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MGCCC Level III
MGCCC Level III-Unit I Psych, Acid/Base, Male Repro
| Question | Answer |
|---|---|
| What is Mental Illness? | Threat to self and an alteration in the perception of reality. Have lost the ability to perform ADLs. |
| What are the three criteria for court commitment? | 1. Threat to harm self or others.2. Not able to care for themselves.3. Observation. |
| Name and explain the most valuable test to determine mental illness. | Minnesota Mutiphasic Personality Inventory (MMPI): True/False questions measuring personality traits and psychopathology. |
| What does a Mental Status Exam consits of? | General Appearance, Mood and Affect, Speech, Perceptual Disturbances, Thought, Sensorium and Cognition, Impulse Control, Judgement and Insight, and Reliability. |
| What is Milieu Therapy? | Socialization in a group with the use of the total environment and its focus on living, learning, or working. Focuses on positive environmental manipulation (both physical and social) in order to effect positve changes. |
| What are the goals and purposes of Milieu Therapy? | 1. Maintaining a safe environment.2. Providing for basic needs, including structure.3. Patient change via support of ego strenghts.4. Promoting coping skills in a teaching and learning environment.5. Supporting patients' spirituality. |
| What are the steps for Group Therapy? | 1. Preinteraction2. Engagement (forming)3. Transistion (storming)4. Norming5. Performing (working)6. Adjourning (termination) |
| whoo may not be suitable for Group Therapy? | Antisocial, paranoid, borderline. |
| Name the types of Groups. | 1. Time Limited Therapy2. Reconstructive3. Therapeutic Milieu4. Behavioral5. Psychoeducational6. Self-help7. Spiritual |
| What is a Forensic Setting? | Type of community mental health services-Criminally insane. |
| What is ECT? | Electroconvulsive Therapy. Probes are placed and the brain is shocked to the point of seizures. |
| What is Affect? | The expression of emotion as observed by others (what we see). 1. Appropriate2. Inappropriate3. Blunted4. Restricted5. Flat5. Latile(rapid/abrupt changes in emotional feeling tone, unrelated to external stimuli) |
| What is Mood? | A pervasive and sustained emotion, subjectively experienced by the patient. (What the patient tells you they feel) |
| Describe an Anhedonia mood. | Loss of interest in and withdrawl from all regular and pleasurable activities, often associated with depression. |
| What is Loosening of Association? | Flow of thought in which ideas shift from one subject to another in a completely unrelated way. EX: then the word became embryonic in Africa-and there was not need for communication...I have been living in vaporous places peopled with one -dimensional fig |
| what is Flight of Ideas? | Rapid, continuousverbalization or plays on words producing a constant shifting from one idea to another.EX: I am here because my mother sent me. She drove me in her car. The car is a Lincoln, and Lincoln is my favorite president. I don't know why they ki |
| What is Clang Association? | Association of words similar in soud but not in meaning, may include rhyming and punning.EX: on the track...have a Big Mac...or get the sac |
| What is a dilusion? | A false belief. |
| What is an Obsession? | Pathological persistance of an irresistible thouht or feeling that cannot be eliminated from consciousness by logical effort. |
| What are compulsions? | Pathological need to act on an impulse tht,if resisted, produce anxiety. |
| What is a phobia? | Persistant, irrational, exaggerated, and invariably pathological dread of some specific type of stimulus or situation. |
| Describe the difference between hallucinations and illusions. | Hallucinations are not actually here.Illusions are misperceptions of something really there. |
| What does psychotropic mean? | affects the brain chemistry. |
| Adverse Drug Reaction | Worse than a side effect. An Unintended effect of a medication resutig in severe unwanted symptoms or consequences |
| Agranulaocytois | a dropp in the production of leukocytes, specifically the neutrophil cell line, leaving the body defenseless against bacterial invasion. |
| Akathisia | Literally, not sitting. syndrome caused by dopamine-blocking drugs characterized by both motor restlessness and a subjective feeling of inner restlessness. |
| Akinesia | An abnormal state of motor and psychic hypoactivity or muscular paralysis. |
| Dystonia | Any impairment of muscle tone. The condition commonly involves the head, neck, and tongue, and often occurs as an adverse reaction of a medication. |
