Final Exam Blueprint Flashcards

(100 cards)

1
Q

Most common complications of late stage NCD

A

-contractures, cannot move, cannot eat, cannot swallow, atrophy, cannot talk

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2
Q

Can clients with late stage NCD hear and see the outside world

A

yes

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3
Q

Nursing considerations for client in late stage NCD

A

-safety!
-learn how to effectively communicate with them

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4
Q

Expected MRI/CT findings for Alzheimer’s disease

A

-sulci begin to unfold
-changes to hippocampus (memory)
-changes to cerebral cortex
-amyloid-beta plaques, tau neurofibrillary tangles, neuronal damage

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5
Q

Area of the brain associated with impaired visuospatial skills

A

parietal lobes?

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6
Q

Opioid intoxication interventions

A

-safety is main priority (may need 1 on 1 observation)
-low stimuli environment
-monitor clients RR, BP and other VS

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7
Q

Symptoms of opioid intoxication

A

slurred speech, impaired memory, small pupils, decreased respirations, decreased LOC

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8
Q

What is the antidote for severe opioid intoxication

A

naloxone

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9
Q

What is disulfiram used for

A

maintaining abstinence from alcohol

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10
Q

Patient teaching for disulfiram

A

-avoid contact with any forms of alcohol (mouthwash, cough syrup, aftershave, hand sanitizer)
-wear a medical alert bracelet
-participate in a self-help program
-potential for acetylaldehyde syndrome (if alcohol is consumed)

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11
Q

Symptoms of acetaldehyde syndrome

A

N/V, sweating, palpitations, hypotension, respirator depression, cardiovascular suppression, seizures ,death

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12
Q

Recovery success in drug treatment

A
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13
Q

First 24 hours of alcohol withdrawal priority intervention

A

-begin treatment so we do not have tremens delirium
-seizure precautions

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14
Q

What medications treat alcohol withdrawal

A

benzodiazepines, anticonvulsants

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15
Q

Symptoms of alcohol delirium

A

hallucinations, severe disorientation, severe hypertension, cardiac dysrhythmias, delirium

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16
Q

What type of drug is risperidone

A

atypical antipsychotic

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17
Q

What type of disorders does risperidone treat

A

psychotic disorders (schizophrenia, delusional disorder, schizoaffective disorder)
-treats negative symptoms (5 A’s)

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18
Q

What are the 5 A’s?

A

-affect (blunted)
-alogia (poverty of thought or speech)
-anergia (lack of energy)
-anhedonia (lack of pleasure or joy)
-avolition (lack of motivation)

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19
Q

client education for risperidone

A

-report indications of metabolic syndrome (increased thirst, urination, appetite)
-monitor blood pressure and HR for orthostatic hypotension
-increase fiber, fluids, exercise (anticholinergic teaching)
-monitor for EPS symptoms
-sexual dysfunction can occur
-monitor for amenorrhea, galactorrhea, and gynecomastia
-avoid smoking
-avoid high and low temps
-avoid alcohol and OTC meds
-sunblock and protective clothing

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20
Q

Should respiridone be used in clients with dementia

A

no

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21
Q

We should tell those on risperidone to avoid

A

-drinking alcohol
-becoming pregnant/breastfeeding

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22
Q

What are the EPS symptoms clients on risperidone should monitor for

A

tardive dyskinesia, acute dystonia, Parkinsonism, dystonia, akathisia

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23
Q

What is tangentiality a symptom of

A

psychotic disorder

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24
Q

What is tangentiality

A

veering away from the topic of discussion and demonstrates difficulty In maintaining focus and attention

“Tangential thinking involves abrupt changes in subject matter that are unrelated to the initial topic”

