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Nsg 28 Mental Health > Mental Health Test #1 > Flashcards

Mental Health Test #1 Flashcards

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1
Q

What are neurotransmitters?

A

They are chemicals that convey information across synaptic clefts to neighboring cells.

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2
Q

Where are NT stored?

A

in small vesicles in the axon terminals of neurons.

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3
Q

Explain the synaptic activity process.

A

When the action potential, or electrical impulse, reaches its point, the NT are released from the vesicles. They cross the synaptic cleft and bind with receptor sites.

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4
Q

Explain the “reuptake” process.

A

After the NT perfoms its fx in the synapse, it either returns to the vesicles to be store or used again, or it is inactivated and dissolved by the enzymes. The process for being stored for reuse is called “reuptake.”

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5
Q

What are the main NT?

A

Acetylcholine, Dopamine, Serotonin, Norepinephrine, GABA.

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6
Q

What are the possible implications of each NT re: mental illness?

A

Ach- increased levels: depression, decreased levels: Alz dz,Huntington dz, Parkins dz.
NE- decreased levels : depression, increased levels: mania, anxiety states, schizo
Dopamine-decreased levels: Parks dz & depression, increased levels: mania & schizo
Serotonin- decreased levels: depression, increased levels: anxiety states
GABA- decreased levels: Huntington dz, anxiety d/o, schizo, and various forms of epilepsy

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7
Q

What is the fx of Ach?

A

sleep, arousal, pain perception, movement, memory

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8
Q

What is the fx of NE?

A

mood, cognitive alertness, perception, locomotion, cardiovascular fx, sleep and arousal.
* Think:
N-no hesitation
O-on alert
R- recall memory aka “stress hormone” turns on SNs and turns off PNS

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9
Q

What is the fx of DA?

A

movement, coordination, emotions, voluntary judgement, release of prolactin

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10
Q

What is the fx of SER?

A

aka “happy hormone”
S- sleep
E-emotion
R-remember (memory)

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11
Q

What is the fx of GABA?

A

slows down body activity

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12
Q

What is the role of the nurse with psych meds?

A

1) asx if meds change behavior
2) asx if meds cause SE
3) proper admin of meds
4) awareness of interactions w/other meds
5) patient/family education re: meds, not a cure, compliance and labs

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13
Q

What is the goal of med admin?

A

“steady state”. Steady state is a balance between competing metabolism, elimination & distribution of the medication. It’s an even level of med in blood constantly competing with kidneys & liver.

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14
Q

what is 1/2 life?

A

The time it takes for the plasma concentration of the med to be reduced by 50%. The longer the 1/2 life, the longer the drug will stay in the pt’s body.
* elderly pts have decreased liver and kidney fx and may need smaller doses.

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15
Q

what is a catecholamine?

A

an amine derived from the amino acid, “tyrosine” (i.e. Epi and Nor and DA) that act as hormones or NTs.

  • Drugs must be lipid soluble to pass through the BBB.
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16
Q

What is the action of psych meds? Agonist/antagonist?

A

block, inhibit reuptake or act on metabolism.

agonist- increases activity of the NT
antagonist- decreases activity of the NT

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17
Q

What are cytochromes?

A

enzymes that like eating pills (meds in the system)

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18
Q

What substances can increase the rate of metabolism of meds and decrease their level in the plasma?

A

cigarette smoking

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19
Q

What do you do if you encounter a “dual relationship”?

A

Transfer care to another nurse.

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20
Q

In family therapy, what is “life script”?

A

plan decided not by fate, but by experiences early in life

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21
Q

What is schism?

A

In family therapy, it means that each parent undermines the other, children are forced to join the warring camp of one of the parents, a split.

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22
Q

What is skew?

A

one mate is dysfunctional, lack of partnership

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23
Q

What is disengagement?

A

(family therapy)

abandonment, oblivious to effects of their actions on other members, separateness from family

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24
Q

what are the phases of group development?

Study These Flashcards
A

initial/orientation-rules, confidnetiality, goals of group, leader role (orient, rules, trust)
middle/working- problem solving and decision making, cooperation, leader’s role (resolve confict, facilitate), members bx
final/termination- should be discussed several meetings before it occurs, loss, leader’s role(encourage, reminisce)

