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Nursing 103 Final

Videbeck review for final

Disengagement aging is an inevitable, mutual withdrawal or disengagement resulting in decreased interaction between aging persons and others in the social system.
Activity remaining as active as possible in the pursuits of middle age is the ideal in later life, due to improved general health
Continuity Based on personal development; life satisfaction with engagement or disengagement depends on personality traits. Personality influences a person’s roles and interest in those roles
Axis 1 Identifying all major psychiatric disorders except mental retardation and
Axis 2 Mental retardation and personality disorders as well as maladaptive personality features and defense mechanisms
Axis 3 – Current medical conditions
Axis 4 – psychosocial and environmental problems
Axis 5 – Global Assessment of Functioning 0 to 100
Trust vs. Mistrust – infant (view the world as safe or unsafe)
Autonomy vs. Shame and Doubt – toddler (sense of control/ free will)
Initiative vs. Guilt – preschool (development of conscience)
Industry vs. inferiority – school age (confidence in abilities)
Identity vs. role confusion – adolescence (sense of self and belonging)
Intimacy vs. isolation – young adult (adult relationships)
Generativety vs. stagnation – middle adult (creative products, creating families)
Ego integrity vs. despair old adult (life review)
Alcohol addiction diet requires more B1 and Thiamine (Wernicke-Korsakoff syndrome if not), also b12 for anemia
Abstract thinking ability to make associations or interpretations about a situation or comment
Affect outward expression of clients emotional state
Automatisms repeated seemingly purposeless behaviors
Circumstantial thinking term used when a client eventually answers a question, but only after giving excessive unnecessary detail
Concrete thinking client continually gives literal translations
Delusions fixed false belief not based in reality
Duty to warn exception to client right to privacy, when a specific threat is made
Flat affect showing no facial expression
Flight of ideas excessive amount and rate of speech composed of fragmented or unrelated ideas, racing after unconnected thoughts
Hallucinations false sensory perceptions or perceptual experiences
Ideas of reference inaccurate interpretation that general events are personally directed to his or her, hearing a speech on the news and beliving the message has a personal meaning
Inappropriate affect noncongruent affect
Insight ability to understand true nature of one’s situations and accept responsibility for it
Judgement refers to ability to interpret one’s environment and situation correctly and adapt one’s behavior
Labile rapidly changing or fluctuating in someones mood
Loose associations disorganized thinking that jumps from one idea to another
Neologisms invented words that have meaning only for the client
Psychomotor retardation overall slowed movements
Restricted affect displaying one type of emotional response
Tangential thinking wandering off the topic and never providing the information requested
Thought blocking stopping abruptly in the middle of a sentence or train of thought, sometimes unable to continue the idea
Thought broadcasting a delusional belief that others can hear or know what the client is thinking
Thought insertion a delusional belief that others are putting ideas or thoughts into the clients heads, that is the ideas are not those of the client
Thought withdrawal a delusional belief that others are taking the client’s thoughts away and the client is powerless to stop it
Word salad flow of unconnected words that convey no meaning to the listener
Denial defense mechanism, clients may directly deny having any problems
Dual diagnosis client with both substance and psychiatric disorders
Flushing reddening of the face and neck as a result of increased blood flow
Manipulative behavior interventions ensure for safety, client assume self care, set limits, assist to identify behaviors, encourage self control, be consistent, role model, explore meanings and consequences of behaviors
Behavioral approach interventions system of rewards and restrictions from outside sources
Cognitive approach interventions seeks to help the person change how he or she thinks about things to things to bring about change
Crisis interventions assessment of person, promotion of problem solving, provision of empathetic understanding
Neurotransmitters chemical messengers
Dopamine excitatory – controls complex movements, motivation, cognition and regulates emotions
Norepinepherine excitatory – changes in attention, learning and memory. Sleep and wakefulness, mood
Epinephrine excitatory – controls fight or flight
Serotonin inhibitory – controls food intake, sleep and wakefulness, temp regulation, pain control, sexual behaviors, regulation of emotions
Histamine neuromodulator – controls alertness, gastric secretions, cardiac stimulation, peripheral allergic response
Acetylcholine excitatory or inhibitory – controls sleep and wake cycle, signals muscles to become alert
Neuropeptides neuromodulator – enhance, prolong, inhibit or limit the effects of principal neurotransmitters
Glutamate excitatory – results in neurotoxicity if levels are too high
GABA inhibitory – modulates other neurotransmitters
Frontal Lobe controls organization of thought, body movement, memories, emotions and moral behavior.
