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Mental Health Exam 1
NUR2459/Rasmussen
| Question | Answer |
|---|---|
| Anhedonia | Lack of pleasure |
| Ataxia | Mimics being drunk. Ex. Slurred speech, stumbling, falling, and incoordination |
| Dysthymia | Mild Depression of atleast 2 years |
| Thymia | Chronic for 2 or more years |
| Anergia | Lack of energy |
| Alogia | Without speech |
| Agnosia | Loss of the ability to recognize objects, faces, voices, or places |
| Avolition | Lack of motivation |
| List the defense mechanisms | Denial, repression, projection, regression, displacement, and rationalization Freud's list includes: Acting out, avoidance, dissociation, identification, intellectualization, isolation, reaction formation, sublimation |
| Denial | The refusal of accepting/Not acknowledging the problem |
| Repression Suppression | * Involuntary suppressing memory until it disappears into the subconscious *Voluntary blocking out unpleasant feelings and experiences from awareness |
| Projection | Forcing your beliefs or behavior on someone else. |
| Regression | the form of acting out of one's age. Ex. toddlers act like an infant |
| Displacement | Blaming or shifting emotions on other people or things for their faults. /Showing emotion toward someone or something completely unrelated to that which caused the emotion. |
| Rationalization | Making up explanations for something that has happened. /Making excuses to rationalize what they did and why. |
| Acting out | Behavioral outcome of conflict between an unconscious need to express anger and a conscious need to deny it. Ex. Issues in early life, that unconsciously act on by resenting a group or subject. abusive mother, resent woman in authority roles. |
| Avoidance | unconsciously staying away from triggers that may cause unwanted feelings. |
| Anxiety Disorders | Panic disorder (PD), PD w/ agoraphobia, phobia, Social anx, disorder (SAD), Social phobia, General anx. disorder (GAD), anxiety due to medical condition, OCD, PTSD, and acute distress disorder. |
| Symptoms of GAD | Diff. concentration, Draw blank, fatigue, trouble sleeping, sweating, irritability, nausea, diarrhea, IBS, muscle tension, Nervousness, anxiety out of proportion, overthinking, inability to relax, indecisive, feel threatened, & dif. handling uncertaity |
| General Anxiety Disorder (GAD) Definition & examples | hypochondriac, |
| Agoraphobia | Extreme or irrational fear of open or crowded spaces. After 1 or more panic attacks |
| Social anxiety disorder (SAD) | sad, lonely, afraid to make friends |
| Fear vs. Anxiety | fear: a reaction to a specific danger Anxiety: unknown/unrecognized real or perceived fear, threat, and uneasiness. |
| Co-Morbidity of anxiety disorders | Highly: substance abuse, major depression disorder Frequently: eating disorder, bipolar, dysthymia Reg: medical conditions. ex. cancer, renal, liver dysfunction, immunocompromised Chronic: cardiovascular morbidity and mortality. |
| What is the normal cycle of the stress system? | 1. body prepares for threatening situation 2. Brain signals hypothalamus 3. SNS signals adrenal glands 4. Epinephrine (adrenal) is released 5. pituitary gland releases ACTH |
| What does heightened alertness cause? | Circulating adrenaline, which causes elevated bp, resp, and blood flow |
| Prolonged stress causes? | colds and flu, asthma, stomach ulcers, eczema, other skin conditions, heart disease, cancer, depression, and PTSD |
| Levels of anxiety | 1. Mild: coping mechanism, learn enhanced, aware and alert 2. Moderate: ego defense, decreased learning & concentration 3. Severe: psychoneurotic resp., inable concentrate, learn or problem solve 4. Panic: psychotic resp., impending doom and terror |
| Phobias | a fear. common, but does not normally cause much difficulty. |
| Anxiety caused by medical conditions | Respiratory, cardiovascular, endocrine, neurologic, metabolic. Ex. asthma, COPD, hypochondriac, heart attack, High BP, Hyperthyroid, addison's disease, TBI, fever, cancer |
| Immature defense mechanisms | Passive aggression, rationalization, acting out, dissociation, idealization, splitting, projections, and denial. |
| Healthy defense mechanisms | Altruism, sublimation, suppression, and humor |
| Intermediate defense mechanisms | Displacement, reaction formation, somatization, undoing |
| Pharm int. Intrusive experiences (flashbacks, avoidance, and numbing) | SSRI antidepressants, 2nd gen. antipsychotic |
| Pharm int. PTSD | 2nd gen. Antipsychotics, anticonvulsants |
| Pharm int. Panic attack | Antidepressants, Monoamine Oxidase Inhibitors (MAOI's), High potency benzos |
| Pharm int. hyperarousal | Antidepressants, benzos, and anticonvulsants |
| Pharm int. Nightmares | prazosin (Minipress) |
