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nurs1220

test 1 mental health part 2

QuestionAnswer
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
Created by: 557102868