Psych Final Flashcards
(168 cards)
1
Q
SSSRI mnemonic
A
Suicide risk, slow onset and taper, serotonin syndrome, sweaty, rigid muscles, increased HR
2
Q
Can’t see, can’t pee, can’t spit, can’t shit
A
TCA side effects
3
Q
True or false you can take MAOI’s with other antidepressants
A
False, must take two weeks to come off MAOI before taking another one
4
Q
MAOI mnemonic
A
Massive HTN risk, Avoid tyramine, OTC drugs HTN crisis, Increased risk suicide
5
Q
MAOI food to avoid
A
Wine and cheese, beer and sausage, chocolate, fermented fruits or veggies
6
Q
maoi otc drugs to avoid CAAN
A
Calcium, antacids, acetaminophen, NSAIDS
7
Q
Which meds have most potential risk for injury?
A
Looking for which ones are sedating like amytriptyline, diphenhydramine, and alprazolam
8
Q
Lithium therapeutic level
A
0.6-1.2
9
Q
What can contribute to lithium toxicity
A
Diuretics
10
Q
Anticholinergic side effects from TCA
A
Blind as a bat, mad as a hatter, dry as a bone, red as a beet
11
Q
Meds linked to Steven’s Johnson syndrome
A
Carbamazepine, lamotrigine
12
Q
Do not take if have hx of head injury or seizures
A
Welbutrin bupropion
13
Q
Which MAOI can come in a patch?
A
Selegeline
14
Q
Which class of meds can cause hypoglycemia?
A
SSRIs
15
Q
Hypotension is associated with this class of antidepressants
A
TCA
16
Q
Med given to help with hand tremors associated with lithium
A
Propranolol
17
Q
What three mood stabilizers to avoid during pregnancy
A
Lithium,carbamazepine, Depakote
18
Q
Hyper reflex fever agitation abdominal pain nause vomiting
A
Serotonin syndrome
19
Q
Why are antipsychotics used with mood stabilizers
A
They work faster to manage the patients symptoms before the mood stabilizers gets in their system
20
Q
Abdominal cramping, vomiting, tremors, restlessness, inability to sleep, Increased HR, Increased Respiratory rate, and temperature, transient hallucinations, anxiety, Increased BP, tonic clonic seizures.
A
Alcohol withdraw symptoms
21
Q
Confusion, disorientation, hallucination, BP Abnormal, tremors, seizures, hyperthermia, cardiovascular collapse
A
Delirium tremens
22
Q
How do you treat delirium tremens?
A
With benzos to keep the GABA neurotransmitters regulated
23
Q
What is wernicke syndrome ?
A
Ataxia, poor coordination, falls, and abnormal eye movement
24
Q
What deficiency causes wernicke encephalopathy and korsakoff psychosis?
A
Vitamin B1 or thiamine
25
What medications do we give someone going through alcohol withdraw
Acamprosate calcium, Ativan, benzos, carbamazepine, clonidine, propranolol, atenolol
26
What are nursing interventions for the medications we give to withdrawing alcoholics?
Around the clock or PRN, baseline vitals, seizure precautions, neuro status, check HR prior to propranolol
27
What are medications used for alcohol abstinence and maintenance?
Disulifiram, naltrexone, acamprosate
28
What drugs are classified as opioids?
Heroin, morphine, hydromorphone
29
What are the s/s of opioid overdose?
Respiratory depression, lethargy
30
Sweating, nose bleed, gooseflesh, tremors, irritability, weakness, diarrhea, fever, insomnia, n/v, pain in muscles/bones, muscle spasms
Opioid withdraw
31
Is withdraw from opioids life threatening
No
32
What meds are used to treat opioid addiction for detox?
Naloxone, flumazenil
33
What meds are used to treat opioid addictions for maintenance?
Methadone, clonadine, and buprenorphine
34
Withdraw symptoms of cocaine?
Depression, fatigue, suicidal, severe craving for coke, agitation, sleep disturbances
35
Is cocaine withdraw life threatening?
Nope but depression and SI can occur
36
What puts a patient at risk for abuse?
