ati nursing
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| 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
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| Basic assessment | Pts LOC, appearance, behavior, cognitive and intellectual ability, mmse, pts description of their illness.
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| Physical examination | Appearance- grooming attire
Behavior- body movements, mood, and affect
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| Cognitive and intellectual | Recent and remote memory, calculate, abstract thinking, judgement, speech
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| 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
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| 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
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| While performing a MMSE the nurse notices that the pts facial expression constantly conveys anger she should document this as the pts | Affect
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| 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
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| Examples of subjective data collection | Pt states that he has no reason to live
Pt states that he drinks 3 beers a day
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| A nurse is caring for a client dx with schizophrenia, DM, and anti social personality which is the axis2? | Antisocial personality disorder
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| An ex of a pt who requires emergency admission is | PTSD who assaulted his son with a bat
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| Pacing | Pt not giving information because the nurse seems busy
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| Connotative meaning | Charting pt complains of instead of client reports
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| Vocabulary | Using words the pt understands instead of medical jargon
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| Timing | Pt education when the patient is comfortable and ready to learn
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| Factors that foster a therapeutic relationship | Consistency, pace with the pt, attentive listening, positive initial impression, comfort, and availability
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| Ocd | Ritualistic behavior that interferes with adls
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| Gad | At least 3 of the following clinical manifestations: fatigue, restlessness, problems with concentration, irritability, muscle tension, sleep disturbances
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| 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
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| 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
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| Medications for anxiety | Antidepressants like Zoloft elavil
Hypnotic anxiolytics valium
ssri effexor
Nonbarbituate anxiolytics BuSpar
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| 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
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| Ssri | Celexa, Prozac, Zoloft
May cause sexual disfunction or cns stimulation which can lead to insomnia
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| Tca | Elavil
Orthostatic hypotension
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| Maoi | Nardil
Hypertensive crisis
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| Benzo diazepines | Valium ativan
Cns depression avoid driving etc
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| Ssnri | Effexor
Nausea, weight gain sexual dysfunction
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| Nonbarbituate | BuSpar
2 to 4 weeks to become effective
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| Mood stabilizer | Lithium depakote
Klonopin
neurotin
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| 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
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| Atypical anti psychotic | Risperdone ziprexa seroquel geodon abilify
Sedation weight gain
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| Conventional anti psychotic | Haldol thorazine prolixin
Anticholinergic effects, Orthostatic hypotension, eps
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| Antidepressants for schizophrenia | Paxil
Suicidal ideation
withdrawal effects with abrupt withdrawal
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| Personality disorders | Cluster A odd or eccentric
Cluster B dramatic emotional or erratic
cluster C anxious or fearful
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| 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
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| Cluster A | Paranoid - distrust of others
Schizoid- disinterested emotional detachment with others do not have psychotic symptoms
Schizotypal odd beliefs eccentric appearance
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| 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
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| Cluster C | Avoidant avoidance of all situations from fear of rejection
Dependant urgent search for relationship when the other one ends
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| Obsessive compulsive | Focus on orderliness and control no ritualistic behavior
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| Data collection for pts with eating disorders | Dietary habits and hx, ht, wt, skin condition, vs, feeling about body image, and family dynamics
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| 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
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| F Expected findings for pt with bulemia | ECG changes peripheral edema and tooth decay
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| Antidote for benzo od or toxicity | Romazicon
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| 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
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