| Extrapyramidal Symptoms (EPS) | Includes acute dystonia, akathisia, parkinsonism, and tardive dyskinesia. The collective term used to describe the motor side effect of dopamine-blocking medications. |
| Neuroleptic | Literally, to clasp the neuron, the term to describe what are now called the typical antipsychotic medications |
| Neuroleptic malignant syndrome (NMS) | rare but lethal toxic rx to dopamine-blocking drugs that presents a constellation of symptoms (fever, autonomic instability, increased muscular rigidity, & altered mental status. Can happen after 1 dose. NO ANTIDOTE |
| Oculogyric crisis | EMERGENCY-give cogentin. An involuntary deviation & fixation of the eyes, usually upward and to one side. An extrapyramidal SE of antipsyhcotics |
| Side Effect (SE) | An undesired nontherapeutic and often predictable consequense of medication. Frequently diminishes with time. |
| Tardive Dyskinesia (TD) | Irriversable. Involuntary movement as result of months or years of tx with certain drugs. EX: Tongue potrusion and movement |
| Antipsychotic Medications | dopamine receptor blockers. Block psychosis, also called "neuroleptics"...primarily treat schizophrenia |
| Clozapine (clozaril) | Antipsychotic that can cause agranulocytosis |
| ziprasidone (Geodon) | Antipsychotic that maycause prolonged Q-T intervals |
| quentiapine (Seroquel) | Antipsychotic sometimes used as sleep aid |
| haloperidole (Haldol) | Antipsychotic sometimes use for aggitation. haloperidol decanoate may cause TD |
| Common SE of older antipsychotics | Blurred vision, dry mouth, drowsiness, EPS |
| Four Classes of antidepressants | tricyclics (TCAs), Monoamine Oxidase Inhibitors (MAOIs), Selective serotonin reuptake inhibitors (SSRIs), and Phenethylamines |
| What is the drug choice for BiPolar? | Litium Carbonate |
| Lithium | Always get a baseline before starting. Normal dosage level range - 0.5-1.5 mEq/L There is NO ANTIDOTE for litium OD. competes with sodium. If lithium level low/high then sodium level high/low |
| Antianxiety (anxiolytics)- mild tranquilizers | Benzodiazepines (highly addictive esp Xanax), Azaspirodecanedione, Beta Blocker (may calm down, ex: propanolol (Inderal)), Tricyclic Antidepressant, Antihistamine, Miscellaneous (Clonidine (catapres) can help with cocaine withdrawls) |
| Stimulants | most are addictive except stratera |
| What's the difference between bipolar and schizophrenia? | BiPolar effects mood, schizophrenia effects thinking |
| Catatonic Schizophrenia | Totally out of it, may not mve for days |
| Persecution dillusion | Most common dillusion. The false belief that one is being singled out for harm by others. |
| Grandiosity Dillusion | 2nd most common. False belief that one is powerful 7 important person. EX: the woman believed she was Mary Magdalene & tht Jesus controlled her thought. |
| auditory | Most common hallucination for schizophrenics. Hearing voices or sounds. Ex: hearing the sound of a dead mother call her a whore and a tramp |
| Gender effects of Mood Disorders | depressive disorder higher in women by about 2 to 1. The incidence of bipolar is about equal. |
| Age effects in Mood Disorders | Depression higher in young women & decreases with age. Depression lower in young men & increases with age. |
| Social Class effects in Mood Disorders | Bipolar disorder occurs more often in higher social class, especially among professionals and highly educated. |
| What is the normal pH range? | 7.35-7.45 If it is low-acidosis If it is high-alkalosis |
| What is the normal PaCO2 range? | 35-45 mmHg When hypoventilation, the PCO2 is elevated causing Resp Acidosis. When hyperventilation, the PCO2 is decreased causing Resp alkalosis. |
| What is the normal HCO3 (Bicarbonate) level? | 22-26 When it is low, metabolic acidosis occurs. |
| Criteria for Metabolic Acidosis | pH <7.35, PCO2 -normal(low if compensating), & HCO3 <22 |
| Criteria for Respiratory Acidosis | pH <7.35, PCO2 >45, HCO3 -normal (high if compensating) |
| What are some common causes of acidosis? | Excessive ingestion of acids(ethanol, methanol, salicylates), renal failure, respiratory depression, inadequate chest expansion, Airway obstruction(COPD), Alveolar-Capilarry blocks, things causing inadequate HCO3(pancreatitis, liver failure, diarrhea) |
| Risk factors to assess in acidotic state | age, OTC meds, prescirbed meds, alcohol, diet, medical hx |
| S&S to assess for in acidotic state | CNS changes(depression)-behavioral changes, lethargy, confusion, stupor, coma |
| Cardiovascular to assess for in acidotic state | Hyperkalemic state-low muscle tone,reflexes&strength, bradycardia, tall tented T-waves, widened QRS, prolonged P-R interval, thready pulse |
