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119 Cards in this Set
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_______ is a term describing ineffective coping with stress that causes mild interpersonal disorganization.
People with this have an insight that they have a psychiatric problem.
Remains oriented to reality but will perhaps have some degree of distortion of reality manifested by a strong emotional response to the trigger event.
Various complains of nervousness or emotional upset, compulsions, obsessiveness, and phobias are common.
Exhibit poor self esteem and have social relationships that suffer. |
neurosis |
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A person suffering with _________ is out of touch with reality and has severe personality deterioration, impaired perception and judgement, hallucinations, and delusions.
Does not recognize the fact of having a psychiatric illness. |
psychosis |
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The _________ describes multiaxial system that classifies mental disorders and outlines various disorders and descriptive references.
It's to facilitate medical diagnosis and to provide a guide to clinical practice. |
the diagnostic and statistical manual of psychiatric disorders |
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DSM-IV-TR examines mental health illness according to five categories called _________. |
axes |
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Identifying all major psychiatric disorders except developmentally delayed and personality disorders, such as depression, shizpophrenia, anxiety, and substance related disorders. |
axis I |
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Personality and developmental disorders, as well as prominent maladaptive personality features and defense mechanisms. |
axis II |
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General medical conditions that are potentially relevant to the understanding or management of the person's mental disorder. |
axis III |
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Psychosocial and environmental disorders that have potential to affect the diagnosis, treatment, and prognosis of mental disorders. |
axis IV |
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Global assessment of functioning that rates the overall psychological functioning of the person on a scale of 0 to 100. |
axis V |
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An identifiable brain disease or dysfunction is the basis for the behavior.
Affects cognitive and intellectual abilities.
Thee effect ranges from mild lapses in memory to severe behavioral changes. |
organic disorder |
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A predominant characteristic of the type of disorder is __________ |
disorientation |
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________ is a rapid change in consciousness that occurs over a short time. Occurrence is possible at any age.
Associated with reduced awareness and attention to surroundings, disorganized thinking, sensory misinterpretation, and irrelevant speech. Sleep patterns are often disturbed.
Possible causes include physical illnesses such as fever, heart failure, pneumonia, azotemia, malnutrition, drug intoxication and anesthesia. |
delirium |
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A person with nocturnal delirium, or _________, displays increased disorientation and agitation only during the evening and nighttime. |
sundowning syndrome |
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_______ is a term describing an altered mental state secondary to cerebral disease. It is usually a slow and progressive loss of intellectual function that is often irreversible. Alzheimer's disease is the most common type. |
dementia |
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Two key aspects of nursing interventions for a person with dementia |
reality orientation and providing a safety environment |
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________ is any one of a large group of psychotic disorders whose defining characteristics are gross distortion of reality, disturbance of language and communication; withdrawal from social interaction; and the disorganization and fragmentation of through, perception, and emotional reaction.
Typically occurs in young adulthood.
Chronic disorder with residual disability in functioning.
Prone to aggravation from stresses in life.
Not the same as multiple personality disorder. |
schizophrenia |
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Behaviors that schizophrenic individuals display fall into different categories: |
positive or excessive and negative or absent |
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Positive behavior patterns in a schizophrenic patient include |
delusions, hallucinations, and disordered thinking |
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A false, fixed belief that is not possible to correct by feedback and that others in the same cultural context do not accept as true. The individual starts with a false premise, believing it to be true. The individual fits this false premise logically into his or her interpretation of reality.
