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Psych > Test #3 > Flashcards

Test #3 Flashcards

1
Q

Anxiety level needed for learning. The person experiencing it is alert, and can perceive at a higher level.

A

Mild Anxiety

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2
Q

A person experiencing this level of anxiety has a narrowed perceptual field, but can be attentive when guided.

A

Moderate Anxiety

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3
Q

A person experiencing this level of anxiety has a greatly decreased perceptual field, and is selectively inattentive.

A

Severe Anxiety

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4
Q

A person experiencing this level of anxiety is overwhelmed and has disorganized thinking, speech, and behavior

A

Panic

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5
Q

This level of anxiety can motivate

A

Mild

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6
Q

This level of anxiety can immobilize

A

High levels (Severe or Panic)

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7
Q

Freud theorized that what prevents a person from learning a variety of methods to resolve anxiety?

A

Overused defense mechanisms

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8
Q

Freud theorized that phobias are…

A

… displacement of unconscious conflict onto an external object.

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9
Q

Excessive, unrealistic worries/free-floating anxiety for 6 months or more

A

Generalized Anxiety Disorder (GAD)

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10
Q

A patient who is hypervigilant for potential threats, is abnormally sensitive to caffeine, and often thinks of “doom and gloom” and “what if’s” is showing symptoms of…

A

GAD (if persistent for more than 6 months)

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11
Q

Psychological Symptoms of a panic disorder include…

A
  1. Sensation of smothering
  2. Derealization
  3. Depersonalization
  4. Feeling of impending doom or death
  5. Fear of losing control
  6. Fear of going “crazy”
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12
Q

Somatic Symptoms of a panic disorder include…

A
  1. Palpitations, pounding heart, increased HR
  2. Sweating
  3. Trembling/shaking
  4. Sensation of SOB
  5. Sensation of choking
  6. Chest pain/discomfort
  7. Nausea/abdominal distress
  8. Paresthesias
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13
Q

A marked, persistent fear that is excessive, unreasonable, and cued by anticipation of an object or situation

A

Phobia

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14
Q

Fear that arises through a process of displacement of unconscious conflict to an external object that is symbolically related

A

Phobia

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15
Q

Agoraphobia is the fear/anxiety of at least TWO of what situations?

A
  1. Using public transportation
  2. Being in open spaces
  3. Being enclosed in places
  4. Standing in line or being in a crowd
  5. Being outside of the home alone
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16
Q

Repetitive disturbing thoughts for which the only relief is compulsion (occur despite efforts to suppress them)

A

Obsession

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17
Q

Repetitive actions which become rituals (client realizes they are illogical, but cannot stop)

A

Compulsion

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18
Q

A nurse should be aware that interrupting the ritual of an OCD client could cause…

A

Patient to act out (i.e. slapping the nurse)

Increased anxiety, leading to increased need for ritual

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19
Q

When initially working with a client with OCD, the nurse should…

A
  1. Allow the completion of the ritual
  2. Try distraction
  3. Try to set limits ONCE THE CLIENT IS MORE COMFORTABLE
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20
Q

The physical expression of psychological conflict (symptoms typically have a SYMBOLIC* meaning for the patient)

A

Conversion Disorder

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21
Q

A patient who is 30 years old, presenting with an exaggerated and detailed medial history, multiple medical providers (without resolution of their complaint), and who unconsciously expresses emotions through physical symptoms is experiencing…

A

Somatization Disorder

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22
Q

Teaching for diaphragmatic breathing behavior treatment

A
  1. Should be practiced daily
  2. Lowers level of arousal
  3. Inhibits progression of panic level
  4. Reduces physical effects of anxiety (such as increased HR)
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23
Q

Main goal of interventions with an anxious client

A

Reduce, not eliminate, anxiety level to enable a full “normal” life

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24
Q

Nursing interventions for an anxious client

A
  1. Maintain a calm demeanor
  2. Move client to a quiet environment with reduced stimulation
  3. Allow the client to express emotion
  4. Reassure client that they are safe
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25
Q

Nursing interventions for a client experiencing a panic attack

A
  1. Stay with the patient
  2. Reassure safety
  3. Maintain a calm demeanor
  4. Decrease stimulation
  5. PRN meds

**Initial goal is to reduce immediate anxiety (develop insight later)

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26
Q

Key points for Buspar

A
  1. No effect on benzo receptors, no sedative effects
  2. Takes 3-6 weeks for maximum benefit
  3. Should not be used PRN (see above)
  4. No cross tolerance with CNS depressants
  5. Fewer side effects than benzos
  6. Not addicting and does not cause withdrawal
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27
Q

Education points when teaching a client taking Buspar

A
  1. Works best with a steady blood level (take as prescribed, NOT PRN)
  2. Don’t double up on doses if a dose is missed
  3. May increase digoxin levels (toxic)
  4. Don’t take with MAOI’s or Demerol
  5. May take 7-10 before begins working
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28
Q

Benzodiazepines can cause this if taken by the elderly

A

Paradoxical excitement**
Confusion
Agitation
Delirium

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29
Q

True or False: Benzos can be stopped abruptly

A

FALSE! Can be lethal or cause seizures. Must taper med d/c

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30
Q

Why should a patient taking benzodiazepines not consume alcohol?