25
Defense mechanisms vs. coping skills
defense mechanisms- used consciously or unconsciously to protect the ego from mild to moderate anxiety. They become maladaptive when they distort reality. coping mechanisms- can be made conscious, voluntary. Adaptive when they protect the individual from harm or restore homeostasis.
26
What are the (3) reasons CA calls 72hr hold or 5150?
1) DTS 2) DTO 3) Gravely Disabled (GD)- inability to provide food, clothing, or shelter d/t a menta d/o
27
what is reise hearing?
a court hearing for refusal of meds
28
what is Roger S hearing?
court hearing for minors 14-17 yrs
29
what is assent?
to agree or concur (children/adolescents)
30
what is Short-Doyle act?
funding for mental health
31
what is Lanterman-Petris-Short Act (LPS)?
involuntary confinement & conservatorship laws. LPS conservators can hospitalize client, financial conservators cannot.
32
what is the biological theory of violence?
d/t biological factors (i.e. hormonal, NTs, neurophysiological, etc)
33
what is the genetic theory of violence?
serotonin under investigation
34
what does the psychoanalytic theory of violence state?
Freud, aggression is a primitive drive
35
what is the sociocultural view of violence?
child abuse, emotional rejection in childhood & parenting styles ( separation & neglect)
36
what is the behavioral view of violence?
learned by witnessing violence (bx modeling)
37
what is the humanistic theory of violence?
undervalued, unneeded of insignificant results in poor self-esteem
38
what are the indicators of dangerousness (asx of violence)?
- hx of violence - severe psychopathology - hostility - suspiciousness - noncompliance to meds & substance abuse - thought disturbances & agitation - length of time in the hospital - early age onset of psychiatric symptoms - frequent admissions to psychiatric hospitals
39
What are the least restrictive restraints used only if DTS or DTO?
- involuntary medication, IM (next level) - seclusion-involuntary confinement behind a locked door (time-out is voluntary with door unlocked) (2nd level) - restraint-physical or mechanical device attached to the client's body which they cannot remove which restricts freedom of movement. RN can get order after the fact. (highest level)
40
Can a RN initiate a seclusion?
Yes, but obtain a MD order asap
41
how often are restraint orders renewed?
- q 4hrs for adults (18 yrs or older) - q 2hrs ages 9-17 yrs - q 1hr children under 9 yrs * The max is q 24hrs
42
What is needed to be done w/in 1 hr of initiation of restraints?
in-person evaluation must be done by HCP
43
What do you monitor for restraint & secluded clients?
safety, respiratory, circulatory, skin, VS, bathroom & hydration needs
44
According to JCAHO, how often do you observe restrained clients?
q 15 min
45
what is the protocol for releasing seclusion and restraints?
determined by nursing and client must meet criteria, one limb @ a time w/ asx of client's response.
46
What theory did defense mechanisms develop from?
Psychoanalytic
47
What is the "id"?
pleasure focus, minimize pain
48
what is the "ego"?
"me" and in the middle of id and superego. It serves to delay immediate impulse gratification, brings reality into consideration.
49
what is the "superego"?
inhibits impulses that are deemed "wrong, " sometimes called the conscience.
50
What theory does transference & countertransference, free assoc, analysis of dreams, hypnosis originate from?
Psychoanalytic
51
Who developed the 8 Stages of Development?
Erickson
52
What are the stages of development?
1) Trust vs. Mistrust (birth-1 1/2 yrs) 2) Autonomy vs. Shame & doubt (1 1/2 yrs-3yrs) 3) Initiative vs. Guilt (3-6yrs) 4) Industry vs. inferiority(6-11yrs) 5) Identity vs. role confusion(11-20yrs) 6) Intimacy vs. Isolation(20-30yrs) 7) Generativity vs. Stagnation (30-65yrs) 8) Ego Integrity vs. Despair (65yrs-death)
53
What is Psychodynamic therapy?
a short term (6mons) therapy focused on 1-2 problems. Goal is to improve functioning not restructuring of the personality. It utilizes basic concepts of psychoanalytical theory which strives for insight.
54
Who developed Interpersonal Theory? What does it entail?
Harry S. Sullivan and Peplau Emphasis is on the importance of interpersonal relationships in a more holistic manner. Development is influenced by interpersonal relationships experienced: infancy, childhood, adolescence, adulthood.
55
What did Sullivan conclude?
individual bx and personality development are the direct result of interpersonal relationships.
56
What is mirroring? give example.
development of self-concept stems mainly from interpersonal theory. Girl is told by friends at school that she is fat and ugly, she goes home and stands in front of the mirror and states repeatedly, "I hate how fat I am." (She is mirroring what other people think of her).
57
Who developed the Interpersonal Nursing Theory? explain
Peplau ( She also developed the stages of development). focus of interpersonal nursing theory is the therapeutic interpersonal relationship. Components include nurse, client, professional expertise, client need. The phase of the Interpersonal Relationship are orientation, identification, exploitation, and resolution.
58
Who developed the Humanistic Theory?
Abraham Maslow. His focus was on a hierarchy of needs to explain human behavior. In order for an individual

Nsg 28 Mental Health (1 decks)

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