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Psych Nursing I
Exam I neurobiology, NP, Anxiety, Ethics, Communication
| Question | Answer |
|---|---|
| Evidence of mental health in the individual | Some signs of mental health are happiness, control of behavior, appraisal of reality, effectiveness in work, healthy self concept, satisfying relationships, and using effective coping strategies. Resiliency is also an important indicator of mental health |
| Evidence of mental illness | Major depressive episode, control disorder (aggressive), schizophrenic disorder (delusions and hallucinations, adjustment disorder with work or academics, dependent personality disorder, borderline personality disorder, and substance dependencies |
| Factors that would tend to promote mental health | Having a good support system such as friends and family, spirituality, and community support as well |
| Factors that would tend to interfere with mental health | Psychosocial stressors, poverty, impaired or inadequate parenting, inherited factors, environmental experiences, and experiences. |
| Axis I | all mental health diagnosis except for what's found in Axis II |
| Axis II | and personality disorder and mental retardation |
| Axis III | any general medical diagnosis such as asthma |
| Axis IV | psyhosocial problems and problems that may affect diagnosis |
| Axis V | global assessment of functioning; below 50 equals hospitalization |
| Frontal lobe | center of thought, planning, decision-making, insight, motivation, judgment; voluntary movement begins in basal ganglia – signals reach skeletal muscles via extrapyramidal (EP) nerve tracts (movement ability, disease example would be parkinsons) |
| Limbic system | the emotional brain” – a ring of structures such as the hippocampus & amygdala, connected to the temporal lobe & the hypothalamus; allow for expression of sexual arousal, aggression, fear, & other emotions |
| Prefrontal cortex | connected to all brain regions to execute goal directed activity. When it is impaired by a mental disorder such as schizophrenia there is a decrease in executive function, attention, impulse control, socialization, regulation of drives and emotions. |
| Dopamine | CNS excess linked with psychosis; deficit in EP tracts linked with disorder of voluntary movement (EPS) (may cause schizo/cause of Parkinson’s disease) |
| What happens when you have increased amounts of dopamine? | Psychosis |
| Norepinephrine | mediator for SNS, mood elevator; deficit linked to depression |
| Serotonin | influences mood states, pain perception, hunger (used for depression, chronic pain, and eating disorders) |
| Histamine | promotes wakefulness |
| Gamma-aminobutyric acid (GABA) | promotes sleep |
| Glutamate | deficit linked to cognitive decline |
| Positive symptoms of psychosis | behavior, thought, and speech (agitation, dellusions, hallucinations, tangenital speech) |
| Negative symptoms of psychosis | social withdrawal, lack of motion, lack of energy, flattened affect, decreased motivation, and decreased motivation of agitation |
| Anticholinergic effects | can’t see, can’t pee, can’t spit, can’t shit … |
| Acute dystonia | muscle cramps of head/neck (sternocleidomastoid) can occur from just one dose of medication |
| Akathisia | constant restless movements (over time/can cause suicide) |
| Pseudo parkinsonism | stiffness, later tremor, etc. (over time) |
| Tardive dyskinesia | chronic movement disorders, may not be reversible (over time) |
| What are some typical antipsychotics? | Chlorpromazine (Thorazine) – prototype antipsychotic - low potency, very sedating.Haloperidol (Haldol) – high potency, much less sedating, oral and IM forms widely used. Significant incidence of EPS. Haloperidol decanoate (Haldol D) – long-acting IM |
| Examples of Atypical Medications | Clozapine (Clozaril) – requires weekly CBC due to incidence of agranulocytosis or decreased WBC count; wt gain common. • Risperidone (Riperdal) – widely used |
| What are some anticholinergics that are used to manage EPS symptoms? | Cogentin and Benadryl |
| what is the therapeutic range for lithium? | 0.4 to 1 mEq; 1.5 |
| common side effects of lithium toxicity? | N/V diarrhea, thirst, polyuria, slurred speech, muscle weakness, coarse hand tremors, and confusion |
| what labs should be monitored with the use of lithium? | Serum lithium levels drawn 8-12 hours after a dose of medication Renal function (don’t like to use in kids) (creatinine, BUN)Thyroid functionSerum electrolytes |
| What drugs are used as mood stabilizers? | antiepleptic drugs Depakote/Tegrotol |
