Life Span 2

Front 1

S/S of OCD (obsessive compulsive disorder)

Back 1

repeated rituals, anxiety occurs if obsessions or compulsions are resisted,

Front 2

N/I of OCD

Back 2

•Identify problems
•DO Not interrupt compulsive behaviors, allow pt to perform rituals unless cause harm to oneself, make schedule to distract
•encourage verbalization of compulsive disorder

Front 3

S/S of Phobic Disorder

Back 3

irrational fear of object or situation that a person recognizes as unreasonable, Panic level anxiety if object or situation cannot be avoided, defense mechanism are repression and displacement

Front 4

I of Phobic Disorder

Back 4

Stay with client while anxiety is high, Identify the anxiety allow client to speak about the object or situation Desensitize by gradually introducing feared object or situation,
DO NOT FORCE contact with object or situation

Front 5

What is agoraphobia

Back 5

fear of being alone in a public place where escape maybe difficult

Front 6

What is Social Phobia I

Back 6

fear of situation in which one might be embarrassed or criticized, and fear of making a fool out of oneself

Front 7

S/S of PTSD (post traumatic stress disorder)

Back 7

After experiencing a psychological traumatic event, the individual re-expierences the event via recurrent dreams or flashbacks,
Emotional numbness, detachment, anxiety, sleep disturbance, hyperviligence, guilt, poor concentration

Front 8

N/I of PTSD

Back 8

After experiencing a psychological traumatic event, the individual re-expierences the event via recurrent dreams or flashbacks,
Emotional numbness, detachment, anxiety, sleep disturbance, hyperviligence, guilt, poor concentration

N/I of PTSD

Desensitation through gradual exposure,
Instruct pt in relaxation techniques,
Provide individual therapy that address loss of control issue or anger issue, Support groups,
Hypnotherapy

Front 9

S/S of dissociative disorder

Back 9

- disruption in integrative function of memory, consciousness or identity.
- Associated to exposure to a traumatic event

Front 10

N/I of dissociative disorder

Back 10

- Develop a trusting relationship with client
- Encourage verbal expression of painful exposure, anxieties or concerns
- Explain methods of coping
- Identify sources of conflict
- Focus on clients strengths and skills
- Provide nondemanding simple routines

Front 11

Types of Dissociative Disorders

Back 11

Multiple personality, Amnesia, Fugue, Depersonalization Disorder

Front 12

What is multiple personality

Back 12

2 or more fully developed distinct and unique personality within the person
- personalities may take full control of the client one at a time
- Personalities may or may not be aware of each other.

Front 13

What is Fugue

Back 13

- Assumption of a new identity in a new environment
- disorder may occur suddenly

Front 14

What is Depersonalization Disorder

Back 14

- altered self perception in which one's own reality is lost or changed

Front 15

S/S of Ulcerative Colitis

Back 15

- Anorexia, wt loss, Malaise, Abd tender and cramping, severe diarrhea may contain blood and mucus, dehydration and electrolyte imbalance, anemia, vit K deficiency, increased bowel sounds

Front 16

N/I of ulcerative colitis

Back 16

- Acute Phase: NPO status, IV and electrolyte possibly TPN
- restrict pt activity to reduce intestinal activity
- monitor bowel sounds
- After acute phase diet progress from clear liquid to low residue diet
- Avoid gas forming foods
- Administer bulk forming agents to decrease diarrhea
- Administer drugs to prevent infection and reduce inflammation

Front 17

What is Ulcerative colitis

Back 17

- Inflammatory disease of bowel that results in poor absorption of nutrients
- colon becomes edematous and may develop bleeding lesions and ulcers
- scar tissue develops and causes loss of elasticity

Front 18

What is Gastric Ulcer?

Back 18

- Ulceration in Mucosal wall of the stomach, that is accessible to gastric secretions erosion may extend through the muscle
- Predisposing factors are stress, smoking, use of corticosteroids, NSAIDS, alcohol, HX of Gastritis
- Complaints of hemorrhage, perforation and pyloric obstruction

Front 19

S/S of Gastric Ulcer

Back 19

Gnawing sharp pain on or left of the midepigastric region 1-2 hours after eating.
- Nausea and Vomiting
- Hematemesis

Front 20

N/I of Gastric Ulcer

Back 20

- Monitor vital signs and for signs of bleeding
- Administer small frequent bland feedings
- Admin. histamines to reduce secretion of Gastric Acid
- Admin. Antacids
- Admin Anticholinergenics to reduce gastric motility
- Admin. mucosal barrier protectants as prescribed 1 hour before meal

Front 21

What is Anorexia Nervosa

Back 21

- Onset is often associated with stressful life event.
- pt. intensely fears obesity
- body image is distorted has a disrupted self concept
- preoccupied with foods that prevent weight gain
- can be life theatning
- self induced wt. loss greater than 15% of normal weight for age and ht.

