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HESI > Mental health > Flashcards

Mental health Flashcards

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1
Q

what is the hallmark of psychiatric nursing?

A

therapeutic communication

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2
Q

face to face communication involves

A

verbal and nonverbal expression of the senders thoughts or feelings

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3
Q

What things convey cognitive and and affective messages?

A

voice inflection, rate of speech and words

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4
Q

how are nonverbal messages communicated?

A

via body language, eye movements, facial expressions, and gestures.

– nurses should always be aware that their nonverbal communication affects clients

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5
Q

messages are conveyed by the sender by what mediums

A

sight, sound, touch, smell, non-verbally

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6
Q

what are coping styles?

A

automatic psychological processes that protect the individual against anxiety and from awareness of internal and external dangers and stressors. The individual may or may not be aware of these processes

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7
Q

what are treatment modalities?

A

psychiatric and mental health treatment modalities used to promote mental health???

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8
Q

types of treatment modalities

A

Milieu Treatment
Behavior Modification
Family Therapy
Crisis Intervention
Cognitive Therapy
Electroconvulsive Therapy
Group Intervention

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9
Q

Milieu Treatment

A

planned use of people, resources, and activities in the environment to assist in improving interpersonal skills, social functioning , and performing the ADLs as well as safety and protection for all clients

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10
Q

Where does milieu treatment occur

A

in inpatient and outpatient settings where clients are provided an opportunity to actively participate in treatment , decrease social isolation, encourage appropriate social behaviors and educate clients in basic living skills

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11
Q

What do milieu treatments provide

A

safe places to learn and adopt mature and responsible behavior through through limit setting and client responses to maladaptive social responses

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12
Q

limit setting

A

a component that requires consistent setting of appropriate limits by all staff, nurses, physicians and health care workers to work with one another via shared communication to maintain and reestablish limit setting

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13
Q

Therapeutic communication techniques

A

acknowledgement
clarifying
confrontation
focusing
information giving
open-ended questions
reflecting/restating
silence
suggesting

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14
Q

acknowledgement

A

recognizing the client’s opinions and statements without imposing your own values and judgement

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15
Q

clarifying

A

process of making sure you have understood the meaning of what was said

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16
Q

confrontation

A

should be used judiciously calling attention to inconsistent behavior

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17
Q

focusing

A

assisting the client to explore a specific topic which may include sharing perceptions and theme Identification

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18
Q

information giving

A

feedback about clients observed behavior

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19
Q

reflecting/restating

A

paraphrasing or repeating what the client has said (do not overuse as client will feel as though you are not listening)

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20
Q

silence

A

can be therapeutic or can be used to control interaction; used cautiously with paranoid patient, may support paranoid ideation

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21
Q

suggesting

A

offering alternatives such as “Have you ever considered…?”

