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Community Mental Health Nursing > HESI Review > Flashcards

HESI Review Flashcards

1
Q

Milieu Therapy

A

Planned use of people, resources, and activities in the environment to assist in improving interpersonal skills, social functioning, and performing ADLs

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2
Q

Behavior Modification

A

Attempts to change ineffective or maladaptive behavioral patterns

Focuses on consequences of actions rather than peer pressure

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3
Q

Crisis Intervention

A

Directed at the resolution of an immediate crisis

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4
Q

Cognitive Therapy

A

Directed at replacing a client’s irrational beliefs and distorted attitudes

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5
Q

Electroconvulsive Therapy

A

Used with severely depressed clients who fail to respond to antidepressant medications and therapy

Anticholinergic (atropine sulfate) given 30 minutes prior to treatment

Have an emergency cart, suction, and oxygen ready

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6
Q

Displacement

A

Transference of feelings to another person or object

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7
Q

Projection

A

Attributing one’s own thoughts or impulses to another person

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8
Q

Reaction Formation

A

Development of conscious attitudes and behaviors that are the opposite of what is really felt

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9
Q

Repression

A

The involuntary exclusion of painful thoughts or memories

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10
Q

Sublimaiton

A

Substitution of an unacceptable feeling with a more socially accepted one

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11
Q

Suppression

A

Exclusion of feelings and ideas

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12
Q

Mild Anxiety

A

Increased levels of sensory awareness

Allows for logical thoughts

Associated with daily life and motivates learning

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13
Q

Moderate Anxiety

A

Motivates learning with assistance from others

Allows client to be attentive and able to focus, but not at an optimal level

Dulls perceptions of stimuli

Client is restless, has headaches, nausea, diarrhea, tachycardia

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14
Q

Severe Anxiety

A

Stimulates fight-or-flight

Stimuli input becomes disorganized

Impairs concentration and results in selective attention

Verbalization of emotional pain

Tremors, increased motor activity

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15
Q

Panic

A

Causes perceptions to be grossly distorted

Client feels overwhelmed

Anger and aggression

Requires immediate intervention

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16
Q

Generalized Anxiety Disorders

A

Unrealistic, excessive, or persistent anxiety and worry about two or more life circumstances

6 months or longer

Severe anxiety, motor tension, SOB, palpitations, on edge

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17
Q

Panic Disorders and Phobias

A

Discrete periods of intense fear or discomfort that are unexpected

Client recognizes fear is unrealistic but can’t help it

Autonomic hyperactivity, panic attacks, drug/alcohol use to cope

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18
Q

Obsessive-Compulsive Disorders

A

Repetitive thoughts (obsession) or irresistible impulses (compulsion)

Magical thinking, difficulty with interpersonal relationships, safety issues, recurring intrusive thoughts

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19
Q

Antianxiety Drugs

A

Benzodiazepines (epams)

Nonbenzodiazepines (Busipirone, Zolpidem, Ramelteon)

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20
Q

Benzodiazepines

A

Safer than sedative hypnotics

Administer at bedtime

Avoid alcohol

Gradually taper drug therapy

Short-term drug

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21
Q

Antidepressants

A

Tricyclic

MAOIs

SSRIs

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22
Q

Tricyclics

A

Amitryptiline, Desipramine, Imipramine

Anticholinergic effects

Administer at bedtime

Takes 2-6 weeks to achieve therapeutic effects

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23
Q

MAOIs

A

Isocarboxazid, Phenelzine sulfate

Depression, phobias, anxiety

May cause HTN crisis

Must not be used with tricyclics

Avoid tyramine (aged cheese, wine, beer, beef, chicken, chocolate)

