PSYCH exam 4! Flashcards
(233 cards)
1
Q
promotes equality in human relationships, enabling us to act in our own best interests, to stand up for ourselves without undue anxiety, to express honest feelings comfortable, to exercise personal rights without denying the rights of others
A
assertive behavior
2
Q
helps us feel good about ourselves and increase our self-esteem.
A
assertive behavior
3
Q
seek to please others at the expense of denying their own basic human rights
A
nonassertive people
4
Q
stand up for their own rights while protecting the rights of others
A
assertive behavior.
5
Q
they communicate tactfully, using lots of āIā statements
A
assertive behavior
6
Q
defend their own basic rights by violating the basic rights of others
A
aggressive
7
Q
individuals defend their own rights by expressing resistance and general obstructiveness in response to the expectations of others
A
passive-aggressive
8
Q
goal of non assertive
A
to please others; to be liked by others
9
Q
feelings on non-assertive
A
anxious, hurt, disappointed with self, angry, resentful
10
Q
goals of assertive
A
to communicate effectively; to be respected by others
11
Q
feelings on assertive
A
confident, successful, proud, self-respecting
12
Q
goals of aggressive
A
to dominate or humiliate others
13
Q
feelings of aggressive
A
self-righteous, controlling, superior
14
Q
goals of passiveāaggressive
A
to dominate through retaliation
15
Q
feelings of passive-aggressive
A
anger, resentment, manipulated, controlled
16
Q
persistently repeating in a calm voice what is wanted.
A
ābroken recordā
17
Q
assertively accepting negative aspects about oneself; admitting when an error has been made
A
agreeing assertively
18
Q
seeking additional info about critical statements
A
inquiring assertively
19
Q
changing the focus of the communication from discussing the topic at hand to analyzing what is actually going on in the interaction.
A
shifting from content to process.
20
Q
concurring with the criticās argument without becoming defensive and without agreeing to change.
A
clouding/fogging
21
Q
putting off further discussion with an angry individual until he or she is calmer
A
defusing
22
Q
putting off further discussion with another individual until one is calmer
A
delaying assertively
23
Q
allow an individual to take ownership for his/her feelings rather than saying they are caused by another person
A
āIā statements
24
Q
were developed by psychiatrist Joseph Wolpe and are intended to eliminate intrusive, unwanted thoughts
A
thought stopping
25
is the cognitive or thinking component of the self, and generally refers to the totality of a complex, organized, and dynamic system of learned beliefs, attitudes and opinions that each person holds to be true about his or her personal existence
self-concept
26
subjective perception of one's physical appearance based on self-evaluation and on reactions and feedback from others
body image
27
an individual's ___ ____ may not be necessarily coincide with his/her actual appearance
body image
28
a disturbance in one's body image may occur with changes in ___ or ____.
structure of function
29
examples in bodily structure include:
amputations
mastectomy
facial disfigurements
30
is that aspect of the personal identity that evaluates who the individual says he or she is
moral-ethical self
31
is the component of the personal identity that strives to maintain a stable self-image.
self-consistency
32
relates to an individual's perception of what he or she wants to be, to do, or to become.
self-ideal/self-expectancy
33
refers to the degree of regard or respect that individuals have for themselves and is a measure of worth that they place on their abilities and judgements
self-esteem
34
it is important for individuals to have a feeling of control over their own life situation and an ability to claim some measure of influence over the behaviors of others
power
35
self-esteem is enhanced when individuals feel loves, respected, and cared for by significant others
significance
36
individuals feel good about themselves when their actions reflect a set of personal, moral, and ethical values
virtue.
37
positive self-esteem develops out of one's ability to perform successfully or achieve self-expectations and the expectations of others
competence
38
a structured lifestyle demonstrates acceptance and caring and provides a feeling of security
consistently set limits
39
identified conditions of positive self-esteem
coopersmith
40
emphasized by parents and others who work with children when encouraging the growth and development of positive self-esteem
warren
41
what did warren focus on:
```
a sense of competence
unconditional love
a sense of survival
realistic goals
a sense of responsibility
reality orientation
```
42
other factors found to be influential in the development of self-esteem include the following:
the responses of others
hereditary factors
environmental conditions
43
birth to 18 months
trust versus mistrust
44
18 months to 3 years
autonomy versus shame and doubt
45
3-6 years
initiative versus guilt
46
6-12
industry versus inferiority
47
12-20
identity versus role confusion
48
20-30
intimacy versus isolation
49
30-65
generativity versus stagnation
50
65 years to death
ego integrity verus despair
51
physical and psychological space of others
boundaries
52
individuals who are aware of their boundaries have a healthy __-___ because they must know and accept their inner selves.
self-esteem
53
occur when 2 people's boundaries are so blended together that neither can be sure where one stops and the other begins, or one individual's boundaries may be blurred with another's
enmeshed boundaries
54
when are boundaries established?
childhood
55
unhealthy boundaries are the products of ____, ____ or ______ families
unhealthy
troubled
dysfunctional
56
in addition to the lack of positive role models, unhealthy boundaries may also be the result of ?
abuse or neglect
57
diagnoses that relate to self esteem
chronic low self esteem
situational low self esteem
risk for chronic low self esteem
risk for situational low self esteem
58
longstanding negative self-evaluating/feelings about self or self-capabilities
chronic low self esteem
59
development of a negative perception of self-worth in response to a current situation
situational low self-esteem
60
at risk for long standing negative self evaluating/feelings about self or self capabilities
risk for chronic low self-esteem
61
at risk for developing negative perception of self-worth in response to a current situation.
risk for situational low self esteem
62
neurocognitive disorders=
dementia
63
is a mental state characterized by a disturbance of cognition, which is manifested by confusion, excitement, disorientation, and a clouding of consciousness.
delirium
64
what's common in delirium
hallucinations and illusions
65
is characterized by a disturbance in attention and awareness and a change in condition that develop rapidly over a short period
delirium
66
sx of delirium
```
disorganized thinking
rambling speech
incoherent
reasoning ability are impaired
disorientation to time and place
misperceptions of the environment
disturbances in the sleep wake cycle
```
67
emotional instability may be manifested by ? in delirium
```
fear
anxiety
depression
irritability
anger
euphoria
apathy
```
68
autonomic manifestations are common in delirium such as?
```
tachycardia,
sweating
flushed face
dilated pupils
elevated blood pressure
```
69
what can cause delirium?
medication
70
a term that is used to describe cognitive functions closely linked to particular areas of the brain that have to do with thinking, reasoning, memory, learning, and speaking
neurocognitive
71
has been a mild decline in neurocognitive fxn
mild neurocognitive disorder
72
a significant decline in cognitive function
major neurocognitive disorder
73
the cognitive deficits do not interfere with capacity for independence in everyday activites
mild neurocognitive disorder
74
the cognitive deficits interfere with independence in everyday activites
major neurocognitive disorder
75
the reversibility of NCD is dependent on ?
basked etiology of the disorder
76
truly reversible NCD occurs in only a small percentage of cars and might be more appropriately termed ____.
temporary
77
reversible NCD can occur as a result of ?
```
cerebral lesions
depression
side effects of certain meds
normal pressure hydrocephalus
vitamin or nutritional deficiencies
central nervous system infections
metabolic disorders
```
78
stage 1 Alzheimers
no apparent symtoms
79
stage 2 Alzheimers
forgetfulness
80
losses in ? memory are common in forgetfulness stage
short term memory
81
stage 3 Alzheimers
mild cognitive decline
82
stage 4 alzheimers
mild to moderate cognitive decline
83
creating imaginary events to fill in memory gaps.
| during stage 4
confabulation
84
stage 5 Alzheimers:
moderate cognitive decline
85
stage 6 Alzheimers:
moderate to severe cognitive decline
86
symptoms seem to worsen in the late afternoon and evening.
| during stage 6
sundowning
87
stage 7 Alzheimers:
severe cognitive decline
88
bedfast and aphasic
problems of immobility, such as decubuti and contractors may occur
stage 7
89
enzyme required to produce _____ is dramatically reduced in alzheimer patients
acetylcholine
90
an overabundance of structures called ___ and ___ appear in the brains of individuals of AD
plaques and tangles
91
are made of a protein called amyloid beta
plaques
92
individuals who have a history of head trauma are at risk for ?
AD
93
some studies indicate that early-onset cases are more likely to be ____ than late-onset cases.
famalial
94
1/3-1/2 of all AD cases may be of the ?
genetic form
95
in _____ NCD, the syndrome of cognitive symptoms is due to significant cerebrovascular dx.
the blood vessels of the brain are affected, and progressive intellectual deterioration occurs.
vascular NCD
96
vascular NCD varies from AD in that it has a more?
abrupt onset and runs a highly variable course
97
in vascular NCD progression of the symptoms occurs as
| ?
"steps"
98
at times the symptoms ___ in vascular NCD
clear up
99
the cause of vascular NCD is directly related to an interruption of?
blood flow to the brain.
100
what is thought to decrease the blood flow to the brain ?
High BP--> multiple small strokes or cerebral infarcts
101
leads to damage to the lining of blood vessels
HTN
102
occur as a result of shrinking of the frontal and temporal anterior lobes of the brain
frontotemporal NCD,
103
symptoms of frontotemporal NCD tend to fall into 2 clinical patterns:
1) behavioral and personality change
| 2) speech and language problems
104
common behavioral changes of frontotemporal NCD are
inappropriate actions
lack of judgement and inhibition
repetitive compulsive behavior
105
caused by an impact to the head or other mechanisms of rapid movement or displacement of the brain within the skull
NCD due to traumatic brain injury
106
the symptons of NCD due to traumatic brain injury can do what?
eventually subside or become permanent
107
similar to AD
presence of Lewy bodies
highly sensitive to extrapyramidal effects of antipsychotic medications.
progressive & irrereversible
NCD with levy bodies
108
eosinophilic inclusion bodies
lewy bodies
109
tremors. closely resemble those of AD.
NCD due to parkinson's disease
110
NCD due to HIV infection
.
111
persist beyond the usual duration of intoxication and acute withdrawal.
substance/medication-induced NCD
112
cognitive impairment and ataxis
NCD due to huntington's disease
113
muscular incoordination
ataxia
114
identified by its insidious onset, rapid progression, and manifestations of motor features of prion disease, such as myoclonus or ataxia, or biomarker evidence
NCD due to prion dx
115
NCD due to another medial condition
examples
hypothyroidism
hyperparathyroidism
pituitary insufficiency
uremia
116
a battery of _____ tests may be ordered as part of the diagnostic examination
psychological
117
The results of the psychological testing will differentiate between
NCD and Pseudodementia
118
depression
pseudodementia
119
progression of symptoms for NCD
slow
120
progression of symptoms for psuedodementia
rapid
121
may wander
disorientated to time and place
NCD
122
no wandering
oriented to time a place
psuedodementia
123
sx worsen as day progresses
NCD
124
better as day progresses
psuedodementia
125
NANDA defines risk for trauma as
at risk of accidental tissue injury
126
what to do for the agitated client?
maintain as low a level of stimuli as possible
127
are problematic however because of their tendency to induce EPS effects
conventional antipsychotics
128
the FDA has issued black box warnings against anti-psychotic use in elderly patients with
NCD-related psychosis
129
have been associated with increased mortality in this patient population
antipsychotics
130
how to act around the agitated client?
remain calm and understanding and avoid pressing the individual to do activities that he/she is refusing
131
wandering behavior can also be attributed to physical causes such as
hunger
thirst
urinary or fecal urgency
132
when the wandering behavior begins after a long period of stability, it is like that what is occuring?
a new complication
133
examples of new complications occurring during wandering
medical
physiatric
cognitive
134
may product the abrupt onset of wandering behavior
delirium
135
what to do for clients who wander:
keep them on schedule of recreational activities
feeding and toileting schedule
provide safe place for wandering
ensure that exits are controlled
136
short term goals for clients who wander
client will utilize measures provided to maintain reality orientation
client will experience fewer episodes of acute confusion
137
for the client who is disoriented ?
use clocks and calendars
place large colorful signs
provide the client with radio, tv, and music
138
there has been some criticism in recent years about reality orientation of individuals with NCD suggesting that???
constant relearning material contributes to problems with mood and self-esteem
139
for the client with delusions and hallucinations:
discourage rumination of delusional thinking.
do not disagree with made up stories
never argue a point with the clients (it will increase their anxiety)
don't ignore reports of hallucinations
140
make sure patients experiencing hallucinations and delusions are wearing their?
glasses and hearing aid
141
how to keep the client occupied to keep from having a hallucination or delusion?
distract the client
142
it may be better to what rather than attempting to distract him or her?
go along with the client
143
not all ____ are upsetting
hallucinations
144
interventions for the client with hallucinations and delusions?
use simple words, speak slowly
use nonverbal gestures
ask only one question
145
how to approach the client with hallucinations and delusions?
from the front
146
family education about nature of the illness
possible causes
what to expect
symptoms
147
management of the illness
ways to ensure client safety
how to maintain reality orientation
providing assistance with ADLs
nutritional info
difficult behaviors
med administration
matters r/t hygiene and toileting.
