Refresher: Psychiatric Nursing 2

Question 1

Disturbances in Communication:

act of being mute

Answer 1

Disturbances in Communication:

Mutism

Question 2

Disturbances in Communication:

always say NO

Answer 2

Disturbances in Communication:

Negativism

Question 3

Disturbances in Communication:

beating around the bush (paligoy-ligoy); WITH AN ANSWER

Answer 3

Disturbances in Communication:

Circumstantiality

Question 4

Disturbances in Communication:

beating around the bush (paligoy-ligoy); WITHOUT AN ANSWER

Answer 4

Disturbances in Communication:

Tangentiality

Question 5

Disturbances in Communication:

flowery words

Answer 5

Disturbances in Communication:

Stilted language

Question 6

Disturbances in Communication:

with meaning, slightly related

Answer 6

Disturbances in Communication:

Flight of ideas

Question 7

Disturbances in Communication:
without meaning, not related at all
(statements, sentences)

Answer 7

Disturbances in Communication:

Loose association

Question 8

Disturbances in Communication:
from the word persevere; one topic only
Ex: Topic: bball
kahit anong topic iopen, they always come back sa topic na bball

Answer 8

Disturbances in Communication:

Perseveration

Question 9

Disturbances in Communication:

parrot-like imitation

Answer 9

Disturbances in Communication:

Echolalia

Question 10

Disturbances in Communication:
repetition of stereotyped words (last syllable)
Ex: Nahulog-log-log..

Answer 10

Disturbances in Communication:

Palilalia

Question 11

Disturbances in Communication:

repetition of the same words all over again, may topic or wala

Answer 11

Disturbances in Communication:

Verbigeration

Question 12

Disturbances in Communication:
Copro (feces), lalia (logic, speech)
trashtalkers, bad words, curse

Answer 12

Disturbances in Communication:

Coprolalia

Question 13

Disturbances in Communication:
coining new words (sila lang nakakaintindi)
Ex: the song, pash pash

Answer 13

Disturbances in Communication:

Neologism

Question 14

Disturbances in Communication:
sudden cessation of thought (mental block)
Ex: during thesis defend, case presentation

Answer 14

Disturbances in Communication:

Blocking

Question 15

Disturbances in Communication:

mixture of unrelated words

Answer 15

Disturbances in Communication:

Word salad

Question 16

Disturbances in Communication:

rhyming

Answer 16

Disturbances in Communication:

Clang association

Question 17

Disturbances in Perception:
fixed false “belief” (maling paniniwala)

Types:

1. Persecutory - laging pinapatay
2. Religious - feeling friend si Lord
3. Grandeur - feeling nakakaangat sa lahat

Answer 17

Disturbances in Perception:

Delusions

Question 18

Disturbances in Perception:

naniniwala sa mahika (Air, fire)

Answer 18

Disturbances in Perception:

Magical thinking

Question 19

Disturbances in Perception:

extreme suspiciousness

Answer 19

Disturbances in Perception:

Paranoia

Question 20

Disturbances in Perception:
obsession in religious ideas
Ex: ako ang tagapagligtas

Answer 20

Disturbances in Perception:

Religiosity

Question 21

Disturbances in Perception:
irrational fear

with experience - PTSD

Answer 21

Disturbances in Perception:

Phobia

Question 22

Disturbances in Perception:
persistent thoughts (naiisip)

Answer 22

Disturbances in Perception:

Obsession

Question 23

Disturbances in Perception:

persistent acts

Answer 23

Disturbances in Perception:

Compulsion

Question 24

Disturbances in Perception:

ideas with intense desire

Answer 24

Disturbances in Perception:

Preoccupation

Question 25

Disturbances in Perception: others know what I am thinking; preoccupation of people; they want to observe Ex: paparazzi, stalker

Answer 25

Disturbances in Perception: | Thought broadcasting

Question 26

Disturbances in Perception: talk of the town/main character Ex: newscaster gives secret message through the news

Answer 26

Disturbances in Perception: | Delusions of reference

Question 27

Affects: | incongruent (wrong emotions shown)

Answer 27

Affects: | Inappropriate

Question 28

Affects: | little response

Answer 28

Affects: | Blunted

Question 29

Affects: | display one type of expression

Answer 29

Affects: | Restricted

Question 30

Affects: unpredictable Ex. masaya biglang nalungkot

Answer 30

Affects: | Labile

Question 31

Affects: | absence of emotions (flat affect)

Answer 31

Affects: | Apathy

Question 32

Affects: | two opposing feelings (mixed emotions)

Answer 32

Affects: | Ambivalence

Question 33

Affects: | absence of pleasure; with emotion

Answer 33

Affects: | Anhedonia

Question 34

Affects: | extreme pleasure

Answer 34

Affects: | Euphoria

Question 35

Stress: You have determined that there is stress Ex: nalaman mong may board exam this Nov.

