Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

semester 4 > mental health 1 > Flashcards

mental health 1 Flashcards

(58 cards)

Start Studying
1
Q

Pica

A

Consistent eating of nonfood, nonnutritive substances for a month or more, usually early childhood, sometimes part of an intellectual disability. Can occur during pregnancy but not elevated to a diagnosis unless the severity poses medical risks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Rumination Disorder

A

Undigested food being regurgitated – then re-chewed or re-swallowed or spit out. Can be fatal in infants. Teens might hide it with fake coughing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Avoidant/Restrictive Food Disorder

A

Often due to sensory disgust of food characteristics and leads to failure to thrive. Not an eating disorder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anorexia Nervosa (AN)

A

Morbid fear of weight gain with failure to recognize low BMI, severity defined by BMI. Subtypes (1) Restricting type (2) Binge/Purge type

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bulimia Nervosa (BN)

A

Distress experienced: severe body dissatisfaction, severity defined by frequency of binge eating and compensatory behavior cycles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Binge-Eating Disorder (BE)

A

Distress (self-disgust, guilt, embarrassment, depressed, physically uncomfortable) due to out of control binge-eating, severity defined by frequency of binge eating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anorexia Nervosa Severity Guide

A

Severity defined by BMI (FYI healthy body weight aprox. 18.5-25)
Mild: >/= 17kg/m2
Mod: 16 to 16.99
Severe: 15-15.99
Extreme: < 15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Restricting type AN

A

no binge-eating or purging, might fast or exercise excessively -not counted as “purge” behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Binge-eating/Purge type AN

A

some binge-eating or purging, example: self-induced vomiting after eating a small meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bulimia Nervosa Severity Guide

A

Mild: binge-eating with 1-3 episodes of compensatory behavior per week
Mod: binge-eating with 4-7 episodes
Severe: binge-eating with 8-13 episodes
Extreme: binge-eating with 14 or more episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Binge Eating Definition

A

consuming a large quantity (more than what most people would eat) of food over 2 hours or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Compensatory behaviors

A

exercise, fasting, and purging (self-induced vomiting – most common, misuse: laxative/enemas, diuretics, thyroid hormone, omit needed insulin), some texts mix-up terms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Binge-Eating Disorder

A

No purging behavior, severity defined by frequency of binge-eating.
Mild: binge-eating 1-3 episodes per week
Mod: binge-eating 4-7 episodes
Severe: binge-eating 8-13 episodes
Extreme: binge-eating 14 or more episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anorexia/Starvation S/S

A

Low efficacy for antidepressants due to lack of endocrine function/hormones/enzyme, and lack of tryptophan intake.
Osteopenia and osteoporosis from ↓ Calcium
Cold and weak from ↓ Thyroid function and decreased VS
Amenorrhea due to lack of hormones
Lanugo (theory – increase warmth)
Hypercarotenemia – orange hue to skin
Excessive exercise
Constipation
Watch for refeeding edema (increased heart rate ….)
EMERGENCIES Below 75% ideal body weight, rapid weight loss, Temp < 96.8, HR < 40, Systolic BP < 70 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Purge Bulimia Nervosa

A

self-induced vomiting is most common, also use of laxatives, diuretics, ipecac, skipping insulin, and thyroid hormone abuse. Might use purge markers such as red smarties before binge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Russel’s sign

A

calluses on back of hand from teeth grazing hand during self-induced vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bulimia Nervosa s/s

A

Russel’s sign, enlarged parotid glands (from high serum amylase), dental caries (from acidic emesis)
Emergencies can include: Potassium < 3 mEq/L, severe dehydration, cardiac arrhythmias, metabolic alkalosis (from increased serum bicarbonate) r/t vomiting, metabolic acidosis (decreased serum bicarbonate) r/t laxatives
High comorbidity: 94% psychiatric issues, 30% substance abuse issues, self-injurious behavior and other impulsive behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cognitive Distortions s/s

A

Overgeneralizations - single negative event is equated with never ending negative situation: “no one will like me if I am fat.”
All-or-nothing thinking - also known as black or white thinking: “I can either have all the cake or none at all.”
Catastrophizing – exaggerating the importance of an event leading to an intolerable situation: “If I gain weight my life will be meaningless.”
Personalization - “Everyone is talking about how fat I am.”
Emotional reasoning – mixing up feelings with facts: “I feel puffed up so I know everyone sees me as gross and fat.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Long Term Goals: Eating Disorders

