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Test 3 NUR 185
| Question | Answer |
|---|---|
| What's another word for affect? | Mood |
| What is pervasive and sustained emotion that may have a major influence on a person's perception of the world? | Mood |
| What do you call an alteration in mood that's expressed by feelings of sadness, despair, and pessimism | Depression |
| What do you call an alteration in mood that is expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation, and accelerated thinking and speaking? | Mania |
| What do researchers refer to as the common cold of psychiatric disorders? | Depression |
| Which disorder is characterized by depressed mood or loss of interest of pleasure in usual activities? | Major Depressive Disorder |
| Does a person with MDD experience periods of Mania? | No |
| Can MDD be caused by medical conditions or substance abuse? | No |
| How long must a person show impaired social and occupational functioning before they're considered to have MDD? | atleat 2 weeks |
| What is used for a person's first diagnosis of MDD? | Single Episode specifier |
| What is specified when the history reveals two or more episodes of depression? | Recurrent |
| How are the MDD categories of Mild, Moderate, and Severe identified? | by the number and severity of symptoms |
| What does the person experience when they're having psychotic features r/t MDD? | Hallucinations or Delusions |
| When a person has psychomotor impairment r/t MDD what feature might they exhibit? | Catatonic feature |
| Describe Melancholic features | Severe form of MDD episode, symptoms are exaggerated, Temporary reactivity to usually pleasurable stimuli is absent, History reveals a good response to antidepressants or other somatic therapy |
| What classification applies when the current episode of depressed mood has been evident continuously for at least the past 2 years? | Chronic |
| what diagnosis indicates the presence of depressive symptoms during the fall or winter months? | Seasonal patterns |
| What is another name for the MDD classification of depression with seasonal patterns? | Seasonal Affectiveness Disorder |
| Which specifier is used when symptoms of MDD occur within 4 weeks postpartum? | Postpartum onset |
| If a patient describes their mood as sad or "down in the dumps" what disorder might they have? | Dysthymic Disorder |
| Does a pt with Dysthymic disorder have any psychotic symptoms? | No |
| What is the essential feature of Dysthymic Disorder? | A chronically depressed mood (or possibly an irritable mood in children or adolescents) for most of the day, more days than not, for atleast 2 years (1 year for children and adolescents) |
| What are the two classifiers of Dysthymic Disorder? | Early onset and Late onset |
| What is Early onset of Dysthymic disorder? | Identifier of cases when the onset occurs before age 21 |
| What is Late onset of Dysthymic disorder? | Identifier of cases when the onset occurs at age 21 or later |
| The essential feature include markedly depressed mood, marked anxiety, mood swings, and decreased interest in activities during the week prior to menses and subsiding shortly after the onset of menstration; What disorder is this? | Premestrual Dysphoric Disorder |
| What is characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy? | Bipolar Disorders |
| What is Bipolar I Disorder? | The diagnosis given to an individual who is experiencing, or has experienced, a full syndrome of manic or mixed symptoms |
| Can a person with Bipolar I experience periods of depression? | Yes |
| What is Bipolar II Disorder? | Characterized by recurrent bouts of major depression with episodic occurrence of hypomania |
| How does a pt with this diagnosis present? | With symptoms or history of depression or hypomania |
| What is hypomania? | a somewhat milder degree of mania; Not severe enough to cause marked impairment in social or occupational functioning or to require hospitalization, and doesn't include psychotic features |
| What disorder is characterized by a chronic mood disturbance of at least 2 year duration, involving numerous episodes of hypomania and depressed mood of insufficient severity or duration to meet the criteria for either Bipolar I and Bipolar II disorder? | Cyclothymic Disorder |
| What disorder might a person have if they're never without hypomanic or depressive symptoms for more than 2 months? | Cyclothymic Disorder |
| What disorder is characterized by a prominent and persistent disturbance in mood that is judged to be the result of direct physiological effects of a general medical condition? | Mood disorder due to General Medical Condition |
| What mood disorder is thought to be the direct result of physiological effects of a substance (ex: drug abuse, medication, or toxin exposure)? | Substance Induced Mood Disorder |
| Can the symptoms of Substanace Induced Mood Disorder occur due to withdrawl from these substances? | Yes |