| Respiratory to assess for in acidotic state | Kussmaul respirations-shallow, rapid breathing w/ resp acidosis...deep, rapid breathing and acetone breath w/ metabolic acidosis |
| Integumentary to assess for in acidotic state | pale, cyanotic skin in Resp acidosis...skin warm & dry (caused by vasodilation) in metabolic acidosis |
| Interventions for Metabolic Acidosis | hydration, insulin, dialysis, etc. |
| Interventions for Respiratory Acidosis | Pulmonary rehab(TCDB, Inc. Spirometer, O2, ^HOB), medications(albuterol, proventil, prednisone, etc.), positioning(semi-high fowlers) |
| What are some causes for Alkalosis? | Ingestion/administration of ^bases(antacids, bld transfusion, sodium bicarb, TPN), loss of acid(vomiting, NG suc, Cushing's Syndrome, hyperaldosteronism, Thiazide, hyperventilation(fear, mechanical, drugs, hypoxemia)) |
| S&S of Alkalosis | Overexcitment of CNS(lightheadedness, agitation, confusion, hyperreflexia, seizure activity, parathesia around mouth and toes) |
| Interventions for Metabolic Alkalosis | fluids, antiemetics, electrolyte replacement, re-evaluation |
| Interventions for Respiratory Alkalosis | rest, comfort, controlled environment |
| Assess for Alkalosis | Hypocalcemia, Chvostek's Sign, Trousseau's Sign, neurotransmitter changes, hypokalemia(cramps, tetany, hyperreflexia), tachycardic, thready pulse, hypovolemia, sensitivity to digitalis |
| What is a hydrocele? | A fluid-filled mass in the scrotum-palpation of scrotum would reveal round, smooth, nontender mass. Can sometimes be associated with inguinal hernia. Repair with SX |
| What is a spermatocele? | sperm-containing cystic mass-develops on epididymis alongside the testicle. Usually small/asymptomatic. I&D can be done if becomes large. |
| What is a varicocele? | Enlarged (varicose) vein posterior and above the testes causing painless swelling. |
| What is testicular torsion? | Twisting of spermatic cord causing a loss of bld flow to the testicle. |
| What is the most common cause of testicular torsion? | Attatchment of the testicle to spermatic cord causing it tpo twist more easily. |
| Intervention for testicular torsion. | Manual distorsion or SX performed with testis affixed to scrotal wall to prevent reoccurence. |
| Post-op care for scrotal SX | Scrotal support for 3wks. Avoid lifting, straining, excessive stair climbing and sexual activity for 6wks. |
| What is epididymis? | long coiled tube behind each testicle that collects and stores sperm made by the testicles prior to ejaculation. |
| Epididymitis | Pain & swelling are most common S&S. Males of any age can get it but most common ages 19-35. Most caused by bacterial infection or gonorrhea or chlmydia or in older men w/ prostate enlargement |
| Interventions for epididymitis | antibiotics(along with sex partner) cool compress/sitz baths. Avoid lifting, straining, sexual activity until infection clear-may be p to 4wks |
| What is orchitis? | Acute testicular inflammation from trauma or infection. Usually bilateral with epididymitis caused by pneumonia, TB, syphillis, GC, mumps. |
| Most common S&S of testicular cancer | heavy feeling in the scrotum and change in size or shape of one or both testes. You may or may not have pain. Dull pressure or pain in lower back, belly or groin or all three places. |
| Intervention for testicular CA | Chemo, radiation, removal of testicle. Pt should consider bankin sperm prior to tx. |
| What is BPH? | Benign Protatic Hyperplasia or Hypertrophy- common past 50, annual digital exam past 40. |
| S&S of BPH | reduction in size & force of stream, dribbling, feeling of being unable to empt bladder, frequent urination, urinary retention, voiding several times a night. |
| What is phimosis? | condition in which the opening of the prepuce, or foreskin, is unable to be retracted behind the glans penis.Circumcision may be necessary. Post-op vaseline gauze with bulky ressure dressing. |
| What is priapism? | Uncontrolled, long-maintained erection for 4hrs or longer...painful. Neural vascular causes or drug-induced(poppers) |
| Interventions for priapism | TX aimed at cause. Administration of alpha-agonists directly to corpora cavernosa, pain management, protatic massage, iced saline enemas. SX with shunts if all else fails. |
| Risk factors for Erectile Dysfunction (ED) | stress, fatigue, DM, vascular disease, neuro disorders(MS, spinal cord injury), drug effects(antidepressants, antihypertensives, beta blockers, or alcohol) |
Created by:
jdarde1
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