A

AN: - Weight gain is the priority. Medical Hospitalization – restore 75% ideal body weight before discharge
Acute Inpatient psych/Eating Disorder Rehab Center – 85%
Partial Hospitalization/OP 90% or more

BN: Interrupting the binge-eating/purging cycles is the priority
Reduce binge/purge cycle

Unless the binge/purge BX causes a medical emergency that becomes the priority
In reality address both weight gain and interrupting the cycles

BE: Reducing the binge-eating episodes is the priority, may also be a bariatric patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Therapeutic Relationship: Eating Disorders

A

do not blame the client
“Help rejecting” can elicit strong countertransference
The nurse’s own relationship with their body and with food needs to be healthy.
Be careful to NOT take a guard or parental approach even when the client is childlike in their behavior
Resistance to change is pervasive and strong, it is part of the illness
Express empathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

AN Interventions

A

Supervise meals- provide low stress environment while watching for food avoidance. Record how much was eaten.
Locked bathroom one hour after meals
Weigh client 3 times a week – gown only, in morning before breakfast after voiding (watch for water loading or hiding heavy items before weight-in
Monitoring VS
Groups and one-to-one talks with nurse: to challenge cognitive distortions, insight into vicious cycles in eating disorders, and providing education on healthy eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

BN Interventions

A

No exercise until binge/purge cycle is more controlled
Acknowledge strong emotions that surface when binge or purge behaviors are interrupted and help client to use healthy coping skills
Help the client make the connections between BN and avoiding life problems
Encourage discussion of the common distress is related to body shame or guilt over body size and shape (FYI – clients with binge eating DO experience distress over out of control binge eating)
Watch for hypokalemia
Watch for risk behaviors and substance abuse behaviors that are more common in individuals with BN versus AN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

General Adaptation Syndrome

A

Alarm reaction stage
Fight, flight, or freeze response starts to prepare for defense
-Adrenal glands – epinephrine and norepinephrine
-Liver converts glycogen stores to glucose
Resistance stage
-blood shunted away from areas such as the GI system to lungs and heart to deliver more oxygen to muscles
Exhaustion stage
-Continual arousal of defense systems and emotions
-Body stores depleted
-Low resistance to disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Mild Level of Anxiety

Study These Flashcards
A

Mild - special attention:
Increased sensory stimulation
Motivational, increased learning, effective problem solving
“Butterflies”

