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Psych Exam 2
| Question | Answer |
|---|---|
| WRAP model | initially for serious mental illnesses developing many checklists when youre doing good, what triggers you to crisis, when you start in crisis, then crisis plan |
| Tidal Model | a person-centered, focusing on the metaphor of life as a journey on an ocean, with individuals often feeling "shipwrecked" or "drowning". It prioritizes the person's narrative, strengths, and empowerment over symptom management. |
| Recovery Model | health, home, purpose, community individual works to improve themselves |
| anxiety vs fear | anxiety= emotional fear= cognitive |
| risks of anxiety | genetics biological (amygdala and hippocampus) neurochemical (serotonin, nore, gaba) |
| cognitive theory anxiety | consistent dysfunction in thinking patterns causes anxiety |
| panic attack | need 4 or more s/s according to dsm most last about 10 mins NOT A DISORDER (specifier for another disorder like agoraphobia, arachnophobia, etc) |
| panic disorder | unexpected and recurrent make sure theyre safe, reduce stimuli if too overwhelming, no teaching rn, stay with them if they can engage somewhat, do some basic grounding techniques |
| Generalized Anxiety Disorder | chronic, unreal9stic and excessive anxiety sometimes not as severe but more constant |
| Phobia | irrational fear |
| agoraphobia | fear of being someplace you cant escape or get help |
| Social anxiety disorder | excessive fear of being judged by others i.e. public speaking, eating in public, etc |
| Anxiety disorder attributable to another med disorder | s/s of medical disorder is mimicking anxiety s/s (increased HR, increased breathing, GI upset, etc) |
| substance use anxiety | did they just drink hella caffeine? did they do nicotoine? all causes s/s of anxiety |
| OCD | recurrent obsessions, compulsions, or BOTH severe enough to be time cnsuming (at least 1 hr/day) obsessions= recurrent intrusive thoughts that are recognized as orrational but acnt be ignored compulsions= repetitive ritualistic behavior/ mental acts |
| Body dysmorphic disorder | exaggerated belief that body/deformed in some specific way repetitive behavior or mental acts in response to appearance concern |
| trichotillomania | relief by pulling hair maladaptive compulsion/stress cope |
| hoarding disorder | persistent difficulties discarding possesions, regardlss of actual value more common in men difficult to treat with high relapse rate due to anosognosia |
| family/patient ed | meds, management, types of therapy, stress management |
| what is 1st line for all these disorders | THERAPY |
| behavior therapy | systematic desensitization (gradual exposure) implosion therapy ("flood" with recollection of stressor) |
| pharm treatments | benzos only short term due to addiction, PRN buspirone- FDA approved anxiety med, take EVERY DAY |
| for kida, emotional problem exists if... | are not age appropriate deviate from cultural norms interfere with adaptive functioning |
| neurodevelopmental disorders (IDD) | intellectual and functional deficits occurs while brain still developing genetics, disruptions in embryonic development pregnancy and perinatal factors after born, meningitis or lead, neglect |
| how is IDD classified | IQ level |
| Autism Spectrum Disorder (ASD) | wide range of communication impairments and restricted, repetitive behaviors mostly boys |
| ASD assessment | impaired social, repetitive behavior risk for self-mutilation: ensure safety of patient limit number of caregivers, positive reinforcement for eye contact, provide familiar objects use pics/tablets. anticipate needs, seek clarification |
| ASD meds | only meds to treat ASD agitation (aggression, hyperactive, temper) risperidone and aripiprazole EPS, DM, hyperglycemia NONPHARM is 1st line (therapies) |
| ADHD | 6 or more symptoms for 6 months, starting before age 12, present in 2 settings inattentive, hyperactive/impulsive, both |
| ADHD interventions | ensure safety of patient impaired social interaction- provide feedback low self-esteem= provide unconditional acceptance and positive regard |
| ADHD meds | stimulants- methylphenidate (start w this), adderall non-stim= atomoxetine/strattera (SNRI, liver dam and htn), buproprion (SNDRI, seizure risk), centrally acting alpha-agonist FDA approved video game |
| Tourette's | multiple motor tics and one or more vocal tics genetics, environmental |
| Tourette's meds | combo best with therapy haloperidol- severe s/s only pimozide- severe only (not for under 12) aripiprazole |
| ODD | persistent pattern of angry mood, defiant behavior, and vindictiveness more frequent than others and interferes with social, ed, functioning always someone elses fault |
| ODD treatment | therapy af |
| conduct disorders | negagtive and persistent pattern of behavior where basic rights of others and social norms or rules are violated childhood onset= hx of odd and antisocialpersonality before 10 adolescent = no s/s nefore 10 genetics, fam hx a abuse, alcohol, negle |
| separation anxiety disorder | cant go without caregiver, etc gradual step management for kids |
| depression in kids | irritability, agitation/aggression, withdrawal, decreased activity interests suicide risk, substance use |
| depression in kids treatment | CBT potentially meds |
| ACE | health risk behavior what happen as kid dictate what happen as adult |
| Anorexia nervosa | restriction of intake leading to significantly low body weight intense fear of weight gain body dysmorphia 2 types: restricting and binging/purging--> AN has low bw but bulimia normal severity based on BMI |
| Anorexia s/s | hypothermia, bradycardia, hypotension, edema, lanugo, constipation, yellow skin, memory issue |
| Bulimia nervosa | rapid uncontrolled episodes of ingestion of food FOLLOWED by compensatory mechanism |
| Bulimia s/s | tooth erosion, esophageal tears, calluses on knuckles (russel's sign), enlarged parotids |