148
cholinterase inhibitors
Donepezil
Rivastigmine
Galantamine
149
NMDA receptor
memantine
150
SE of Donepezil
dizziness
GI upset
headache
INSOMNIA
151
SE of Rivastigmine
dizziness
GI upset
headache
FATIGUE
152
SE of Galantamine
dizziness
GI upset
headache
153
SE of memantine
dizziness
headache
CONSTIPATION
154
what is common in AD and could even be a risk factor?
depression
155
duration of the disorder is commonly brief
delirium
156
client uses confabulation to hide cognitive deficits
NCD
157
symptoms may be confused with depression
NCD
158
can be caused by a series of small strokes
NCD
159
is commonly reversible
delirium
160
can occur as the result of seizures
delirium
161
level of awareness is affected
BOTH
162
reversibility occurs in only a small percentage of cases
NCD
163
severe migraine headache can lead to this condition
delirium
164
personality change is common
NCD
165
illusions and hallucinations are common symptoms
delirium
166
symptoms can occur as a result of cocaine intoxication
delirium
167
symptoms can occur as a result of alcohol withdrawal
delirium
168
can occur as a result of head trauma
both
169
disturbance in memory is commonly the first symptom
NCD
170
characterized by the use of alcohol to relieve the everyday stress and tensions of life
phase 1: prealcoholic phase
171
begins with blackouts--brief period of amnesia that occur during or immediately following a period of drinking
alcohol is REQUIRED by the individual
phase 2:
| early alcoholic stage
172
individual has lost control and physiological addiction is clearly evident
phase 3: crucial phase
173
emotional and physical disintegration. usually intoxicated more that he/she is sober
phase 4: chronic phase
174
peripheral nerve damage that results in pain, burning, tingling or prickly sensations of the extremities
peripheral neuropathy
175
the individual experiences sudden onset of muscle pain, swelling, and weakness
alcoholic myopathy
176
is thought to be a result of B vitamin deficicey that contributes to peripheral neuropathy
alcoholic myopathy
177
most serious form of thiamine deficiency in alcoholics
wernicke's encephalopathy
178
syndrome of confusion, loss of recent memory, and confabulation in alcoholics
kosakoff's psychosis
179
treat of korsakoff's psychosis
thiamine replacement
180
inflammation and pain in the esophagus--occurs because of the toxic effects of alcohol on the esophageal mucosa
esophagitis
181
effects of alcohol on the stomach include inflammation of the stomach lining characterized by epigastric distress, nausea, vomiting, and distention
gastritis
182
usually occurs 1-2 days after a binge of excessive alcohol consumption.
sxs include constant severe epigastric pain, nausea and vomiting and abd distention
acute pancreatitis
183
leads to pancreatic insufficiency results in steatorrhea, malnutrition, weight loss, and DM
chronic pancreatitis
184
from long-term heavy alcohol use.
enlarged and under liver, nausea and vomiting, lethargy, anorexia, elevated WBC count, fever, and jaundice.
ascites and weight loss may be evident in more severe cases
alcoholic hepatitis
185
is the end-stage of alcoholic liver disease and results from long term chronic alcohol abuse
cirrhosis of the liver
186
elevation of blood pressure through the portal circulation results from defective blood flow through the cirrhotic liver
portal HTN
187
excessive samt of serous fluid accumulates in the abd.
ascites
188
are veins in the esophagus that become distended because of excessive pressure from defective blood flow though the cirrhotic liver
esophageal varicees
189
occurs in response to the inability of the disease liver to convert ammonia to urea for excretion
hepatic encephalopathy
190
impaired WBC production
leukopenia
191
plate production impaired
thrombocytopenia
192
there may be problems with learning, memory, attention span, communication, vision, hearing or a combo of these.
FAS
193
characteristics of FAS
abnormal facial features
small head size
intellectual disability
194
intoxicate of alcohol levels
100-200
195
when do you see alcohol withdrawal
4-12 hours after last drink
196
examples of sedative, hypnotic, or anxiolytic use disorder drugs
barbiturates
nonbarbiturate hypnotics
antianxiety agents
197
examples of stimulants
```
amphetamines
synthetic stimulants
nonamphetamine stimulants
cocaine
caffeine
nicotine
```
198
amphetamine and cocaine intoxication sxs of intoxication
```
euphoria or affective blunting
changes in sociability
hypervigilance
interpersonal sensitivity
anxiety
tension or anger
sterotyped behaviors of impaired judgement
```
199
intoxication from caffeine usually occurs following consumption in excess of
250 mg
200
withdrawal of caffeine
headache, fatigue, drowsiness, dysphoric mood, irritability, difficulty concentrating
201
effects on the body of opioid use disorder
CNS
GI
Cardiovascular
Sexual functioning
202
use of hallucinogens is usually
episodic
203
effects of cannabis on the body
cardiovascular (HTN)
respiratory effects (obstruction of airway)
reproductive effects (decreased sperm count)
CNS
sexual functioning (enhances sexual experience)
204
what to do before seeing pt with substance abuse
must examine his/her own feelings about working with a client who abuses substances
205
most common questionniare
CAGE questionnaire
206
CAGE
should you CUT down your drinking?