25
Moderate Level of Anxiety
Moderate - something definitely wrong: Focus on one task only Hard to make connections between concepts – hard to learn on own Example – nursing students learning new skill anxiety with prompts Increased pulse, dry mouth, speech rate and pitch, urination, irritation Nurse able to redirect the patient
26
Severe Level of Anxiety
Severe - trouble thinking and reasoning: Reduced perceptual field Can focus on one detail only or scattered details Cannot complete tasks or respond to redirection Tightened muscles, ↑ VS, N&V, restless, irritable, angry, crying, vertigo
27
Panic Level of Anxiety
Panic: fight, flight, or freeze response: Increased vital signs and behaviors, dilated pupils, bolting or freezing Self-focused, cannot talk, cannot process stimuli, may not even see danger Irrational, distorted perceptions, may experiencing hallucinations/delusions May be suicidal
28
Anxiety Defense Mechanisms
Compensation, conversion, denial, displacement, dissociation, identification, intellectualization, projection, rationalization, reaction formation, regression, repression, splitting, sublimation, suppression, undoing
29
General Criteria for Mental Health Disorders
The symptoms cause clinical distress or significant inability/impairment to work, complete education, perform usual roles, socialize or function 2. The symptoms are not due to substance use/withdrawal or other medical conditions – standard of practices: Rule out medical issues or physical issues Rule out other psychiatric issues that may better explain the signs and symptoms
30
Separation Anxiety
Excessive distress when anticipating or experiencing separation Excessive worry about losing significant other, accidents, kidnapping, refusal to sleep over or go out, nightmares, somatic issues
31
Specific Phobic
Marked and out or proportion fear towards a situation or object, must be 6 months or more. Interferes with functions of daily life, avoids situation or object
32
Social Anxiety
Similar to a specific phobia Distress caused by possible scrutiny of others and social interactions
33
Panic Disorder
Recurrent and unexpected panic “attacks” followed by (for at least a month) Persistent worry of another attack OR avoidance of situations that might trigger an attack
34
Agoraphobia
Similar to a specific phobia Fear 2 of the following 5 Using public transportation Open spaces Enclosed spaces Standing in a crowd or line Being outside the home alone
35
Generalized Anxiety Disorder (GAD)
Over half the time in the last 6 months: Excessive anxiety and worry and with 3 or more of the following Restlessness/on edge Easily fatigued Decreased concentration Increased irritability Muscle tension Sleep disturbance
36
Obsessive-Compulsive Disorder (OCD)
Obsessions are unwanted, intrusive, repetitive thoughts or images. Thoughts lead to intense fear or distress Compulsions are repetitive behaviors or alternative thoughts, used to decrease OR PREVENT the obsessive thoughts, fear, or distress Experience one or both for at least an hour a day
37
Body Dysmorphic
Preoccupied with a perceived physical body defect Excessive observation, grooming, other BX targeting the “defect” Example – excessively discussing the differences between their nose and your nose
38
Hoarding
Cannot part with possessions regardless of actual value Worries that they will need the item in the future Clutter compromises use of home OR it is orderly but only due to helpers
39
Trichotillomania
Recurrent pulling out of hair Results in hair loss Repeated attempts by patient to stop pulling out hair Common areas: scalp, eyebrows, eyelids
40
Excoriation
Skin picking resulting in lesions Most common – face, arms, hands – using fingernails Can pick healthy skin or skin with a irregularity
41
Disruptive Mood Dysregulation DO
temper outbursts in younger folk
42
Major Depressive DO
Includes MDD with seasonal pattern (old term “Seasonal Affective DO”)
43
Persistent Depressive DO (Dysthymia)
milder depression than MDD
44
Premenstrual Dysphoric DO
S/S week before menses, improves a few days after menses
45
Bipolar I DO
has had mania or hospitalization or psychosis
46
Bipolar II DO
less severe than Bipolar I DO (no psychosis, never mania, never need for hospitalization)
47
Cyclothymic DO
less severe than Bipolar II
48
Depression Assessment
Always assess if the client has: SI, psychosis (hallucinations, delusions, disorganized brain), anxiety (50-60% will have anxiety)
49
Comorbidity Concern: Bipolar and Depression
we do not want them to flip into a drug induced mania caused by using only an antidepressant, people with bipolar disorders need a mood stabilizer
50
HAM-D 17 items to score
Depressed mood, Guilt feelings, suicide, insomnia (early, middle and late), work and activities, retardation - psychomotor, agitation, anxiety, somatic symptoms, sexual dysfunction, hypochondria, unintended weight loss, insight
51
HAM-D Scoring
0 - 7 = Normal 8 - 13 = Mild Depression 14-18 = Moderate Depression 19 - 22 = Severe Depression >23 = Very Severe Depression
52
ECT “Electroconvulsive Therapy”
check BM High efficacy for MDD Highly regulated but relatively safe Temporary memory loss is frequent Done under general anesthesia, 3 x week for 12 treatments, then monthly
53
Bipolar II DO bumped up to Bipolar I if the client
Has, or has had, full blown mania in their mood cycles for a period of a week or more Has, or has had, periods of psychosis Has, or has had, S&S severe enough to require acute psychiatric hospitalization
54
Bipolar I High Risk Behaviors
spending sprees, bad business investments, indiscriminate sex, gambling, stealing
55
Five Steps in the SAFE-T approach
Identify Risk Factors Identify Protective Factors Assess Suicidal Ideation (SI) Determine Risk Level and Appropriate Interventions Document
56
Stages of Change and Addiction
Pre-contemplation (‘denial’) Contemplation Preparation Action Maintenance Relapse Assess the stage to focus on the best intervention for that stage
57
Negative Symptoms Schizo
Affective blunting - minimal emotional response (but has feelings) Avolition - decrease in motivation/initiative/spontaneity. Alogia - decreased (old term: poverty) of speech and thought Anergia - lack of energy Anhedonia - lack or loss of pleasure in pleasurable activities Anosognosia NOT DENIAL(this is a symptom, not a defense mechanism or coping skill, and usually leads to decreased interest in taking prescribed medication). Anosognosia negatively correlates with and predicts prognosis. Asociality - lack of interest in social interactions Attention Impairment – not able to focus on important details
58
Catatonia
Waxy flexibility – slow even resistance and then a possible “melt” when clinician moves pts limbs Catalepsy – pt. maintains the position after the clinician has moved pt. limbs (even if it is against gravity) Posturing (active) pt. demonstrates spontaneous posture and holds it, even if against gravity Echopraxia (mimic movement of others) Stereotypy (repetitive non-goal bx) Mutism/Stupor (non-reactive) Staring

semester 4 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions