Unit III Flashcards

Question

flashbacks

Answer 1

transitory recurrences or perceptual disturbance caused by a persons earlier hallucinogenic drug use occur during persons drug free state visual distortions, time expansion, loss of ego boundaries, and intense emotions reported common in PTSD

Answer 2

cluster or behaviors originally identified through research involving the families of alcoholic patients

Answer 3

when some drugs taken together, the effect of either or both drugs in intensified or prolonged many deaths come from this

Answer 4

many people combine drugs to weaken or inhibit the effect of one of the drugs

Answer 5

``` slurred speech incoordination unsteady gait drowsiness decreased BP disinhibition of sexual or aggressive drives impaired judgment impaired social or occupational function impaired attention or memory irritability ```

Answer 6

benzo's glutethemide alcohol(ETOH)

Answer 7

``` cardiovascular or respiratory depression or arrest(mostly barbiturates) coma shock convulsions death ```

Answer 8

``` if awake: keep awake induce vomiting give activated charcoal to aid absorption of drug check VS q 15mins coma: clear airway - intubate IV fluids gastric lavage with activated charcoal check VS frequently seizure precautions possibly perfrom HD or peritoneal dialysis flumazenil (Romazicon) IV ```

Answer 9

``` cessation of prolonged heavy use: N/V tachycardia diaphoresis anxiety/irritability tremors in hands, fingers, eyelids marked insomnia grand mal seizures 5-15 years use: delirium ```

Answer 10

``` .05% 1-2drinks .08 5-6 drinks .2 10-12 drinks .3 15-19 drinks .4 20-24 drinks .5 25-30 drinks ```

Answer 11

disulfiram(antabuse): used after sober for a few months, motivational aid. DO NOT mix with alcohol naltrexone(ReVia, Vivitrol) reduces desired pleasant feelings by blocking endorphins , blocks drug craving acamprosate(Camprol) reducing some of the unpleasant symptoms of abstinence such as anxiety, tension, dysphoria, helps pt abstain topiramate(Topamax) works to decrease alcohol cravings

Answer 12

benzos: chlordiazepoxide(Librium)- safe withdrawal and anti-convulsant effects diazepam (valium) - anticonvulsant oxazepam(serax) - not metabolized in liver lorazdepam (Ativan) - not metabolized in liver

Answer 13

carbamazepine (tegretol/Depakote) - reduce symptoms and risk of seizures mag sulfate - increase effect of vit B1 and reduce postwithdrawal seizures thiamine(vit B1) - IM or IV before glucose loading to prevent wernickes encephalopathy

Answer 14

beta blockers(propranolol) or alpha blockers(clonidine) - help reduce ANS hyperactivity (tremor, tachy, inc BP, diaphoresis) folic acid - effective in short time mulitvitamins - malabsorption due to heavy long term alcohol abuse

Answer 15

naloxone (narcan) - dramatically reverse the signs of OD. short acting, and must be readministered every few hours nalmefene(revex) - longer half life, less doses, prolonged withdrawal detox first step methadone - long acting opiod, substituted for opioid of addiction and then titrated downward.

Answer 16

coma pinpoint pupils respiratory depression

Answer 17

most effective tx of heroin and other illicit opioids

Answer 18

``` morphine heroin codeine fentanyl methadone meperidine ```

Answer 19

``` constricted pupil dec resp dec BP slurred speech drowsiness psychomotor retardation initial:euphoria later: dysphoria impaired: concentration, judgment, memory ```

Answer 20

``` yawning insomnia irritability rhinorrhea panic diaphoresis cramps N/V muscle aches chills and fever lacrimation diarrhea ```

Answer 21

similar to methadone maintenance | longer duration of action\

Answer 22

methadone(dolophine) - synthetic opiate that blocks craving and effects of heroin L-x-acetylmethadol(LAAM) - alternative to methadone naltrexone(ReVia) - antagonist that blocks the euphoric effects of opioids clonidine(Catapres) - effective somatic tx when combined with naltrexone buprenorphine(Subutex) - blocks the signs and symptoms of opiois withdrawal

Answer 23

pupil dilation oronasal dryness excessive motor activity

Answer 24

cocaine/crack methamphetamine caffeine nicotine

Answer 25

``` extracted from the leaf of a coca bush smoked - 4-6seconds for effects; after 5-7 minutes = "high" two main effects - anesthetic - stimulant produce imbalance in neurotransmitters ```

Answer 26

