Mental Health exam 3 Flashcards
(80 cards)
1
Q
substance use nursing history Q’s
A
- type of substance
- amount of substance
- pattern and frequency of use (look for changes)
- age at onset
- date of last substance use
- changes in occupational/school performance
- hx of abstinence periods
- previous withdrawal manifestations
2
Q
rate of substance abuse is highest in ages
A
18-25
3
Q
people at increased risk of substance disorder
A
- alaska natives
- native american groups
4
Q
people at a decreased risk of substance disorder
A
asian groups
5
Q
older adult indications of substance abuse
A
- decreased self care
- incontinence
- manifestations that look like dementia
6
Q
opioid intoxication antidote
A
naloxone
7
Q
opioid abstinence syndrome s/sx
A
- starts with sweating and rhinorrhea
- piloerection
- tremors
- irritability
- diarrhea
- weakness
- insomnia
- N/V
- pupil dilation
- muscle weakness/pain
- suicidal ideation
8
Q
things BAC depends on
A
- weight
- gender
- alcohol concentration
- number of drinks
- gastric absorption rate
- tolerance level
9
Q
when does alcohol withdrawal start?
A
4-12 hours after last drink
10
Q
how long does alcohol withdrawal last?
A
5-7 days
11
Q
when does alcohol delirium start?
A
2-3 days after last drink
12
Q
alcohol delirium is considered a
A
medical emergency
13
Q
nicotine abstinence syndrome s/sx
A
- cravings
- irritability
- nervousness
- restlessness
- anxiety
- insomnia
- anger
- depressed mood
- increased appetite
14
Q
safety for substance use disorders
A
- prevent falls
- seizure precautions
- 1:1 observation (withdrawal)
- low stimulation
- monitor for covert substance use during detox
15
Q
education for substance use disorders
A
- addiction
- initial tx goal
- removing unnecessary meds
- not sharing meds
16
Q
emergency plan components
A
- what client needs to do
- who client needs to contact
17
Q
12 step program
A
Alcoholics Anonymous (AA)
18
Q
family groups
A
- Al-anon
- Ala-teen
19
Q
what does a 12-step program teach?
A
- abstinence is needed for recovery
- a higher power can assist with recovery
- clients are not responsible for their disease, but are responsible for their recovery
- client cannot blame others
- client must acknowledge their feelings and problems
20
Q
disulfiram: acetaldehyde syndrome s/sx
A
- N/V
- weakness
- sweating
- palpitations
- hypotension
21
Q
what tests/labs should you monitor while taking disulfiram?
A
LIVER (hepatotoxicity)
22
Q
should you take naltrexone with food?
A
yes to decrease GI distress
23
Q
who should not take acamprosate?
A
pregnant women
24
Q
what medication must be administered from an approved tx center?
A
methadone
25
what medication does not reduce the cravings of opioids?
clonidine
26
mild tension relieving behaviors
- finger/foot tapping
- fidgeting
- lip chewing
27
at what level of anxiety should gross motor activities be encouraged?
- severe
- panic
(walking)
28
how should you speak to those with severe/panic level anxiety?
- firm, short, simple, statements
- repetition
- slow, low-pitched, calm voice
29
generalized anxiety disorder criteria
uncontrollable, excessive worry
- majority of days
- at least 6 months
30
manifestations of separation anxiety
- during or in anticipation
- HA
- N/V
- sleep disturbances
31
how might people with specific phobias try to decrease anxiety?
alcohol or substances
32
panic attack criteria
- 15-30 minutes
- 4+ manifestations
33
what type of environment should be provided for anxiety?
- safe
- calm
- quiet
- structured
34
when should you teach someone with anxiety?
after acute anxiety subsides
35
obsessive-compulsive behaviors are
- time consuming
- repetitive
36
how long does ASD last?
3 days to 1 month following event
37
how long does PTSD last?
longer than 1 month following event
38
how long does dissociative fugue last?
weeks to months
39
what does severity of trauma depend on?
- duration
- amount of personal threat
- far from home or familiar surroundings
40
individual vulnerabilities of ASD/PTSD
- past coping mechanisms
- personality
- preexisting mental disorders
41
intrusive findings of ASD/PTSD
- involuntary, distressing
- memories
- flashbacks
- nightmares/dreams
42
behavior changes in adjustment disorder
- arguing
- erratic driving
43
when should the nurse help with decision making in dissociative disorders?
during dissociative periods
44
when are grounding techniques used and what are they?
- clapping hands
- touching objects
45
should you talk to those with dissociative disorders about their past?
not too much
46
what problems are avoided with buspirone that are problems with benzos?
- sedation
- tolerance
- dependence
- withdrawal
47
defense mechanisms without a maladaptive use
- altruism
- sublimation
48
defense mechanisms without an adaptive use
- conversion
- splitting
- projection
49
3 characteristics of ADHD
- inattention
- hyperactivity
- impulsivity
50
what are those with ADHD at risk for?
injury
51
ADHD criteria
- behaviors present prior to age 12
- behaviors present in more than 1 setting
52
autism s/sx
- delayed cognitive/language development
- inability to maintain eye contact
- repetitive actions
- strict routines
53
when is autism diagnosed?
early childhood
54
who is autism more common in?
boys
55
how should you talk to those with ADHD, disruptive, impulse control, and conduct disorders?
- be calm, firm, and respectful
- use short, clear explanations
- obtain attention before giving directions
56
how should you talk to those with autism?
be short, concise, and developmentally appropriate
57
what system should you develop with parents?
a reward system
58
when should you give plenty of notice to those with autism?
before changing routines
59
what can separation anxiety in children develop into?
- school phobia
- phobia of being left alone
- depression
- panic disorder
60
how is play affected in children with PTSD?
- decreases
or
- involving aspects of traumatic events
61
when do manifestations of disruptive, impulse control, and conduct disorders worsen?
- situations that required sustained attention (classroom)
- unstructured group situations (playground)
62
when do those with ODD misbehave most?
- home
- toward the person they know the best
63
what can ODD develop into?
conduct disorder
64
temper outburst criteria
- present 3+ times per week
- observable by others
- in at least 2 settings
- does not correlate with situation
65
DMDD onset
ages 6-18
66
IED onset
- typically ages 13-21
- as early as age 6
67
IED can lead to
chronic disease (HTN, DM)
68
conduct disorder behaviors
- aggression to people/animals
- destruction of property
- deceitfulness/theft
- violation of rules
69
conduct disorder childhood onset
- before age 10
- more common in males
70
conduct disorder adolescent onset
- after age 10
- prevalence equal in males and females
71
what do those with conduct disorder do?
- lie
- bully
- threaten
- intimidate
- shoplift
- truant from school
72
education for children/adolescents
- gun/weapon control
- seat belts
- protective sports gear
- contraceptives, STI's, abstinence
- substance use
- who to voice concern to: police, school nurse, counselor, teacher
73
when should you take methylphenidate?
- 30-45 mins before meals
- last dose before 4 pm
74
transdermal methylphenidate location and timing
- hip (alternate)
- no more than 9 hours
75
what type of prescription is needed for methylphenidate?
handwritten
76
when should atomoxetine/bupropion be taken?
- with or after meals
- last dose before 4 pm
77
when should TCA's be taken?
bedtime
78
what happens when guanfacine/clonidine are stopped abruptly?
rebound HTN
79
who should not be given guanfacine/clonidine?
children under 6 y/o
80
when should you take SSRI's?
- in the morning
- with food to decrease GI effects
