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Mental Health
Ch 5, 12, 4
| Term | Definition |
|---|---|
| Legislation can determine what is ______ or _______ in a society | right, wrong |
| Nurses need to understand their __________ | scope of practice |
| branch of philosophy that deals with distinguishing right from wrong | ethics |
| ethics in medical field | bioethics |
| critical thinking to determine how individuals ought to treat others | moral behaviors |
| personal beliefs about what is important | values |
| self-exploration by which people identify and rank their own personal values | values clarification |
| legally recognized claim or entitlement, encompassing freedom from gov or discriminatory treatment and entitelement to a service | right |
| no restriction on an individuals's entitelment | absolute right |
| a right in which the society has agreed and formulated the law | legal right |
| ethical theory- promotes action based on end result that promotes most GOOD for all | utilitarianism |
| ethical theory - decisions are based on duty, not outcome | kantianism |
| do unto others as you would have them do to you | christian ethics |
| do good and avoid evil- difference between these are what directs decision making | natural law theories |
| decisions based on what is best for individual | ethical egoism |
| situations that require individuals to make a choice between TWO EQUALLY UNFAVORABLE ALTERNATIVES | ethical dillema |
| not taking any action is still considered | an action |
| patient's rights and decisions | autonomy |
| one's duty to benefit or promote good of others | beneficence |
| avoiding harm | nonmalificience |
| social contract that is a duty to treat others equally and fairly | justice |
| always tell the truth | veracity |
| steps for making ethical decision- | assessment, problem identification, planning, implement, evaluation |
| Ethical issue- right to refuse medicine as long as its ___ | non-emergent |
| patients who are combative or need to be restrained have right to | least restrictive treatment- start by calming down first |
| defines legal parameteres of professional and practical nursing | Nurse Practice Act |
| Nurse practice act varies by | state |
| statuatory law | based on legislative body |
| common law | based on court orders |
| protects private and property rights of individuals and businesses | civil law |
| torts | violation civil law |
| providers protection from conduct deemed injurious to public | criminal law |
| HIPAA protects | confidentiality and right to privacy |
| exception to HIPAA | mandatory reporting abuse, specific threats |
| failure to obtain ________ is a legal issue | informed consent |
| false imprisonment referes to | violated the self determination act of restraints |
| Involuntary commitments occur because | pt is unstable and is at threat of hurting themselves or others |
| MOT- mandatory outpatient treatment can be used | for patient that is required to attend doctor but not neccesarily needed to be in an in-patient facility |
| Malpractice | form of negligence and doing something wrong even if you didn't mean to do so |
| Defamation of character types | libel - written, slander- verbal |
| assault is a | threat |
| battery is | contact |
| what is PFA | psychological first aid- used to help those in immediate aftermath of disaster or terrorism --> reduces distresses |
| grieving is a _____ response | natural |
| Four phases of crisis intervention | assessment, planning, implementation, evaluation |
| crisis intervention is based on | problem-solving techniques |
| Goal of crisis intervention is to restore _____ | individual to previous functioning at minimum (or higher level) |
| situational crisis | loss/change experienced everyday- job loss |
| maturational crisis- | developmental stage change- marriage, baby |
| adventitious crisis | unexpected- crime, natural disaster |
| 3 factors that affect individuals experencing a crisis | 1- perception, 2- support system, 3- coping mechanisms |
| what are psychotropic medications used for | turn the mind - along with therapy |
| why are we turning away from specific classes of meds | meds can be used for multiple diagnosis! |
| _______ and ________ were the only options before 1950 of psychotropics | sedatives and amphetamines |
| Neurotransmitter- (NT) | chemical stored in axon terminal or presynaptic neuron- activated during electrical impulse and if the NT is released into synapse |
| Receptor is ____ to NT | specific (lock and key) |
| Receptors are _________ | binding sites for neurotransmitters |
| how to get NT out of space in synapse? | reuptake pumps, enzymes |
| where do reuptake pumps move neurotransmitters | back into the pre-synaptic neuron |
| example of enzyme that breaks down NT in synapse | Monamine Oxidase- breaks down all monoamines |
| psychotropic meds work by 2 ways- | blocking receptors or activating receptors |
| reason for taking med | therapeutic effect |
| effects that go along with taking med, not desired | side effect |
| some meds have same NT that they block/activate, but also causes effect- ex: | blocking serotonin cuases less depression, but can cause gut issues |
| most meds bind to _____ receptors, even though only one type is meant to be binded for therapeutic effect | MULTIPLE |