``` depression paranoia lethargy anxiety insomnia N/V sweating chills apathy agitation fatigue craving ```

Answer 27

``` highly addictive neurotoxic effects - destroy dopamine and serotonin visual hallucination delusions paranoia ```

Answer 28

Parkinson-like symptoms occur

Answer 29

``` cracked teeth skin infections stroke lung disease kidney liver damage birth defects death ```

Answer 30

indian hemp plant which THC is the main/active ingredient usually smoked euphoria, sedation, hallucinations adolescence to young adulthood illegal long term effects: lethargy, anhedonia, diff concentrating, loss of memory

Answer 31

``` chronic use of cannabis leading to: apathy loss of achievement motivation decrease productivity difficulty with learning and memory impaired concentration lack of personal hygiene preoccupation with drug ```

Answer 32

``` MDMA(Ecstasy) gamma hydroxybutyrate(GBA) - fantasy, GBH, liquid ecstasy, cherry meth, flunitrazepam - rohypnol - date rape bath salts ketamine - date rape ```

Answer 33

disinhibition relaxation of voluntary muscles anterograde amnesia

Answer 34

lysergic acid diethylamide (LSD or acid) mescaline (peyote) psilocybin (magic mushroom) phenycyclidine piperidine(PCP, angel dust, horse tranquilizer, peace pill)

Answer 35

``` pupil dilation tachy diaphoresis palpitations tremors incoordination elevated temp, pulse, resp fear of going crazy paranoid ideas marked anxiety, depression synesthesia(colors are heard, sounds are seen) depersonalization hallucinations grandiosity ```

Answer 36

psychosis brain damage death

Answer 37

keep in room, low stim 1:1 - reassure and talk down pt speak slow and clear in low voice diazepam or chloral hydrate for anxiety or tension

Answer 38

``` spray paint glue cigarette lighter fluid propellant gases used in aerosols age 13-17 accessable! ```

Answer 39

history of use medical hx psych hx psychosocial issues

Answer 40

address behaviors - dysfunctional anger, manipulation, impulsiveness, grandiosity develop relationship know your own feelings

Answer 41

``` withdrawal symptoms OD that warrants medical attention SI knowledge of pt and family evaluate for physical comlications explore the patients interest in doing something about the problem ```

Answer 42

``` brain injury BAL psych hx support system coping strategies ```

Answer 43

basics: keep program simple at first, review instructions, write down important phone numbers skills: provide CBT to increase coping skills relapse prevention groups: AA, NA enhancement of personal insight: become involved in groups, individual and or family therapy

Answer 44

enhance and maintain motivation to abstain coping with urges problem solving lifestyle balance

Answer 45

``` emerges from hope person-driven many pathways holistic supported by peers/allies supported through relationships/social networks culturally based supported by addressing trauma involves individual, family, community based on respect ```

Answer 46

``` psychotherapy group therapy CBT motivational incentives motivational interviewing 12 step programs - AA, NA SMART residential intensive outpatient outpatient drug free employee assistance ```

Answer 47

an enduring pattern of perceiving, relating and thinking about the environment the style a person adopts to deal with the world

Answer 48

personality traits are exaggerated and rigid to the point that they cause dysfunction in their relationships

Answer 49

inflexible and maladaptive responses to stress disability in work and personal relationships difficulty with accurately perceiving and interpreting the world and others around him have inappropriate emotional responses(range and intensity) to stress, happenings in the environment, or interpersonally people with PDs may often have a great deal of difficult with impulse control as well

Answer 50

9-16% of gen population meet criteria for PD psych pop = 30-50% have co-occurring PD associated with emotional, social and occupational disability do not believe problem exists, rarely enter tx

Answer 51

genetic neurobiologic: impulsive and aggressive behaviors, affective instability psychological influences: abuse and trauma

Answer 52

the odd, eccentric schizotypal PD paranoid PD schizoid personality

Answer 53

``` pathological personality traits avoid interpersonal relationships unusual beliefs indifferent to the rxns of others in their lives up to 10% commit suicide some develop schizphrenia ```

Answer 54

``` not strangers to healthcare system hostile angry irritable injustice collectors pathologically jealous of their partner litigious cranks constantly suspicious and believe others are lying, cheating, exploiting or trying to harm them in some way ```

