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Baker MH Final

Final for Baker AH Mental Health

QuestionAnswer
Mild Anxiety Symptoms perceive in sharp focus; symptoms are discomfort; restlessness; irritability; mild tension relieving behaviors;
Mild Anxiety Nursing Things to Remember ask calming, open-ended questions; explore; seek clarification; and listen
Moderate Anxiety selective attention; thinking impaired
Moderate Anxiety Symptoms tension; pounding heart; increased pulse and resp; perspiration; mild somatic symptoms; voice tremors; shaking
Severe Anxiety perception greatly reduced; can't learn or problem solve; person seems dazed/confused; behavior automatic
Severe Anxiety Symptoms increased somatic complaints; trembling; pounding heart; hyperventilation/ sense of doom
Severe Anxiety Nursing Things to Remember provide safety; meet physical needs; measures to reduce anxiety like moving person to a quiet room
contagious anxiety during a crisis anxiety spreads, also can occur from mom to baby
Conversion disorder unconscious transformation of anxiety into a physical symptom with no organic cause
denial escaping unpleasant thoughts, feelings or wishes by ignoring them
Splitting inability to integrate positive or negative qualities into one image of yourself; aspects alternate. You're either all good or all bad
Compensation used to make up for perceived deficiencies and cover up short comings (unconscious)
Rationalization justifying unreasonable ideas by developing acceptable explanations
Projection unconscious rejection of emotionally unacceptable features and attributing them to others
BuSpar doesn't cause dependence
Benzodiazepines quick onset of action; need to be used for short periods of time; monitor for sedation, ataxia, and decreased cognitive function
Irrational Beliefs with Anxiety keep pts safe from themselves; be firm; use short,simple sentences; stay with them; go to quieter setting; low-pitched voice; speak slowly; reinforce reality; listen for themes in speech; offer exercise; offer high-cal foods/fluids
PTSD persistent reexperiencing of a highly traumatic event that involved actual or near death or injury to self or others to which the person responded with intense fear, helplessness, or horror; often begins 3 months after event
Acute Stress Disorder occurs within one month after exposure to a traumatic event; must display at leasst 3 dissociative symptoms during/after event inclu.: numbing, detachment, absence of emotion, decrease of awareness, derealization, depersonalization, dissociative amnesia
Panic Disorder panic attacks are key part of this
Agoraphobia intense, excessive anxiety or fear about being in a place or situation from which escape might be difficult or embarrassing or in which help might not be available if panic attack occurred
OCD Treatment and Techniques Celexa, Lexapro, Prozac, Lucox, Paxil, Zoloft, Anafranil; promote elimination
Social Anxiety Disorder and Treatment a.k.a. social phobia; severe anxiety or fear provoked by exposure to a social or a performance situation
Treatment for Anxiety BuSpar is non-habit forming; Benzos are habit-forming
Generalized Anxiety Disorder characterized by excessive anxiety or worried about numerous things, lasting for 6 months or longer; think WAT; may experience: restlessness,fatigue, poor concentration, irritability, tension, sleep disturbance
Depression Symptoms blunted affect; disturbed thought process; feel worthless, guilt, helplessness, hopelessness, anger; psychomotor agitation/retardation; neglected grooming, dress, hygiene; change in bowel habits; decreased libido
Monitoring for Depression Beck Depression Inventory; Hamilton Depression Scale; Zung Depression Scale; and the Geriatric Depression Scale
Antidepressants blackbox warning for suicide strongest within to weeks; kept on long term after 3 incidences of depression
SSRIs side effects (Celexa, Lexapro, Prozac, Luvox, Paxil, Zoloft) antidepressant; agitation, anxiety, sleep disturbance, tremor, sexual dysfunction, or tension headache, weight change, diaphoresis, hyponatremia
SNRIs side effects (Effexor, Cymbalta) antidepressants; HTN, nausea, insomnia, dry mouth, sweating, agitation, sexual dysfunction
NRIs side effects (Vestra) antidepressant; insomnia, sweating, dizziness, dry mouth, constipation, urinary hesitancy, tachycardia, decreased libido
Seratonin receptor agonists side effects(Nefexadone) antidepressent; sedation, hepatotoxicity, dizziness, hypotension, paresthesias
