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Nursing Psy
| Question | Answer |
|---|---|
| psychoanalysis | Freud: disorders related to unresolved childhood experiences. uses free assoc & dream analysis to construct personality |
| Peplau | reduce symptoms and improve social functioning |
| bad me | Sullivan: aspects of the self that are considered negative and are therefore hidden from others and possibly even the self. The anxiety that we feel is often a result of recognition of bad part of us, embarrased/guilty about past action |
| good me | Sullivan: everything we like about ourselves |
| not me | Sullivan: anything so anxiety provoking we don't consider it part of us |
| Trust Versus Mistrust | Erickson: inability to trust, and therefore an sense of fear about the inconsistent world. It may result in anxiety, heightened insecurities, and an over feeling of mistrust in the world around them. |
| Autonomy vs. Shame and Doubt. | Erickson: encouraged/supported in their increased independence: more confident / able to survive in world. Children criticized, over-controlled: feel inadequate in their ability to survive/overly / lack self-esteem, /sense of shame or doubt in abilities. |
| Initiative vs. Guilt. | Erickson: Children encouraged/supported in their increased independence: more confident / able to survive in world. Children criticized, over-controlled, not allowed to assert themselves: feel inadequate in their ability to survive/overly / lack self-est |
| Industry vs. Inferiority | Erickson: Develop a sense of initiative and feel secure in their ability to lead others and make decisions. If this tendency is squelched, via criticism or control, children develop a sense of guilt. They may feel like a nuisance to others and will theref |
| Identity vs. Role Confusion. | Erickson: form own identity based upon the outcome of explorations. Can be hindered, which results in a sense of confusion ("I don’t know what I want to be when I grow up") |
| Intimacy vs. Isolation | Erickson: explore relationships leading toward longer term commitments developing sense of commitment, safety, and caring. Avoiding intimacy, fearing commitment and relationships can lead to isolation, loneliness, and sometimes depression. |
| Generativity vs. Stagnation | Erickson: We give back to society through raising our children, being productive at work, and becoming involved in community activities and organizations. By failing to achieve these objectives, we become stagnant and feel unproductive |
| Ego Integrity vs. Despair | Erickson:contemplate our accomplishments, develop integrity if we see ourselves as leading a successful life. If unproductive, feel guilt, or feel we failed to accomplish life goals, we become dissatisfied, despairing, leading to depression, hopelessness |
| Schizophrenia biochemisty | imbalance in NT dopamine, imbalance between dopamine-other NT (seritonin 5-HT) |
| mood disorder markers | dec REM latency, abn DST |
| panic/anxiety biochemistry | GABA: dec antianxiety ability of GABA recptors, NE: inappropirate activation of NE system, Seritonin: dysregulation fo 5 HT |
| panic/anxiety imaging | hypothesis: greater activation in right frontal lobe |
| orthostatic BP | 15 mm Hg when moving from lying to standing up |
| antipsychotics | antagonsits of D2 receptors for dopamine, reduce Sx of schizophrenia (delusions, halluncinations) |
| antipsychotic side effects | from receptor blocking activity: motor disturbances, dry mouth, weight gain |
| atypical antipsychotics | minimal extrapyramidal Sx, target - and + Sx |
| Clozapine | atypical antipsychotic, agranulocytosis (dec WBC) so not first line |
| Risperidone | reduce delusion/hallucination, cause hypotension, sedation |
| Olanzapine | same as Clozapine but w/o agranulocytosis, doesn't always work so there are other options |
| Lithium | anti-manic, prob affects electrical conductivity in neurons, Sx: dysrhythmias, convulsions, tremor, low therapeutic index |
| antiepileptics | anti-mainc-reduce firing rate of very high frequency neurons in brain: carbamezapine, depakote, klonopin |
| typical antidepressants | block reuptake of NE and some seritonin. amytriptyline, nortriptyline, TCAs |