Answer 55

``` eccentric isolated lonely periphery of society content to avoid relationships of even the most superficial nature indifferent to praise or criticism flat emotional coldness interest in mathematics and astronomy ```

Answer 56

``` dramatic, emotional, erratic antisocial PD BPD narcissistic PD histrionic PD ```

Answer 57

``` deceit manipulation revenge harm to others with an absence of remorse for hurting others sense of entitlement callousness no restraint on behavior charming, engaging, uncanny with intent to usefor more sadistic purpose ```

Answer 58

90% of having another psych disorder and 40% may have two or more frequently raised in families in which they were subjected to constant belittling, devaluation, and invalidation instability of affect marked by unstable and frequent mood changes intense feelings but short lived intense neediness and lack of trust recurrent suicide attempts self-mutilation splitting: can't integrate both positive and negative qualities of an individual into one person

Answer 59

maladaptive social response characterized by person's grandiose sense of personal achievement expect special treatment entitled attention seeking envy others, believing they deserve it more fragile self esteem shallow and superficial manipulation splitting tantrums arrogance with sadistic and paranoid tendencies anorexia nervosa and SA-cocaine highest on list

Answer 60

manipulate others through their dramatic, charming, flamboyant and sexually seductive behaviors act out: tempers, tears, accusations

Answer 61

anxious, fearful avoidant PD OC PD dependent PD

Answer 62

have high levels of anxiety and outward signs of fear and feelings of low self worth hypersensitive to criticism and rejection avoid socialization view self as unappealing unable to feel empathy d/t their own low self worth

Answer 63

preoccupied with orderliness, perfectionism, control, neatness and achievement of perfection cautious rules and details and follow them rigidly unlike OCD: do not display unwanted obsessions or ritualistic behaviors

Answer 64

believe they are incapable of surviving if left alone intense fear of being alone great risk for anxiety and mood disorders commonly occurs with pt's with gen med condition or disability requiring them to depend on others

Answer 65

passive-aggressive traits:

Answer 66

primitive defenses: ABCD

Answer 67

unmodulated: rage, envy, shame

Answer 68

``` attacking clinging lying indentity: violation, diffusion/boundary impulsivity passive aggression/masochism irrationality selfishness cruelty suicide ```

Answer 69

``` vague self good/bad split entitlement/need = want wish is reality no = yes selective perception self as empty ```

Answer 70

``` splitting dissociation psychotic denial primitive idealization omnipotence/devaluation projective identification ```

Answer 71

assess for suicidal or homicidal thoughts medical disorder? personality functioning within ethnic, cultural and social background loss? evaluate for change in personality be aware of strong/negative feelings

Answer 72

may feel confused, helpless, angry, and frustrated practice self health management acknowledge and accept own emotional responses attempt to ensure personal well being

Answer 73

frequent communication among staff set limits on pt behavior all staff should consistently enforce limits provide necessary support when behavior starts to affect confidence, feelings, behaviors, and effectiveness of staff assess own reactions have discussions with peers

Answer 74

minimize self destructive or aggressive behavior reduce effect of manipulating behaviors link consequences to functional as well as dysfunctional behaviors practice substitution of functional alternatives during a crisis initiate functional alternatives to prevent a crisis practice ongoing management or anger, anxiety, shame and happiness create lifestyle that prevents regression

Answer 75

limit setting trustworthiness manipulations management authenticity with own natural style

Answer 76

psychodynamic CBT dialectical BT - stabilize pt, behavioral control, regulate emotions STEPPS - systems training for emotional predictability and problem solving

Answer 77

``` assess before labeling set limits objectively document behaviors provide clear boundaries and consequences enforce consequences avoid: discussing self or other staff secret keeping(or promise) accepting gifts doing special favors ```

Answer 78

identify and discuss what proceeds impulsive acts explore effects on self and others recognize cues identify triggers discuss alternative behaviors teach or refer pt for coping skills training

Answer 79

no meds specifically. treat symptoms benzos (maintenance dosing) for anxiety are not appropriate because of the potential for abuse and OD, emergent only meds with low toxicity are appropriate

Answer 80

SSRI's - treat co-morbid depression and panic attacks trazodone and venlafaxine - low toxicity in OD carbamazepine - targets impulsivity and self harm lithium, anticonvulsants, SSRI's - minimize aggression atypical antipsychotics - help with psychotic features

Answer 81

people with eating disorders have cognitive distortions that are the result of processing errors in the brain determining which distortions were present before the ED and which ones are the result of semistarvation is important EDs connected to underlying emotions of: anxiety, dysphoria, low self esteem and feelings of lack of control

Answer 82

intense irrational feelings about their shape and weight and they engage in self starvation, express intense fear of gaining weight and have a disturbance in self evaluation of weight and its importance two types: food restriction vs binging and purging

Answer 83

repeated episodes of binge eating followed by inappropriate compensatory behaviors such as self induced vomiting, misuse of laxatives, diuretics, fasting or excessive exercise

Answer 84

individuals engage in repeated episodes of binge eating, consuming large amounts of calories, after which they experience significant distress

Answer 85

