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Week 2 Flashcards

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1
Q

What are the goals and functions of therapeutic relationships?

A
  • Facilitate communication of thoughts and feelings
  • Assist with problem-solving
  • Assist client to examine alternatives to prior unsuccessful behaviours
  • Promote self-care and independence
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2
Q

What distinguishes therapeutic relationships from personal relationships?

A
  • Patient needs are central
  • Clear boundaries
  • Problem-solving approach
  • New coping/behavioural change is encouraged
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3
Q

What is transference in therapeutic relationships?

A

A phenomenon where a patient projects feelings or attitudes from past relationships onto the nurse

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4
Q

What is countertransference?

A

A nurse’s emotional entanglement with a patient based on the nurse’s own past experiences

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5
Q

What are the phases of the therapeutic relationship?

A
  1. Pre-orientation
  2. Orientation
  3. Working
  4. Termination
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6
Q

What factors can affect communication in therapeutic relationships?

A
  • Personal
  • Environmental
  • Relationship
  • Cultural
  • Other
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7
Q

What is the diathesis-stress model?

A
  • Diathesis: Biological predisposition
  • Stress: Environmental stress or trauma
    Significant dysfunction in mental functioning
  • developmental
  • biological
  • physiological
  • social
  • spiritual
    Cultural defined
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8
Q

What are the symptoms of Major Depressive Disorder?

A
  • Depressed mood, Emotional, cognitive, physical, behavioural symptoms, Impaired functioning
  • lifetime prevalence = 11.38%
    *etiology
  • biological factors
    —> genetic
    —> biochemical
    —> hormone regulation
  • diathesis stress model
  • Psychological factors
    —> cognitive theory
  • learned helplessness
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9
Q

What is the lifetime prevalence of Major Depressive Disorder?

A

11.38%

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10
Q

What are the biological factors in the etiology of Major Depressive Disorder?

A
  • Genetic
  • Biochemical
  • Hormone regulation
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11
Q

What psychological factors contribute to Major Depressive Disorder?

A
  • Cognitive theory
  • Learned helplessness
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12
Q

What is the significance of the Beck Depression Inventory (BDI)?

A

It is an assessment tool for measuring the severity of depression

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13
Q

What are the first-line pharmacological treatments for depression?

A
  • Selective Serotonin Reuptake Inhibitors (SSRI)
  • Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRI)
  • Norepinephrine and Dopamine Reuptake Inhibitors (NDRI)
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14
Q

What is Serotonin Syndrome?

A

A potentially life-threatening condition caused by excessive serotonin levels

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15
Q

What are some non-pharmacological therapies for depression?

A
  • Electroconvulsive Therapy (ECT)
  • Transcranial Magnetic Stimulation (TMS)
  • Light therapy
  • Vagus nerve stimulation (VNS)
  • Psychotherapy
  • St. John’s wort
  • Exercise
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16
Q

What defines Bipolar I disorder?

A

One or more mixed or manic episodes, with depression, possibly accompanied by psychosis

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17
Q

What defines Bipolar II disorder?

A

One or more depressive episodes, with at least one hypomanic episode

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18
Q

What are common symptoms of mania?

A
  • Persistent elevated or irritable mood
  • Significant impairment in functioning
  • May require hospitalization
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19
Q

What are expected reactions to Lithium therapy?

A
  • Edema of hands or feet
  • Fine hand tremor
  • Mild diarrhea
  • Muscle weakness, fatigue, memory/concentration problems
  • Metallic taste
  • Nausea/abdominal pain
  • Polydipsia
  • Polyuria
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20
Q

What is the definition of suicide?

A

Intentional act of killing oneself by any means

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21
Q

What is a suicide attempt?

A

A desperate call for help with different levels of risk

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22
Q

What are common warning signs of suicide?

A
  • Verbal cues
  • Nonverbal cues
  • Behavioural changes
  • Cognitive and emotional cues
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23
Q

What are risk factors for suicidality in individuals with Major Depressive Disorder?

A
  • Suicidal thoughts
  • Suicidal plans
  • Suicide attempts
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24
Q

What is the significance of the ISPATHWARM mnemonic?