A

Can increase the chances of CNS depression

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31
Q

A patient who has a prescription for benzos presents with insomnia, shaking, sweating, itching, tremors, palpitations, sensitivity to light, and an increase in BP. This patient could be experiencing…

A

Benzodiazepine Withdrawal

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32
Q

What medications will be used for long-term treatment of anxiety?

A

SSRI’s

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33
Q

The nurse should teach a patient taking benzodiazepines for anxiety that…

A
  1. Their use is for short-term only

2. They need to taper off the benzo when the SSRI reaches it’s therapeutic effect

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34
Q

Paxil, Prozac, and Zoloft are used to treat…

A

Panic Disorder

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35
Q

Effexor and Paxil are used to treat…

A

GAD

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36
Q

Prozac, Paxil, Zoloft, and Luvox** are used to treat…

A

OCD

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37
Q

Why are beta-blockers (Propanolol) sometimes used to treat anxiety disorders?

A

Reduce SNS symptoms

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38
Q

Alpha 2-receptor agonists (Clonidine) are used to treat anxiety because…

A
  1. Blocks epinephrine (fight or flight response)

2. Prevents symptoms: racing heart, elevated BP

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39
Q

Needing more of the drug to obtain the same effect

A

Tolerance

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40
Q

Symptoms of intoxication include…

A
  1. Alterations in perception
  2. Alterations in thinking
  3. Alterations in judgement
  4. Alterations in psychomotor skills
  5. Alterations in interpersonal behavior
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41
Q

Affects of alcohol on the CNS

A
  1. Depressant

2. Selective anesthetic

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42
Q

What can happen during a blackout?

A

Anything

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43
Q

Occurs 6-12 hours after last drink and causes irritability, anxiety, agitation, headache, nausea/vomiting, and insomnia

A

Minor Withdrawal

44
Q

Occurs 24 hours after last drink, and causes tremors, tachycardia, increased BP, diaphoresis, GI distress, and hallucinations

A

Withdrawal

45
Q

Occurs 48-72 hours after last drink, and causes seizures, delirium tremens, and can last for up to 5 days

A

Major Withdrawal

46
Q

A patient whose last drink was 48 hours ago presents with disorientation, hallucinations, profuse sweating, increased BP, irregular pulse, and severe tremors is exhibiting signs of…

A

Delirium Tremens (DT’s) - Also at risk for seizures

47
Q

Why is denial important in planning treatment for a patient who is a substance abuser?

A

Treatment plan won’t be followed if they don’t think there’s a problem

48
Q

Drug used in the prevention and treatment of alcoholism by inhibiting the breakdown of alcohol by an enzyme

A

Disulfiram (Antabuse)

49
Q

A patient taking Disulfiram who has an evening cocktail will exhibit what symptoms?

A
  1. Nausea and vomiting
  2. Sweating
  3. Tachycardia
  4. Decreased BP (Hypotensive)
  5. Throbbing headache
50
Q

The biggest education point for a patient taking Disulfiram is…

A

NO alcohol of ANY kind (i.e. cough medicine, mouthwash)

51
Q

Signs/Symptoms of benzo withdrawal include…

A
  1. Muscle pain
  2. Tinnitus
  3. Itching
  4. Anxiety/panic
  5. Hypersensitivity to sounds
  6. Depression
  7. Insomnia
  8. Hallucinations, paranoia
  9. Sweating
  10. Balance problems, shaking, jumpiness
  11. Seizures
52
Q

Physical effects of opioids

A
  1. Respiratory depression
  2. Hypotension
  3. Decreased biliary, gastric, and pancreatic secretions
  4. Urinary retention
  5. Constipation
  6. Constricted pupils
53
Q

Effects of cannabis

A
  1. Sense of well-being
  2. Alterations in perception
  3. Increase appetite
  4. Antiemetic properties
  5. Impaired balance and stability
  6. Impaired short-term memory and concentration
  7. Impaired decision making and judgement
  8. Amotivational
  9. Possible pulmonary effects
  10. Weakening heart contraction
  11. Immunosuppression
  12. Reduced testosterone and sperm count
54
Q

The best treatment for a patient with substance abuse involves…

A

Treating both the psych disorder AND the abuse (clients with psych issues are more susceptible to substance abuse)

55
Q

Maladaptive coping pattern that results from a prolonged relationship with the person who uses substances

A

Co-dependency

56
Q

Persistent pattern of inattention, hyperactivity, and impulsivity more frequent and severe than others at developmental level

A

ADHD

57
Q

Before what age must SYMPTOMS of ADHD be present before a child can be diagnosed?