``` anorexia women 1%, men 0.3% bulimia women 1.5%, men 0.5% female athletes have higher incidence anorexia onset = early to middle adolescence bulimia onset = late adolescence intermittent and chronic in nature almost always comorbid with psych illnesses up to 1/3 of deaths r/t EDs are suicide binge eating women 1.6%, men 0.8% ```

Answer 86

neurobiologic and neuroendocrine model - abnormalities caused by ED or they cause ED genetic model = moderately heritable, female with hx 12 times more likely psychological model - low self esteem and self doubt about self worth

Answer 87

``` terror of gaining weight preoccupation with thoughts of food view of self as fat even when emaciated peculiar handling of food possible rigorous exercise possible self induced vomiting, diuretics, laxative judges self worth by weight control of food gives power ```

Answer 88

``` binge eating behaviors often self induced vomiting, laxative, diuretics, after bingeing hx of anorexia in 1/4-1/3 of pts depressive signs and symptoms inc levels of anxiety and compulsivity possible chemical dependency possible impulsive stealing ```

Answer 89

``` bradycardia orthostatics murmur sudden cardiac arrest - electrolyte imbalance prolonged QT interval acrocyanosis symptomatic hypotension leukopenia lymphocytosis carotenemia hypokalemic alkalosis electrolyte imbalance OP amenorrhea abnormal thyroid function hematuria proteinuria ```

Answer 90

``` cardiomyopathy dysrhythmias sinus brady sudden cardiac arrest orthostatics murmur elect imbalances hypochloremia hypokalemia dehydration severe attrition and erosion of teeth loss of dental arch diminished chewing ability parotid gland enlargement abd pain Russell's sign - callus on knuckles ```

Answer 91

``` weight loss more than 30% over 6mos rapid decline in weight inability to gain weight with outpt tx severe hypothermia HR less than 40bpm systolic BP less than 70 hypokalemia ECG changes ```

Answer 92

suicidal or severely irrepressible, self-mutilating behaviors uncontrollable use of laxatives, emetics, diuretics, street drugs failure to comply with tx contract severe depression psychosis family crisis or dysfunction

Answer 93

``` emotional/physical difficulites SI? VS, elctrolytes strict weight protocol monitor during meals assess strengths ```

Answer 94

``` ICU coronary care ED units crisis state counseling med management ```

Answer 95

``` overgeneralization all or nothing thinking catastrophizing personalization emotional reasoning ```

Answer 96

chronic illness possible long term tx individual, group and family therapy

Answer 97

``` milieu therapy health teaching and promotion psychotherapy CBT and DBT psychodynamic therapy group and family therapy ```

Answer 98

``` inpatient CBT effective binge/purge cycle interrupted eating habits normalized distortions examined co-morbid depression and SA are treated ```

Answer 99

on d/c pt referred for solidifying goals and address attitudes and perceptions that maintain ED pt and family benefit from connecting with the national network psychotherapy is performed

Answer 100

now recognized as disorder with DSM-5 high rates of mood disorders soothing and helps regulate mood dieting antecedent

Answer 101

modification improve depressive symptoms achieve appropriate weight

Answer 102

Olanzapine(Zyprexa) - second gen antipsychotic = affects weight gain and improves cognition and body image fluoxetine(Prozac) - SSRI = shown mixed results in maintaining weight and preventing relapse

Answer 103

difficult to handle arouse strong feelings prevalent among all ethnic, religious, age and social and socioeconomic groups domestic violence occurs anywhere more visible DV in lower socioeconomic areas