| SSRIs | antidepressants: selective seritonin reuptake inhibitors: fluoxetine: block reuptake of seritonin with little effect on other monoamine transmitters |
| MAOI | antidepressants: inhibit enzyme MAO |
| trazodone | atypical antidepressant: weak antagonist of muscarinic recpetors |
| benzodiazepines | antianxiety: diazepam, clonazepam: allows GABA to inhibit more forcefully, |
| buspirone | antianxiety w/o strong sedative-hypnotic effects |
| alternative anxiety treatment options | antidepressant (SSRI) |
| benzodiazepine side effects | interfere with motor, attn, judgement |
| MAOI side effects | , tyramine not destroyed in liver resulting in HTN crisis- no aged cheese, wine |
| antidepressant categories | TCAs, Novel, SSRIs, MAOIs |
| schizophrenia brain imaging | frontal cortex impairment |
| OCD brain imaging | frontal cortex impairment |
| Depression brain imaging | prefrontal ccrtex impairment |
| CT/ MRI | identify gross anatomical changes |
| PET, SPECT | identify biochemical changes in live tissue, metabolism and blood flow |
| amines | NTs synthesized from amino molecules such as tryptophan (turkey) |
| schizophrenia Sx | psychotic disorders of thinking (delusion/hallucinations, disorganization of speech and behavior( incoherence, word salad, catatonia) |
| catatonia | wax-figure like movment |
| dysthymias | depression, bipolar, SAD |
| NE/5HT | Norepinephrine and seritonin which are causitive facotrs in mania and depression |
| neurotransmitters | perfrom vital brain function, maor role in brain disea, behavioral disorders |
| DSM-IV | classifies disorders that people have (vs. mental disorders classifying people) |
| DSM Axis I | signs and symptoms that constitute a particular disorder (major depression) |
| DSM Axis II | personality disorders, mental retardation (dependant personality disorder) |
| DSM Axis III | general medical conditions (HNT, diabetes) |
| DSM Axis IV | psychosocial/ environmental problems ( family work probs -summary) i.e. divorce 3 months ago |
| DSM Axis V | global assessment of functioning at the person's BEST LEVEL. 31 y/o male unable to respond to family or friends |
| Clinical Interview | ABC affect, behavior, cognition |
| Clinical Interview content and diroection is decided by | the patient |
| MSE | mental status exam is a structured report of the mental activite of a pt as a specific MOMENT IN TIME |
| MSE basic areas | 4: appearance and speech, thinking, affect, executive/neuro-vegetative functioning |
| MSE appearance and speech | group of obs about pt, descriptive, non-specific |
| MSE thinking | form (process), content, context: associational train, causality |
| MSE form or process | linear fow, contextual appropriateness, rambling, tangential, sudden stops in thinking |
| Therapeutic nurse-patient relationship: preinteraction phase | self exploration |
| Therapeutic nurse-patient relationship: orientation phase | find out why the patient sought help, establish contract, explore feelings |
| Therapeutic nurse-patient relationship: working phase | most therapy conducted in this phase, prmotoe development of insight leading to behavior changes |
| Therapeutic nurse-patient relationship: termination phase | most important-eval progress and goal attainment, work through feelsing of separation |
| transference | pt expereinces feelings towards the nurse initially associated with other signifcant figures in their life |
| countertransference | impasse created by the nurse's specific emotional response to the qualities of the patient. Identify the patient with individuals in the nurses past. |
| ID | freud, instinctual forces, ctc with env modifies id, maturation achieved through frustration/gratification of id-core of our being, pleasure principle, fantasy, wishes to satisfy need |
| Ego | freud: maintain sn4ese of reality, distinguishes between things in mind vs. external world, reality principle, reality testing (failure is delusion/hallucination) |
| Freud and executive functions | Not easy, must integrate external realtiy, ID and superego |
| Superego | internalized atitudes, values, ideals and morals of parents, strives for perfection, what the self would like to be |
Created by:
sdcarlson
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