Mental Health Problems Flashcards
Review the different types of mental health problems, hallucinations and delusions, and ECT. (63 cards)
1
Q
Why are psychiatric clients admitted to the hospital?
A
Because of suicidal or homicidal tendencies, or because they are unable to care for themselves such as a drug addiction or another psychological disorder.
2
Q
What is the priority when working with a client with a mental health problem?
A
Keep the client SAFE by preventing them from harming themselves or someone else:
- Implement suicide precautions
- Restraints if client is violent
3
Q
What is the difference between a psychotic and a non-psychotic mental health problem?
A
- Psychotic clients are not grounded in reality and can have delusions and hallucinations. They do not realize that they have a problem.
- Non-psychotic clients understand that they have a problem such as depression or anxiety, but aren’t sure how to manage it.
4
Q
What are the main psychotic disorders?
A
- bipolar
- schizophrenia
- schizotypical
5
Q
What is the treatment for psychotic clients?
A
- antipsychotics
- therapeutic communication focuses on presenting reality and acknowledging feelings
6
Q
What are the main non-psychotic disorders?
A
- depression and anxiety
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- phobias
7
Q
What is the treatment for non-psychotic clients?
A
- antidepressants and anxiolytics
- therapeutic communication focuses on getting client to open up about problem and learning how to cope and problem solve
8
Q
Describe:
Anxiety
A
A feeling of apprehension, uncertainty, or dread.
It is a normal response to stress and can be mild to severe.
9
Q
Describe:
Panic
A
A severe type of anxiety where death can occur.
Clients can experience panic attacks.
10
Q
Signs and symptoms:
Severe anxiety
A
- increased tremors
- pounding heart
- hyperventilation
11
Q
Interventions:
Anxiety
A
- provide a quiet environment
- promote relaxation techniques
- monitor vital signs and give anxiolytics
- don’t force client into situations that cause anxiety
12
Q
What are therapeutic communication techniques for a client with mild to moderate anxiety?
A
- ask client to identify what and how they feel
- encourage discussion of feelings
13
Q
What are the immediate interventions for severe anxiety and panic?
A
- stay with client
- provide clear, simple instructions
- use a low-pitched voice
- give anxiolytics
14
Q
Describe:
Generalized anxiety disorder
A
An unrealistic anxiety about everyday worries that persist for more days than not for at least 6 months.
It is not associated with any other mental health or medical problem.
15
Q
Describe:
Post-traumatic stress disorder (PTSD)
A
When a client experiences a psychologically traumatic event and experiences scary flashbacks.
The symptoms last at least 1 month and can occur months to years after the event.
16
Q
Interventions:
Post-traumatic stress disorder
A
- encourage client to talk about feelings
- encourage recognition between feelings and traumatic experience
17
Q
Describe:
Phobia
A
An irrational fear of an object, activity, or situation. The phobia can cause severe anxiety and panic.
18
Q
Interventions:
Phobia
A
- allow client to discuss fears
- teach relaxation techniques
19
Q
Describe:
Obsessive-compulsive disorder (OCD)
A
A preoccupation with thoughts or impulses. It is brought on by anxiety and the need for control.
Ritual behaviors are performed such as constant handwashing or checking the locks.
20
Q
Interventions:
Obsessive-compulsive disorder
A
- help client recognize what caused behavior
- let client do behavior unless safety is an issue
- set limits on behavior
- provide activities to distract from behavior
21
Q
Describe:
Somatic symptoms
A
Also known as the “hypochondriac”. The client frequently thinks there is a medical problem when there is NO medical problem.
22
Q
Interventions:
Somatic symptoms
A
- put a time limit on letting client discuss symptoms
- don’t respond with positive enforcement about physical complaints
23
Q
Describe:
Conversion disorder
A
When a mental health issue is converted into physical symptoms.
Example: a client that was emotionally abused becomes blind.
24
Q
Interventions:
Conversion disorder
A
Let client talk about relating the physical symptoms with their feelings.
25
# Describe:
Dissociative disorder
When a client **develops different personalities to deal with a traumatic event**.
26
# Interventions:
Dissociative disorder
* encourage discussion of feelings and experiences
* focus on strengths and skills
27
# Describe:
Bipolar mood disorder
**Extreme changes in mood**, going from mania to depression.
28
# Interventions:
Bipolar mood disorder
* ignore or distract grandiose thinking
* present reality
* set limits on behavior
* provide high calorie finger foods
* no group activities when manic and aggressive
29
# Describe:
Depression
An **unpleasant feeling** after some type of loss.
## Footnote
Many times there is no obvious cause of it.
30
# Interventions:
Depression
* assess for suicidal tendencies
* make a contract for suicide
* gentle encouragement for simple activities
31
# Describe:
Schizophrenia
When the client experiences **illogical, disorganized thoughts** such as delusions and hallucinations.
32
# Signs and symptoms:
Schizophrenia
* delusions/hallucinations
* talk to themselves and repetitive speech
* may be completely still or put their body in strange positions (catatonic behavior)
* negative symptoms (diminished emotional expression)
33
What are **delusions**?
A **false belief** with evidence showing that it's false.
34
What are some **examples of a delusion**?
* client thinks they are very powerful
* partner is cheating
* are being singled out for harm
## Footnote
All evidence would show that none of the delusions are true.