Front 22

S/S of Anorexia Nervosa

Back 22

- vary depending on severity of illness
- wt loss greater than 15% of normal weight
- Bradycardia, hypotension, cold intolerance, hypothermia, dry skin, constipation, ABD pain
- psychological manifestations include perfectionist and OCD with high performance expectations
- anxiety increased exercise activity, inhibited or destructive social interactions

Front 23

N/I of Anorexia Nervosa

Back 23

Asses pt. nutritional status
- Establish contract concerning the diet plan
- Assist pt. in Identifying preceptors of the eating disorder
- Encourage behavior modifications technique
- record I & O
- set time limit on meal time
- weight pt daily
- asses and limit pt activity level

Front 24

What is Bulimia Nervosa

Back 24

- Pt indulges in eating binges followed by purging behavior
- most pts remain within normal wt limits but are dominated by eating related conflict
- use of self induced vomiting, excessive laxatives, diuretics, fasting, excessive exercise

Front 25

S/S of Bulimia Nervosa

Back 25

Preoccupied with body weight
_ consumes high calorie food in secret
- Binge Purse syndrome
- Lower self esteem
- Poor interpersonal relationship
- mood swings

Front 26

N/I of Bulimia Nervosa

Back 26

- same as anorexia
- nutritional plan
- balanced diet

Front 27

What is schizophrenia

Back 27

group of mental disorders characterized by psychotic factors, inability to trust others, disordered thought process, and disrupted interpersonal relationships
- Disturbance in affect, mood, behavior, and thought process

Front 28

Factors related to schizophrenia

Back 28

Genetic - if one parent is affected 19% child will, if both parents affected 39% child will
- Biochemical , Dopamine, Norepi, serotonin may have a role
- psychosocial factors , interpersonal theory proposes lack of a warm nurturing relationship in early years of life

Front 29

S/S of schizophrenia

Back 29

Disheveled appearance, body image disturbance, preoccupied with somatic complaints
- catatonic posturing, catatonic excitement, movements may be repetitive, motor activity increase
- mistrust, view world as unsafe and threatening display feelings of helplessness, anxiety, anger
- compulsive rituals, abnormal thought process

Front 30

Nursing Diagnosis for Schizophrenia

Back 30

- altered thought process related to perceptual and cognitive distortions
- social isolation related to inability to trust
- risk for activity intolerance related to adverse reactions to meds
- risk for violence self directed or toward others

Front 31

N/I of schizophrenia

Back 31

- provide pt with honest and consistent feedback
- avoid challenging the content of pts behavior
- focus on pts behavior
- administer meds

Front 32

Evaluate outcome criteria for pts with schizophrenia

Back 32

- exhibits improved reality orientation, concentration and attention span
- communicates with family and shift in a clear manner without evidence of loose thinking
- maintain personal hygiene

Front 33

What is Autism

Back 33

- severe mental disorder before the age of 3
- Impairment in reciprocal social interaction, and in verbal and non verbal communication
- cause unknown and prognosis is poor

Front 34

S/S of Autism

Back 34

- Disturbance in the rate and appearance of physical and social and language
- Abnormal response to body sensations
- Abnormal ways of relating to people or objects
- Child may play happy alone for hours but disturb him and he will throw a temper tantrum
- Language disturbance often includes repetition of previously heard words

Front 35

N/I of Autistic Child

Back 35

Determine child’s routine and habits and preferences and maintain
- Facilitate communication through picture board
- Evaluate for safety
- Monitor for stress and anxiety
- Initiate referrals to special programs

Front 36

S/S of paranoid Disorder

Back 36

- suspicious and mistrustful
- emotionally distant
- distorts reality
- poor insight
- Hyperviligence
- Low self esteem
- Evasive

Front 37

Nursing Diagnosis for pts with paranoid Disorder

Back 37

- Altered thought process to perceptual and cognitive distortions
- Social Isolation related to inability to trust
- Risk for activity intolerance related to adverse reactions
- Ineffective individual coping related to misinterpretation
- Risk for violence

Front 38

N/I for paranoia Pts

Back 38

- Assess suicide risk
- Diminish suspicious behavior
- Establish trusting relationship
- Promote increased self esteem
- Follow through on commitment made to pt