Female partner, vulnerable persons, pregnancy, older adults, child under 4, child is unwanted, disabled, or vulnerable
37
Educations for client with ECT therapy
ECT is not permanent cure, weekly or monthly maintenance ECT can decrease incidence of relapse
38
Nursing care for a patient undergoing ECT
Frequent orientation, safety, assist with ADL as needed, continuous monitoring, vitals
39
What patient is a good candidate for ECT
One who has been unsuccessful with medication
40
What are the various types of crisis?
Adventitious (natural disaster), situational/external (unanticipated loss), maturational/internal (new development stages)
41
Assessment questions for crisis?
Immediate safety, time since last crisis, coping skills, problem that is identified, perception of event, resources used, no hx questions!
42
What is normal grief
Uncomplicated, anger, resentment, withdraw, hopelessness, guilt but change to acceptance with time
43
What is anticipatory grief?
Terminal illness, letting go before the loss, have chance to greive before loss
44
What is disenfranchised grief?
Cannot be publicly shared or not socially acceptable (suicide, abortion)
45
What is delayed grief?
Does not demonstrate expected behaviors, can remain in denial for long time
46
What is an appropriate meal for someone who is manic?
Finger food and high calorie drink cuz they're on the go!
47
What meds are cardiotoxic in an overdose?
TCA's
48
What med class can cause hyponatremia?
Lithium and SSRI
49
Psychological risk factors for addiction
Hx of abuse, anxiety, low self esteem, difficulty expressing emotions, mental illness
50
Result of alcoholic portal HTN due to cirrhosis?
Esophageal varices
51
CAGE Questionnaire
Have you ever CUT down on drinking? Have people ANNOYED you by telling you about it? Have you ever felt GUILTY about drinking? Have you ever had a drink first thing in the morning? (EYE opener)
52
Alternative to methadone during pregnancy
Buprenorphine
53
Why can clonidine be used to treat withdraw?
Decreases autonomic hyperactivity
54
What is exaggerated grief?
Somatic manifestations to an exaggerated level, unable to perform ADL, remain in anger stage, can develop depression
55
What are the signs of mild lithium toxicity?
Apathy, lethargy, irritability, muscle weakness, nausea
56
What are the signs of severe lithium toxicity?
Cardiovascular collapse, coma, seizure
57
What are the signs of moderate lithium toxicity?
Blurred vision, confusion, drowsiness, progressing tremor, slurred speech, unsteady gait
58
Sexual dysfunction, CNS stimulation, weight loss/gain, serotonin syndrome, withdraw, hyponatremia
SSRI adverse effects
59
Do not take SSRI with...
Other antidepressants, warafrin, lithium, NSAIDs and anticoagulants
60
TCA adverse effects
BP problems (low) anticholinergic effects, CNS effects (sedation, sweating)
61
CNS stimulation, orthostatic hypotension, hypertensive crisis, rash
MAOI adverse effects
62
MAOI should not be taken with...
other antidepressants, antihypertensive, mepredine, tyramine, vasopressors (caffeine)
63
CNS effects, blood effects, teratogensis, hypo-osmolarity, skin disorders (SJS)
Carbamazepine adverse effects
64
LaMotRiGinE adverse effects
Double or blurred vision, dizziness, headache, nausea, vomiting, serious skin rash
65
Nausea, vomiting, indigestion, hepatotoxicity, pancreatitis, thrombocytopenia, teratogensis
Depakote adverse effects
66
Carbamazepine should not be taken with...
Warfarin, oral contraceptives, grapefruit, phenytoin, phenobarbital
67
Lamotrigine should not he taken with....
Carbamazepine, phenytoin, phenobarbital, Depakote, oral contraceptives
68
Depakote should not be taken with...
