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nurs1220
test 1 mental health part 2
| Question | Answer |
|---|---|
| What are patients rights concerning medications? When can they be forced? | They have the same rights as everyone else they don’t have to take the medication but when they become a danger to themselves or someone or when they can’t take care of themselves they can be forced medication. |
| How do you use Maslow’s hierarchy of needs to prioritize patient needs? | Maslow Hierarchy of Needs provides each nurse with a priority of client care needs organized to provide the best care to your client directed toward preventing any type of harm. |
| What are Maslow's hierarchy of needs | Physiology 2. Safety 3. Love 4. Esteem 5. Self-Actualization |
| How would you respond therapeutically to a patient who divulges that he wishes to kill his father? | Why do you feel that way?” Requesting an explanation. Placing an event in time or sequence, “what seemed to lead up to that?” |
| How would you respond therapeutically to a patient who divulges that he wishes to kill his father? | Inform patient that you can not withhold that information |
| How would you demonstrate the termination phase of the therapeutic relationship? | Summarize goals and objectives achieved Discuss ways for patient to incorporate new coping strategies learned Review situations of relationship Exchange memories |
| How do know when a patient is ready to enter the working phase of a therapeutic relationship? | Facilitate behavioral change Overcome resistant behaviors Evaluate problems and goals Redefine them as necessary Promote practice and expression of alternative adaptive behaviors |
| Where would you place a person on the mental health continuum who says that he is happy most of the time and feels good about himself | 1 being the worst and 5 being the highest) |
| What technique can you use to best show that you’ve been listening to a patient? | Paraphrasing … As a result, the patient is made aware that the interviewer is actively involved in the search for understanding. |
| What technique would you be using if you told a patient “I noticed anger in your voice just now” “tell me about that”? | What technique would you be using if you told a patient “I noticed anger in your voice just now” “tell me about that”? |
| What technique would you be using if you told a patient “I noticed anger in your voice just now” “tell me about that”? | Making observations Calls attention to the person's behavior . Encourages patient to notice the behavior and describe thoughts and feelings for mutual understanding. Helpful with mute and withdrawn people |
| The patient is trying to shift the focus by asking you personal questions. What would be your most therapeutic response? | Why don’t we talk about you (redirect back |
| What kind of a statement is this?: “Tell me what was happening to you that led to you being hospitalized”? | Giving a broad opening Open-ended questions and comments encourage lengthy responses and information about experiences, perceptions, or responses to a situation. |
| What statement shows that the nurse has empathy for the patient | “How upsetting this must be for you. Something similar happened to my Mother last year, and I had so many mixed emotions. What thoughts and feelings are you having?” |
| How would you respond to a patient who tells you he has done a lot of lying and cheating in his relationships? | “Would you like to tell me about it?” |
| Antianxiety and hypnotic drugs: | Diazepam (Valium) -Clonazepam (Klonopin) -Buspirone (BuSpar) |
| Short-Acting Sedative-Hypnotic: Sleep Agents (“Z-hypnotics”) | Zolpidem (Ambien) -Zaleplon (Sonata) -Eszopiclone (Lunesta) |
| Antidepressant drugs: Selective serotonin reuptake inhibitors (SSRIs) | Fluoxetine (Prozac) -Sertraline (Zoloft) -Paroxetine (Paxil) |
| Mood Stabilizers: | Lithium |
| Anticonvulsant drugs Also used as mood stabilizers | Valproate (Depakote, Depakene) -Oxcarbazepine (Trileptal) -Topiramate (Topamax) Atypical Antipsychotics -Clozapine (Clozaril) -Risperidone (Risperdal) |
| For Attention Deficit Hyperactivity Disorder (ADHD) | -Methylphenidate (Ritalin) -Dextroamphetamine (Adderall) |
| For Alzheimer's disease | Tacrine (Cognex) -Donepezil (Aricept) |
| What kind of teaching should you is doing for somebody who is receiving an antipsychotic? | Extra-pyramidal Symptoms |
| Akathesia- | A movement disorder characterized by a feeling of inner restlessness and a compelling need to be in constant motion as well as by actions... |
| Akinesia | Impaired body movement; without movement (or without much movement) |
| Dystonia | - involuntary movements and prolonged muscle contraction, resulting in twisting body motions, tremor |