It is difficult for the individual to accept what is really true. |
delusion |
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A sensory experience without a stimulus trigger. |
hallucination |
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occurs when the individual is not able to interpret information being received in the brain. Loose association-making in speech sometimes evident. Conversation does not flow logically. |
disordered thinking |
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_______ is sometimes a sign of disordered thinking. |
concreteness |
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Negative behavior patterns of a schizophrenic patient |
apathy (avolition), social withdrawal, alogia, blunted emotional responses, and anhedonia. |
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a lack of energy or interest, an acceptance of just sitting and doing nothing. an unkempt appearance. |
apathy |
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occurs in an attempt to reduce stimuli to the brain. some are frightened or overwhelmed by the experience of trying to communicate with others and find it easier to withdraw from the contact. |
social withdrawal |
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defined as reduced content of speech. occurs as part of the overload of information that occurs in conversation. the individual needs more time to sort out the message received. |
alogia |
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the lack of nonverbal expression of emotions, such as by means of facial expression or tone of voice. |
flat affect |
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the inability to experience happiness or joy. |
anhedonia |
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Subtypes of schizophrenia |
disorganized, paranoid, catatonic, undifferentiated, residual. |
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flat or inappropriate affect, incoherence, prognosis is poor. |
disorganized |
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delusions, auditory, hallucinations, prognosis is good with treatment |
paranoid |
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stupor, negativism, rigidity, excitement, posturing; prognosis is fair |
catatonic |
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delusions, hallucinations, incoherence, gross disorganization; prognosis is fair |
undifferential |
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demonstrates typical signs and symptoms associated with schizophrenia without displaying evidence of gross disorganization, incoherence, delusions, and hallucinations; prognosis is poor. |
residual |
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Stages of schizophrenia |
prodromal phase, presychotic phase, acute phase, residual phase |
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often begins in adolescence and begins with lack of energy or motivation and withdrawal. Other symptoms common in this stage are as follows: affect becomes blunted, beliefs and ideas become odd; the person sometimes develops an excessive interest in philosophy or religion; self-care and personal hygiene fall by the wayside; emotional liability is present; speech is difficult to follow; and the person often complains about multiple physical problems. |
prodromal phase |
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passive behavior. prefers to be alone. hallucination and delusions sometimes occur. odd, suspicious, or eccentric behavior patterns are present. family members report that they feel the individual has changed into a stranger. |
prepsychotic phase |
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signs and symptoms sometimes vary widely, but disturbances in thought, perception, emotion, and behavior are very apparent. |
acute phase |
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features a group of symptoms similar to that in the prodromal phase. it follows the acute phase. |
residual phase |
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following the residual phase is a _________ wherein the individual is able to experience some relief of symptoms and to manage some basic activities in life. |
remission period |
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_______, also known as affective disorders, are any of a group psychotic disorders whose defining characteristics are severe and inappropriate emotional responses, prolonged and persistent disturbances of mood and related though distortions, and other symptoms associated with either depressed or manic states. |
mood disorders |
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a prolonged emotion that affects a person's psyche. |
mood |
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a mood disturbance characterized by exaggerated feelings of sadness, despair, lowered self-esteem, loss of interest in former activities, and pessimistic thoughts. more than a state of mind.
so severe at times that an affected person will contemplate, or actually succeed at, committing suicide. |
depression |
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the eight leading cause of death in the United States |
suicide |
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_________ or major depressive disorder, defined as repeating, severe depressive, episodes lasting more than 2 years. |
unipolar depression |
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a daily moderate depression that lasts more than 2 years. this disorder often ends up as a lifestyle which the individual is able to function but not enjoy life. |
dysthymic disorder |
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__________, or manic-depressive disorders, feature sudden shifts between emotional extremes from depression to mania. |
bipolar disorder |
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a mood disorder whose signal characteristic is persistent, abnormal overactivity and a euphoric state. We often refer to early phase of an episode as a hypomanic episode when symptoms are not severe.