Front 39

S/S of hostility

Back 39

- Hx of violence or self harm
- poor impulse control and low tolerance of frustration
- defiant argumentation
- verbal threats
- Increase in pacing and agitated
- muscle rigidity
- flushed face
- glaring
- Loud voice

Front 40

N/I of hostility

Back 40

- Acknowledge Anger
- Set limits on behavior
- listen actively and assist pt to deal with consequences of anger
- provide safety for expressing anger and to safety of others

Front 41

4 types of Cirrhosis

Back 41

Alcoholic
Post necrotic
Biliary Cirrhosis
Cardiac Cirrhosis

Front 42

Late s/sx of Cirrhosis
(Decreased liver size scar Tissue)

Back 42

Ascites d/t decreased albumin
Jaundice
Spider angioma
gastrointestinal. varices
edema
anemia
Clotting dysfunction.
Pruritus d/t accumulation of bile salts
Hepatic encephalophy or coma

Front 43

What are some Clinical Manifestations of Hepatic Coma

Back 43

Neuro: Disoriented,confusion,personality changes, memory loss, Dec.loc,dec. motor activity,
Positive Babinski reflex
Seizures
Asterixis or flapping tremor of the hands.
EEG slowing brain waves
breath odor SULFUR

Front 44

What is given to Dec. ammonia level

Back 44

Lactulose
the lactulose traps the ammonia in the intestine.

Front 45

Diet for hepatic coma (if pt can eat)

Back 45

high-carb,low-protein,low fat

Front 46

What is the best position for pt w/ hepatic coma

Back 46

semi-fowler's or fowler's supporting arms w/ pillows.

Front 47

if pt. is on lactulose what labs should be monitored.

Back 47

sodium and potassium

Front 48

Cholecystitis

Back 48

acute inflammation and infection of the gallbladder

Front 49

when eating fatty foods what hormone is secreted by the small intestines?

Back 49

Cholecystokinin

Front 50

What is the time period (age) for Freud's Anal Stage?

Back 50

18 months to 3 years

Front 51

What is the time period (age) for Freud's Oral Stage?

Back 51

Birth to 18 months

Front 52

What is the time period (age) for Freud's Phallic Stage?

Back 52

3 years to 6 years

Front 53

What is the time period (age) for Freud's Latency Stage?

Back 53

6 years to puberty

Front 54

What is the time period (age) for Freud's Genital stage ?

Back 54

puberty – on

Front 55

What would be characteristic of someone who had unresolved issues from Freud's Anal stage?

Back 55

Too clean and orderly or too messy

Front 56

What would be characteristic of someone who had unresolved issues from Freud's Oral stage?

Back 56

Eating, biting nails, smoking

Front 57

What would be characteristic of someone who had unresolved issues from Freud's Phallic stage?

Back 57

confused sexual identity

Front 58

What is the Oedipus Complex?

Back 58

Psychological theory where males are attracted to women like their mother

Front 59

What is the Electra Complex?

Back 59

Psychological theory where females are attracted to men like their father

Front 60

At what age does Erickson’s struggle of Trust vs. Mistrust occur?

Back 60

Birth to age 1

Front 61

At what age does Erickson’s struggle of Identity vs. Role Confusion occur?

Back 61

Adolescence

Front 62

At what age does Erickson’s struggle of Initiative vs. Guilt occur?

Back 62

3 to 6 years

Front 63

At what age does Erickson’s struggle of Intimacy vs. Isolation occur

Back 63

Young adulthood

Front 64

At what age does Erickson’s struggle of Generativity vs. stagnation occur?

Back 64

Middle adulthood

Front 65

At what age does Erickson’s struggle of Ego Integrity vs. despair occur?

Back 65

Senior citizen age

Front 66

At what age does Erickson’s struggle of Industry vs. Inferiority occur?

Back 66

6 to puberty

Front 67

At what age does Erickson’s struggle of Autonomy vs. shame/doubt occur?

Back 67

1 to 3 years

Front 68

Unresolved issues during Erickson’s stage of autonomy vs. Shame/Doubt would result in?

Back 68

overly dependent, low self-esteem

Front 69

Unresolved issues during Erickson’s stage of Trust vs. Mistrust would result in?

Back 69

Suspicious and mistrusting

Front 70

Unresolved issues during Erickson’s stage of Initiative vs. Guilt would result in?