| What type of drugs contribute to Substance Induced Mood Disorder? | Alcohol, amphetamines, cocaine, hallucinogens, inhalants, opioids, phencyclidine, sedatives, hypnotics, anxiolytics |
| What type of toxins contribute to Substance Induced Mood Disorder? | gasoline, paint, organophosphate, insecticides, nerve gases, carbon dioxide, carbon monoxide; Heavy metals as well. |
| What type of medications contribute to Substance Induced Mood Disorder? | anesthetics, analgesics, anticholinergics, antihypertensives, antiparkinsonians, anticonvulsants, antiulcer, cardiac medications, oral contraceptives, psychotropics, muscle relaxants, steroids, and sulfamonides |
| What exactly causes depression? | That is unclear |
| It has been hypothesized that depressive illness may be r/t defficiency of the neurotransmitters ________, _________, and ________ at functionally important receptor sites in the brain. | Norepinephrine, Serotonin, Dopamine |
| How do electrolyte disturbances play a role in depressive disorders? | Excessive levels of sodium bicarbonate or calcium can produce symptoms of depression, as can deficits in magnesium and sodium. |
| What role does Potassium play in depressive disorder? | Too much potassium or too little potassium can cause depression |
| What role does hormonal disturbance play in depressive disorder? | Depression is associated with dysfunction of the adrenal cortex and is commonly observed in both Addison's disease and Cushing's syndrome |
| What role do nutritional deficiencies play in depressive disorder? | Deficiencies in vitamin B1 (thiamine), B6 (pyroxidone), B12, niacin, Vitamin C, iron, folic acid, zinc, calcium, and potassium |
| What type of medical conditions have been known to play a role in depressive disorders? | SLE, CHF, and CVA |
| What are the 4 psychosocial theories for depressive disorders? | Psychoanylytical, Learning, Object Loss, and Cognitive |
| According to Freud what is Melancholia? | A profoundly painful dejection, a cessation of interest in the outside world, loss of the capacity to love, inhibition of all activity, |
| What did Freud propose about Melancholic clients? | The depressed patient's rage is internally directed because of identification with the lost object |
| What is the learning theory pertaining to depressive disorders? | Learned helplessness predisposes people to depression by imposing a feeling of lack of control over their life situation |
| What is the theory of object loss? | The theory of object loss suggests that depressive illness occurs as a result of having been abandoned by or otherwise separated form a significant other during the first 6 months of life |
| Where do cognitive theorists believe depression stems from? | Negative thinking |
| Suicide is the _____ leading cause of death among ages 15-24 | 3rd |
| Which medication is the only medication currently approved to treat depression in children and adolescents? | Fluoxetine (Prozac) |
| What medication is never given to children or adolescents to treat depression? | Paxil |
| What is the most common psychiatric disorder in the elderly? | Depression |
| What is Bereavment Overload? | A phenomenon that occurs when an individual experiences so many losses in their lives that they aren't able to resolve one grief response before another one begins |
| The elderly account for what percentage of suicides in the US? | 16 percent |
| Highest number of suicides is among _______ ______ _______ years of age and older. | caucasian men, 85 |
| What mis-diagnosis is commonly given to an elderly person with depression? | Dementia |
| Depression accompanies what other illnesses commonly found in the elderly? | Parkinson's, cancer, arthritis, early stages of Alzheimer's |
| What's considered the safest and most effective treatment for depression in the elderly? | ECT |
| When does a mild depressive episode occur? | When the grief process is triggered in response to the loss of a valued object: loved one, pet, friend, home, significant other |
| When does moderate depression occur? | When grief is prolonged or exaggerated |
| When does sever depression occur? | When the symptoms of the moderate level intensify. The person oftens loses touch with reality |
| At what level is the desire for suicidal completion at it's strongest? | The severe level of depression |
| What are some Nsng. Dx for a person with depression? | , Low Self-Esteem/Self-Care Deficit |
| What are the Nursing interventions for the pt with a Dx of Risk for Suicide? | Ask the client directly, "Have you thought about killing/harming yourself today?", Create a safe environment, Formulate a shorterm written or verbal contract, Maintain close observation, Make rounds at frequent, irregular intervals, etc. |
| What are the Nursing interventions for the pt with a Dx of Complicated Grieving? | Determine stage of grief, Establish rapport with client, Encourage anger expression, Teach normal stages of grief, Communicate that crying is acceptable, Assist with problem solving, Encourage reaching out for spiritual support, Support groups |