| Parkinsonian symptoms | characterized by a fixed inexpressive face, a tremor at rest, pill rolling |
| Tardive Dyskinesia- | A neurological syndrome characterized by repetitive, involuntary, purposeless movements |
| Tricyclics: | used in tx of affective disorders; 1-4wks for max effects; Anticholinergic side effects(blurred vision, dry mouth, HTN, menstrual irreg., urinary retention |
| Tricyclics: | Amitriptyline (Elavil) Imipramine (Tofranil) Nortriptyline (Pamelor) |
| MAO inhibitors: | cumulative effect; can cause a hypertensive crisis w/ certain food & drugs (cheese effect)*aged meats, aged cheeses or wine(tyramine free diet) |
| MAO inhibitors: | Phenelzine (Nardil) Tranylcypromine (Parnate) Selegiline (ENSAM |
| SSRI’s: | usually the 1st defense, not as many side effects |
| SSRI’s: | Fluoxetine(Prozac) -Sertraline (Zoloft) -Paroxetine(Paxil) -Citalopram(Celexa) -Esitalopram (Lexapro) -Fluvoxamine(Luvox) |
| What are the anticholinergic side effects that are associated with certain drugs. | Side effects for SNDIs include: weight gain, sedation, dizziness, and headache. Side effects for tricyclics include: blurred vision, dry mouth, hypotension, urinary retention, dilated pupils, constipation, tachycardia, esophageal reflux, and menstrual irr |
| What are the anticholinergic side effects that are associated with certain drugs. | Side effects for MAOIs include: Insomnia, nausea, agitation, and confusion. |
| What are the anticholinergic side effects that are associated with certain drugs. | SSRIs have fewer side effects than the other groups, but could include: GI disturbance, sedation, sexual side effects, and insomnia |
| How do we know when an SSRI is working? | We know an SSRI is working when the patient becomes more active, and generally feels better. Serotonin is the “feel good” neurotransmitter, so behavioral changes should be evident quickly. |
| Defense mechanisms | are automatic coping styles that protect people from anxiety and maintain self-image by blocking feelings, conflicts, and memories |
| Repression | Placing thoughts in inaccessible area of brain. To deal with later or in hopes that they will disappear |
| Sublimation | Transforming unwanted/unacceptable feelings/ behavior into something wanted/ acceptable Ex: Running when angry |
| Regression- | Reverting to earlier developmental stage |
| Displacement- | Taking behavior/ feelings out on someone else |
| Conversion | Converting behavior/ feeling into physical reaction (neurological) |
| Rationalization- | Finding good reason for things |
| Introjection- | Taking on someone’s traits |
| Projection- | Projecting behavior/ feelings on someone else. |
| Compensation- | Behavior that compensates real or imagined deficiencies |
| Reaction Formation | having negative behavior feelings but pretending that one does not when around stimulus causing feelings |
| Denial- | not recognizing behavior/ feelings |
| Undoing- | person tries to undo behavior/ feelings by doing the opposite behavior. |
| Identification- | Forming an imaginary or real alliance with a group of people to raise self-esteem |
| Suppression- | Bottling behavior/ feelings up |
| Types of crises | Situational: a specific situation. Ex. Death in family. Maturational: A crisis that happens during a transition from developmental stages (mile stone). Ex. Becoming a teenager. Pathological: After major event Ex. Natural disaster |
| Panic disorder | Recurrent episodes of panic attacks At least one or the attacks has been followed by 1 month or more of persistent concern about having additional attacks, or worry about consequences or significant change in behavior |
| Phobias | Irrational fear of an object or situation that persists although the person may recognize it as unreasonable – agoraphobia, social phobia, specific phobia, •&νβσπ;Anxiety is sever if the object, situation, or activity cannot be avoided |
| ocd | either obsessions or compulsions person knows the O/C are excessive and unreasonable the O/C can cause increased distress and is time consuming |
| gad | Excessive anxiety or worry more days than not over 6 months – inability to control worrying. |
| Your patient suffers from obsessive compulsive disorder; what are some appropriate therapies to use with that person. | OCD is related to anxiety. Anxiety should be treated. OCD can be addressed through drug therapy and cognitive behavioral therapy |
| What is the etiology behind anxiety disorders | Biologic factors -Genetics -Neurobiological |
| Psychological Theories | Psychodynamic theories -Interpersonal theories -Behavioral theories -Cognitive theories |
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