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22
Q

antianxiety drugs categories

A

benzos
nonbenzos

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23
Q

benzo drugs

A

chlordiazepoxide HCl

diazepam

Clorazepam

Lorazepam

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24
Q

nonbenzo drugs

A

busparone

zolpidem

ramelteom

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25
benzo indications
reduce anxiety induces sedation treats etoh withrawl
26
busparone indications
reduces anxiety helps ctrl symptoms insomina sweating palpitations related to anxiety
27
zolpidem indications
ST tx for insomina
28
ramelteon indications
LT tx for insomina binds melatonin receptors
29
benzo rxns
sedation drowsiness ataxia dizziness irritbility
30
benzo implications
at bedtime to reduce daytime sedation dont mix with etoh taper ST drug
31
busparone rxn
dizziness
32
zolpidem rxn
daytime drowsiness
33
ramelteon rxn
dizziness
34
busparone NI
takes weeks to become apparent
35
zolpidem NI
give with food 1-1.5 before bedtime
36
ramelteon NI
appropriate for clients with delayed sleep onset
37
tricyclics indications
depression clients with morbid fanatasiess that do not respond well to these drugs
38
tricyclic rxns
anticholinergic (dry mouth, blurred vision, consitpation, retention) CNS sedation CV TC HoT GI effects narrow therapeutic range
39
tricyclic NI
admin at bed time 2-6 weeks for effects 2-3 weeks from ~ to MAOIs avoid etoh and antiHT drugs lethal overdose and eval suicide risk
40
MAOI indications
depression phobias anxiety
41
MAOI rxn
TC urinary hesitancy, C impotence dizziness insomnia dry mouth retention HT crisis confusion
42
HT crisis
severe HT severe HA chest pain/palpitations fever sweating NV increased BP
43
MAOI NI
mix with tricyclics for HT crisis Tyramines can cause HT crisis do not take with SSRIs no OTCs caution with machinery
44
SSRI indication
depresssion anxiety panic agression OCD anorexia
45
SSRI rxn
drowsiness lightheadedness HA insomnia depressed appetite serotonin syndrome sexual dysfunction wt gain
46
SSRI NI
2-6 weeks HT crisis when with MAOI 14 days from MAOI to fluoxitine - 5 weeks otherway around bedtime in case of sedation caution with st johns wart taper
47
serotonin syndrome
3\> symptoms rapid onset of altered mental state agitation myoclonus hyperreflexia fever shivering diaphoresis ataxia D
48
atypical - trazodone indications
depression insomnia dementia with agitation
49
atypical - trazodone rxn
safer than tricyclics or MAOI
50
atypical - trazodone NI
4-6 weeks
51
SNRI indications
depression anxiety panic agression anorexia OCD DM neuropathic pain
52
SNRI rxn
N dry mouth insomina HA fatigue low appetitie more sweating sex dysfunction withdrawl at cessation
53
SNRI NI
no with MAOI 14 days from MAOI to SNRI monitor BP can cause HoT can worsen pretx symptoms same as SSRIs
54
NDRIs norepi dopamine reuptake inhibs indications
secondline antiD when SSRI and SNRI not effective enough anxiety sleep disturbances
55
antidepressant drug classes antiD
SSRI SNRI NDRI MAOI tricyclics atypicals
56
antipsychotic drug classes antiP
phenothaizines non-phenothiazines long-acting drugs atypicals
57
phenothiazines indications
to control psychotic behavior, hallu, delu, and bizarre behaviors
58
phenothiazines rxns
drowsiness ortho HoT wt gain extrapyramindal effects akathisia tardive dyskinesia pseudoparkinsons
59
phenothiazines NI
extrapyramidal effect (EP effects) are a major concern monitor older clients 2-3 weeks avoid etoh sedatives antacids
60
nonphenothiazines indications
ctrl psychotic behavior useful in psychomotor agitation associated with thought disorders
61
nonphenothaizines rxns
severe EP effects leukocytosis
62
nonphenothiazines NI (suas haldol)
avoid alcohol
63
Long acting drugs like fluphenazine decanoate haloperidol decanoate
takes months require supervision
64
Atypical antipsychotic dugs like risperidone abilify ziprasidone clozapine
treats SZ +/- without EPS monoitor WBCs baseline vitals and ECG
65
mood stabilizers drugs
lithium carbonate valproic acid carbamazepine lamotrigine
66
lithium indications
bipolar in mania
67
lithium rxn
N fatigue thirst polyuria fine hand tremors wt gain hypothyroidism renal impairment
68
lithium toxicity
DV drowziness muscle weakness lack of coordination
69
anticonvulsant mood stabilizers indications
used as with lithium, as alts or for bipolar
70
anticonvulsant mood stabilizers NI
admin with food and monitor blood leves valproic acid - 50-125 carbamazepine - 8-12 lamotrigine given in low dose to prevent rash
71
anticholinergic drugs
EP system effects relaxes musles given with antiP drugs
72
mild anxiety
produces increased levels of sense awareness and alertness daily living pt is able to concentrate
73
moderate anxiety
dulled perception, hesitation rate of speech and volume increase restlessness HA, ND, TC attentive but less optimal
74
severe anxiety
fight or flight disorganized sensory input distorted perceptions and impaired concetration selective concentration
75
severe anxiety SS
increased HR and BP rapid and shallow resp dry mouth muscle tension anorexia frequency
76
panic
grossly distorted perceptions unable to concentrate or be logical loss of control requires intervention
77
what to do when dealing with anxious client
assess self anxiety self calmness will help calm client
78
generalized anxiety disorder (GAD)
excessive persistent anxiety with previous coping mechanisms insuffient
79
GAD SS
severe anxiety motor tension (restlessness, quickly fatigued, shakiness, tension) autonomic hyperactivity (SoB, heart palpitations, dizziness, diaphoresis, frequency) vigilence and scanning (diff concentrating, sleep disturbance, irritibility, nervousness, low self-esteem)
80
GAD NI
assess anx and label feelings help relate stressor to level of anx encourage coping techniques decrease environmental stimuli
81
panic disorders and phobias
periods of intense fear of an external object or activity that is chronic that is unrealistic
82
common phobias acrophobia agoraphobia claustrophobia hydrophobia social anxiety thanatophobia
heights crowds or open spaces tights spaces water social situations death
83
panic disorder coping styles used
displacement projection repression sublimation
84
how long do panic attacks last
peak in 10 min but last up to 30 min
85
what to do when a pt has a phobia
acknoledge the fear and and dont expose them to the fear gain trust and reduce stimuli discuss alt coping strategies after trust discuss desensitization pair negative with positive meds
86
OCD
irresistibe imples to perform an action or repetivie thoughts hoarding, excoriation (skin picking), trichotillomania (hair pulling)
87
OCD coping styles
repression isolation undoing
88
OCD assessments
magical thinking (belief that one's thoughts can ctrl others) hostile/delu thought content difff interpersonal relationships interferes with day to day living safety issues intrusive thoughts repetetive
89
OCD interventions
listen, acknowledge

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