often the individual is engaging, outgoing, and charming, as well as achieving and successful, has excessive energy and optimism, and possibly a very productive member of the community |
mania |
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a pattern that also involves repeated mood swings of hypomania and depression, although they are less intense. there are no periods of normal function with this condition. thought to be a muted version of bipolar disorder. |
cyclothymic disorder |
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practitioners treat SAD (seasonal affective disorders) also known as winter depression, with ________ |
phototherapy |
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Some antidepressants such as amitriptyline are best to take at _____ because of a transient adverse effect of sedation; and this sometimes also helps normalize sleeping pattern. |
bedtime |
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some antidepressants, such as flouxetine, are best to take in the ______ to prevent adverse effect of insomnia |
morning |
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_____ has a narrow therapeutic range and close monitoring of the drug is necessary for safety |
lithium |
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bupropion is also a first-line medication for |
smoking cessation |
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A normal response to stress of threat. It is a state or feeling of apprehension, uneasiness, agitation, uncertainty, and fear resulting from the anticipation of some threat or danger. |
anxiety |
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a learned response to an event such as test taking |
signal anxiety |
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associated with feelings of dread that are not possible to identify |
free-floating anxiety |
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a learned aspect of personality. has anxious reactions to relatively nonstressful events. respond more quickly and more strongly to stress and are slower to level off than normal. |
anxiety trait |
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characterized by a high degree of anxiety and/or avoidance behavior. tends to worry or fret over many things and finds it difficult to concentrate on the task at hand. |
generalized anxiety disorder |
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can be defined as an attack of acute, intense, and overwhelming anxiety accompanied by a degree of personality disorganization, such as being unable to solve problems or think clearly. |
panic |
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in a panic attack, symptoms can occur abruptly and peak within |
10 minutes |
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______is considered to be a type of panic disorder. high anxiety brought on by situations in which a panic attack is possible. individuals avoid people, places, or events that have potential to trigger an attack. fear of not receiving any help or embarrassment when an attack occurs in a public place. |
agoraphobia |
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________ and ________ are important nursing interventions for individuals suffering with panic disorder |
emotional support and reassurance |
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a _______ is irrational fear in which the individual tends to dwell on the object of the phobia. individual sometimes recognizes the irrational fear of the phobia but is still unable to control paralyzing anxiety. |
phobia |
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_______ are thoughts that are recurrent, intrusive, and seneless. these thoughts are anxiety producing and distressful in that they are uncontrollable. |
obsessions |
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_________ are behaviors that are performed in response to an obsessive thought. |
compulsions |
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experts believe that activity addictions such as compulsive gambling, sexual promiscuity, excessive internet use, or overeating arise from ____________. |
obsessive compulsive behavior disorders |
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formerly called shell shock. describes a response to an intense traumatic experience that is beyond the usual range of human experiences. these experiences tend to evoke feelings of terror and helplessness. |
posttraumatic stress disorder (ptsd) |
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_______ often arise in response to a trigger, a stimulus that resembles the experience or perhaps the anniversary of the event. |
flashbacks |
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flashbacks sometimes include ______ and _______. |
illusions and hallucinations |
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There are three types of PTSD. In the _______, symptoms occur within 6 months of the event and last about 6 months. The _______ features symptoms that last 6 months or longer. The ________ involves symptoms that start 6 months or more after the event. |
acute type chronic type delayed type |
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Treatments for PTSD include |
antidepressant or antiseizure meds, cognitive therapy, behavioral therapy, debriefing people |
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_________ are inflexible, maladaptive patterns of behavior or thinking that accompany significant impairment of functioning. usually surfaces during adolescence or earlier and continues through adulthood. |
personality disorders |
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The DSM-IV-TR has classified 20 distinct personality disorders. These disorders are possible to cluster into groups of similar behavior: |
eccentric, erratic, and fearful |
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An individual who uses violent or abusive behavior to cope with anxiety |
abusive personality |
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an individual who is overcooperative from a deep fear of abandonment; unable to take responsibilty for his or her own activites of daily living; usually seeks overprotective, dominating, or abusive relationships. |
dependent personality |
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characterized by suspicion, secretiveness, distortion of reality, and oversensitivity; thinks that others are out to get him. |
