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Exam 2 Psych 103
Exam 2 study stack for Psychiatric Nursing
| Question | Answer |
|---|---|
| Anger is | a normal response to fear, hurt, frustration. Only unhealthy when out of control |
| Manic patients speech | flight of ideas |
| Directing Anxious patients | short, simple and direct statements or questions, cannot think clearly so nothing complicated |
| Symptoms of Alcohol Withdrawal | tremors, vs changes, nausea and vomiting, agitation, restlessness |
| Assessing the Lethality of Suicide threat | do they have a plan, do they have the means to carry out the plan, is the plan likely to be lethal (in the patient's eyes) |
| When assessing a depressed patient | always ask if they are thinking about hurting themselves (lethality assessent |
| anergia | lack of energy |
| flight of ideas | excessive amount and rate of speech composed of fragmented or unrelated ideas, racing often unconnected thoughts |
| adhedonia | having no pleasure or joy in life, losing any sense of pleasure from activities formerly enjoyed |
| ECT | electroconvulsive therapy - used to treat depression in select groups such as clients who do not respond to antidepressant meds, or those who experience intolerable med side effects at therapeutic doses |
| Euthymic | normal or level mood |
| Hypertensive crisis | life threatening condition that can result when a client taking MAOI's ingest tyramine containing foods and fluids or other medications |
| hypomania | a period of abnormally and persistently elevated, expansive or irritable mood lasting for days, does not impair the ability to function and does not involve psychotic features |
| labile emotions | rapidly changing or fluctuating moods |
| latency of response | refers to hesitation before the client responds to questions |
| mania | a distinct period during which mood is abnormally and persistently elevated, expansive or irritable |
| mood disorders | pervasive alterations in emotions that are manifested by depression or mania or both |
| pressured speech | unrelenting, rapid, often loud talking without pauses |
| psychomotor agitation | increased body movements and thoughts |
| psychomotor retardation | overall slowed movements, a general slowing of all movements, slow cognitive processing and slow verbal interaction |
| Ruminate | to repeatedly go over the same thoughts |
| SAD | seasonal affective disorder, mood disorder with two subtypes winter and spring, affected by weather and light |
| Suicidal ideation | thinking about killing oneself |
| suicide | the intentional act of killing oneself |
| suicide precautions | removal of harmful items, increase supervision to prevent acts of self harm. |
| what are the immediate effects of ECT | confusion and short term memory loss |
| Who is limit setting used for? | manic patients (manipulators) |
| What do you do for a patient who is lethargic, apathetic, depressed activity wise? | give a simple task to accomplish (catching a ball) not a puzzle, you want them to feel they accomplished something |
| Kubler Ross Stages of Grief | Denial, Anger, Bargaining, depression, acceptance |
| Denial (grief) | shock and disbelief, this isn't happening |
| anger (grief) | towards God, relatives, doctors etc... |
| bargaining (grief) | asking for more time, or for it not to happen |
| depression (grief) | awareness of loss becomes acute |
| acceptance (grief) | coming to terms with it |
| Person who is in the acceptance stage of grief... | can see the positive and negative |
| Communicating with someone experiencing grief | requires presence, empathy, and interpersonal skills |
| Pt with terminal cancer(3 months left) is talking about long range plans... what should you do | Intervention, the patient needs to accept the reality of their situation... short term yes, long term no |
| Patient is dying, what do you do for family? | allow them to be there as much as possible, encourage them to speak to and touch the patient, give them as much time as they need once the patient has expired |
| Client is attempting to hurt you, what do you do? | matter of factly say "you need to control yourself, if you are unable to we can assist you with that" |
| Manic patient is taking things from other patients, what do you do? | Distract him as best you can, take the things from him. Safety is a priority but he cannot be allowed to continue this behavior |
| Imminent danger, what do you do first? | call for help |
| Interventions for manic or anxious patient | reduce stimulation, noise and activity level |
| If you decide to spend time with a patient who is depressed and you tell them you will stay, then they turn away. What do you do? | you still say, it's acceptable to move your chair back a little, but you stay until they are ready to talk |
| Family teaching for suicidal patient | antidepressent meds may increase the risk for suicide at first since patient has more energy, watch for changes in behavior, remove any weapons. |
| Psyhcosomatic patients (somatoform disorders) | illness where mental issues result in physical symptoms |
| Primary gain | the relief of anxiety achieved by performing the specific anxiety driven behavior, the direct external benefits that being sick provides a relief of anxiety, conflict or distress |
| secondary gain | the internal or personal beliefs received from others because one is sick, such as attention from family member, comfort measures and being excused from usual responsibilities |
| Goals for Somatic Disorder patients | remember anxiety is causing the symptoms so provide alternate methods of coping, divert attention form preoccupation of self, identify primary and secondary gains |