Answer 104

recurrent ED visits for injuries attributed to being accident prone presenting problems reflecting high anxiety and chronic stress: ``` hyperventilation panic attacks GI upset HTN physical injury depression ``` stress related conditions: ``` insomnia violent nightmares anxiety extreme fatigue eczema loss of hair ```

Answer 105

social learning theory societal and cultural factors psychological factors

Answer 106

``` low self esteem poor problem solving hx of impulsive behavior hypersensitivity narcissistic PD immature poor coping skills ```

Answer 107

pattern of assault and course of behaviors that may include physical injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation, threats any race, economic status, religion, educational background any age, married, single, divorced or never married

Answer 108

number one cause of ED visits by women underreported 25-37% of all women experience battering prevalence of DV by women against men is increasing LGBT leading cause of homelessness among women

Answer 109

25-33% adolescents report 1/11 victims boys and girls equally

Answer 110

abusive relationship is all about instilling fear and wanting to have power and control depression, PTSD, anxiety disorders and SI may follow

Answer 111

children of homes are 30-60% more likely to be abused | children more likely to imitate actions seen

Answer 112

``` doesn't ask for it lives in terror doesn't initiate feelings of powerlessness loses sense of self remains secret about 93% of women who kill spouse have been battered by them high risk of secret alcohol or drug abuse contemplates suicide may complete suicide contemplates homicide, occasionally completes frequently loses job ```

Answer 113

``` denial and blame emotional abuse control through isolation control through intimidation control through economic abuse control through power violence learned frequently from abusive homes low sense of self, poor impulse control, limited tolerance to frustration no guilt lack concern over their aggressiveness ```

Answer 114

tension building serious battering honeymoon

Answer 115

``` financial support isolation afraid to be alone low self esteem depression sake of children positive reinforcement during honeymoon phase ```

Answer 116

``` ED's injury match explanation? complete physical hx, xray study rape may be part of it burns, bruises, scars, other wounds around neck and head internal injuries broken bones cigarette burns acids, scalding, liquids, appliances burns ```

Answer 117

``` anxiety stress insomnia chest pain back pain dizziness GI upset HA PTSD ```

Answer 118

1. have you been hit, kicked, punched or otherwise hurt by someone within the last year. if so, by whom? 2. do you feel safe in current relationship? 3. is there a partner from a previous relationship who is making you feel unsafe now?

Answer 119

always ask about children assess support systems document verbal statements ask if you can take photographs

Answer 120

pressing charges? call local authorities if not, provide list of resources : hotlines, shelters, womens groups,

Answer 121

``` more than one exit in room avoid knives, like kitchen quickest route out of the workplace tell neighbors have a code word to use safe place in case you have to leave pack a bag include legal documents ```

Answer 122

act of violence, power hate but not sex

Answer 123

teen pregnancy STD's HIV

Answer 124

``` rape date rape acquaintance rape gang rape marital or partner rape sexual molestation incest statutory rape sexual assault of older adults ```

Answer 125

someone who has experienced a sexual assault and worked through many of the issues and moving forward

Answer 126

identifies a person who has experienced a sexual assault and can become a survivor with time, intervention and/or counseling

Answer 127

applies to all survivors who do not consent or who are unable to consent or refuse to all the act of: 1. completed nonconsensual sexual act 2. attempted sexual act, but not completed 3. abusive sexual contact 4. noncontact sexual abuse

Answer 128

1/3 girls and 1/6 boys molested 75% from a family member 30% reported were from 4-7 years of age

Answer 129

legal tern vs medical dx varies from state to state date rape is a form of acquaintance rape, but victim agreed to spend time with attacker rape should be considered a criminal act with long term medical, psychologic, legal and social problems

Answer 130

reporting is not mandated unless with minor or older adult survivor must make decision healthcare worker offer support, info and forensic evidence

Answer 131

biological factors: neurotransmitter alterations psychosocial factors: psychopath and PD's, antisocial most prevalent, report hx of sexual assault as children impulsive hostile towards women gang members

Answer 132

benzo's may help with acute anxiety and agitation after trauma SSRI - symptoms of PTSD evaluate signs of hyperarousal, agitation, insomnia, depression, and panic attacks

Answer 133

crisis counseling group therapy safe houses

Answer 134

change in thinking and behavior needs to be undertaken to effect change most do not acknowledge the need for change no single method has been found to be totally effective

Unit III Flashcards

(159 cards)