paranoid personality |
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has not established self-identity, fears being alone, experiences mood swings over a short period, relationships with others reveal rapid shifts from adoring to cruel and punishing, impulsive. |
borderline personality |
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has a history of difficulties with personal relationships, does not profit from experience or punishment, has no loyalties to any person, group, or code of ethics, has a tendency to rationalize behavior, relies on deciet and manipulation to get his or her way. |
antisocial personality |
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________ occur in private between two consenting adults, and are satisfying and not forced upon each other. |
adaptive sexual behaviors |
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__________ are harmful to self or others and are possibly performed publicly and sometimes without the consent of all those involved. |
maladaptive sexual behavior |
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The DSM-IV-TR lists sexual and gender identity disorders in three main clusters: |
sexual dysfunctions paraphillias gender identity disorders |
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__________ is a disturbance during sexual respinse. Dyspareunia (painful intercourse), hypoactive sexual desire, and premature ejacculation are examples that have a possible psychological as well as physical component. |
sexual dysfunction |
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_________ are a group of sexually gratifying activities that are not common to the general public and are illegal in some countries, including the U.S. |
paraphilias |
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The term __________ refers to a physical disorder arising as a result of a psychological trigger. This term developed a negative connotation as it acquired the implication that "it's all in your head." |
psychosomatic illness |
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_______ addresses the stress-related problems that have the potential to result in physical signs and symptoms. Psychological disorders are thought to have an emotional basis, manifested as a physical illness. |
psychophysical illness |
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the body responds to continual or repeated stress by overactivating its stress response mechanism; this tends to result in many physical signs and symptoms such as |
diarrhea, heart palpitations, backaches, and headaches |
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___________, or somatoform disorder, is a disorder whose typical characteristics are recurrent, multiple, physical complaints and symptoms for which there is no organic cause. An individual's feelings, needs, and conflicts are manifested physiologically. Diagnosis follows the ruling out of any possible physical causes of dysfunctions, any drug or other toxic substance reaction, or mental health problems that are possibly related to the symptoms. Also call briquet's syndrome. |
somatization |
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__________ is a severe form of self-starvation that potentially leads to death. It occurs predominantly in adolescent girls of above-average intelligence. They have an intense fear of obesity, bizarre attitudes toward food, and disturbed self-image. The etiology of the disease has nothing to do with food and everything to do with self-control and willpower. |
anorexia nervosa |
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_________, commonly known as bingeing. Characteristics are episodes of overeating followed by purging through induced vomiting, laxatives, diuretics, fasting, or vigorous exercise. Occurs primarily in white females of high school age, usually middle to upper class and well educated.
Signs and symptoms include feelings of low self esteem, lack of control, and guilt. Anxiety and depression. Physical signs are hoarseness, esophagitis, dental erosion, palate lacerations, and complaints of weakness or fatigue.
Lab tests show electrolyte imbalance. |
bulimia nervosa |
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Flouxtetine (Prozac) and Sertraline (Zoloft) are helpful for treating patients with _________. |
eating disorders |
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The key components to psychiatric-mental health treatment is the development of a ___________.
a therapeutic professional relationship; it is not social in nature.
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helping-trust relationship |
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________ serves to relieve anxiety through the conditioning and retraining of behavioral responses by repitition. Often possible to resolve phobias with this technique |
behavioral therapy |
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___________ focuses on breaking negative thought patterns and developing positive feelings about memories or thoughts. |
cognitive therapy |
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______________ is often a useful modality in a hospital setting or day treatment programs. A group of patients with similar problems gain insight through discussion and role playing. |
group therapy |
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____________ often helps children express themselves by using toys such as puppets as their "spokesperson" of feelings. |
play therapy |
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__________ helps a person recover deeply repressed emotions and speed recovery. It also serves to help change habits such as smoking. |
hypnosis |
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_______ was developed by Sigmund Freud. It is a long-term and intense form of therapy that allows the individual to bring unconsious thoughts to the surface. Free association and dream interpretation are among the tools. |
psychoanalysis |
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_____________ include occupational therapy, recreational therapy, music therapy, magnetic therapy, art therapy, and hydrotherapy. These types of therapy allow expression of feelings, help increase self-esteem and promote positive interaction and reality orientation. |
adjunctive therapies |
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Introduced by Ugo Cerletti and Lucio Bino in the late 1930's.
