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MENTAL HEALTH > Mental Health ABC's > Flashcards

Mental Health ABC's Flashcards

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1
Q

What is a 302

A

Involuntary admittance ( court hearing must be within 72 hr, after 72 hours if a judge determines you are safe to go home; you go home, if deemed unsafe, you get 303 all the way up to 305.

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2
Q

How do hospitals manage relaying info in accordance to

HIPPA?

A

Give a code out to ppl authorized to receive info

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3
Q

What does ROI mean

A

Release of information

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4
Q

When can info be disclosed without consent

A

To protect the safety of others. If the person states a plan to cause harm to a specific person, putting a person in immediate danger.

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5
Q

What does informed consent entail

A

A person has the right to know about treatment, alternatives, right to decline.

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6
Q

What is the exception to informed consent

A

2 Drs must deem the person may cause harm to self or others which leads to the informed consent to be overturned. The meds will be forced usually by injection.

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7
Q

What is least restrictive seclusion

A

In a room by ones self with the door open

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8
Q

What is restrictive seclusion

A

In a room by ones self with door closed and locked

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9
Q

Can a nurse initiate restraints?

A

Yes! She doesn’t have to call the dr first. After applying the restraints, she MUST THEN CALL THE DR WHO MUST PHYSICALLY ASSESS THE PT WITHIN 1 HOUR

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10
Q

What does Mileu mean

A

Environment

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11
Q

What is a 201

A

Voluntary admittance

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12
Q

What are the positive symptoms of szhizophrenia

A

Altered perception, hallucinations, delusions

Hallucinations can occur with all 5 senses

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13
Q

Exhopraxia

A

Imitating movements of others

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14
Q

Echolalia

A

Repeat words said

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15
Q

Flat affect

A

No expression on face

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16
Q

Apathy

A

Don’t care

Unconcerned

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17
Q

Positioning

A

Take on bizarre positions

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18
Q

What are nursing diagnosis Related to schizophrenia

A

Risk for violence: self directed or others directed
Disturbed thought process
Social isolation
Disturbed sensory perception

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19
Q

What are typical antipsychotics

A

The oldest form of antipsychotics
BLOCKS DOPAMINE
targets positive symptoms

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20
Q

What are contraindications to typical antipsychotics

A

Parkinson’s disease, liver, renal or cardiac insufficiency ( may prolong QT INTERVAL), uncontrolled seizure disorder

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21
Q

What are interactions of typical antipsychotics

A

They have an additive hypotensive effect with hypotensive agents

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22
Q

Why is Parkinson’s a contraindication to typical antipsychotics

A

Parkinson’s already is due to a decreased dopamine and you don’t want to decrease the levels of dopamine even further.

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23
Q

What is a select prototype of typical antipsychotics

A

Chlorpromazine ( Thorazine)

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24
Q

What are other typical antipsychotics

A

Haloperidol ( haldol)
Fluphenazine ( prolixin)
Perphenazine ( trilafon)
There are many more this is only a short list.