Trust issues in compliance with meds Why are they noncompliant
Dicontinuation Syndrome abrupt stopping of psych meds can cause medical symptoms (dizziness, disorientation etc)
Anger interventions manage environment, manage behavior
PTSD symptoms recurrent memories of event, nightmares, flashbacks, avoidance, memory problems, apathy, detachment, sleep disturbances, irritable, hypervigilence.
PTSD interventions safety, cope with stress and emotions, promote self esteem
Anxiety Interventions short simple directions, calming actions, separate from stimuli, stay with them
OCD symptoms recurrent, persistent intrusive thoughts and impulses, attempt to neutralize thoughts with compulsions.
OCD interventions offer encouragement, be clear they can change, encourage them to discuss their feelings, decrease time of ritualistic activity, use exposure techniques, assist to complete adl’s in a timely manner, schedule
MDD (Major Depressive Disorder) depressed mood, anhedonism, weight change of 5% or more in a month, sleep pattern changes, psychomotor retardation or agitation, tiredness, worthlessness or guilt inappropriate, hopelessness, helplessness or suicidal.
MDD Interventions safety, suicide assessment, spend nondemanding time with patient, completion of ADL’s, nutrition, rest, activities, verbailiztion of emotions, manage meds and side effects
Manic clients nutrition too busy to sit and eat, finger foods or foods they can eat while moving around, high calorie and protein foods, easy t eat.
Compensation Overachievement in one area to make up for deficiency elsewhere
Conversion Expression of emotional conflict through the development of physical symptoms – teenager watches X rated movie, goes blind
Denial Failure to acknowledge an unbearable condition, failure to admit reality
Displacement Ventilation of intense feelings towards persons less threatening the the one who upset you – mad at boss, but yells at spouse
Dissociation Dealing with emotional conflict by a temp alteration in consciousness
Fixation Immobilization of a portion of personality resulting from unsuccessful completion of phase – never learning to delay gratification
Identification Modeling actions and opinion of influential others while searching for identity
Intellectualization Separation of the facts of the situation from the emotional side of it
Introjections Accepting another person’s attitudes and beliefs as your own
Projection Unconscious blaming of unacceptable inclinations on an external object – prejudice person who proclaims others are bigots
Rationalization Excusing one own behavior to avoid guilt – teachers fault you failed cause she’s mean
Reaction formation Acting the opposite of how you feel – never wanted kids so you become super mom
Regression Moving back to a previous developmental stage
Repression Excluding emotionally painfulthought and feelings from conscious – women has no memory before age of 7 when she was molested
Resistance Overt of covert antagonism towards remembering or processing anxiety producing info
Sublimination Substituting a socially acceptable activity for an impulse that is unacceptable – quit smoking sucks on hard candy instead
Substitution Replacing the desired gratification with one that is more readily available – women who would one day like to have children opening a day care
Suppression Conscious exclusion of unacceptable thoughts and feelings from conscious awareness – decides not to think about something bad so you can focus
Undoing Exhibiting acceptable behavior to make up for or negate unacceptable behavior
Pseudoparkinsonism one of EPS (antipsychotic side effects)symptoms of parkinsons such as stiff, stooped posture, mask face, fine tremors etc.
Treatment for Pseudoparkinsonism Change med or add amantidine
Dystonia one of EPS (antipsychotic side effect)Muscular rigidity, difficulty swallowing
Dystonia Tx cogentin orbenadryl
Akathisia one of EPS (antipsychotic side effect)Constant fidgeting, inablility to be still
Akathisia Tx Change med or add betablocker or benzodiazepine
Neuroleptic malignant syndrome (NMS) Rigid, fever, BP issues, pallor etc…
NMS Tx DC med
Created by: 582303342