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ati mental health

ati nursing

Levels of consciousness Alert - responsive and able to fully respond Lethargy- respond but are drowsy and fall asleep quickly Obtundation- pts need to be lightly shaken confused coma- no response from painful stimuli
Basic assessment Pts LOC, appearance, behavior, cognitive and intellectual ability, mmse, pts description of their illness.
Physical examination Appearance- grooming attire Behavior- body movements, mood, and affect
Cognitive and intellectual Recent and remote memory, calculate, abstract thinking, judgement, speech
Interview strategies Private quiet space, introduce yourself, pts name preference, sit close and at eye level, questions about sleeping, incontinence, family, medical hx, summarize when interview is over and get pt feedback
Dsm axis codes Axis 1- abnormal behavior and mh dx not coveted in axis 2 Axis 2- personality disorder and MR Axis3- general medical ex: asthma axis4- gaf
While performing a MMSE the nurse notices that the pts facial expression constantly conveys anger she should document this as the pts Affect
During the MMSE a hospitalized pt states she is undergoing tx to "learn to be a doctor" the nurse should record this as Poor perception of illness
Examples of subjective data collection Pt states that he has no reason to live Pt states that he drinks 3 beers a day
A nurse is caring for a client dx with schizophrenia, DM, and anti social personality which is the axis2? Antisocial personality disorder
An ex of a pt who requires emergency admission is PTSD who assaulted his son with a bat
Pacing Pt not giving information because the nurse seems busy
Connotative meaning Charting pt complains of instead of client reports
Vocabulary Using words the pt understands instead of medical jargon
Timing Pt education when the patient is comfortable and ready to learn
Factors that foster a therapeutic relationship Consistency, pace with the pt, attentive listening, positive initial impression, comfort, and availability
Ocd Ritualistic behavior that interferes with adls
Gad At least 3 of the following clinical manifestations: fatigue, restlessness, problems with concentration, irritability, muscle tension, sleep disturbances
Specific therapies for anxiety Relaxation - controls pain tension and anxiety Modeling- allows the pt to see appropriate behavior in a stressful situation Systematic desensitization - begins with the mastery of relaxation techniques then exposes them to increasing levels anx pro stim
Specific therapies for anxiety continued Flooding- exposes pt to great deal of stimulus Thought- teaches pts to say stop to negative thoughts and replace with positive ones
Medications for anxiety Antidepressants like Zoloft elavil Hypnotic anxiolytics valium ssri effexor Nonbarbituate anxiolytics BuSpar
Depressive disorder 5 of the following at least 2 weeks Depressed mood, difficulty sleeping or excessive sleeping, indecisiveness, decreased concentration, suicidal ideation, increase or decrease in motor activities, inability to feel pleasure,increase or decrease in weight of more than 5% in 1 month
Ssri Celexa, Prozac, Zoloft May cause sexual disfunction or cns stimulation which can lead to insomnia
Tca Elavil Orthostatic hypotension
Maoi Nardil Hypertensive crisis
Benzo diazepines Valium ativan Cns depression avoid driving etc
Ssnri Effexor Nausea, weight gain sexual dysfunction
Nonbarbituate BuSpar 2 to 4 weeks to become effective
Mood stabilizer Lithium depakote Klonopin neurotin
Types of schizophrenia Paranoid- hallucinations and delusions Disorganized- loose association, bizarre, Catatonic- psychomotor retardation Residual- active clinical manifestations gone but 2 or more residual finding Undifferentiated
Atypical anti psychotic Risperdone ziprexa seroquel geodon abilify Sedation weight gain
Conventional anti psychotic Haldol thorazine prolixin Anticholinergic effects, Orthostatic hypotension, eps
Antidepressants for schizophrenia Paxil Suicidal ideation withdrawal effects with abrupt withdrawal
Personality disorders Cluster A odd or eccentric Cluster B dramatic emotional or erratic cluster C anxious or fearful
4 common characteristics of personality disorders Inflexible maladaptive response to stress Disability in social and professional relationship Tendency to provoke interpersonal conflict Ability to merge personal boundaries with others
Cluster A Paranoid - distrust of others Schizoid- disinterested emotional detachment with others do not have psychotic symptoms Schizotypal odd beliefs eccentric appearance
Cluster B Antisocial disregard for others, deceit, failure to accept personal responsibility Borderline fear of abandonment, splitting, manipulation histrionic seductive flirtatious, emotional attention seeking Narcissistic arrogance sensitive to criticism
Cluster C Avoidant avoidance of all situations from fear of rejection Dependant urgent search for relationship when the other one ends
Obsessive compulsive Focus on orderliness and control no ritualistic behavior
Data collection for pts with eating disorders Dietary habits and hx, ht, wt, skin condition, vs, feeling about body image, and family dynamics
Cognitive distortions for those who have an eating disorder Over generalization no one will like her if she's fat All or nothing any carb will make her fat and lead to unbearable weight gain
F Expected findings for pt with bulemia ECG changes peripheral edema and tooth decay
Antidote for benzo od or toxicity Romazicon
A nurse knows that pt teaching for a client with new prescription for BuSpar is understood when The pt states I will not take this medication with grapefruit juice
Created by: 100000839384613