NDRI side effects (Wellbutrin) antidepressant; agitation, insomnia, headache, N/V, seizures. Can be used to help quit smoking
SNDIs side effects (Remeron) antidepressant; weight gain, sedation, dizziness, headache, sexual dysfunction rare
Tricyclic side effects (elavil,anaranil, nopramin, adapin, sinequan, tofranil, aventyl, pamelor, vivactil) antidepressants; dry mouth, constipation, urinary retention, blurred vision, orthostatic hypotension, cardiac tox, sedation
MAOIs side effects (Nardil, EMSAM, Parnate) antidpressant; insomnia, nausea, agitation, confusion, potential for HTN crisis or serotonin syndrome when used with other antidepressants
Electroconvulsive Therapy Side effects patient may be confused or disoriented, memory usually, but doesn't always recover
Delusions Vs Illusions illusion is an error in perception of sensory stimulus (polka dots perceived as spiders) Delusions-a false belief held to be true even with evidence to the contrary
Bipolar Signs/Symptoms euphoric mood, get rich quick schemes, gives away things, spends lavishly, nonstop movement, continuous flow of speech (flight of ideas), clang associations, grandiosity
Bipolar Nursing Recommendations intervene with hyperactivity, use firm/calm approach, use short concise phrases, be neutral and consistent, redirect energy, low level of stimuli, structured solitary activities, frequent high cal finger snacks, observe for lithium tox, remind patients
Bipolar I vs Bipolar II I- one episode of mania alternates with depression. psychosis may accompany manic II- hypomanic episodes alternate with alternate depression, psychosis not present, hypomania is euphoric/increases function, depression puts people at risk for suicide
Cyclothymia hypomanic episodes alternate with minor depressive episodes (at least 2 years in duration), tend to have irritable hypomanic episodes
Meds for Rapid Cycling lithium, valproate (depakote), carbamazepine
Lithium Therapeutic levels 0.8-1.4, Toxic levels >1.5, SE: fine hand tremor, polyuria, mild thirst, mild nausea, general discomfort, weight gain; toxicity looks drunk; C/I in pts with CV disease, brain damage, renal disease, thyroid disease, or myasthenia gravis
Valproate (depakote) monitor liver function and platelet count periodically
Schizophrenia (Prodromal Symptoms) occur month to year before dx; represent clear decline in functioning. pt was socially awkward, lonely, depressed, expressed himself in vague/odd/unrealistic ways. complaints about anxiety, phobias, obsessions, dissociative features, and compulsions
Clanging choice of words based on sounds rather than meaning, often have rhyming sounds or begin with same sounds
neologisms made-up words
Associative looseness no general connection in words or phrases, thoughts are illogical and difficult to follow
ideas of reference giving personal significance to trivial events, perceiving events as relating to you even though they don't
paranoia state characterized by the presence of intense and strongly defended irrational suspicions, cannot be corrected by experience or modified by facts or reality
Hallucinations perceiving a sensory experience for which no external stimulus exists; auditory (hearing), Visual (seeing), olfactory (smelling), gustatory (taste), tactile (feeling).
Command Hallucinations prompt person to take action
Waxy flexibility you move the person's arm and they leave it there, believing it is stuck
echopraxia mimicking of another's movements
conventional antipsychotics (thorazine, mellaril, loxitane, moban, trilafon, trifluoperazine, navane, prolixin, haldol, orap) affect primarily the positive symptoms of schizophrenia
Atypical Antipsychotics (Abilify, clozaril, zyprexa, invega, seroquel, risperdal, geodon) affect primarily the negative symptoms of schizophrenia
Dystonia abnormal muscle tonicity resulting in impaired voluntary movement. occurs in antipsychotics as muscle spasms of face, head, neck, and back
tardive dyskinesia a serious and irreversible side effect of the phenothiazines and related drugs, consists of involuntary muscle spasms typically involving the tongue, fingers, toes, neck, trunk, or pelvis
akathisia regular rhythmic movements, usually of the lower limbs, constant pacing may also be seen, often noticed in ppl taking antipsychotics
neuroleptic malignant syndrome (NMS) rare and sometimes fatal reactino to high-potency neuroleptic drugs. symptoms include muscle rigidity, fever, elevated WBC count
agranulocytosis occurs with conventional antipsychotics, symptoms include sore thraot, fever, malaise, and mouth sores
Created by: rwrigh17