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25
What is meant by 'prodromal symptoms'
early signs of a disease
26
Prodromal symptoms of schizophrenia
-depression, social withdrawal, cognitive impairment, OCD behaviors
27
When may ECT be utilized
depressive disorders, mania, schizophrenia
28
Nursing interventions before ECT
-CBC, urinalysis, ECG, X-ray -maintain NPO status
29
Nursing interventions during ECT
-succhinylcholine given (prevent seizures) -monitor airway and administer oxygen - monitor patient has bite block during seizure
30
Nursing interventions following ECT
-monitor HR, BP, and RR q 15 min for first hour -position patient on side -stay with patient until they are awake -assess patient for memory loss or decreased cardiovascular functioning
31
What factors increase a client's risk for suicide
widows, sex (women attempt more, more men die by suicide), financial strain, previous suicide attempt, family member die by suicide, diagnosed mental illness, being a minority, veterans, disabled, certain occupations (physicians, law enforcement officers, dentists, insurance agents)
32
A client is more at risk for suicide if their plan is
-more detailed, availability of the plan to be carried out, more lethal
33
Risk to a client once antidepressants take effect
suicidal ideation
34
Lithium carbonate is used to treat what class of disorders
bipolar disorders
35
lithium carbonate dietary education
maintain a diet adequate in sodium, drink 1.5-3L of water a day
36
Most common comorbid disorder found in children before being diagnosed with bipolar disorder
ADHD
37
what are signs and symptoms of ADHD
short attention span, irritability, hyperactivity, accelerated speech, talk a lot
38
What is the cognitive theory of fear
39
What is the therapeutic technique of flooding
involves exposing the client to a great deal of an undesirable stimulus in an to turn off the anxiety resposne
40
the flooding therapeutic technique is useful for clients who have
phobias
41
which neurotransmitter causes hyperarousal and anxiety
GABA
42
What are the two most common phobia disorders
agoraphobia, SAD (social anxiety disorder)
43
What is agoraphobia
fear of not being able to escape
44
What is social anxiety disorder
excessive fear someone may do something embarrassing/be judged/ negatively evaluated by others
45
What is a crisis precipitated by normal life changes
crisis of anticipated life transitions
46
example of a crisis precipitated by normal life changes
JT's wife had a baby and quit her job. JT is having to work extra shifts
47
Identify maladaptive responses to stress
adjustment disorder , self-harm, anger, substance abuse, withdrawal
48
Function of self-help groups in trauma care
group experiences, with or without a professional facilitator. members of the group exchange advice, share coping strategies, and support one another
49
How do members benefit from self-help groups
hope is derived from knowing that others have survived from similar traumas
50
the focus of crisis care in a client with stress/trauma
assessing for suicidal behavior, maintaining client safety, restore adaptive functioning and promote personal growth,
51
Which repressed emotion creates somatic and dissociative disorders
severe anxiety
52
Which somatic and dissociative disorder is more prevalent in adolescents
conversion disorder
53
What is the typical onset of DID
childhood, although the disorder may not be recognized until late adolescence or early adulthood
54
goals for anorexia nervosa
-improved self-body image -gradual weight increases -small, frequent meals -use of self-care activities -attending individual or group therapy
55
Bulimia nervosa assessment
-normal to slightly elevated bodyweight -BMI 18.5-30 -Russels sign (callouses) -low HR, BP, and body temp -enlargement of parotid glands -dental erosions -hypokalemia
56
Which disorders are strongly correlated to eating disorders
depression, personality disorders, substance use disorder, anxiety
57
Borderline personality disorder
-always in a state of crisis -frequent mood swings and changes in behacior -affect = extreme intensity -generate chaos , especially in interpersonal relationships -inappropriate outbursts of anger
58
What are some diagnostic criteria a patient must have to be diagnosed with BPD
-unstable self image -self damaging or impulse behavior -inappropriate anger -recurrent SI, threats, or mutilation -frantic effort to avoid abandonment -unstable interpersonal relationships
59
Common patterns of interaction with BPD
-clinging and distancing -splitting (pitting staff against each other) -self destructive behavior -impulsivity (safety risk to themselves, staff, milieu)
60
What is defensive coping
similar to acting out
61
Defensive coping interventions
-explain acceptable vs unacceptable behaviors -explain consequences of violation of limits -be consistent with enforcing limits -clear, concise, concrete -specific rules and regulations for the environment
62
Avoidant personality disorder
-awkward and uncomfortable in social situations -perceived as timid, withdrawn -sensitive, touchy, evasive -speech is slow and constrained, frequently hesitate -view others as critical/betraying/humiating