Phenytoin, phenobarbital
69
Cluster A personality disorders
Paranoid, schizoid, schizotypal
70
Cluster B personality disorder
Antisocial, borderline, histrionic, narcissistic
71
Cluster C personality disorder
Avoidant, dependent, obsessive compulsive
72
A pattern of distrust and suspiciousness such that others motives are interpreted as malevolent
Paranoid personality disorder
73
A pattern of detachment from social relationships and a restricted range of emotional expression, loners no interest in close relationships
Schizoid personality disorder
74
A pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior. Magical thinking, odd speech, inappropriate affect
Schizotypal personality disorder
75
A pattern of disregard for and violation of the rights of others. Social norms and rules don't apply, no remorse or guilt
Antisocial personality disorder
76
Pattern of instability in interpersonal relationships, self-image, and affects and marked impulsivity. Unstable mood, relationships, self image, impulsive and self destructive.
Borderline personality disorder
77
Pattern of excessive emotionally and attention seeking. Excessive expression overly dramatic, always drawing attention to themselves, seductive.
Histrionic personality disorder
78
Pattern of grandiosity, need for admiration, and lack of empathy. Exaggerated sense of self importance, needs constant attention, preoccupied with fantasies
Narcissistic personality disorder
79
Pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation and rejection. Feel inadequate, want unconditional acceptance, fear criticism.
Avoidant personality disorder
80
Pattern of submissive and clinging behavior related to an excess need to be taken care of.
Dependent personality disorder
81
Pattern of preoccupation with orderliness, perfectionism, and control. Loves rules, lists, devoted to work.
Obsessive compulsive personality disorder
82
Odd and eccentric
Cluster A
83
Dramatic and emotional
Cluster B
84
Anxious, fearful, depressed, compliant, tense, inflexible, rigid routines, low self confidence
Cluster C
85
Safety, gentle approach be consistent with care, respectful of client need fir distance, privacy, remember they withdraw to protect themselves
Nursing implications for cluster A
86
Set limits, be aware of manipulative behavior, use consistency, be firm in what is expected
Nursing interventions for antisocial personality disorder
87
Safety, set limits, be consistent with firm guidelines, provide structure, do not give a reaction to self injury
Nursing interventions for borderline personality disorder
88
Use self awareness, need to relieve feedback on their behavior and how it affects others
Interventions for histrionic and narcissistic personality disorder
89
Redirect their perceptions of self in relationships with others, short but frequent contacts to show interest, important to boost self esteem
Nursing interventions for avoidant personality disorder
90
Teach assertive skills, help learn that it's okay to express anger, reward for independence, ignore dependent behavior
Nursing interventions for dependent personality disorder
91
Talk about behavior and gains, teach assertive behavior, modify perfectionist standard, decrease anxiety
Nursing interventions for obsessive compulsive personality disorder
92
Haloperidol, fluphenazine, trifluophenazine, chlorpromazine
Typical antipsychotics
93
Risperidone, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, ziprasidone, ariprozole, brexpiprazole
Atypical antipsychotics
94
pseudoparkinsonism, akathesia, neuroendocrine effects, orthostatic hypotension, sexual dysfunction, skin effects, liver impairment, anticholinergic effects
Common and expected side effects of typical antipsychotics
95
Metabolic syndrome, orthostatic hypotension, anticholinergic effects, agitation, dizziness, sedation, sleep disruption, mild EPS (tremor), elevated prolactin levels, sexual dysfunction, anticholinergic effects
Common and expected side effects of atypical antipsychotics
96
Agranulocytosis, tardive dyskinesia, neuroleptic malignant syndrome, sedation, seizures, severe dysrhythmias, acute dystonia
Serious side effects of typical antipsychotics
97
Prolonged QT interval, sedation, neuroleptic malignant syndrome, DRESS, Steven Johnsons, agranulocytosis, severe dysrhythmias, hepatotoxicity
Serious side effects of ATYPICAL antipsychotics
98
Metabolic toxic state. Drug use, head injury, delirium, dementia, Huntington, MS, thyrotoxicosis
Neuro conditions that can cause psychosis
99
Client has psychotic thinking or behavior present for at least 6 months areas of functioning are school, work, self-care, and interpersonal relationships are impaired
Schizophrenia
100