35
# Interventions:
Delusions
* ask client to describe delusion for safety reasons
* don't say the delusion doesn't exist (to them it does exist)
* focus on feelings that the delusion causes
* set limits on delusion
* focus on reality-based topics
36
How would the nurse **respond** to a client who is delusional and is reporting *"the person in the mail truck is the FBI and they want to kill me!"*
1. **Address feelings** - "It sounds like you are scared"
2. **Focus on reality** - "That is the mailman delivering the mail"
37
What are **hallucinations**?
When the client **senses something that isn't real**.
## Footnote
This can include hearing, tasting, smelling, feeing, and seeing things that aren't there.
38
# Interventions:
Hallucinations
* ask to describe hallucination for safety reasons
* don't pretend it's real, but don't deny the hallucination either
* focus on reality instead
* don't touch the client
* distract client with an easy activity
39
What is a **personality disorder**?
When the client's **inflexible behavior impairs life functioning and relationships.**
## Footnote
It is usually NOT associated with substance abuse.
40
What are the **Cluster A Personality disorders**?
* schizoid
* schizotypal
* paranoid
## Footnote
These clients have a hard time forming relationships and tend to be paranoid.
41
# Describe:
Schizoid Personality Disorder
When a client **cannot form personal relationships.**
## Footnote
They lack emotion and interest in others.
42
# Describe:
Schizotypal Personality Disorder
When a client is **suspicious, paranoid, or uses magical thinking.**
43
# Describe:
Paranoid Personality Disorder
When the client is **suspicious, argumentative, and critical of others.**
44
What are the general **interventions** for Cluster A Personality Disorders?
* schizoid
* schizotypal
* paranoid
Due to the "paranoid" tendency of Cluster A Personality Disorders, do not laugh or whisper in front of them.
## Footnote
These clients are typically NOT admitted to the hospital since they are not usually violent or a harm to themselves.
45
What are the **Cluster B Personality Disorders**?
* histrionic
* narcissistic
* borderline
## Footnote
These clients have a tendency to be manipulative and overly dramatic.
46
# Describe:
Histrionic Personality Disorder
When the client is **overly dramatic and expressive.**
## Footnote
These clients are frequently admitted due to suicide attempts.
47
# Describe:
Narcissistic Personality Disorder
When the client has an **increased sense of self-importance.**
## Footnote
They frequently lack empathy and sensitivity.
48
# Describe:
Antisocial Personality Disorder
When the client can **seem charming but are actually very manipulative.**
## Footnote
They can be irresponsible, selfish, cannot maintain relationships, and tend to be irritable and hostile. These clients are frequently admitted because of risk of harming others.
49
# Describe:
Borderline Personality Disorder
When the client is **impulsive, unpredictable, and manipulative.** They tend to see everything as either all good or all bad.
## Footnote
These clients have a tendency for self-mutilation.
50
What are the general **interventions** for Cluster B Personality Disorders?
* histrionic
* narcissistic
* borderline
* set limits on behavior
* discuss consequences for unacceptable behavior
* remove from group if aggressive or attention-seeking behavior occurs
* provide praise for non-manipulative and positive behavior in social situations
## Footnote
Cluster B Personality Disorders have a tendency to be **manipulative and overly dramatic:**
51
Regardless of the mental health disorder, how should the nurse respond to clients that are **having feelings that could harm themselves or someone else?**
Encourage clients to **discuss feelings** instead of acting the feelings out.
52
# Describe:
Alzheimer's and Dementia
**Intellectual deterioration.** First there is short-term memory loss and then long-term memory loss.
## Footnote
Eventually, the client forgets how to care for themselves.
53
# Interventions:
Alzheimer's and Dementia
* room close to the nurses' station
* provide safety measures for wandering
* put familiar objects around
* have a routine and simple tasks
* avoid stimuli if agitated
* don't argue or force activity
* encourage discussion of feelings
* provide caregiver support
* Anti-alzheimer meds
54
Why should sedative medications like anxiolytics be avoided by clients that have Alzheimer's or dementia?
Sedatives can cause more confusion.
55
What are **communication disorders?**
When the client has **a hard time communicating** for a variety of reasons.
## Footnote
Causes are from hard of hearing, eye disorders, CVA, and other neurological issues.
56
How should the nurse **talk to a client with a communication disorder?**
* firm volume, calm and low-pitched voice
* speak slowly with simple words
* don't yell or speak in a loud voice
* stand in front of client and maintain eye contact
* repeat questions, don't rephrase questions
57
What is **sundowners**?
A condition in which older clients **get more confused in the evening.**
58
What are the interventions for **confused and agitated** clients?
* first rule out any physical problem
* provide a calm environment
* allow wandering in a safe place
* don't argue and don't force any activity
* orient frequently
* avoid sedatives as it usually causes more agitation
* provide simple activities like folding washcloths
59
What is **Electroconvulsive treatment (ECT)**?
**Inducing a seizure to provide relief for severe mental health problems** such as severe depression, bipolar and schizophrenia.
## Footnote
It is used when medications or other therapies aren't working.
60
Is informed consent needed for a client receiving electroconvulsive treatment (ECT)?
Yes!
## Footnote
ECT is an invasive procedure that include risks.
61
# Interventions:
**Electroconvulsive treatment (ECT)**
Client will receive **muscle relaxers and anesthesia** to prevent full body seizures. Also assess for breathing.
62
What is the **characteristic symptom** after ECT?
Confusion.
62
What is the nursing care after a client has undergone ECT?
* assess vital signs
* re-orient