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25
What are atypical antipsychotics
They were developed after typical antipsychotics, they have less side effects. THEY BLOCK SEROTONIN AND to some degree DOPAMINE Target both positive and negative symptoms
26
What are contraindications of atypical antipsychotics
Severly depressed ppl | Elderly ppl with dementia related psychosis
27
What are commonly used atypical antipsychotics
``` Risperidone ( risperdal) Olanzapine ( zyprexa) Quetiapine ( seroquel) Aripipraziole ( abilify) Ziprasidone ( geodon) Clozapine ( clozaril) this does not include a list all drugs. ```
28
What are potential side effects of all antipsychotics
* seen to a lesser degree in atypical antipsychotics* Extrapyramidal symptoms Pseudoparkinsonism- tremor, shuffling gait, drooling, rigidity Akathisia- restlessness Akinesia- muscle weakness Dystonia- spasms and stiffness of neck, face, arms or legs Oculogyric crisis- rolling back of eyes
29
What are medications to reverse EPS
anticholinergics such as benztropine ( cogentin), trihexphenidyl ( artane) Antihistamines such as diphenhydramine ( Benadryl)
30
What anticholinergic can be given in conjunction with psychotic meds
Benztropine ( cogentin) can be given as a maintenance dose in conjunction with psychotic meds to prevent dystopia and oculogyric crisis.
31
What is tardive dyskinesia
Seen months to years after prolonged use of antipsychotics Consists of bizarre facial and tongue movements, stiff neck, difficulty swallowing Symptoms are potentially irreversible
32
What is neuroleptic malignant syndrome ( NMS)
Rare but potentially life threatening Typically seen after initiation of antipsychotics but can be years afterwards Consists of muscle rigidity, VERY HIGH FEVER, tachycardia, tachypnea, and changes in LOC
33
What is treatment for neuroleptic syndrome
Immediately stop antipsychotics | Monitor VS, IV fluids, I&O
34
What are other side effects seen with antipsychotic therapy
Anticholinergic effects- dry mouth, paralytic ileus, urinary retention, photophobia, Metabolic syndrome- seen with new atypical antipsychotic meds, causes pt to gain weight as a result diabetes develops.
35
What drug must be monitored very carefully because of agranulocytosis
Clozaril- before initiation a baseline WBC cont and absolute neutrophil count is drawn. WBC must be at least 3500/mm3. WBC count and absolute neutrophil must be drawn weekly for first 6 months, then every 2 weeks
36
What is the definition of depression
A mood disorder expressed by feelings of sadness, despair, and pessimism It is one of the leading causes of disability in the U.S. rates are higher in woman but suicide rate is higher in men
37
What are types of depressive disorders
Seasonal affective disorder (SAD) Postpartum depression Major depression disorder (MDD)
38
What is major depressive disorder characterized as
Characterized by a depressed mood and or loss of interest or pleasure in ones usual activities. There must be impaired social and occupational functioning that has lasted for at least 2 weeks.
39
What are the rating scales for major depressive disorder
Beck depression inventory (BDI) | Hamilton depression rating scale
40
What is subjective assessment data of major depressive disorder.
``` Anergia Anhedonia Anxiety Fatigue Somatic complaints Loss of appetite Sleep disturbances Negative thoughts ```
41
What is objective assessment data of major depressive disorder
``` Affect Disheveled appearance Slowed physical movements Socially isolated Slowed thought process and speech patterns ```
42
For a suicide assessment what should the nurse do
Be direct Talk openly and matter of factly about suicide. Ask ARE YOU AHVING THOUGHTS OF KILLING YOURSELF? Assess for a plan,means and intent
43
What are nursing diagnosis For major depressive disorder
Risk for suicide Social isolation Self care deficit Imbalanced nutrition; less than body requirements
44
What Are interventions for major depressive disorder
Cognitive behavior therapy- a type of therapy that helps a person realize and change negative thoughts Group therapy Individual therapy
45
What is true regarding therapeutic levels of antidepressants
Relief is not immediate. May take 2-4 weeks to reach full therapeutic level. Patients are at risk for suicide because as the mood lightens the patient experiences more energy to act out
46
What is the prototype TCA
Amitriptyline ( elavil)
47
What are side effects of TCAs
Orthostatic hypotension Anticholinergic effects Sedation - advise to take at bedtime Decreased seizure threshold- use cautiously in someone with seizure disorder
48
What do TCAs do
Blocks the reuptake of norepinephrine and serotonin in the synaptic space