Answer 35

Stress: | Stage 1: Alarm reaction

Question 36

Stress: You will utilize all of your resources to solve the problem Ex: mag-aaral ka araw-araw

Answer 36

Stress: | Stage 2: Resistance

Question 37

Stress: You have utilized all resources but he problem is not solved Ex: Bumagsak ka sa board exam

Answer 37

Stress: | Stage 3: Stage of exhaustion

Question 38

Differentiate Anxiety vs. Fear

Answer 38

Anxiety (unknown) | Fear (known)

Question 39

Levels of Anxiety: | good anxiety; logical thinking, increase concentration, increase alertness; problem-solving approach

Answer 39

Levels of Anxiety: | Mild

Question 40

Levels of Anxiety: decrease attention span, selective in attentiveness Management: - relaxation techniques: deep breathing exercise - encourage ambulation - give medications: anxiolytics (to prevent anxiety) as early as moderate

Answer 40

Levels of Anxiety: | Moderate

Question 41

Levels of Anxiety: loud and rapid speech, difficulty of focusing even with assistance; distorted perception (don't know what to do/say) Management: - remain with the patient (physically present)

Answer 41

Levels of Anxiety: | Severe

Question 42

Levels of Anxiety: suicidal attempts, fixed eyes, hysterical/mute Management: - decrease stimuli - stay with the client - paper bag (to alleviate hyperventilation)

Answer 42

Levels of Anxiety: | Panic

Question 43

Neurotransmitters: | excitatory

Answer 43

Neurotransmitters: | Dopamine/Epinephrine/Norepinephrine

Question 44

Neurotransmitters: - inhibitory by nature could also be excitatory

Answer 44

Neurotransmitters: | Serotonin

Question 45

Neurotransmitters: | balancer

Answer 45

Neurotransmitters: | GABA - gamma amino butyric acid

Question 46

Serotonin: exchange of neurotransmitters if inside the cells = inhibitory if outside the cells = excitatory

Answer 46

synapse

Question 47

``` Anxiety Related Disorders: - worry worm; pacing - no apparent reason - 6 months - no phobias, no panic attacks, no OC manifestations if (+) = considered as disorders ``` Signs and Symptoms: - palpitations (tachycardia, headache, insomia, chest pain Management: - assist in problem solving, teach coping behaviors, DOC: Benzodiazepines/Anxiolytics/Anti-anxiety agents: "pam-lam"

Answer 47

Anxiety Related Disorders: | Generalized Related Disorder

Question 48

Anxiety Related Disorders: - recurrent - unpredictable - panic attacks: heightened manifestations of anxiety trembling, racing heart (tachycardia), chest pain, DOB, choking sensation ``` Management: - assist in problem solving, teach coping behaviors, DOC: Benzodiazepines *if with addiction to Benzodiazepine = Antihistamines 1. Primary effect: antiallergic reactions 2. Secondary effect: depressant Other meds: Betablockers: block SNS "olol" MAOI's (monoamine oxidase inhibitor) SSRI's ```

Answer 48

Anxiety Related Disorders: | Panic Disorder

Question 49

Anxiety Related Disorders: - S/Sx are 2 days to 4 weeks (1 month) Management: - progressive review of the trauma (Acceptance), DOC: Benzodiazepines

Answer 49

Anxiety Related Disorders: | Acute Stress Disorder

Question 50

``` Anxiety Related Disorders: - S/Sx more than 4 weeks (> 1 month) - recurrent FLASHBACKS (intrusive thoughts) - re-experiencing of the trauma - defense mechanism: Displacement S/Sx: general numbing to somatic (bodily) Sx a. Irritability b. Aggressiveness c. Depression -- suicidal d. Anger e. Social withdrawal Management: assist in gaining control over angry impulses (Acceptance); DOC: Benzodiazepines; Other meds: Beta blockers, antihistamines ```

Answer 50

Anxiety Related Disorders: | Post traumatic stress disorder (PTSD)

Question 51

Anxiety Related Disorders: - persistent irrational fear - fear is unreasonable proportion to the actual danger Management: - systemic desensitization (gradual exposure to the fear object); by level Ex: pinakita ang water -- to wisik and so on.. to Pacific Ocean "therapy of choice for phobia disorder" Counterpart: Flooding (sudden exposure) - not anymore practiced Ex: fear of water then exposed to pool - breathing exercises - throught stopping; rubberband: diversional guided imagery: conditioning (pinapakita)

Answer 51

Anxiety Related Disorders: | Phobic Disorder

Question 52

``` Anxiety Related Disorders: Phobic Disorder 3 main types: 1. fear of open public "takot gumora" - stay at home, stay near exits 2. fear of socializing 3. specific types (hydro, aero) ```

Answer 52

Anxiety Related Disorders: Phobic Disorder 1. Agora Phobia 2. Social Phobia 3. Simple Phobia

Question 53

Anxiety Related Disorders: - obsessions: persistent thoughts - compulsions: persistent actions OCD: - anxiety disorder, awareness, real obsessions and compulsions ``` OCPD: - personality disorder, not aware, no real obsessions/compulsions, perfectionist, rigid, moralistic Management: - Aversion therapy: pain/punishment DOC: SSRI (balances neurotransmitters) - give time for ritualistic behaviors unless dangerous - establish limits - diversional activities - SLRC: set limits, reality, consistency ```

Answer 53

Anxiety Related Disorders: | Obsessive Compulsive Disorder