63
Which avoidant personality disorder, do they desire close relationships?
yes
64
Histrionic personality disorder
-colorful, dramatic, excitable -require constant affirmation and acceptance -engage in seductive, flirtatious behaviot -manipulative behavior to be the center of attention -easily influenced -fleeting and superficial relationships... provocative and sexua l
65
Obsessive compulsive personality disorder
-serious and formal demeanor -overly discipled, perfectionistic, preoccupied with rules -conscious of social ranking -inflexible and rigid -difficulty expressing emotions -concerned with organization, efficiency, and procedure
66
Dependent personality disorder
-lack of self-confidence, apparent in posture/voice/mannerisms -passive and acquiscent to desires of others -overly generous and thoughtful -discouragement, dejection, and pessimism in silence BUT appears to see the world through 'rose tinted glasses'
67
paranoid personality disorder
-on guard, hypervigilant, ready for threat -appear tense and irritable -avoids other people -do not accept responsibility for behaviors -envois of success -overly sensitive and misinterpret environmental clues
68
Most common symptoms of personality disorders
-impairment in interpersonal relationship functions -dysfunctions in thoughts, mood/affect, impulse control
68
Antisocial personality disorder
-disregard and violation of rights of other (since age 15) -failure to respect lawful behavior -deceitfulness, lying -impulsivity, failure to plan -reckless disregard for the safety of others -lacks remorse -repeated fights/assaults -failure to sustain consistent work
69
What makes up someone's personality
emotional and behavioral characteristics that are particular to a specific person -remains someone stable ad predictable over time
70
How do personality disorders develop
when there is a deviation in what is expected, behaviors go maladaptive, leads to distresses in life
71
How is our personality developed
hereditary, temperament, experiential learning, social interaction
72
Cluster A personality disorders will see behavior described as
odd, eccentric
73
Which personality disorders are cluster A ?
74
cluster B personality disorders will see behavior described as
dramatic, emotional, erratic
75
Which personality disorders are cluster B?
76
Symptoms of antisocial personality disorder we may see in children
abuse to other people or animals
77
Antisocial personality disorder is more common in men or women
men
78
Borderline personality disorder is more common in men or whomen
women
79
Nursing interventions for self-mutilation
-frequent and close observation -seek staff with experience -care for wounds in a matter-of-fact manner -encourage discussions about feeling -act as a role model -remove dangerous objects -redirect with physical outlets -ensure sufficient staff is available
80
Schizoid personality disorder nursing diagnosis
80
Characteristics of shizoid personality disorder
-profound defect in ability to form personal relationships -eccentric, isolated, lonely -lifelong pattern of social withdrawal -engage in solitary activities/ be with animals -work ion isolation and are unsociable, no desire for emotional ties -unable to experience pleasure
81
Factors impeding accurate assessment in children and adolescents
-language development. Children may not have language or cognitive skills to describe what is happening -Children demonstrate a wide variety of normal -difficult to distinguish if behavior indicates an emotional problem.
82
What questions should we ask during assessment with a child?
ask everything about the birth and pregnancy. Ask about any complications that might of occurred for mom or baby
83
What puts babies at higher risks for mental health disorders?
nutrition in womb and out, pre-mature birth, If mom used substances or alcohol while pregnant
84
What is intellectual Developmental Disorder?
onset of deficits and impairments during the developmental period of infancy or childhood
85
What four areas are effected by IDD?
86
What are some characterisitcis of IDD?
impaired ability to maintain personal independence and social responsibility
87
What areas are impaired with IDD?
daily living, social participation, and the need for ongoing support at school
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90
Pediatric PTSD
caused by experiancing, witnessingm or learning about something traumatic.
91
Pediatric PTSD can lead to what kind of disorder?
conduct disorder
92
Characterisitcs of Children with PTSD
93
What is an event that can cause a trigger an obsession with death and could cause PTSD in children?
funerals
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96
Difference between Ped conduct disorder and Intermittent Explosive disorder?
conduct: destructive and harm things with no remorse Explosive: harm but has remorse about it, more common in males 13-21
97
Why do we normally not perscribe medicine for kids under 8 for mental health disorders?
There are black box warning for SI on anti-depressants, so we want to try therapy first
98