Client has manifestations of schizophrenia but the duration is from 1 to 6 months and social/occupational dysfunction may or may not be present
Schizophreniform disorder
101
Client meets both criteria for schizophrenia and bipolar disorder
Schizoaffective disorder
102
Hallucinations, delusions, alterations in speech, bizarre behavior
Positive schizophrenia symptoms
103
Blunted affect, alogia, anergia, anhedonia, avolition
Negative schizophrenia symptoms
104
Disordered thinking, inability to make decisions,poor problem solving, difficulty concentrating, memory deficits
Cognitive symptoms of psychotic disorders
105
Hopelessness, suicidal ideation
Affective symptoms
106
Misconstrues trivial events and attaches personal significance to them, such as believing that others, who are discussing the next meal are talking about him
Ideas of reference
107
Made up words that have meaning only to the client
Neologisms
108
Client repeats the words spoken to him
Echolalia
109
Meaningless rhyming of words often forceful such as oh fox box lox
Clang association
110
Words jumbled together with little meaning or significance to the listener such as hip hooray the flip is cast and wide sprinting in the forest
Word salad
111
I like birds, birds can fly, flying a plane is hard, hard boiled eggs are good
Loose association
112
Extreme agitation, stereotyped behaviors, automatic obedience, wavy flexibility, stupor, negativism, echopraxia
Alterations in behavior
113
Purposeful imitation of movements made by others
Echopraxia
114
Excessive maintenence of behavior
Wavy flexibility
115
Doing the opposite of what is requested
Negativism
116
Lack of hygiene, outbursts, unusual behavior, anxiety, confusion, terror, unreasonable fear
Prodromal or initial phase
117
Hallucinations, delusions, disorganized speech, disorganized behavior
Active or acute phase
118
Positive symptoms tend to become less intense, may regain some social skills, not all individuals experience this
Residual phase
119
How does benztropine work?
Blocks effect of acetylcholine to help relieve tremors, rigidity, and complete loss of muscle movement
120
Late onset, very serious, can be irreversible, initial lip smacking, tongue darting, progress to rapid movement of arms, legs and trunk
Tardive dyskinesia
121
Pacing, squirming, inability to sit still, uncontrollable need to move
Akathisia
122
High fever, unstable VS, Muscle rigidity, can be fatal
Neuroleptic malignant syndrome (NMS)
123
Your pt is taking olanzapine, what should you carefully monitor for?
Increased blood glucose
124
Client takes quetiapine (seroquel) which lab tests should the nurse monitor
Lipid profile
125
Client receiving haloperidol complains of stuff jaw and difficulty swallowing. Your first action is to
Administer as needed benztropine IM as ordered
126
Which instruction by the nurse to a client prescribed diazepam for anxiety is appropriate
This medication Is good fir short term only
127
How does the nurse differentiate fear and anxiety?
Fear results in physiological response, anxiety is psychological
128
Which is the priority nursing action when providing care to a client who demonstrate signs of escalating anxiety?
Provide a safe, quiet, and protective environment
129
A client is prescribed fluoxetine for treatment of obsessive compulsive disorder. During the office visit they note the client is still exhibiting OCD behaviors. What should be the priority assessment?
Whether the client is taking the medication as prescribed
130
Which assessment findings would indicate that the client is experiencing PTSD?
fear of returning to sleep, terrifying nightmares, aggressive behavior
131
Which outcomes would indicate the intervention in the plan of care has been effective for someone with PTSD
The client has been sleeping throughout the night, client verbalizes future plans with family and friends
132
What medication do you anticipate client being ordered with PTSD who is depressed, suicidal, and irritable?
Prazosin
133
What is the priority nursing dx for client with PTSD SI, and sleep disturbances with frequent nightmares
Risk for self-directed violence
134
Which treatment is most appropriate for pt with generalized anxiety disorder
Long-term treatment with buspirone
135
Nurse is giving d/c instructions for pt with benzodiazepine. What statement needs further teaching
I will need to schedule blood work in order to monitor for toxic levels of thus drug
136
Best nursing interventions for pt with generalized anxiety disorder
Encourage client to recognize signs of escalation, employ newly learned relaxation techniques, cognitively reframe thoughts about situations that generate anxiety, avoid caffeine
137
What symptoms can be present in both bulimia and anorexia?