| Binge Eating Disorder | recurrent episodes of rapid intake of large amounts of food NO compensation |
| Binge eating disorder assess | assess s/s (vs, BW) ask about eating pattern, exercise, body image |
| refeeding syndrome | when treating anorexia, if you nourish them too fast, it can KILL |
| ED interventions for imbalanced nutrition/FVD if admitted to hospital | give patient as much control as possible if patient unwilling to eat, NG tube may be needed observe patient 1 hr after meals monitor lab values and body weight/vitals |
| ED treatments part ii | therapy |
| ED meds | AN= no FDA approved, fluoxetine and other ssris bulimia= fluxetine FDA approved Binge eating disorder= lisdexamphetamine FDA approved |
| mood is... vs affect... | what the patient tells you it is vs what we can see (we want them to be congruent) |
| MDD | one of leading disability cause up to 50% diagnosed as BPD DOUBLE in women and TRIPLE w unemployed depressed, anorexia, slumped posture |
| MDD vs Persisitent depressive disorder | MDD_ depressed, loss of interest/pleasure, impaired social/occupational functioning, no hx of mania PDD- no psychotic s/s, chornically depressed mood (milder form), lasts at least 2 years in adults and 1 in kids |
| childhood depression differences | not depressed but IRRITABLE and withdraw from usual activities can increase suicidality in adolescents |
| senescense | bereavement overload, lots of suicide among elderly Treat- antidepressants, Electroconvulsive therapy, psychotherapies |
| Postpartum Depression | Dx like "MDD w peripartum depression" fatigue, irritability, sleep disturb, decreased appetite and libido treatment varies with severity |
| catatonia | higher risk in older people lay in bed for weeks and cause mental changes/behavior changes |
| Depression outcome goals | encourage self care, nutrition, no physical harm, sleep then we can do more self-value stuff Risk for suicidal behavior- stay w patient and notify provider, get as much info as you can |
| Depression Treatments: Therapy | individual, group, family, CBT (focus on changing automatic thoughts) |
| Depression Treatments: Neuromodulation | ECT= electrodes on brain, usually only if meds dont work rTMS= most effective for depression, magnet pulses Vagal Nerve Stimulation and Deep Brain Stimulation= VNS under skin electrode, DBS need craniotomy (last resort) |
| Depression Treatments: Other | Bright light therapy Physical activity |
| Depression Meds | antidepressants first line atypical antipsychotics (aripiprazole) can adjunct antidepressants can increase energy for suicide plan |
| MDD risks | fam hx, chronic medical isuses, hx of panic disorder |
| Bipolar Disorder | mood swings with periods of normalcy |
| bipolar manic vs hypomanic episode | mood elevated, impaired function and require hospitalization, maybe psychosis vs not as severe, no psychosis, no hospitalization |
| Bipolar I Disorder vs Bipolar II | has full manic episode vs has hypomanic episodes |
| If someone has EVER had one full manic episode in their life, they should never get which diagnoses? | MDD and Bipolar II |
| Cyclothymic disorder | less severe symptoms but longer lasting chronic mood disturbance slightly manic but not enough to be hypomanic |
| never give someone with bipolar which meds | antidepressants bc it can switch to mania |
| Bipolar treatment | therapies, ECT (sometimes), BLT, meds for mania= lithium, antipsychotics/convulsants for depression= lithium and mood stabs, use antidepressant with caution |
| A nurse is planning care for a client who has BD and is experiencing a manic episode. Which of he following interventions should be included in the plan of care? Select all that apply | est consistent limits, use direct communication, concise explanations |
| psychosis | loss of contact with reality |
| illusion/hallucinations | misinterpretations of senses (see shirt in hallway and think its a person) |
| delusion | false fixed belief |
| schizo and marijuana link | if genetic predisposed, if they use weed while brain still forming, it can cause schizophrenia |
| Schizoaffective disorder | schizo+ mood disorder |
| Substance induced psychotic disorder | drugs causing schizo like s/s |
| brief psychotic disorder | 1day-1 month |
| schizophreniform | 1month-6months, anything more than 6 months is schizo |
| catatonia (hypo and hyper) | hypo- stupor, coma like hyper- high energy, twitchy |
| types of delusion | grandiose- im more important than i am reference- they talking about ME control/influence= someone controlling/ use thoughts control others somatic- body, stickers nihilistic- world is already dead erotomaniac- obsessed jealous- cheating on them |
| Schizo Positive s/s speech | disturbances in thought processes manifested in speech loose associations, neologisms (made up words), clang assoc (rhymes), word salad, circumstantiality, tangents, perseveration (keep talking abt that one thing), echolalia (repeating what others say) |
| Schizo Positive s/s perception | hallucinations(all senses), illusions, echopraxia (repeat peoples movements) |
| Schizo Negative s/s | flat affect, apathy, anhedonia, anergia, cant think abstractly, anosognosia |
| schizo nursing interventions | assess hallucinations/anxiety DONT touch patient assess suicide adpt attitude of acceptance try to distract patient from hallucinations ask what voices are saying if they hear them |
| schizo treatments | not while psychotic (like mania in bd) ACT - designed for 24/7/365 support to keep out of hospitals RAISE- very first psychotic episode helps with early intervention antipsych meds (positive s/s decrease but neg increase) |
| EPS what med class to give to terminate | too much dopamine and AcH so give anticholinergic to terminate bc it blocks AcH/decreases it which decreases movement and stuff |
| clozapine assoc with what? | agranulocytosis AF |
| ODD vs Conduct disorder | ODD- persiistent, against authority Conduct- violate human rights and societal expectations (More severe) |
Created by:
andywattana