Week 5 (Personality disorders/Substance use disorders)

Question 1

Describe somatic symptom disorders

Answer 1

believe symptoms are medical, even with negative test findings

have difficult time accepting anxiety over physical symptoms

Question 2

What are example of somatic symptom disorders?

Answer 2

illness anxiety disorder
functional neurological disorder
factitious disorder

Question 3

What is illness anxiety disorder?

Answer 3

anxiety symptoms

hypochondriac (2 types)
1: goes to Dr. too much
2: will not go to Dr.

Question 4

What is functional neurological disorder?

Answer 4

sudden loss of function
- no medical findings
- all of a sudden can’t walk, see, etc.

Question 5

What is factitious disorder?

Answer 5

intentionally faking symptoms in order to assume sick role

want attention

AKA - munchausen syndrome

Question 6

Define malingering

Answer 6

intentionally faking symptoms for a benefit

ex: getting out of work, criminal prosecution, medications

Question 7

What will a nurse do for someone with factitious disorder?

Answer 7

encourage visitors
do not leave pt alone with parent
check on pt frequently/unexpectedly

Question 8

What is the assessment for someone with any somatic symptoms disorders?

Answer 8

• full assessment (rule out anything physical
• dramatic terms used
• ability to meet basic needs
• family/work dynamic (stressor causing symptoms)
• childhood trauma (increased risk of suicide)
• ability to express feelings/needs
• dependence on medication

Question 9

What is the outcome for someone with any somatic symptom disorders?

Answer 9

live a normal life as possible
articulate feelings
identify ineffective coping patterns

Question 10

What will the nurse do during the implementation phase for someone with any somatic symptom disorders?

Answer 10

• do not imply symptoms are fake
• spend time w/ pt when they are NOT expressing physical complaint
• show concern, but avoid dependency
• reinforce strengths
• teach stress reduction

Question 11

What will the nurse see during the evaluation phase for someone with any somatic symptom disorders?

Answer 11

goals met (even partially)
identified coping strategies
decreased somatic symptoms
able to function in daily life

Question 12

Describe personality disorders

Answer 12

maladaptive patterns in behavior
lack of insight
tendency to blame others

they don’t see that they are the problem

Question 13

What are the causes of personality disorders?

Answer 13

genetics
neurological
psychological (childhood trauma)
culture

Question 14

When do symptoms begin for personality disorders?

Answer 14

early adulthood

Question 15

How do people with personality disorders view others?

Answer 15

as all good or all bad (splitting)

Question 16

What are examples of cluster A personality disorders?

Answer 16

schizotypal
paranoid
schizoid

(odd & eccentric)

Question 17

Describe schizotypal personality disorder

Answer 17

social anxiety (awkward)
no need to socialize
magical thinking (weird ideas)
suspicious of others

Question 18

Describe paranoid personality disorder

Answer 18

distrust of others
sees everything as attacks
can’t forgive insults
hostile to weak individuals

Question 19

Describe schizoid personality disorder

Answer 19

mean/cold
unable to establish relationships
restricted emotions
enjoys animals (no humans)

Question 20

What are examples of cluster B personality disorders?

Answer 20

antisocial
borderline
narcissistic
histrionic

only care about themselves

Question 21

Describe antisocial personality disorder

Answer 21

sense of entitlement
lack of remorse (lying/manipulation)
impulsive (fail to plan ahead)
disregard for safety of others

Question 22

How were those with antisocial personality disorder treated as children?

Answer 22

disciplined harshly
parents used substances
no supervision

Question 23

Describe borderline personality disorder

Answer 23

chronically suicidal
mood instability (hard to calm down/sensitive)
unstable self-image and relationships
frantic efforts to avoid abandonment

Question 24

What disorder is similar to borderline personality disorder? How can you differentiate?

Answer 24

bipolar

borderline has unstable relationships

Question 25

Describe narcissistic personality disorder

Answer 25

arrogant require excessive admiration lack empathy they think they are better than everyone

Question 26

Describe histrionic personality disorder

Answer 26

theatrical use physical appearance they are the main character and only want attention

Question 27

What are examples of cluster C personality disorders?

Answer 27

avoidant obsessive-compulsive dependent

Question 28

Describe avoidant personality disorder

Answer 28

hypersensitive to criticism-avoid tasks won't take risks imposter syndrome avoids relationships, but need them

Question 29

Describe obsessive-compulsive personality disorder

Answer 29

can't break rules rigid perfectionism financially stingy high achievers

Question 30

Describe dependent personality disorder

Answer 30

clingy excessively submissive difficulty making decisions hard time w/ conflict tolerates abusive tx

Question 31

What is done during the assessment phase for someone with personality disorders?