A

A tool for remembering warning signs and assessing potential suicidal patients

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25
What interventions are part of a team approach to suicide care?
* Ongoing assessment * Suicide precautions * Counseling * Health teaching and health promotion
26
Specifiers and depression sub-types
- with psychotic features - with melancholic features - with atypical features - with catatonic features - postpartum onset (within 4 weeks of delivery) - seasonal patterns (seasonal affective D.O) - premenstrual dysphoric disorder (PMDD) - persistent depressive disorder (PDD) - substance/medication induced depressive disorder
27
Pharmacological treatment options
- tricyclic antidepressants (TCA) - tetracyclic antidepressants - monoamine oxidase inhibitors (MAOI) - selective serotonin reuptake inhibitors (SSRI) - selective serotonin and norepinephrine reuptake inhibitors (SSNRI) - norepinephrine and dopamine reuptake inhibitors (NDRI)
28
Examples of non-therapeutic communication skills
- false reassurance - advising / giving advice - defending - belittling feelings - denying feelings - multiple questions - not tracking/ changing the subject
29
What is major depressive disorder
Depressive symptoms lasting >/= 2 weeks - occurring every day - have to be experiencing at least 5 systems - low mood, decreased energy, decreased attention/ concentration, disturbed sleep, disturbed appetite, weight loss/gain Diseases where MDD is common - thyroid disease - chronic pain - diabetes - nutritional deficiency -
30
What does SIGECAPS stand for
Sleep disturbances interest guilty feelings energy (decrease) concentration (decrease) appetite (up or down) psychomotor functioning suicidal ideation
31
What does A SAD FACE(S) stand for
Appetite Sleep Anhedonia Depressed mood Fatigue Agitation Concentration Esteem Suicidal
32
Overview of Bipolar Disorder
Biological factors - genetic (strong heritability) - neurobiological - neuroendocrine - Gender (bipolar 1- males; bipolar || females) —> males: legal issues, violence —> females: alcohol abuse, suicide, thyroid disease Psychological factors Environmental factors
33
Lithium therapeutic range
Acute mania 1-1.5 mEq/L Maintenance 0.5-1.2 mEq/L
34
Divalproex sodium therapeutic range
50-150 ng/mL
35
Carbamazepine therapeutic range
8-12 ng/ml
36
What are the goals and functions of therapeutic relationships?
* Facilitate communication of thoughts and feelings * Assist with problem-solving * Assist client to examine alternatives to prior unsuccessful behaviours * Promote self-care and independence
37
What distinguishes therapeutic relationships from personal relationships?
* Patient needs are central * Clear boundaries * Problem-solving approach * New coping/behavioural change is encouraged
38
What is transference in therapeutic relationships?
A phenomenon where a patient projects feelings about important figures in their life onto the nurse
39
What is countertransference in therapeutic relationships?
Nurse's emotional reaction to the patient based on their own personal experiences
40
What are some examples of non-therapeutic techniques?
* Distraction * Judgmental responses * Lack of empathy
41
What is the diathesis stress model?
* Diathesis: Biological predisposition * Stress: Environmental stress or trauma
42
What are the symptoms of Major Depressive Disorder?
* Depressed mood * Emotional symptoms * Cognitive symptoms * Physical symptoms * Behavioural symptoms * Impaired functioning
43
What is the lifetime prevalence of Major Depressive Disorder?
11.38%
44
What factors contribute to the etiology of Major Depressive Disorder?
* Biological factors * Genetic factors * Biochemical factors * Psychological factors * Cognitive theory * Learned helplessness
45
What are the specifiers of Major Depressive Disorder?
* With psychotic features * With melancholic features * With atypical features * With catatonic features * Postpartum onset * Seasonal patterns * Premenstrual Dysphoric Disorder * Persistent Depressive Disorder * Substance/medication-induced depressive disorder
46
What are the first-line pharmacological treatment options for depression?
* Selective Serotonin Reuptake Inhibitors (SSRI) * Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRI) * Norepinephrine and Dopamine Reuptake Inhibitors (NDRI)
47
What are common side effects of Lithium?
* Edema of hands or feet * Fine hand tremor * Mild diarrhea * Muscle weakness * Metallic taste * Nausea/abdominal pain * Polydipsia * Polyuria
48
What is the definition of suicide?
Intentional act of killing oneself by any means
49
What differentiates a suicide attempt from a suicide threat?
A suicide attempt is a desperate call for help with varying levels of risk, while a suicide threat is more serious than a casual statement of intent and is usually accompanied by behavioral changes
50
What are the potential risk factors for suicide?
* Biological factors (e.g., low serotonin levels) * Psychosocial theories (e.g., hopelessness) * Cultural factors * Social factors
51
What does the mnemonic ISPATHWARM stand for?
It is a tool to remember risks and warning signs for suicide (not an actual assessment tool)
52
What are the phases of the therapeutic relationship?
The stages typically include orientation, working, and termination phases
53
What is the role of environmental factors in therapeutic communication?
They can impact the effectiveness of communication, including comfort and distraction levels
54
What are the characteristics of mania?
* Persistent elevated or irritable mood * Significantly impairs functioning * May require hospitalization * At least 3 of: grandiosity, decreased sleep, pressured speech, flight of ideas, psychomotor agitation, risk-taking activities
55
What are the characteristics of hypomania?
Mild form of mania that does not markedly impair function and does not require hospitalization
56
What role does psychotherapy play in the treatment of mood disorders?
It provides support, education, and coping strategies for patients
57
What is the significance of the term 'self-harming behaviours'?
They should not be confused with suicidal ideation, but suicidal intention must still be investigated
58
What is the expected reaction to lithium regarding fine hand tremor?
Support, reassure, minimize stressors, and consider frequent & smaller doses
59
What is the importance of ongoing assessment in suicide prevention?
It ensures that the patient's risk level is continuously monitored and addressed
60
Pharm treatments for Bipolar Disorder
-Lithium carbonate - anticonvulsant therapy - anxiolytic drugs - atypical antipsychotics

Nsg 3120 (5 decks)

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