| Examples of moods: | joy, sadness, anger, anxiety, elated, depression. (hyperactive and stuporous are behaviors, not moods) |
| Flat affect: | Emotionless and severely depressed |
| Expressions of depression | Sadness, despair, and pessimism |
| Depression effects? | Young women and men under 44, women older 65, single, and divorced. seasoned: Affect disorders present in fall and spring |
| Types of depression | Major depressive disorder: 2 weeks, w/ no other factors Dysthymic disorder: mild, chronic, at least 2 years Premenstrual dysphoric disorder: before cycle, subside after onset Senescence: Depression common for elderly Postpartum depression: Hormonal |
| Depression-First line meds | SSRI's: Fluoxetine (prozac), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa) |
| Anxiety-short term (C4, CNS suppressants, Benzos) | Diazepam (valium), Alprazolam (Xanax), Lorazepam (Ativan) |
| Anxiety-long term (maintenance and not substance abuse and respiratory pt) | Buspirone (busbar) |
| High risk suicides | Late teens-early adults likely to attempt, Elderly male successful. African americans least likely to attempt. |
| 3 top nursing interventions for suicide | Keep pt 1:1, remove harmful objects, obtain suicide contract. |
| What is MMSE used for and how does it work? | Measure cognitive impairment (Thinking, communication, memory, understanding). Graded numerically on range or everyday mental skill. and lower means more severe. |
| Neurotransmitter for Anxiety | GABA/Calming |
| Neurotransmitter for Depression | Serotonin/Mood |
| Neurotransmitter for Parkinson's | Dopamine/Pleasure |
| Neurotransmitter for Alzheimer's | Acetylcholine/Learning |
| Neurotransmitter for Schizophrenia | Dopamine/Pleasure |
| Mood | A persuasive and sustained emotions that have a profound experience on a person's perception of the world. |
| Depression | Loss of interest and somatic symptoms present |
| Electroconvulsive therapy ECT | Invasive, but Safe effective therapy for depression, bipolar disorder, mania, and schizophrenia. pt is sedated and given muscle relaxer. Used after unsuccessful treatment therapies. CBT, medications, pregnancy. 6-12 treatments. 20 to get to baseline. |
| ECT side effects and adverse reaction | temp. memory loss, and confusion. Fall risk after treatment. |
| Transcranial magnetic stimulator TMS. (Nclex/ATI) | Non invasive. use magnet to activate area of brain that regulates mood. Coil on forehead & Electromagnetic forces. 30-60 mins. Implanted or put on helmet --Parkinson's, seizure therapy |
| Milieu Therapy | therapeutic community. controlled environment. Ex. rehab center |
| Aversion therapy | consequences for behavior. Ex. alcoholics are given meds, to make them sick if they drink. |
| Light therapy | for seasonal effect disorders. |
| Individual psychotherapy | Talk therapy -Individual -group: Sharing, gain personal insight, improve interpersonal coping strategies. -family: group therapy with your family. -cognitive: create change in client belief and thinking for lasting emotion and behavioral changes. |
| Psychosocial theories | Freud, Erickson's, and maslow's |
| Freud- psychoanalytic theory | A loss is internalized and directed towards the ego. Id, ego, and superego |
| Id | Primitive and instinctual part of the mind that contains sexual aggression drives and hidden memories. Front of brain. |
| Ego | Modulator between the Id, and superego. Balance out. |
| Superego | Moral compass. Black or white. There is no gray area in right or wrong. |
| Erikson's stages of psychosocial development | Typical for people to revert back in times of distress. |
| Erikson stage 1: Babies | trust and mistrust Needs are dependably met. |
| Erikson stage 2: Toddlers | Autonomy vs. shame/doubt Independent abilities or doubt themselves ex. walk, tie shoes, dress themselves. |
| Erikson stage 3: Preschool | Initiative vs. guilt initiate task or feel guilty ex. potty train |
| Erikson. stage 4: Children | Industry vs. Inferiority learn to apply themselves or feel inferior ex. accomplish or feel inferior for not |
| Erikson stage 5: Teens | Identity vs. Confusion create single identity, test roles as teen, |
| Erikson stage 6: Young adults | Intimacy vs. Isolation close relationships, love, isolated |
| Erikson stage 7: Middle age | Generativity vs. Stagnation contributing to work, family, world/lack of purpose |
| Erikson stage 8: Older age | Integrity vs. Despair Reflect on life. Satisfaction or failure |
| Maslow's | Physiological, safety, love and belonging, esteem, self-actualization Ex. Think ABC's, safe and have money to live, loved, self-esteem, and legacy. |
| Learning theory | Learned helplessness/give up |
