Block #1 / Exam #4: Mental Health

Front 1

Ageism:

Back 1

-discrimination against people of increased age

Front 2

ABCT of mental status assessment:

Back 2

A ppearance
B ehavior
C ognition
T hought Process

Front 3

Cognition
(mental assessment):

Back 3

-orientation
-attention span
-recent & remote memore
-new learning

Front 4

Thought Process
(mental assessment):

Back 4

-does this person make sense
-can I follow train of thought?
-any suicidal tendencies?

Front 5

Cognitive Disorders:

Back 5

refers to all disorders that cause a disturbance in orientation, memory, intellect, judgement, and affect
(changes in the brain)

Front 6

Delirium:

Back 6

an acute confusional state characterized by disburbances of change in cognition, consciousness, & alterations in slep-wake cycle

Front 7

Delirium Facts:

Back 7

-more frequent in the elderly
-common in children w/fever
-develops over short period of time and can fluctuate through the day
-reversible if treated before brain injury occurs
-20-40% drug caused
-35% elderly developed at hosp.

Front 8

Delirium causes:

Back 8

I WATCH DEATH:

Infections

-Withdrawal from drugs or alcohol
-Acute metabolic (DKA, renal/liver failuer)
-Trauma
-CNS pathology (tumor, stroke, seizure, bleeding)
-Hypoxia

-Deficiencies (electrolyte, vitamin, nutritional)
-Endocrine pathology
-Acute vascular problems
-Toxins (including drugs or alcohol)
-Heavy Metals exposure (lead, mercury)

Front 9

Environmental factors:

Back 9

sensory deprivation or unfamiliar settings

Front 10

Psychosocial factors:

Back 10

emotional distress or stress from pain

Front 11

Sundowners Syndrome:

Back 11

-cognitive impairment may be more pronounced in the evening or in as institutional setting
-difficulties with: thinking, memory, attention, perception

Front 12

Delirium may include difficulties with:

Back 12

-thinking
-memory
-perception
-attention

Front 13

Delirium Symptoms:

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-difficulty sustaining & shifting attention
-distractibility & disorganized thinking
-rambling, irrelevant, incoherent speech
-Disorientation to time & place
-Impairment of recent memory
-Agitated & restless
-Illusions & halluinations
-disturbances in level of consciousness

Front 14

Autonomic manifestations of Delirium:

Back 14

-tachycardia
-sweating
-flushed face
-dilated pupils
-elevated BP

Front 15

What is the first indicator of delirium?

Back 15

abrupt onset

Front 16

Prolonged delirium can lead to?

Back 16

dementia or death

Front 17

Common drug classes which may cause delirium:

Back 17

-digitalis
-narcotic analgesics
-antihistamines
-benzodiazepines(Valium,Ativan)
-Anti-hypertensive's
-anticholinergics (scopalamine)
-Anti- depressants
-Parkinson’s medications

Front 18

Dementia:

Back 18

-general impairment of intellectual functioninf that interferes with social and occupational functioning
-comes in slowly
-decline in cerebral function
-leads to decline in ADLS

Front 19

How do you dx dementia?

Back 19

Requires biopsy or autopsy of brain tissue

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What is the most common form of dementia?

Back 20

Alzheimer's

Front 21

Patho of Alzheimer's:

Back 21

-plaques are formed
-overproduction of B-amyloid
-affects short term memory (early)
-affects language and reasoning (later)
-Changes in braing structure and cortex

Front 22

What does Namenda do?

Back 22

protects brain's nerve cells against excess amounts of glutamate which damage cells

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SSRIs are used for?

Back 23

to treat depression and improve cognition

Front 24

Signs & Symptoms of Alzheimers: (Stage 1 / Mild)

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-forgetfulness
-short-term memory impairment
-diff. recognizing #s
-loss if initiative and interests
-decreased judgements
-geographic disorientation

Front 25

Signs & Symptoms of Alzheimers: (Middle Stage)

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-cannot recognize close family members or friends
-confusion
-wandering
-loss of remote memory
-can not perform simple tasks
-unable to read or write
-delusions
-hallucinations

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Apraxia:

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unable to perform simple task such as dressing

Front 27

Agraphia:

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unable to read or write

Front 28

Illusions:

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-seeing or hearing something as different from what it really is
ex: puff of smoke is a ghost

Front 29

Hallucinations:

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seeing and/or hearing people or objects that are not there

Front 30

Delusions:

Back 30

false ideas or misbeliefs
ex: thinking one God, President

Front 31

Delusions of Grandeur:

Back 31

thinking one is God, President, King

Front 32

Persecution Delusions:

Back 32

instructor is out to get you

Front 33

Signs & Symptoms of Alzheimers: (Late Stage)

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-unable to process info
-can't walk or talk
-urinary & fecal incontience
-diff. eating
-repeating sounds or words
-death due to 2ndary causes

Front 34

Goals for Dementia Treatment:

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-remain safe & free from harm
-will feel safe & free from fear
-maintain cognitive & physical function as long ast possible

Front 35

Dementia Interventions:

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-ensure safety
-monitor & maintain physical health
-verbal & nonverbal communtication as needed per patient
-modify environment as needed due to changes in ability
-facilitate independence as mush as possible
-promote social interaction

Front 36

Prevention of Dementia:

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-keep mind & body active
-exercise
-balanced diet
-limit stress & anxiety
-socialize daily
-control chronic diseases

Front 37

Risk factors for depression:

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-hx of depression
-family history
-Hx of suicide attempt or family hx
-female gender
-chronic medical illness
-poor socail support
-stressful life events
-alcohol or substance abuse
-chronic pain
-memory loss

Front 38

S/SX of depression:

Back 38

-depressed mood, loss if interest ir pleasure
-longer then 2 weeks

Front 39

DX if 5 are present:
(depression)

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SIG E CAPS
-sleep disturbance
-interest decreased
-guilt feelings
-energy decresed
-concentrate decreased
-appetite change
-psychomotor function decreased
-suicidal thoughts

Front 40

Treatment of depression:

Back 40

-early detection
-couseling & psychotherapy
-group therapy or support groups
-inpatient or outpatient treatment
-medication
-light therapy
-exercise
-massage
-herbal meds
-electroconvulsive therapy

Front 41

SSRI

Back 41

Selective Serotonin reuptake inhibitor

Front 42

Antidepressants aim to:

Back 42

increase serotonin, dopamine and norepinephrine in some way

Front 43

Akathisia

Back 43

inability to stay still restlessness

Front 44

Dystonia

Back 44

involuntary muscle contractions which contort the body into abnormal, sometimes painful postures

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Bradyphrenia

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Slowed thought process

Front 46

Bradykinesia

Back 46

slow movement