A

Age 7

58
Q

A child’s symptoms of ADHD are present in more than one setting. True or False?

A

True - can cause problems with social and academic settings

59
Q

A child that fidgets, talks a lot, cannot sit still for long periods of time, is impulsive, and does not wait their turn is exhibiting symptoms of which type of ADHD?

A

Hyperactive Type ADHD

60
Q

What is the PRIORITY concern for children with ADHD?

A

SAFETY in all environments!

61
Q

The BEST type of nursing management for a child with ADHD is…

A
  1. Consistent
  2. Structured
  3. Predictable
62
Q

An example of increase productivity in a child with ADHD could be…

A

Reading for 10 minutes independently

63
Q

Psychostimulant medications are indicated for..

A
  1. Narcolepsy
  2. ADHD
  3. Obesity
64
Q

Half-life of Ritalin

A

2-4 hours (Important for administration of doses)

65
Q

Which psychostimulant is usually tried first in children with ADHD?

A

Ritalin (cheap)

66
Q

Types of Psychostimulants

A
  1. Ritalin
  2. Ritalin LA
  3. Metadata CD
67
Q

Dextroamphetamine, Dexadrine, Adderall, Vyvanse

A

Amphetamines (Mixed Salts)

68
Q

What do you hope to see in a child who is taking psychostimulants for ADHD?

A

Paradoxical calming!

  1. Increased attention span
  2. Increased short term memory
  3. Increased ability to follow directions
  4. Decreased disruptive behavior
  5. Decreased distractability
  6. Decreased impulsivity
69
Q

The biggest common side effect of psychostimulants are…

A

Anticholinergic symptoms (can’t see, can’t pee, can’t spit, can’t poop)

70
Q

Non-stimulant medications that can be used to treat ADHD

A
  1. Strattera
  2. Intuniv
  3. Alpha-2 Noradrenergic Agonists (Clonidine, Tenex)
  4. Tricyclic Antidepressants
71
Q

A child who is disobedient, argumentative, has angry outbursts, is spiteful/vindictive, is easily annoyed, blames others, but doesn’t NOT break the law is exhibiting signs of..

A

Oppositional Defiant Disorder (ODD)

72
Q

Repetitive and persistent pattern of behavior in which rules and the basic rights of others are violated

A

Conduct Disorder (CD)

73
Q

Nursing management for children with both ODD and CD must be…

A
  1. Consistent
  2. Structured
  3. Predictable
74
Q

Nursing interventions for children with ODD and CD

A
  1. Decrease violence and increase compliance
  2. Protect others
  3. Set limits
  4. Create behavioral contracts
  5. Time outs
  6. Routine schedule
75
Q

A child displaying OCD symptoms who has no prior psych history and who recently recovered from a strep diagnosis may be displaying signs of…

A

Pediatric Autoimmune Disorder Neuropsychiatric Disorder Associated with Group A Streptococcus (PANDAS)

76
Q

True or False: Stimulants should be given for a child diagnosed with Tourette’s

A

False! Make the symptoms worse.

77
Q

Involuntary excretion of urine that occurs after the age at which bladder control should have been obtained

A

Enuresis

78
Q

Treatment for encoporesis and enuresis include..

A
  1. Thorough physical assessment
  2. Calm, matter-of-fact approach
  3. No fluids before bed
  4. Increased fluids and fiber (encoporesis only)
  5. Setting alarms
79
Q

Medication that can be used to treat elimination disorders

A

Tofranil (imipramine) - one of the side effects is urinary retention

80
Q

Pattern of intentional and purposeful behavior that adults and adolescents use to control their intimate partner (perpetuated through generations of cycle of violence)

A

Domestic Violence

81
Q

Nursing interventions when dealing with a child suspected of child abuse include…

A
  1. Safety!! (Primary intervention)
  2. Documentation
  3. Pictures
  4. Body map to document injuries
82
Q

A child who has been a victim of abuse may exhibit…

A
  1. Dysfunctional coping
  2. Fantasies about revenge
  3. Poor social functioning
  4. Self-neglect
83
Q