| What is the drug of choice for depression and anxiety disorders? | SSRI increases serotonin uptake at the synapse Zoloft, Prozac |
| How does MAOI's work? | inhibit monoamine oxidase, an enzyme that destroys norepinephrine & serotonin; this increases monoamine levels at receptor sites |
| What are some foods that include tyramine? | in aged/fermented foods) (picture a wine and cheese feast with sausage, pickles, gourmet foods, fava beans, and tofu, yogurt, dairy |
| How do ADHD medications work? | Selective increase in CNS levels of norepinephrine improves ability to focus on tasks at hand |
| Mild and Moderate Levels of anxiety hints | Can alert the person that something is wrong and can stimulate appropriate action |
| Severe and Panic Levels | Person is out of control, cannot effective problem solve or choose effective action; ineffective attempts generate more anxiety in a vicious cycle |
| Altruism | dealing with emotional issues and stress by meeting needs of others ex: grieving mother hosts grieving meetings for others |
| Sublimation | unconscious process of substituting constructive and socially acceptable activity for strong impulses that are not accepted in their original form which are usually aggressive or sexual |
| Humor | emphasizing amusing or ironic aspects of emotions or stressors |
| Suppression | conscious denial of disturbing situation or feeling. Ex: student studying for board says they can’t worry about their rent until after their test |
| Repression | exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness. Ex: forgetting former BF name, or a meeting to discuss bad grades |
| Displacement | transfer of emotions with a person, object, or situation to another person, object, or situation that is not threatening |
| Reaction Formation | AKA overcompensation, unacceptable feelings or behaviors are kept out of awareness by developing the opposite behavior or emotion. Ex: person who doesn’t like kids becomes a boy scout leader |
| Somatization | transforming anxiety that has no organic cause to the body. Ex: teacher develops laryngitis and cant come to class for debate |
| Undoing | makes up for an act or communication by giving a gift, or compulsive hand washing to wash away acts or thoughts that are unacceptable |
| Rationalization | justifying unreasonable ideas or actions by making acceptable explanation. Ex: everybody cheats, why shouldn’t I? Or if I had good brains I would make good grades |
| Dissociation | a disruption in integrated functions of consciousness, memory, identity, or perception of environment. A mother whose child was hit by a car only addresses what happened before |
| Devaluation | emotional conflicts or stressors are dealt with by attributing negative qualities to self or other. Ex: a woman jealous of a co worker says “ oh yeah she won an award but awards don’t mean anything anyway” |
| School Age (6-12) Industry vs. Inferiority | healthy competitive drive that leads to confidence. Learning how to accept instruction with recognition by producing things, the child opens the way for capacity of work environment. Danger: the development of a sense of inadequacy and inferiority in a |
| Adolescence (12-20) Identity vs. Identity- diffusion | differentiation from parents leads to fidelity and sense of self. They physiological revolution that comes with puberty forces the young person to question beliefs and to refight many of the earlier battles. Danger: temporary identity diffusion |
| Young Adulthood (20-30) years Intimacy vs. Isolation | maturity and social responsibility results in the ability to love and e loved. people feel more secure in their identity they are able to establish intimacy with themselves and with others, eventually in a love based satisfying sexual relationship with a |
| Adulthood (30-65) Generativist vs. Self-absorption | Inters it in nurturing subsequent generations causes a sense of caring, contributing and generativity. Danger: Lack of generativity results in self-absorption and stagnation. |
| Senescence (65 years to death) Integrity vs. despair | acceptance of mortality and satisfaction with life leads to wisdom. Satisfying intimacy with other human beings |
| Psychoanalytic | focus on past & recovery of repressed thoughts/feelings |
| Brief psychodynamic | shorter, more focus on here & now |
| Behavioral | working to change distorted ways of thinking –be able to recognize those |
| Cognitive | working to change behavior |
Created by:
jshawell
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