| Object loss theory | Separated for first 6 months. |
| Cognitive theory | cognitive distortion. negative attitude and thinking. Basis of depression |
| Scope of practice | We can administer meds. We can't conduct therapy. we can assess. |
| Defense mechanisms | Coping mechanisms used to decrease anxiety |
| Cognitive Behavioral Therapy CBT | Talk Therapy Aims to replace negative distortion thinking with positivity. Automatic thought: test anxiety Cognitive distortion: fortune tailing. I'm going to fail. Used for: Depression, anxiety, substance disorder, eating disorder, |
| Dialectical Behavior Therapy. DBT | Type of CBT used for self regulating behavior and decrease self destructing behaviors with personality disorder. * Personality disorder. |
| Eye Movement Desensitization and Reprocessing EMDR | process traumatic memory that cause distress. PTSD and trauma disorder 6-12 sessions |
| How ECT is preformed and Action mechanism. | Use electrical current to brain to create seizure. Increase neurotransmitters: Dopamine, serotonin, and norepinephrine. Electrodes attached to pt temple. Meds: anticholinergics (atropine:Decrease secretions), Anesthesia, muscle relaxer. |
| Nurse care for ECT | Stop anticonvulsant meds, NPO pt for 6-8 hrs, Informed consent. Monitor vitals, ECG/EKG, Hyperventilate before and after. Teaching: 6-12 rx 3x week |
| Vagus Nerve Stimulation. VNS | Surgically implanting device in chest. stimulates vagus nerve and alters levels of neurotransmitters in the brain. DX: Treatment resistant depression & Epilepsy used with antidepressants and can deactivate with magnet over device |
| VNS side effects | hoarsness, cough, tingling over implantaion device. |
| Intentional Torts | -Nurse physically harms or threatens Assault (threat) and Battery (touch) -false imprisonment -Invade privacy or violate HIPPA -Defamation of character |
| Unintentional Torts | -Neglect, malpractice |
| How to avoid restraints | Calm pt with simple non threatening language, setting clear boundaries, reduce environmental stimuli, Diversion, and PRN medications. |
| 6 indications that reflect mental health | 1 positive attitude toward self 2 Growth, development, and the ability to achieve self-actualization 3 Integration 4 Autonomy 5 Perception of reality 6 Environmental mastery |
| Mental health | successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms |
| Mental illness | Health condition with change in emotions, thinking, or behavior |
| Levels of anxiety. | mild, moderate,severe, panic |
| Compensation | Covering up a real or perceived weakness by emphasizing a trait one considers more desirable |
| Reaction Formation | Adopting feeling or emotion that is opposite of the emotion |
| Identification | Unconsciously modeling another person’s values, attitude, and behavior |
| Intellectualization | Attempting to avoid expressing actual emotions about stressful situations by processing logic, reasoning, and analysis. Hide anxiety by verbalizing logic and reasoning. |
| Sublimation | Substituting constructive & socially acceptable behavior for strong impulses not acceptable in their original form. |
| Introjection | Integrating the beliefs and values of another individual into one’s own ego structure |
| Isolation | Separating a thought or memory from the feeling, tone, or emotions associated with it |
| Undoing | Canceling out experiences that one finds intolerable. Ex. Trying to make things better by doing the opposite. |
| Projection | Forcing your beliefs or behavior on someone else. |
| Avoidance | Unconsciously staying away from any person, situation, or place that might bring up unwanted feelings. |
| Mild Anxiety | Heightened perception. Increased awareness. Learning enhanced. Motivation increased. S/S: restless and irritable |
| Moderate Anxiety | Reduction in perception. Reduced alertness. Learning, but not optimal. S/S: Increased restless, tachycardia, tachypnea, sweating, |
| Severe Anxiety | Greatly diminished. Only extraneous details are perceived. Fixation. cant concentrate, problem solve, or effectively learn. S/S: headache, dizzy, nausea, trembling, insomnia, tachycardic, hypertensive, urinary freq, diarrhea. Dread, loathing, horror |
| Panic Anxiety | Unable to focus on one detail. Misperceptions of the environment. Cant learn, concentrate, or comprehend. S/S: dilated pupils, tachypnea, severe trembling, palpitations, sweating, pallor, imobility, hyperactive, incoherent. Doom, terror, bizzare. |
| Mild | coping mechanisms |
| Moderate anxiety | ego defense mechanisms |
| Between moderate and severe | Psycho-physiological responses |
| Severe | psycho-neurotic responses |
| Panic | Psychotic responses |
Created by:
ccharles653
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