Back 70

Being followers, self-limiting

Front 71

Unresolved issues during Erickson’s stage of Industry vs. Inferiority would result in?

Back 71

self-doubt, inferiority

Front 72

Unresolved issues during Erickson’s stage of Identity vs. Role Confusion would result in?

Back 72

confusion about self

Front 73

Unresolved issues during Erickson’s stage of Intimacy vs. Isolation would result in?

Back 73

loneliness, depression

Front 74

Unresolved issues during Erickson’s stage of Generativity vs. stagnation would result in?

Back 74

unproductive feelings

Front 75

Unresolved issues during Erickson’s stage of Ego Integrity vs. despair would result in?

Back 75

despair/depression

Front 76

antidiuretic hormone (ADH)

Back 76

AKA vasopressin
synthesized in hypothalamus
stored & secreted by posterior pituitary
decrease = diabetes insipidus
increase = syndrome of inappropriate antidiuretic hormone (SIADH)

Front 77

diabetes insipidus

Back 77

caused by ADH deficiency usually due to tumors/trauma to pituitary gland
occasionally caused by pt drinking large amounts of water in absence of true disease
S/S: polyuria - nocturia - high serum osmolality - low urine osmolality - decreased urine specific gravity – polydipsia

Front 78

hypophysectomy

Back 78

surgical removal of pituitary gland

Front 79

syndrome of inappropriate antidiuretic hormone (SIADH)

Back 79

*results from too much ADH in body causing excess water to be reabsorbed by kidney tubules & collecting ducts
*results in decreased urine output & fluid overload
*certain cancers, several drugs, and head trauma or surgery can cause SIADH
*S/S: weight gain - serum osmolality less than 275 mOsm/kg - concentrated urine - muscle cramps & weakness - lethargy - seizures – coma

Front 80

growth hormone (GH)

Back 80

AKA somatotropin
responsible for normal growth of bones, cartilage, & soft tissue
synthesized & secreted by anterior pituitary
excess = acromegaly
deficit = dwarfism

Front 81

hyperplasia

Back 81

abnormal increase in number of cells in tissue/organ
is NOT a tumor

Front 82

Triiodothyronine (1____) and thyroxine (2_____) are secreted by the 3_____ gland. These hormones may be collectively referred to as 4_____ 4_____ (TH). Deficient secretion of these hormones results in 5_____; excess TH results in 6_____.

Back 82

1 T3
2 T4
3 thyroid
4 thyroid hormone
5 hypothyroidism
6 hyperthyroidism

Front 83

cretinism

Back 83

hypothyroidism occurring in infancy

Front 84

myxedema

Back 84

hypothyroidism that develops in an adult

Front 85

hypothyroidism

Back 85

occurs when thyroid gland fails to produce enough TH despite enough TSH being secreted
cause can be due to congenital defect, inflammation, iodine deficiency, autoimmune dx, postpartum pituitary necrosis
S/S: reduced metabolism - fatigue - weight gain - Bradycardia - constipation - mental dullness - feeling cold - SOB - dry skin & hair - water retention

Front 86

hyperthyroidism

Back 86

excessive amounts of circulating thyroid hormone

increases metabolism, number of beta-adrenergic receptor sites & activity of NE resulting in 'fight-or-flight' response

S/S: heat intolerance - increased appetite w/weight loss - increased bowel movements - nervousness - tremor – tachycardia

Front 87

thyrotoxic crisis

Back 87

AKA thyroid storm
severe hyperthyroid state that can occur in hyperthyroid pts who are untreated or who are experiencing another illness or stressor
can result in death in as little as 2 hrs if untreated

Front 88

Chvostek's sign

Back 88

method for assessing pt for hypocalcemia
tap on pt's facial nerve just in front of ear - spasm of face = + hypocalcemia

Front 89

Trousseau's sign

Back 89

method for assessing pt for hypocalcemia
place sphygmomanometer on pt's arm & pump to above pt's systolic pressure - spasm of thumb & fingers occurs w/i 3 min if pt has hypocalcemia

Front 90

adrenal medulla

Back 90

part of adrenal gland

secrete epinephrine & norephinephrine
secretion stimulated by sympathetic impulses from hypothalamus during stress

Front 91

cortisol

Back 91

produced in adrenal cortex
most abundant of glucocorticoids
stimulates liver to change glucose to glycogen - increases conversion of excess amino acids to carbs - increases use of fats for energy - has anti-inflammatory effect by blocking histamine & stabilizing lysosomes in cells
stimulus for secretion is ACTH from anterior pituitary gland (brought on by stress)