Mental Health Nursing

Question 1

Major Depressive

Answer 1

persistent sad mood lasting 2 wks or longer

Question 2

Monitor clients in the first _____ ______ of starting medications for Major Depressive Disorder

Answer 2

2 weeks

Question 3

Post ECT Procedure

Answer 3

position client on their side to prevent aspiration

stay w client
temporary memory loss is expected
reorient repeatedly

** before procedure they’re given a benzo, NPO, void, and atropine

Question 4

Schizophrenia Positive Symptoms

Answer 4

Alterations in Speech

• disorganized thoughts
• echolalia (hear a word and repeat it all the time)
• neologism (making up new words) / seek clarification
• word salads

Alterations in Thinking

• delusions (religiosity)
• concrete thinking

Alterations in Perception
* hallucinations

Question 5

Schizophrenia Negative Symptoms

Answer 5

inappropriate affect
flat affect
blunted affect

Question 6

Treatment for Schizophrenia

Answer 6

decrease stimuli
observe / orient
warn before you touch them
don’t refer to voices as they
let them know that you don’t believe the hallucinations / delusions
distract them with activity
elevate HOB (more hallucinations happen lying flat)

Question 7

paranoid personality disorder

Answer 7

• you can’t explain away delusions / they don’t trust you
• client can’t relax, has no humor, is unemotional / abnormal anger response
• consitent nurses w brief visits
• be careful with touch
• don’t mix meds / keep seperate and identify each one
• may need to eat sealed foods

Question 8

Restraints

Answer 8

• client must be evaluated by HCP within one hour of restraint
• orders must be renewed q4hrs for adult, q2hrs for 9-17 year olds, and q1hr for less than nine year olds
• check client face-to-face q15 min
• if under 14 yrs old, must have constant face-to-face observation

Question 9

SSRIs

Answer 9

Sertraline (Zoloft)

Question 10

SNRIs

Answer 10

duloxetine (cymbalta)

venafaxime (effexor)

Question 11

anorexia s/sx

Answer 11

bradycardia and hypotension <90/50

lanugo on back and face

itellectualization (perfectionists)

Question 12

Stage 1 of Alcohol Withdrawal

Answer 12

minor withdrawal

• starts withtin 4-12 hours of cessation of drinking
• mild tremors, nervous, nausea, insomnia, headaches, and palpitations
• oriented to time, place, and person

Question 13

Stage 2 of Alcohol Withdrawal

Answer 13

moderate to Severe Withdrawal

• increased tremors, confused, hyper-thermic, hyperactive, nightmares, increased BP, increased respirations, hallucinations, and illusions
• carefully assess and provide treatment during Stages I and II to prevent the client from progressing to delirium tremens

Question 14

Stage 3 of Alcohol Withdrawal

Answer 14

most dangerous (Delirium Tremens / DTs)

• medical emergency
• kinesthetic DTs are most common (feel things crawling on them)
• tonic clonic seizures are possible

Question 15

What meds do we give pts undergoing alcohol withdrawals?

Answer 15

anxiolytics

sedatives like benzodiazepines bc they have anti-convuslant qualities
*ex. chlordiazepoxide, diazepam, lorazepam

thiamine injections

monitor electrolytes (they’re usually very low)

Question 16

Wernicke’s Encephalopathy

Answer 16

thiamine deficiency in alcoholics

paralysiss of ocular muscles, diplopia, ataxia, somnolence, stupor

without thiamine injections, death will occur

Question 17

Korsakoff’s Psychosis

Answer 17

syndrome of confusion and loss of recent memory.

often seen when client is coming out of wenickes

*when they both occur it’s called Wernicke-Korsakoff syndrome

Question 18

Disulfiram

Answer 18

deterrent to drinking

client must sign consent

cough syrup, aftershave, colognes, varnish, etc will make them sick too

family issues common

Question 19

most common opiates

Answer 19

heroin, oxycodone, merperidine

Question 20

Opiate Intoxication S/sx

Answer 20

pinpoint pupils

resp depression

coma

Question 21

Naloxone

Answer 21

opiate antagonist

0.4-2.0 mgs given IV and repeated at 2-3 min intervals

all pts given naloxone must be taken to hospital (short acting / readministered every few hours)

Question 22

Opioid Withdrawal S/sx

Answer 22

agitated / anxious mood

N/V

muscle aches

excessive tearing (crying) / running nose

sweating

pupil dilation

Question 23

methadone

Answer 23

long acting opioid given in subsitition for opioid addiction and then titrated downward

no cravings

Question 24

Alzheimers Dz

Answer 24

identify yourself

speak slowly / short, simple sentences and words

one piece of info at a time

face to face

talk about self-esteem things like their life and family (pictures on wall, etc.)

clocks, calendars, personal items (big X on calendar)

label doors to bathrooms and closets

monitor I/O (forget to eat or drink)

group activities

dress in own cloths

calm atmosphere

let them do what they can (brush teeth, hair, etc.)