Answer 31

look for: - primitive defenses (splitting, dissociation, projecting) - suicide/self-harm - aggressiveness (safety) - substance use - past-abuse

Question 32

What are the outcomes for someone with personality disorders?

Answer 32

minimize self-destructive/aggressive behaviors link consequences to behaviors identify ways to prevent crisis prevent regression

Question 33

What is done during the implementation phase for someone with borderline and antisocial personality disorders?

Answer 33

set limits reward positive behavior for aggressive/manipulative pt: - nurse will acknowledge, but not dismiss

Question 34

What is done during the implementation phase for someone with dependent and histrionic personality disorders?

Answer 34

modeling good behavior

Question 35

What is done during the implementation phase for someone with schizoid and schizotypal personality disorders?

Answer 35

respect need for isolation

Question 36

What is done during the implementation phase for someone any personality disorders?

Answer 36

milieu therapy give pt choices

Question 37

Define dialectical behavioral therapy Who can benefit from it?

Answer 37

addresses strategies for extreme mood swings personality disorders

Question 38

What will the nurse see during the evaluation phase for someone with any personality disorders?

Answer 38

minimized suicide and self-harm behaviors

Question 39

What is the most used substance? What is the second most used?

Answer 39

1 - alcohol 2 - marijuana

Question 40

Who is mostly likely to have substance use? aka: comorbidities

Answer 40

anxiety disorders PTSD depressive disorders mania schizophrenia

Question 41

What do those with substance use/addictive disorders have a higher risk of?

Answer 41

suicide

Question 42

Define dual diagnosis

Answer 42

substance use disorders and mental disorders

Question 43

What can happen with substance induced disorders?

Answer 43

intoxication withdrawal psychosis or delirium

Question 44

Define addiction

Answer 44

chronic, relapsing brain disease characterized by compulsive behavior all they care about is drugs

Question 45

Define alcohol use disorder

Answer 45

problematic pattern of alcohol use leads to impairment or distress

Question 46

What is the CAGE assessment tool?

Answer 46

Cut down drinking or drugs? Annoyed by ppl criticizing alc/drug use? Guilty of alc/drug use? Eyeopener? (drink or drugs first thing in the morning to calm nerves)

Question 47

What criteria needs to be met from the CAGE assessment tool?

Answer 47

answer yes to at least 2 = alc or substance use disorder

Question 48

What are medical issues that can result from alcohol use?

Answer 48

- gastrointestinal - cardiovascular (dysrhythmias or stroke) - wernicke-korsakoff's syndrome (can't make new memories) - nervous system/brain damage

Question 49

What is the legal limit for alcohol intoxication?

Answer 49

BAC .08%

Question 50

How soon can alcohol withdrawal syndrome occur?

Answer 50

as soon as 2 hours after last use

Question 51

Describe the signs of alcohol withdrawal syndrome

Answer 51

Autonomic - elevated BP. pulse, temp - sweating - n/v/d Motor - tremors - dysarthria - seizures Awareness - agitation - insomnia - disorientation Psychiatric - anxiety - hallucinations - paranoia

Question 52

What is alcohol withdrawal delirium?

Answer 52

medical emergency peak 48-72 hours after last use lasts 2-5 days can lead to seizures

Question 53

Describe opioid overdose

Answer 53

pinpoint pupils respiratory depression decreased LOC

Question 54

Describe opioid withdrawal

Answer 54

can last up to 4 weeks peak 3-5 days low energy irritability flu-like hot/cold sweats severe muscle aches/pains abd. cramping

Question 55

What can a person who is addicted to nicotine experience?

Answer 55

abstinence syndrome (not life threatening) - strong cravings - impaired concentration - restlessness - increased appetite

Question 56

What is done during the assessment phase for someone with substance/alc abuse disorder?

Answer 56

What did they take? urine toxicology/BAC toxicity/overdose symptoms insight injury suicide/homicide defense mechanisms (denial)

Question 57

What are the outcomes for someone with substance/alc abuse disorder?

Answer 57

free from injury while withdrawing increased insight attend self help groups develop relationships w/drug-free programs demonstrate one new coping strategy

Question 58

What is done during the implementation phase for someone with substance/alc abuse disorder?

Answer 58

be nonjudgmental/accepting treat other disorders active listening health promotion relapse prevention