| Ex of same Nt that a med binds with and side effects from it- | Lexapro --> all therapeutic and side effects come from binding to SERT |
| most case of NT binding and side effects is : | NT binds to one/a few receptors for therapuetic effect, but the rest of the ones binded cause the SIDE EFFECTS - can be a lot |
| big 3 for side effects | anti-HAM |
| H of anti-Ham | antihistamine- sedation and weight gain side effects |
| A of anti-ham | anti-adrenergic- hypotension and dizziness side effects |
| M of anti-ham | anti-muscarinic- causes anti-cholinergic effects like dryness |
| how are the majority of medications metabolized | in the liver by ENZYMES |
| example of a medication not changed or metabolized by body | lithrium |
| genetic variations can affect how a med is | metabolized |
| more enzymes= _____ levels of drug in system | less |
| less enzymes= _________ levels of drug in system | more- toxic |
| types of meds used for anti-anxiety | Benzodiazepines, Buspirone, SSRIs(even though depression too) |
| Benzodiazepines characteristics | very addictive, do not mix with other CNS depressants, have to taper off, increase GABA levels |
| Buspirone characteristics | non-benzo med. does not depress the CNS |
| buspirone must be taken _____ to be effective | daily |
| 1st line treatment for long term anxiety | SSRIs |
| paradoxical excitemetn with benzos | side effect that can cuase person to be wired up out of no where |
| how do anti-depressants work | increase serotonin, dopamine, and or norephinephrine |
| MAOI | monoamine oxidase inhibitor- blocks MAO from breaking down monoamines |
| what should patient avoid on MAOIS | tyramine- will increase blood pressure (body cannot break it down) |
| MAOIS have _______- | deadly food and drug interactions- rarely prescribed |
| less drug itneractions than MAOIs for depression, but not as effective | tricyclic antidepressants |
| TCA increase ________ | norepinephrine |
| TCA are anti-_______ | HAM side effects |
| what are we worried about with TCA | overdose, heart arrythmias, one week at time prescription |
| 1st line treatmetn for depression | SSRIs and SNRIS |
| can add ________ on top of other antidepressants | atypical antidepressants |
| nurses should be alert in sudden changes of _____ when dealing with patients taking anti-depressants | mood- more energy- more risk of kms |
| anti-depressants have black box warning for | increased suicide risk |
| antidepressants can take up to _____ to work | a month |
| serotonin syndrome signs | increased vital signs, hallucinations, muscle hyperflexia |
| why do you take mood stabilizing agents | stabilize depression or mania- any swing |
| lithium | be aware of danger- used to treat bipolar mania |
| 1st sign of lithium toxicity | nausea and VOMITING |
| lithium competes with ___, so worry about ______ and ______ levels | salt, sodium and water |
| more lithium- less ____ | water and sodium |
| lithium has a narrow _______ | therapeutic range |
| Anti-convulsants can treat (valproate, carbamazepine, verapamil) | mood stabilization |
| anti-convulsants have increased risk for | suicidal thoughts |
| SJS is side effect of | anti-convulsants like carbamazepine |
| worried about blood dyscrasias with ______ | anti-convulsants |
| valproic acid has high risk of | birth defects |
| Anti-psychotics | relieve symptoms of psychosis- schizophrenia, bipolar, autism, irritability, Tourettes, adjunct with anti-depressants |
| MOA of anti-psychotics | blocking dopamine receptors |
| what meds are associated with high level of EPS to treat psychosis | First Gen Anti-psychotucs |
| atypical anti-pyschotics were developed because of | high rate EPS with first-gen anti-psychotics |
| atypical anti-psychotics have less EPS but high ___ | metabolic symptoms- weight gain, more blood sugar |
| mneumonic for EPS | ADAPT |
| AD in EPS mneumonic | acute dystonia- muscle spasms of face, neck, throat |
| treat Acute dystonia with | IV or IM |
| A in EPS mneumonic | akthisia or akinesia |
| P in EPS mneumonic | Pseudoparkinsonism- tremor, shuffling gait, drooling, rigifity |
| T in EPs mneumonic | tardive dyskineasia - face and tongue movements (permanent)) |
| black box warning on anti-psychotics for what pt population | elderly dementia patients- increased death risk |
| antipsychotics can cuase | long QT syndrome |
| CLOZAPINE (anti-psychotic) | can cause seizures, agranulocyotis so watch for infection |
| newer anti-psychotics worry about | metabolic syndrome |
| used to counteract EPS | antiparkinsonism or anticholinergic |
| sedative- hypnotics cause | CNS depression (except for newer) |
| what does hyponotics treat | insomnia, anxiety states, |
| "z drugs" --> complex behaviors like sleep driving | sedative safety issues |
| go to type of med for ADHD | stimulants |
| 2 main classes of stimulants | amphetamines and methylphenidate |
| CNS stimulants increase levels of | dopamine, norepinephrine, and serotonin |
| non-stimulants- | clonidine, NRI, and NDRI |
| when would you take non-stimulants | when you can't handle stimulants |
| side effects of stimulants | decreased appetite, intereferes with sleep, substance use disorder risk |
| you should never give CNS stimulants to patients with _______ | cardiovascular disease- because of raising BP and pulse |
Created by:
katesurratt