| treatment for somatic disorders | focuses on managing symptoms and improving quality of life, anti anxiety meds, |
| Benzodiazepams (valium, versed, librium, klonopin) | addictive, remember you must be tapered off them, not cold turkey. No alcohol, orthostatic hypotension |
| Buspar | is routine anti anxiety med, not for immediate relief. takes 3-4 weeks for optimal effectiveness, not controlled med, not addictive |
| Communicating with anxious patients, you should | be calm and direct, not loud. Decrease distractions |
| Generalized anxiety patients should avoid | caffeine and other stimulants |
| Obsessive Compulsive Disorder patients | use ritualistic behavior to calm themselves, do not interrupt their cycle allow them to complete it |
| interventions for OCD patients | help them decrease the length of activity over time, teach them to replace these activities with things that aren't detrimental to themselves |
| Goals for anxiety patients | reduce anxiety, safety too, teach alternate methods of coping, decrease stimulation |
| Patient who had his last drink 24 hours ago and is experience nausea and vomiting is experiencing | alcohol withdrawal symptoms |
| Alcoholic patient who is experiencing GI issues (liver and pancreas) | Pancreatitis affects Blood sugar levels, check them |
| antiabuse is | given to stop alcohol from being drank (causes severe vomiting... risk for aspiration |
| codependent behaviors | symbiotic relationship, goal is to please and care for substance abuser, poor relationship skills, excessive anxiety and worry, compulsive behaviors and resistance to change |
| Signs of Drug addiction in nurses and doctors | drug miscounts, excessive wasting of narcs, increased pharmacy errors, unexplained absences from floor, patient complaning of pain when the meds worked before (was it actually given) |
| Patient using CNS depressants (opiates) | watch respiratory function |
| Blame game of abusers | always someone else's fault |
| Patient who has been clean and sober for years comes in now drinking again... | ask what happened (triggered) this relapse |
| Phobia | intense, illogical and persistent fear of something |
| Phases of Anger | triggering, escalation, crisis, recovery, postcrisis |
| Grieving tasks | recognize, react, recollect, relinquish, readjust, reinvest |
| disenfranchised grief | grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially |
| complicated grieving | response outside the norm of grieving |
| risk factors for complicated grieving | death of spouse or child, death of parent, sudden unexpected death, multiple deaths, death by suicide or murder |
| interventions for grief | focus on perception of loss, exploring the meaning of the loss, allowing adaptative denial, , process of gradually adjusting to the reality of the loss, being there |
| mild anxiety | something is different and warrants attention, increases some abilities, not harmful |
| moderate anxiety | something is definitely wrong, can still process info, solve problems, headache, dry mouth, gi upset |
| severe anxiety | trouble thinking and reasoning, cannot think clearly, rigid, trembling etc |
| panic anxiety | focus only on self, cannot process, loss of rational thought, fight, flight or freeze |
| Interventions for moderate anxiety | be certain client is following what you are saying, short, simple easy to understand sentances, reduce stimulation |
| interventions for severe anxiety | lower the patient's anxiety level, remain with them. deep breathe, calm, soothing voice, reduce stimulation |
| interventions for panic anxiety | stay with them, reduce stimulation, keep safe... can last for 5-30 minutes |
| anxiety disorder incidence | highest prevalence rate of all mental disorders in the US |
| Anxiety disorders include | phobias, panic disorder, social phobia, OCD, Generalized anxiety disorder, acute stress disorder, PTSD |
| Generalized anxiety disorder | at least 6 months of persistent and excessive worry and anxiety. about multiple things |
| Acute stress disorder | anxiety, dissociation and other symptoms within 1 month of traumatic stressor, lasting 2 days to 4 weeks (similiar to PTSD but more dissociative) |
| PTSD | reexperiencing an extremely traumatic even, avoiding stimuli associated with event, numbing of responsiveness begins within 3 months to years after the event may last months or years. |
| Anxiety disorders in the elderly | phobias, and GAD most common late in life, treated with SSRI's |
| panic disorder | discrete episodes of panic attacks, recurrent unexpected followed by at least 1 month of persistent concern or worry about future attacks |
| Interventions for Panic Disorder | safety, remain with them, deep breathing, talk in calm reassuring voice, use relaxation techniques, cognitive restructuring, decrease stressors |
| flooding | form of rapid desensitization in which a behavorial therapist confronts the client with the phobic object until it no longer produces anxiety |
| obsessions | recurrent, persistent, intrusive and unwanted thoughts, images or impulses that cause marked anxiety and interfere with interpersonal, social or occupational function |
| compulsions | ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety |
| OCD diagnosed | only when these thoughts images, and impulses interfere with the persons life |
| exposure | assisting the client to deliberately confront the situations and stimuli they normally avoid |
| response prevention | focuses on delaying or avoiding the performance of rituals |
| Interventions for OCD | offer encouragement, be clear that you believe they can change, encourage the client to talk, decrease the time for the client to carry out the behavior, assist them to manage anxiety, completing a daily routine |
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