Binge eating and purging, highly focused on wt and appearance, inaccurate perceptions of the body
138
Dehydration, hypophosphatemia, muscle cramps, irregular heart beat
Refeeding syndrome
139
Avoid driving until client knows how it effects them, do not drink alcohol or take other CNS depressants, notify provider of all OTC medications, notify provider of any abnormal movements
Education for buspirone
140
Advise pt to weigh self twice weekly to assess for fluid retention, may cause dizziness or drowsiness, avoid sudden changes in position, do not breastfeed on medication
Education for prazosin
141
Restlessness, increased motivation, irritability
Mild anxiety
142
Agitation, muscle tightness
Moderate anxiety
143
Inability to function, ritualistic behavior, unresponsive
Severe anxiety
144
Distorted perception, loss of rational thought, immobility
Panic level anxiety
145
Stay with the pt, reassure you will not leave, give clear concise directions, assist to an environmental with little stimulation, walk or pace with the patient, administer medication, allow pt to vent
Interventions for panic
146
Fear/anxiety, ineffective coping, social isolation, sleep pattern disturbance, impaired communication, risk for self harm
Nursing dx for anxiety
147
Dizziness, nausea, headache, light headed, agitation, no sedation, do not take while pregnant, or breast feeding, caution in older adults, liver dysfunction, renal dysfunction, no not take with MAOI
Buspirone complications and contraindications
148
Erythromycin, ketoconazole, St. John's wort, grapefruit may increase levels
Buspirone medication/ food interaction
149
Take with meals, effect does not occur immediately,should be taken on regular basis, tolerance, dependence, or withdraw are not an issue with this medication
Buspirone nursing admin
150
CNS depression, ataxia, decreased cognitive function, amnesia, acute toxicity, paradoxical response, withdraw
Adverse effects of benzodiazepines
151
Experience a loss or alteration in physical functioning, loss of functioning appears to be a physical problem. Really an expression of emotional conflict or need, la Belle indifference, primary and secondary gains
Conversion disorder
152
Pt has seizure when it is their turn to share about their trauma, pt no longer has to share trauma. Later patient gets special care for having seizure
Primary and secondary gains
153
The falsification of medical or psychological signs and symptoms in oneself or others that are associated with the identified deception
Fictitious disorder
154
Individuals may take actions to misrepresent, stimulate, or cause signs and symptoms of illness or injury in the absence of obvious external rewards
Factitious disorder
155
Establish therapeutic relationship, provide calm reassurance, show empathy but focus on feelings rather than physical complaints, encourage verbalizing feelings, redirect client, coordinate physical and psych care
Nursing care for somatic disirders
156
Sudden high fever, blood pressure fluctuations, diaphoresis, tachycardia, muscle rigidity, decreased level of consciousness, coma
Neuroleptic malignant syndrome
157
What is the difference between NMS and serotonin syndrome?
Serotonin syndrome is hyperrelfexive, NMS is muscle rigidity
158
Which meds address both positive and negative symptoms?
Atypical antipsychotics
159
Which meds only address positive symptoms?
Typical antipsychotics
160
What do we watch for with antipsychotics?
Liver function, BP, ECG, CBC, cholesterol, glucose
161
How often is a CBC done with clozapine?
Every 2 weeks
162
What is the AIMS scale used for?
Delirium tremens
163
Is prazosin a benzo?
No
164
Which alcohol withdraw meds help with cravings
Naltrexone
165
Which narcotic withdraw meds help with cravings
Buprenorphine
166
Pseudoparkinsonism, acute dystonia, akathisia, tardive dyskinesia are associated with what?
EPS, associated with typical antipsychotics
167
Restless, unable to sit still
Akathesia
168
Confusion, agitation, poor concentration, hostility, disoriented, hallucinations, delirium, seizures, tachycardia, labeled blood pressure, diaphoresis HYPERREFLEXIA nausea, vomiting
Serotonin syndrome