Characteristics of an abuser include…

A
  1. Difficulty expressing their feelings
  2. Come from all different backgrounds
  3. Jealous and possessive
  4. Prey on the most powerless
  5. Behavior that is perpetuated through generations of violent cycle
84
Q

The stage of the cycle of violence includes relatively minor incidents (pushing, shoving, yelling) that the victim ignores or accepts and the abuser rationalizes their behavior is acceptable

A

Tension-building Stage

85
Q

This stage of the cycle of violence is when the abuser releases built up tension (brutal beatings, minor incidents) and the victim may be seriously hurt

A

Explosion/Acute Battering Stage

86
Q

This stage of the cycle of violence involves the abuser feeling remorseful and apologetic (makes promises and has kind, loving behavior) and the victim believes the promises and feels needed and loved

A

Honeymoon Stage

87
Q

What is the main reason that victims of abuse stay with the abuser?

A

Fear - worried they or others they love will be seriously injured or killed

88
Q

Other reasons victims of abuse stay with their abuser include…

A
  1. Lack of job and/or education (financially dependent)
  2. Money controlled by partner
  3. Cultural or religious beliefs
  4. Inadequate response from police and/or courts
  5. Low self-esteem
  6. Children
  7. Don’t know anything else
89
Q

How can the health care provider help victims of abuse (whether admitted or denied)?

A
  1. Gather relevant information
  2. Document
  3. Victim may decide to press charges later
  4. Assist to develop safety plan**
90
Q

The motivation for rape is…

A

Control and power

91
Q

Long term impact of rape includes…

A
  1. Self blame
  2. Disruption of daily routine
  3. Depression
  4. Sleep disturbances
  5. Flashbacks
  6. Erratic mood swings
92
Q

The nurses priority concerns when dealing with a victim of rape are..

A
  1. Inform client about the process

2. Inspect and provide treatment for serious injury

93
Q

Nursing assessment for a victim of abuse includes…

A
  1. Quality of sleep
  2. Any incidence of flashbacks and intrusive thoughts
  3. Risk for suicide
  4. Irritability, angry outbursts
  5. Hypervigilance/hyperarousal
  6. Emotional numbing
94
Q

Nursing interventions for a victim of domestic abuse include..

A
  1. Good assessment
  2. Being aware for signs of abuse
  3. Collaboration
  4. Safety plan**
  5. Community resources
  6. Encourage diverse ways to express emotions
95
Q

Factors that interfere with a smooth transition from combat zone to civilian life include…

A
  1. Persistence of effects of combat training
  2. Inability of family/friends to understand veteran experience
  3. Feelings and support of local community
  4. Loss of support system
  5. Finding a new career
  6. Loss of structure
96
Q

Refusal to acknowledge seriousness or existence of problem and a significantly disturbed perception are signs of…

A

Anorexia Nervosa

97
Q

Eating disorder that is precipitated by emotions

A

Bulimia Nervosa

98
Q

Biological factors of Anorexia and Bulimia include

A
  1. Dysfunction of hypothalamus

2. Neurochemical changes (norepinephrine and serotonin)

99
Q

This eating disorder can result from overprotective parents and blurred boundaries (enmeshment)

A

Anorexia Nervosa

100
Q

This eating disorder can result from isolation between family members or possible abuse

A

Bulimia

101
Q

Patients will show signs of obsessive rituals, cessation of menses, electrolyte imbalances, irregular HR, mild anemia, muscle loss, possible kidney failure, and low BP

A

Anorexia

102
Q

Patients will show signs of rupture of esophagus, depression, self guilt/disgust/shame, stomach pains, irregular HR, diabetes, constipation, and tooth decay from stomach acid

A

Bulimia

103
Q

Treatment goals for anorexia nervosa include..

A
  1. Safety
  2. Gradual weight restoration
  3. Collaborative treatment team efforts
  4. Target weight about 90% of average for age and height
  5. Correct malnutrition (protect organ function)**
104
Q

How are the cognitive distortions treated for a patient experiencing an eating disorder?

A

Reframing of cognitive perceptions (i.e. that binge eating cures feelings of lonliness)

105
Q

Medications that may be used to help treat eating disorders

A

SSRI or SNRI (can be used to treat depressive/anxiety symptoms)

106
Q

Nursing priorities when caring for a patient with an eating disorder

A
  1. SAFETY
  2. Intake
  3. Weights
  4. Fluid and electrolytes
107
Q

Nursing interventions when caring for a patient with an eating disorder include..

A
  1. Weights
  2. Supervised eating (tube feeding if necessary)
  3. Monitored toileting
  4. Monitoring after eating
  5. Education
  6. Listening!
  7. Observation

Psych (3 decks)

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