| What are the Nursing interventions for the pt with a Dx of Low Self-Esteem/Self-care Deficit? | Be accepting of the client, Promote attendance in therapy group, Encourage recognition of change,Teach assertiveness, Teach effective communication, Encourage independence, Keep strict records of I&O, provide nursing measures that promote sleep |
| What are some biochemical influences of Bipolar Mania? | Functional deficiency of norepinephrine, and dopamine, and mania with a functional excess of these amines. |
| What medications have the possibility for triggering Manic episodes? | Amphetamines, antidepressants, and high doses of anticonvulsants |
| What does FIND stand for? | Frequency, Intensity, Number, Duration |
| What are some psychopharmacological treatments for Bipolar disorder? | Monotherapy with the traditional mood stabalizer (Lithium) or atypical antipsychotics is considered to be the first line of treatment |
| What is the most common co-morbid condition found among children and adolescents with Bipolar disorder? | ADHD |
| What are some Nursing Dx for a person with Bipolar Disorder? | Risk for violence: Self Directed or Other Directed, Impaired Social Interaction, Feeding Self Care Deficit/Insomnia |
| What are some Nursing interventions for a client with a diagnosis of Risk for Violence? | Maintain low level of stimuli, Observe client behavior frequently, Remove all dangerous objects, Intervene at the first sign of increased anxiety, Maintain a calm attitude, Use show of strength, Use of mechanical restraints |
| What are some Nursing interventions for a client with a diagnosis of Impaired Social Interaction? | Recognize purpose of client behavior, Set limits on manipulative behavior, Don't argue or bargain, Provide positive reinforcement for nonmanipulative behavior, teach Accepting consequences for behavior, Identify positive aspects about their self |
| What are some Nursing interventions for a client with a Dx of Feeding Self Care Deficit/Insomnia? | Determine number of calories per day for client, Provide high protein-high calorie finger food that can be eaten "on the run", Maintain accurate record of I&O, Assess client's activity level, Monitor sleep patterns, Avoid intake of caffeinated drinks |
| What is suicide? | A behavior, not a diagnosis or disorder |
| Suicide is the ______ leading cause of death among 25-44 years of age. | 5th |
| Suicide is the ___ leading cause of death among 45-64 years of age. | 8th |
| What's the suicide ratio of single to married people? | Rate for single is twice that of married |
| Attempts suicide more, women or men? | Women |
| Who succeds at committing suicide more, women or men? | Men |
| ______ _______ over the age of ___ are at the greatest risk of all age/gender/race groups for committing suicide. | White male, 80 |
| The overall rate of suicide for women declines at what age? | 65 |
| With regards to ethnicity who is at highest risk/lowest risk for suicide? | Caucasians, Native Americans, African Americans, Hispanic Americans, and Asian Americans |
| With what psychiatric disorder are you most likely to see the highest risk for suicide? | Mood Disorders |
| What is Freud's theory about suicide? | Freud beleived that suicide was a response to severe hatred turned inward. It was actually an earlier desire to kill someone else; It's actually supposed to be directed toward someone else |
| Suicide rates are the highest among who? | Highest in people older than 50, but also very high in Adolescents |
| Who is at higher risk for suicide Men or Women? | Men |
| Which socioeconomic status is shown to have the highest suicide rate? | Lowest followed by the highest |
| What occupation has the highest risk for suicide? | Healthcare professional followed by Business executives |
| What's the common method for committing suicide? | Use of firearms |
| what are the guidelines for treating a suicidal patient in an outpatient setting? | Don't leave them alone, Establish a no-suicide contract, Ensure safety of environment, Establish rapport, Be nonjudgemental, Be direct, talk matter-of-factly about suicide, Discuss crisis, |
| What's another name for a group on mental disorders characterized by psychotic features disordered thought processes and disrupted interpersonal relationships. Disturbances in affect, mood, behavior, and thought processes occur? | Schizophrenia |
| What type of schizophrenia happens when symptoms begin before age 25 and is commonly chronic? | Disorganized Schizophrenia |
| What type of schizophrenia is characterized mainly by the presence of delusions of persecution or granduer and auditory hallucinations of a single theme? | Paranoid Schizophrenia |
| When a pt's behavior is highly primitive, contact with reality is extremely poor, affect is flat and inappropriate with periods of silliness and incongruous giggling? | Disorganized Schizophrenia |
| When is the onset of symptoms for a pt with Paranoid schizophrenia? | Late 20s-early 30s |
| In which schizophrenic disorder is the prognosis more promising? | Paranoid schizophrenia |