have people ANNOYED you by criticizing your drinking?
have you felt GUILTY?
do you drink 1st thing in morning? (EYE-opener)
207
the client has coexisting substance disorder and a mental illness, he/she may be experiencing what?
dual diagnosis
208
2 NDs for withdrawing from substances
risk for injury
risk for suicide
209
risk for injury examples
CNS agitation (tremors, elevated BP, N/V, hallucinations, illusions, tachycardia, anxiety, seizures)
210
highest risk for suicide when withdrawing from which type of drug?
stimulants
211
what is the most widely abused drug?
alcohol
212
followed by?
narcotics
213
a need to to define the dysfunctional behaviors that are evident among members of the family of a chemically addicted person.
all individuals from families that harbor secrets of physical or emotional abuse, other cruelties, or pathological conditions
codependecy
214
the codependent person is able to achieve a sense of ____ only through fulfilling the needs of others.
control
215
results in a syndrome of symptoms, that can produce a great deal of discomfort for the individual if they drink alcohol
disulfiram (antabuse)
216
what should pts on antabuse avoid
```
vanilla extract
aftershave
colognes
mouthwash
nail polish removers
isopropyl alcohol
```
217
when does gambling disorder usually begin?
after the "big win"
218
alcohol intoxication
```
aggressiveness
impaired judgement
impaired attentition
irritability
euphoria
depression
emotional lability
slurred speech
incoordination
unsteady gait
nystagmus
flushed face
```
219
withdrawal of alcohol
```
tremors,
N/V
weakness
tachycardia
sweating
elevated BP
anxiety
depressed mood
irritability
hallucinations
headache
insomnia
seizures
```
220
what is alcohol withdreawl usually treated with?
benzo
221
amphetamines and related substances intoxication
```
fighting
gradiosity
hypervigilance
psychomotor agitation
impaired judgement
tachy cardia
PUPIL DILATION
elevated BP
perspiration or chills
N/V
```
222
amphetamines and related substances withdrawal
```
anxiety
depressed mood
irritability
craving for the substance
fatigue
insomnia
psychomotor agitation
paranoid
SI
```
223
withdrawal of caffeine
headache
224
intoxication of cannibas
```
euphoria
anxiety
suspiciousness
sensation of slowed time
impaired judgement
social withdrawal
tachycardia
conjuctival redness
increased appetite
hallucinations
```
225
withdrawal of cannibas
```
restlessness
irritability
insomnia
loss of appetite
depressed mood
tremors
fever
chills
headache
abd. pain
```
226
cocaine intoxication
```
euphoria
fighting
gradiosity
hypervigilance
psychomotor agitation
impaired judgement
tachycardia
elevated BP
PUPIL DILATION
perspiration or chills
N/V
hallucinations
delirium
```
227
cocaine withdrawal
```
depression
anxiety
irritability
fatigue
insomnia
psychomtor agitation
paranoid or SI
apathy
social withdrawal
```
228
intoxication of inhalants
```
beligirence
assaultiveness
apathy
impaired judgement
dizziness
nystagmus
slurred speech
unsteady gait
lethargy
depressed reflexes
tremor
blurred vision
stupor or coma
euphoria
irritation around the eyes throat and nose
```
229
nicotine withdrawal
```
cravings for the drug
irritability
anger
frustration
anxiety
difficulty concentrating
restlessness
decreased HR
increased appetite
weight gain
tremor
headaches
insomnia
```
230
opioid intoxication
```
euphoria
lethargy
somnolence
apathy
dysphoria
impaired judgement
pupillary constriction
drowsiness
slurred speech
constipation
nausea
decreased respiratory rate and BP
```
231
withdrawal of opioids
```
cravings for the drug
N/V
muscle aches
lacrimation or rhinorrhea
pupillary dilation
piloerection or sweating
diarrhea
yawning
fever
insomnia
```
232
sedative intoxication
```
disinhibition of sexual or aggressive impulses
mood lability
impaired judgement
slurred speech
incoodination
unsteady gait
impairment in attentition or memory disorientation
confusion
```
233
withdrawal of sedatives
```
N/V
malaise
weakness
tachycardia
sweating
anxiety
irritability
orthostatic hypotension
tremor
insomnia
seizures
```