A treatment for depression, mania, schizoaffective disorders that do not respond to other treatment modalities. The course usually requires about 10 treatments over several weeks. |
Electroconvulsive Therapy |
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Before an individual recieves ECT, it is necessary to do |
a thorough physical & mental examination electrocephalogram (EEG) chest and lumbosacrial spine radiography electrocardiogram (ECG) |
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In preparing the patient for ECT |
make sure patient is NPO for at least 8hrs
instruct pt to void
remove all watches, jewelry, glasses, contacts, dentures, hairpins
administer pre-ect medications
establish an IV line |
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Post ECT |
give a light meal or snack with acetaminophen
give a warm bath
assist with mobility
supervision and assurance
do not allow pt to drive |
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Medications work in different ways in the brain to alleviate signs and symptoms of depression, such as decreased appetite or sleep pattern disturbance, prolonged sadness, and lack of concentration.
it will generally take 2 to 4 weeks to note improvement |
antidepressants |
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____________ is a potentially life-threatening condition that occurs usually as a result of an interaction between an SSRI and another serotonergic agent. Occurance is possible in older adults. Symptoms include altered mental status, autonomic dysfunction, and neuromuscular abnormalities. |
serotonin syndrome |
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___________ can include blood pressure fluctuation, tachycardia, hyperthermia, marked pupil dilation (mydriasis), shivering, and diaphoresis. |
autonomic dysfunction |
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Lab work indicating _________ shows elevated creatine phesphokinase (CPK) from muscle distegration, elevated WBCs and transaminases, and decreased serum bicarbonate level. |
serotonin syndrome |
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Treatment for serotonin syndrome is to _________ the dosage of the drug |
slowly decrease |
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____________ is the chief drug health care providers use to stabilize the mood and behavior of a patient with mania. |
lithium carbonate |
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the therapeutic level of lithium |
0.4 to 1.3 mEq/L |
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Antipsychotic medications or major tranquilizers serve for acute and chronic management of |
schizophrenia, organic mental disorders with psychosis, and the manic phase of bipolar mood disorder |
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A number of dose-related side effects occur in association with antipsychotics. ________ and ________ are common when first starting the drugs.
Other side effects include |
postural hypotentsion and sedation
photosensitivity, autonomic reactions, pseudoparkinsonism, akathisia, dystonia, dyskinesia |
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_____________ is an extrapyramidal reaction that occurs when reducing the medication dosage, and it sometimes has a permanent effect. |
tardive dyskinesia |
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___________ or minor tranquilizers often help individuals experiencing moderate to severe anxiety |
antianxiety drugs |
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__________ is one of the most common weeds in the world. its possible effectiveness to treat mild depression with few side effects when the patient takes therapeutic doses. potentially interact with MAOIs and has the capacity to trigger HTN if taken with allergy meds containing monoamines or phenylalanine, or amino acid supplements containing tyrosine. |
st john's wort |
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________ is a herb some people take to treat anxiety and insomnia because of its sedative effects. Scaly rash on the backs of hands and forearms and on the soles of feet is a common side effect. Alcohol potentiates the sedative effect and, if taken with benzodiazepines, it produces toxicity and induces coma. |
kava |
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Provides moderate memory and cognitive improvement in treatment of early Alzheimer's disease by promoting cerebral blood flow, but it sometimes potentiates the action of anticoagulant drugs such as aspirin and warfarin, which poses the risk of fatal hemorrhage.
Has the capacity to affect insulin secretion. |
ginkgo |
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_______ sometimes lowers blood glucose in diabetes |
ginseng |
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__________ is use to generally enhance or potentiate another remedy. Use takes the form of scented oils for massage, volatile oils to sniff or inhale, and scented candles or incense.
Focuses on the atmosphere of the moment and uses the body's senses to try to achieve balance within. It has a definite place in holistic care. |
aromatherapy |