| What is the Erotomanic type of delusion? | The individual believes that someone, usually of higher status, is in love with him or her. Famous persons are usually the subjects of these delusions |
| What is the Grandiose type of delusion? | Individuals have irrational ideas regarding their own worth, talent, knowledge, or power. (Ex: I am Jesus Christ) |
| What is the Jealous type of delusion? | centers on the idea that the person's sexual partner is unfaithful. The idea is irrational and without cause, but the individual with the delusion searches for evidence to justify the belief |
| what is the persecutory type of delusion? | Individuals believe they are being malevolently treated in some way. This is the most common type of delusion. (Ex: The FBI bugged my room and intends to kill me) |
| What is the Somatic type of delusion? | The individual has a false idea about the functioning of his or her own body (Ex: I'm 70 years old and I will be the oldest person to ever give birth. The doctor says I'm not pregnant, but I know I am) |
| What is the Delusion of Reference? | Everything relating to the individual's environment is pertaining to them. (Ex: someone is trying to message me through newspaper articles) |
| What is a Nihilistic Delusion? | The individual has a false idea of the self or world around them. (Ex: the world no longer exists) |
| What is an example of Associative Looseness? | Thinking that is characterized by speech in which ideas shift from one unrelated subject to another. The individual is unaware that the topics don't connect. (Ex: We wanted to take the bus, but the airport took all the traffic. Driving is the ticket) |
| What is an example of Neologisms? | The psychotic person invents new words. They have no meaning to others but mean something to the psychotic person |
| What is an example of Concrete Thinking? | "It's raining cats and dogs", the pt may believe there really are cats and dogs falling out of the sky |
| What is an example of Clang Associations? | "It's very cold. I am cold and bold. The gold has been sold." |
| What is an example of Word Salad? | It's a group of words put together randomly, without any logical connection. (Ex: Most forward action grows life double plays circle uniform) |
| What is an example of Circumstantiality? | The individual has a hard time getting to the point of communication because of unnecessary and tedious details. Interviewer must keep them on track |
| What is an example of Tangentiality? | Individual nevers gets to the point |
| What is an example of Mutism? | Inability or refusal to speak |
| What is an example of Perseveration? | Individual continuously repeats the same word or idea in response to different questions |
| What is Anhedonia | The inability to experience pleasure. This symptom sometimes compels clients to commit suicide |
| What are some Nursing Dx given to a client with Schizophrenia? | Disturbed Thought Processes, Disturbed Sensory Perception: Auditory/Visual, Risk for violence: Self-Directed/Other directed, Impaired Verbal Communication |
| What are some Nursing interventions for a person with the Dx of Disturbed Thought Processes? | Don't argue or deny, Focus on reality, Avoid physical contact, don't laugh at them, Don't choose competitive games for the paranoid client |
| What are some nursing interventions for the client with Diturbed Sensory Perceptions as their Dx? | Observe for hallucinations, Don't touch the client, Don't reinforce the hallucinations, Help client to understand that increased anxiety allows hallucinations to happen, distraction when hallucinating, teach voice dismissal |
| What are some nursing interventions with the patient with a Dx of Risk for violence? | Lower stimuli in environment, observe client, remove all dangerous objects, stay calm, use sufficient number of staff, talk down first then medicate and lastly restrain |
| What are some Nursing interventions for client with a Dx of Impaired Verbal Communication? | Try to figure out what client is meaning, validate the info and clarify it, to establish trust use consistent staffing, verbalize the implied, use concrete communication for concrete thinking |
| What is the purpose of psychotherapy in regards to schizophrenia? | The focus is to decrease anxiety and increase trust; Orientate the patient to reality and educate them |
| What are some characteristics of the Typical medications in the treatment of schizophrenia? | They take several weeks to work. They block dopamine receptors, control positive symptoms. S/E: EPS, anticholinergic, Tardive dyskinesia, and NMS. They also carry a higher risk of death in elders with Dementia |
| What are some characteristics of the Atypical medications in the treatment of schizophrenia? | They work with negative symptoms. S/E: Agranulocytosis, seizures, hypersalivation, tachycardia, sedation, anticholinergics. Block dopamin with less chances of EPS. Cause weight gain and Hyperglycemia |
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kn72118
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