week 5 notes

Question 1

depersonalization/derealization disorder is when

Answer 1

a client experiences feeling detached from themselves or that the outside world is unreal

Question 2

client has a new diagnosis of dissociative identity disorder. which meds should the nurse expect the doctor to prescribe

Answer 2

fluoxetine (ssri)
bensodiazepenes
beta blockers

Question 3

somatization

Answer 3

physical manifestations that cannot be explained medically

*not under conscious control

Question 4

illness anxiety disorder is treated with..

Answer 4

*hypochondriac

antidepressants (ssri’s-fluoxetine)

Question 5

factitious disorder

Answer 5

gypsy rose
*** conscious control
falsifying symptoms to oneself or others even w/o reward

Question 6

malingering

Answer 6

intentional reporting of symptoms for personal gain

drug seeking

Question 7

dissociation

Answer 7

mental state of discnnecting from one’s thoughts memories or feelings

Question 8

positive dissociative symptoms

Answer 8

identity
depersonalization, derealization, & division of identity

Question 9

negative dissociative symptoms

Answer 9

mental issues
lack of control/access to mental functions, amnesia

Question 10

functional neurologic disorder

Answer 10

neurological manifestations are present (blindness, paralysis, inability to swallow) w/o identifiable medical causes

Question 11

grounding techniques

Answer 11

shower, exercising, holding an object & focusing, 5 x see, 4x feel, 3x hear, 2x smell, & 1x taste

Question 12

withdraw from alcohol is usually treated with and includes

Answer 12

benzodiazepenes

agitation, high temp, increased respirations, irritability, & confusion

Question 13

stage 2 withdraw of alcohol may include

Answer 13

anxiety
diaphoresis
increased BP & body temp
tachypnea
mood disturbances

Question 14

stage 3 withdrawl of alcohol includes

Answer 14

hallucinations
disorientation
SEIZURES

Question 15

sets of lab data that indicates chronic use of alcohol

Answer 15

liver panel
compressive metabolic panel
BAL/BAC
magnesium

Question 16

hallucinogen withdrawal symptoms

Answer 16

headaches
increased appetite
sleepiness
depression

Question 17

opiod withdrawal symptoms

Answer 17

*occurs 12 hrs after
n/v/d
generalized body pain
insomnia
low energy
irritability
hot & cold sweats
restlessness
muscle & bone pain

Question 18

stimulant withdrawal symptoms

Answer 18

vivid dreams
slowness
restlessness
insomnia
depression
fatigue
increased appetite

Question 19

screening tool to determine severity of alcohol withdrawal

Answer 19

CIWA-AR

score > 19 = severe

Question 20

cluster A personality disorders

Answer 20

ODD & ECCENTRIC behavior

1. Paranoid
2. Schizoid
3. Schizotypical

focus on relationships

Question 21

cluster B personality disorders

Answer 21

*DRAMATIC, ERRATIC, & EMOTIONAL behavior

1. Antisocial
2. Borderline
3. Histrionic
4. Narcissistic

focus on boundaries

Question 22

Cluster C personality disorders

Answer 22

*ANXIOUS & FEARFUL behavior

1. Avoidant
2. Dependent
3. Obsessive-Compulsive

focus on decreasing anxiety

Question 23

paranoid personality disorder

Answer 23

suspicious & distrustful of others
holds grudges
unwilling to forgive
social withdrawal

cluster a

Question 24

Schizoid Personality Disorder

Answer 24

AVOID

**solitud preferred
**animals > humans

socially withdrawn w/ little to no interest in close relationships

emotional coldness
enjoy math

depersonalization
does not occur with schizophrenia

*nurse should respect need for isolation – cluster a

Question 25

Schizotypical Personality Disorder

Answer 25

eccentric & peculiar thoughts, behaviors & speech *blames others for social isolation suspicious supernatural powers trouble w relationships *nurse should respect need for isolation -- cluster a

Question 26

Antisocial Personality Disorder

Answer 26

- lack of remorse - dismiss rules & disregard others - reckless disregard for safety - do not fear rejection and believe they are correct *MEN -- cluster b ***biggest concern is harm to others

Question 27

Borderline Personality Disorder

Answer 27

*PSYCHOTIC *women poor boundaries excessive emotions impulsive & fears abandonment *self harm & suicide begins w rejection or trauma in childhood cluster b