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24
Q

SSRIs

A

Fluoxetine, Sertraline, Citalopram

Depression, anxiety, panic disorder, aggression, anorexia, OCD

Effective 2-4 weeks after treatment is initiated

Wait at least 14 days between discontinuing MAOI and starting Fluoxetine

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25
Traumatic and Stressor Related Disorders
Anxiety level is proportional to perceived degree of threat Shock, anger, panic, denial Self-destructive behavior Visible reminders of trauma
26
Antipsychotic Drugs
Phenothiazines Nonphenothiazines
27
Phenothiazines
Chlorpromazine Extrapyramidal symtpoms May cause drowsiness, weightgain, photosensitivity Used to control hallucinations, delusions, bizarre behavior
28
Nonphenothiazines
Haloperidol Controls psychotic behavior with less sedation Severe extrapyramidal symptoms
29
Somatic Symptom Disorder
Long history of health visits to HCPs for multiple somatic complaints Most frequently pain, palpitations, or dizziness
30
Factitious Disorder
Deliberate exaggeration of symptoms for self gains
31
Munchausen Syndrome
Severe and chronic form of factitious disorder that may result in severe self-harm that requires treatment at the hospital
32
Factitious Disorder by Proxy
Occurs when a person foists deliberate fabricated symptoms onto another person
33
Munchausen Syndrome by Proxy
Occurs when a caregiver causes a child to require treatment for an injury stimulated by them
34
Malingering
Occurs when a client creates complaints for secondary gain (to obtain a disability check)
35
Dissociative Amnesia
Sudden temporary inability to recall extensive personal events Occurs after traumatic event Most common dissociative disorder
36
Dissociative Identity Disorder
Person assumes two or mote identities simultaneously Emerges during stress
37
Depersonalization Disorder
Characterized by temporary loss of one's reality and the ability to feel and express emotions Expresses detachment with regard to surroundings
38
Schizotypal Personality
Has interpersonal deficits Has eccentricities and odd beliefs Is socially isolated
39
Antisocial Personality
Shows aggressive acting-out behavior pattern without remorse Clever and manipulative Lacks social conscience; immature and impulsive
40
Borderline Personality
Has disturbances regarding self-image Shows impulsive, self-damaging behavior, makes suicidal gestures Overly dependent Self-critical, demanding, whiny, manipulative, argumentative, verbally abusive
41
Narcissistic Personality
Perceives self as all-powerful and important, is critical of others, arrogant Needs attention and admiration Exploits others, lacks empathy
42
Avoidant Personality
Socially inhibited, feels inadequate Hypersensitive to negative criticism/rejection Longs for relationships
43
Dependent Personality
Has unreasonable wishes/wants, expresses needs in a demanding manner while professing independence Passive and does not accept responsibility Low self-esteem
44
Obsessive-Compulsive Personality
Attempts to control self through the control of others or the environment Shows inattention to new facts or viewpoints Perfectionist, cold and rigid towards others Preoccupied with efficiency and productivity
45
Anorexia Nervosa
Distorted body image and intense fear of becoming obese drive excessive dieting and exercise
46
Bulimia Nervosa
Eating disorder characterized by eating excessive amounts of food followed by self-induced purging
47
Mild Depression
Feelings of sadness Difficulty concentrating and performing activities
48
Moderate Depression
Feelings of helplessness and powerlessness Decreased energy Sleep pattern disturbances Appetite and weight changes Slowed speech, thought, movement Rumination on negative feelings
49
Severe Depression
Feelings of hopelessness, worthlessness, guilt, shame Despair, flat affect, indecisiveness, suicidal thoughts
50
Nursing Interventions for Depression
Directly ask about self-harm Do not give the client a choice about participating in activities Observe for sudden elevation in mood (may indicate increased risk for suicide) Encourage discussion of feelings Sit in silence if client in nontalkative
51
Suicide Precautions
Previous suicide attempt History of family suicide Giving away possessions Depressed --> happy
52
Evaluation of Suicidal Intent
Identify the method (the more lethal the method, the higher the probability that attempt is imminent) Determine availability of method chosen
53
Mild Mania
Feeling of being on a high Feelings of well-being Minor alterations in habits
54
Moderate Mania
Grandiosity, talkativeness, pressured speech, impulsiveness, excessive spending, bizarre dress/grooming
55
Severe Mania
Extreme hyperactivity, flight of ideas, nonstop activity, talkativenss, easily distracted Delusions of grandeur or persecution
56
Mood-Stabilizing Drugs
Lithium carbonate Anticonvulsant Mood Stabilizers
57
Lithium Carbonate
Used for bipolar disorders Assess electrolytes (Na+) Keep salt usage consistent Do not use with diuretics
58
Anticonvulsant Mood Stabilizers
Valproic Acid, Carbamazepine, Lamotrigine
59
Key Symptoms of Schizophrenia
``` Delusions Hallucinations Disorganized speech Disorganized behavior Negative symptoms ```
60
Catatonia
Stupor (decrease reaction to environment) Rigidity (maintenance of a posture against efforts to be moved) Posturing (waxy flexibility) Negativism (resistance to instructions) Excitement (severely agitated)
61
Schizophrenia
Characterized by thought disturbance, altered affect, withdrawal from reality, regressive behavior, difficulty with communication, and impaired interpersonal relationships
62
Alcohol Withdrawal Symptoms
Begin 4-6 hours after drinking, peaks in 48-72 hours Delirium tremens may appear 12-36 hours after last drink Tachycardia, tachypnea, diaphoresis, hand tremors, insomnia, NV, paranoia, grand mal seizures, hallucinations
63
Disulfiram
Treatment of alcoholism; aversion therapy Causes NV, hypotension, headaches, rapid pulse and respirations, flushed face, confusion, chest pain, weakness
64
Opiate Withdrawal Symptoms
Dilated pupils, anxiety, diaphoresis, depression, fatigue, insomnia, tachycardia
65
Opiate Overdose Symptoms
Constricted pupils, respiratory depression, unconsciousness leading to coma, death
66
Antianxiety Drug Withdrawal Symptoms
Tremors, agitation, anxiety, abdominal cramps, NV, grand mal seizures
67
Antianxiety Drug Overdose Symptoms
Drowsiness, confusion, hypotension, convulsion, shock, coma, death
68
Delirium
Occurs in response to a specific stressor (infection, drug reaction, substance intoxication, electrolyte imbalance, head trauma) Reversible if it is recognized by its sudden onset Treatment is correction of causative disorder
69
Dementia
Cognitive impairments characterized by gradual, progressive onset; irreversible Aphasia, apraxia, agnosia
70
Attention Deficit Hyperactivity Disorder (ADD/ADHD)
Disruptive behavior, excessive talking, underachievement, failure to follow instructions
71
Autism Spectrum Disorder
Causes problems in social skills, communication, repetitive behaviors and routines, emotional attachment
72
Conduct Disorder
Characterized by callous and unemotional interpersonal relationships Significant impairment in social, educational, or occupational functioning Physical fighting, running away, lying, stealing, animal cruelty, truancy, vandalism, alcohol/drugs
73
Oppositional Defiant Disorder
Characterized by behavior that causes significant problems at school, work, or home Argumentativeness, blaming others, defying rules, obscene language, resentfulness, vindictiveness

Community Mental Health Nursing (4 decks)

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