49
What is the prototype SSRI
fluoxetine ( Prozac)
50
What are side effects of fluoxetine ( Prozac)
Sexual dysfunction CNS stimulation - take in the am can make A person more alert Changes in weight Serotonin syndrome
51
What is serotonin syndrome
Can become life threatening May begin 2-72 hr after initiation of SSRI treatment Symptoms include mental confusion, fever, hallucinations,diaphoresis,,abdominal pain with diarrhea
52
How do SSRIs work
By blocking the reuptake of serotonin
53
What are MAOIs
Blocks MAO in the brain thereby increasing norepinephrine, dopamine, and serotonin
54
What is the prototype MAOI
Phenelzine (Nardil)
55
What are side effects of phenelzine (Nardil)
Serotonin syndrome, if used with SSRIs | Hypertensive crisis
56
What is a hypertensive crisis
Results from ingestion of foods containing tyramine
57
What foods contain tyramine that should be avoided while on MAOI therapy
Cheese Figs Yogurt Raisins
58
What are atypical antidepressants
They are a alternate to SSRIs | Blocks the reuptake of dopamine
59
What is the prototype atypical antidepressant
Bupropion ( Wellbutrin) | * also combats nicotine addiction**
60
What are side effects of bupropion ( Wellbutrin)
Weight loss Seizures Anticholinergic effects
61
What are indications for electro convulsive therapy
MDD- no response to medications Certain schizophrenia disorders Acute manic
62
Can ECT happen on a outpatient basis
It can happen on a inpatient or outpatient basis
63
Can a client eat food before ECT
they must be NPO after midnite of the procedure
64
What are nursing interventions of ECT
Establish IV line, monitor VS, IM robinul or atropine 30 min prior to treatment
65
What is nursing care during ECT
Mechanical ventilation with 100% O2 Cardiac monitoring Anesthesiologist administers anesthetic breuvital and then a muscle relaxant anectine by IV Electrical stimulus provided by physician
66
What is aftercare of ECT
``` Transfer to recovery room Monitor VS especially HR and BP position in side to prevent aspiration Assess for headache, muscle soreness, and nausea Assess memory ```
67
What is the definition of bipolar
A mood disorder manifested by cycles of mania and depression
68
What is the prevalence of bipolar
Incidence of bipolar equal between males and females Average age is 20's Genetic predisposition
69
Types of bipolar disorder
Bipolar 1 disorder- full blown manic episodes | Bipolar 2 disorder- distinguished by bouts of MDD with episodes of hypomania.
70
What are nursing diagnosis of bipolar disorder
Risk for injury Risk for violence: self directed or other directed Imbalanced nutrition: less than body requirements Disturbed thought process Insomnia
71
What are medications for bipolar disorder
Lithium carbonate
72
What are contraindications of lithium carbonate
Cardiac or renal disease, dehydration, sodium depletion
73
What are side effects of lithium carbonate
The margin between therapeutic levels and toxic levels is very narrow
74
What is the therapeutic ranges of lithium
Acute mania- 1.0 to 1.5 Maintenance- 0.6 to 1.2 Lithium toxicity- symptoms begin to appear at levels above 1.5
75
How often are labs drawn on a person prescribed lithium
1-2 times a week until levels are stable then monthly afterwards Hold med until lithium levels are drawn
76
What are the clinical manifestations of lithium toxicity with a serum level of 1.5 to 2.0
``` Blurred vision Ataxia Tinnitus Fine hand tremors Persistent nausea and vomiting Severe diarrhea ```
77
What are clinical manifestations of lithium toxicity with serum levels of 2.0 to 3.5
Excessive output of dilute urine Increasing tremors Mental confusion
78
What are clinical manifestations of lithium toxicity with a serum level above 3.5
``` Decreased LOC anuria Seizures Coma Death ```
79
What is pt education for lithium administration
Drink 2-3 liters of water daily,by not drinking enough, lithium levels can rise Maintain a sufficient level of sodium not more not less Avoid use of NSAIDs Use diuretics cautiously
80
What is the anticonvulsant valproic acid ( depakote) used for
It is used to treat bipolar disorder
81
What is the prototype typical antipsychotic
Haldol
82
What is the prototype atypical antipsychotic
Risperidal
83
What is a major symptom to watch out for with clozaril
Agranulocytosis
84
What are anticholinergic meds used to treat side effects
Cogentin | Diphenhydramine
85
What labs are assoc with depakote therapy
LFT | PLATELETS
86
What is included in a suicide assessment
Plan means intent hx of past attempts
87
What are assoc side effects of TCAs
Orthostatic hypotension

MENTAL HEALTH (17 decks)

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