minds against their will
* Thought Withdrawal – Others are taking their thoughts
Thought Process and Content
128
Flat affect
Blunted affect
Anhedonia
Schizophrenia
129
- Organs are not functioning or are rotting away
Nihilistic
130
Teach social skills through education, role modeling and practice
Schizophrenia
131
Insomnia
Weight loss
Poor appetite
Spring onset SAD
132
```
Hypersomnia
Increased appetite
CHO cravings
Weight gain
Irritability
```
Winter depression
133
Set LIMITS on behavior that is destructive
• ALWAYS stay grounded in reality & DON’T feed into neologisms & delusions/hallucinations
• DECREASE stimuli whenever possible b/c manic pts feed off stimuli
• Provide consistent, structured environment & always maintain SAFETY • Use firm, calm, relaxed approach
• Ensure physiologic needs- finger foods
Bipolar
134
-social isolation, ineffective individual coping, defensive coping, biological root
Cluster A
135
Paranoid
Schizoid
Schizotypal
Schizotypal
136
-powerlessness, self mutilation, risk for violence, altered family processes,
psychodynamic roots!*
Cluster B
137
```
Antisocial
Borderline
Histrionic
Narcissistic
* self mutilate
```
Cluster B
138
- self-esteem disturbances, hopelessness, anxiety-key factor, chronic trauma root!
Cluster C
139
Avoidant
Dependent
Obsessive
Cluster C
140
Tell the truth
Veracity