Question 28

Histrionic Personality disorder

Answer 28

attention seeking -- SEDUCTIVE, provocative, dramatic, & emotional superficial & shallow *THEATRICAL nurse should model behavior-- cluster b

Question 29

Avoidant Personality Disorder

Answer 29

fears criticism inferior to other anxious & embarrassed feels inadequate *cluster c

Question 30

nursing intervention if suspecting factitious disorder by proxy

Answer 30

do not leave client alone be unpredictable no cluster care -- limit ability to cause harm

Question 31

expected outcomes for patients with somatic symptom disorders

Answer 31

*live a normal life *articulate feelings *resume performance *can identify ineffective coping patterns

Question 32

Obsessive Compulsive Disorder presents as

Answer 32

cant bend/break rules high achiever financially stingy

Question 33

implementing the nursing process with Borderline & Antisocial personality disorders consists of

Answer 33

limiting abusive language addressing negative behavior do not bargain

Question 34

substance induced disorders include

Answer 34

intoxication withdrawal psychosis / delirium

Question 35

CAGE Assessment tool

Answer 35

screen for high tisk of substace abuse **alcohol C = have you ever felt like you should CUT down on drinking/drug use A= have people ANNOYED you by criticizing your use G = ever felt GUILTY for your drug use E= eye opener yes to 2+ = need for further evaluation

Question 36

Wernicke-Korsakoff's syndrome

Answer 36

vitamin D deficiency delirium cant learn new things

Question 37

Alcohol withdrawal delirium

Answer 37

medical emergency that can last 2-5 days peaks 48 to 72 hours after cessation/reduction *high risk for seizures -- rails -- aspiration equipment

Question 38

symptoms of opioid overdose

Answer 38

respiratory depression decreased level of consciousness pinpoint pupils

Question 39

CNS stimulants include

Answer 39

cocaine & meth *homeless population *kept warm

Question 40

symptoms of CNS stimulants

Answer 40

*cocaine & meth dryness of nasal cavity dilated pupils heart issues increased alertness, energy, & sexual arousal

Question 41

a nurse is caring for a client who has avoidant personality disorder. which of the following statements is expected from a client who has this disorder? 1. "Im scared that you are going to leave me." 2. "I'll go to group therapy if you let me smoke." 3. " I need to feel that everyone admires me." 4. " I sometimes feel better if I cut myself."

Answer 41

1. "Im scared that you are going to leave me."

Question 42

a client has antisocial personality disorder. which of the following findings should the nurse expect? 1. demonstrates extreme anxiety when placed in a social situation 2. Often engages in magical thinking 3. attempts to convince other clients to relinquish their belongings 4. becomes agitated if personal area is not neat an orderly 5. blames others for personal, past, & current problems

Answer 42

3. attempts to convince other clients to relinquish their belongings 5. blames others for personal, past, & current problems

Question 43

a nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. which of the following findings should the nurse expect? sap 1. bradycardia 2. fine tremors of both hands 3. hypotension 4. vomiting 5. restlessness

Answer 43

2. fine tremors of both hands 4. vomiting 5. restlessness

Question 44

a nurse is planning care for a client who is experiencing a benzodiazepine withdrawal. which of the following intervention should the nurse identify as priority? 1. orient the client frequently to time. place. and person 2. offer fluids and nourishing diet as tolerated 3. Implement seizure precautions 4. Encourage participation in group therapy sessions

Answer 44

3. Implement seizure precautions

Question 45

a nurse is caring for a client who has alcohol use disorder. the client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? 1. Chlordiazepoxide 2. Buproprion 3. Disulfiram 4. Carbamazepine

Answer 45

3. Disulfiram

Question 46

a nurse is providing teaching to the family of a client who has substance use disorder. which of the following statements by a family member indicates an understanding of the teaching? sap 1. "we need to understand that our sibling is responsible for their disorder." 2. "eliminating codependent behavior will promote recovery." 3. "our sibling should participate in the Al-anon group to assist with recovery." 4. "the primary goal of treatment is abstinence from substance use. " 5. "our siblings need to discuss personal feelings about substance use to help with recovery."

Answer 46

2. "eliminating codependent behavior will promote recovery." 4. "the primary goal of treatment is abstinence from substance use." 5. "our siblings need to discuss personal feelings about substance use to help with recovery."