Final Exam Flashcards by Angelina Franco

What is trichtillomania?

Hair pulling disorder
Ex: pulling hair from scalp, eyebrows, or other areas of the body

Treatment: antidepressants

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What is mutism?

The inability or willingness to speak
Can happen due to a traumatic event

*Selective Mutism is only talking in certain situations.

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Phobia?

The intense fear of a specific item or situation

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How do you know someone with anorexia is getting better

Gaining weight
No compulsive actions
Vitals return to normal
Absence of cognitive distortions

They are eating something
observe patient while eating and 1-3 hrs after

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Borderline personality disorder: What to do if they get angry?

Low stimuli
Separate from the room
Change of scenery

Want to prevent self mutilation & self harm
- these ppl are often self injurious & suicidal

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What is the purpose of the SANE nurse

Sexual assault nurse examiner

-Trust & security

They also provide compassion

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Main symptoms for someone clinically depressed ?

Anedonia- loss of pleasure in things they used to love doing

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The theory of Freud what is meant under “id”

Pleasure motivated
Instant gratification
Impulsivity
Devil

This is where sexual desire, jealousy, greed, and self preservation come from

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What does behavior therapy focus on ?

Change maladaptive behaviors

Examples of maladaptive behaviors: avoidance, withdrawal (avoiding stressful situations)

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How would you describe Milieu Therapy?

Low stimuli
Structured
safe - no hazards or weapons, & having supervision
Increase self esteem
Decrease isolation

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Warning signs of suicide

Giving away possessions
More energy but still having depressive episodes
Sudden change in mood

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What kinds of food to ignore when taking methylphenidate?

Stimulants

Ex: caffeine, coffee, tea, cola, energy drinks

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Medications for anorexia

Olanzepine
Fluoxetine

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Which medications to avoid with anorexia

laxatives and diuretics

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Symptoms of depression?

Loss of appetite
Flat affect
Loss of energy
Insomnia or hypersomnia
No motivation
low self esteem
irritable
somatic pains

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How to prevent a relapse?

Try to identify what the clients triggers are

This is in regards to relapse of schizophrenia, eating disorders, substance abuse, etc.

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What is reactive attachment disorder?

Doesn’t respond to comfort or seek comfort
- does not show response when given comfort

This can be due to emotional neglect or abuse at a certain age

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Medications for paraphilia (abnormal sexual desires)

Naltrexone [normally to prevent relapse into alcohol or drug abuse
Antidepressants
- Lithium
- SSRIs
Mood stabilizers
- Valproate, valproate acid, divalproex, depakote, carbamazepine, lamotrigine
2nd Gen antipsychotics
- Risperidone
- olanzepine
- clozapine

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What is a poor coping skill?

Drinking alcohol

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Someone refusing medication, what do you do first?

-assess identify the reasons why they don’t want the medication
-Then document

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Who would be placed on an involuntary legal hold?

Someone who is a harm to themselves or others
Greatly disabled

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Someone panicking, how would you communicate

Short, simple commands

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If someone looks sad, not answering questions, and makes no eye contact then what are you concerned about?

Worried if they are going through some type of abuse

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If taking care of a child who needs to care for younger siblings that are not going to school.

We can consider this as neglect

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When can you breach confidentiality

-When someone has been threatened -STDs (since they are a threat to infect someone else)

Why does someone act on an impulse with an impulse control disorder?

-achieving relief -they get a sense of pleasure

Medications to treat ADHD

Methylphenidate Amphetamine salts Lisadexafetamine Atomoxetine Bupropion

If someone wants to end their life what do you want to ask ?

Ask what their plan is

Best therapy for depression

Cognitive behavioral therapy

If someone is inattentive, impulsive, hyperactive; what class of meds are best

CNS stimulants

If someone is having delusions & hallucinations what meds are best?

Antipsychotics Examples:

Labs that indicate sexual abuse

STI Children: Bruising Swelling and bleeding in genital area Hard time sitting

Signs of emotional abuse

Harsh criticism *Low self esteem Humiliation *Rationalizing for abuser

If a suicidal person is being discharged how to know if they are safe

- They have a safety plan knowing they have resources outside Ability to reach out

Someone having auditory hallucinations

Ask what they are saying Beware of command hallucinations

How long does it take for antidepressants to start working

Few weeks 2-4 weeks

What antipsychotics give extrapyramidal symptoms

First gen antipsychotics Chlorpromazine Loxapine Fluphenazine Haloperidol

What disorder has a hard time following directions, disorganized, and hard time at work.

ADHD - starts in adolescence

Specific meds for major depression

SSRIs *— Citalopram — Escitalopram — Fluoxetine — Paroxetine* SNRIs *-- Venlafaxine -- Desvenlafaxine -- Duloxetine -- Levomalinacipran * TCAs *— Amitriptyline — Doxepine — Imapramine — Nortriptyline * MAOIs *— Phenelzine — Isocarboxazid — Tranylcypromine — Selegiline*

What does attending mean for our patients

Being there for patient The intensity of presence

Most common mental illness

Anxiety

Alcohol intolerance- how is it seen ?

No affect with high BAC level > 0.08

Interventions for Alzheimer’s disease

Remind them to do ADLs Short instructions in step by step - break activity into short time frames Encouraging Keep consistent daily routine Minimize need for decision making to avoid frustration

Pavlov- Behavioral theory

Conditioning: dog example

B.F skinner - behavioral theory

Behaviors are learned through both positive or negative reinforcement

Aversion therapy

Punishment through pain Ex: pedophile with electrodes on his penis

Peplau- Interpersonal theory

Nurse-patient relationship influences patient outcomes

Neglect signs

Underweight Poor hygiene School problems Stealing food Early or late to school Psychosomatic complaints * Headache * backpain * muscle pain * stomach pain

Cycle of violence

Honeymoon phase Tension-building phase Serious battering phase (Can then go back to honeymoon phase)

Honeymoon phase

Abuser: Loving behavior, regretful, sorry, makes promises to change Victim: trusting, hoping for change, wants to believe partners promises

Tension-building phase

Abuser: edgy, has minor explosions, may become verbally abusive, minor hitting, and other incidents Victim: Feels tense and afraid, walking on eggshells, feels helpless, and blames themself

Serious battering phase

Abuser: serious battering incident Victim: may cover up injury (wear turtleneck) or may look for help. The victim may provoke an incident to get it over it

Why do people stay when being abused?

Being afraid of being murdered Lack of exposure to violence Dependence for financial need

Interventions for Intimate partner violence (IPV)

Assess in nonthreatening manner Do they have a safe place? *Remind them that it is not their fault*

Who’s at higher risk for elder abuse

Those with psychiatric illnesses Women 80+ *Abuser usually son or nephew *

Sexual violence

Completed or attempted penetration of a victim Even just talking about it Unwanted sexual contact *act of violence, power and hate* **93% of perpetrators are someone they know**

Vulnerable individuals for sexual violence

Women Ages 16-19 higher rate Higher risk —> history of sexual violence Ethnicity: Native Americans, Alaskan

Sexual violence-Young adults

Afraid to report Cannot remember incident clearly

Interventions for violent patient

**Always make sure you have access to an exit** Let patient yell, listen attentively Set clear limits “What will help now” Distraction Leave room ‘

Psychopharmacology for anger, agression, and violence

Fast acting: Olanzepine, chlorpromazine Other: haloperidol and diphenhydramine