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126 Cards in this Set
- Front
- Back
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What are the important benzos?
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Xanax
Librium Klonopin Tranxene Valium Ativan |
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What are the important nonbenzos?
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BuSpar
Vistaril |
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What is the action of anxiolytics?
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works on neurotransmitters
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What are anxiolytics used to treat?
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anxiety, acute ETOH withdrawl syndrome
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What are the side effects of anxiolytics?
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oversedation, drowsiness, constipation, decreased libido, urinary retention, blurred vision, may be habit forming, withdrawl syndrome with prolonged use
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What are some nursing implications for anxiolytics?
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withdraw drugs slowly, watch for changes in liver function, moitor for development of paradoxica excitement, assess mood and affect, avoid use with ETOH or CNS depressants
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Anxiety d/o is a response to what?
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prolonged stress
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What is somatic d/o?
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physical complaints like migranes, GI problems
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What would be done during a physical exam for an anxiety d/o?
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thyroid levels, drug use, adrenal sufficiency, caffeine
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What is psycho therapy?
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cognitive-behavioral therapy, groups
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What meds would be used for an anxiety d/o?
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antidepressants, anxyiolytics
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What is panic d/o?
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individuals experiences repeated epidoses of intense fear occuring without a warning or trigger and can last 10-30 minutes
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What is agoraphobia?
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fear of open spaces, fear of the outside world
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What is the DSM criteria for panic d/o?
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4 attacks per month or 1 attack followed with 4 weeks of fear of having another
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What are the symptoms of panic d/o?
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racing heartbeat
difficulty breathin terror is almost paralyzing dizziness trembling, sweating, shaking choking, chest pains host flashes, sudden chills tingling in fingers or toes fear that you're going to go crazy or are about to die tunnel vision worry about occurence which can lead to agoraphobia |
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What would be checked before diagnosing panic d/o?
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thyroid and mitral valve
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What are the treatments for panic d/o?
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anxiolytics, SSRIs, TCAs, MAOs, cognitive therapy, behavioral therapy
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What is the best class of meds for panic d/o?
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SSRIs
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What is cognitive therapy?
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reframing negative messages, assertiveness training
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What is behavioral therapy?
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relaxing, exposure therapy, time management
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What are some nursing interventions for when a panic attack is witnessed?
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provide safe environment
stay calm-talk slowly help individual focus on breathing stay in visual field may need to walk or ground |
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What is GAD?
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persistent, unrealistic, excessive anxiety for 6 months or longer
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What are the s/s of GAD?
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motor tension, autonomic hyperactivity, vigilance and scanning
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What should be r/o before diagnosing GAD?
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excessive caffeine use, Cushing's, hyper-thyroidism and assess ETOH and drug abuse
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What are the treatments for GAD?
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cognitive-behavioral therapy, anxiolytics, SSRIs, beta blockers
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What is social phobia?
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fear of situations in which an individual may be exposed to scrutiny by others or may be humiliated or embarrassed.
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How are phobias treated?
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cognitive-behavioral therapy, PRN benzos, SSRIs, groups
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What is PTSD?
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experiencing an extreme stressor out side the range of usualy expereince that is followed by psychological symptoms and re-experiencing the trauma
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What are the s/s of PTSD?
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insomnia, hypervigilence, decrease in concentration, out of control, feel afraid, anger outbursts, guilt, decrease in appetite, numb or detached
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What is the treatment for PTSD?
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talk about it
behavioral therapy meds depend on symptoms groups |
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What is an obsession?
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involuntary, unwated, persistent thought that causes anxiety
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What is a compulsion?
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unwated, excessive, repetitive behavior that reduces tension
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How do you get the diagnosis of OCD?
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the obsession and/or compulsion is so severe and time consuming it interferes with ones occupational and/or social functions
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What is the treatment for OCD?
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break compulsion
SSRIs- luvox behavioral therapy deep breathing, relaxation |
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What is euthymia?
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normal mood
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What is dysphoria?
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unpleasant mood
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What is mood?
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inner emotions
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What is affect?
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outer response
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What is major depression?
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serious depression that last for at least 2 wks
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What are the s/s of major depression?
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depressed mood
decreased intrest in activites, hobbies, intimacy weight gain or loss sleep gain or loss motor activity decreased energy exaggerated guilt decreased concentration suicide |
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What is major depression with psychotic features?
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hallucinations, delusions
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What is melancholic type of major depression?
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guilt, not having energy, eating, sleeping, depression with anhendonia, mostly in morning, wake up feeling horrible
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What is dysthymia?
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chronic, milder than major depression, long term blues, chronically unhappy, can be w/ OCD or substance abuse
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What is SAD?
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depressed when light cycle is shortest
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What is post partum depression?
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brief period of time after delivery
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What are some symptoms children might have for depression?
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somatic complaints, withdrawl, school performance issues, issuses w/ peers
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What is the treatment for depression?
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psychotropic meds, cognitive-behavioral therapy, group therapy, family therapy, ECT
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What is bipolar?
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a mood that causes radical emotional changes from manic to depressive
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What are the s/s of mania?
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excessively high or euphoric feelings
increased energy, activity, restlessness, reacing thoughts pressured speech over-inflated-self esteem extreme irritability and distractibility reduced need to sleep unrealistic beliefs in one's abilities and powers poor judgment and aggressive behavior increased sexual drive substance abuse denial |
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What is bipolar I?
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mania/major depression
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What is bipolar II?
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major depression/hypomania
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What is cyclothymia?
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chronic mood swings not severe
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What is the treatment for bipolar?
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lithium, anticonvulsants/mood stabilizers, antidepressants, antipyschotics, benzos
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What are the important SSRIs to treat mood d/o?
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Cymbalta
Prozac Luvox Paxil Zoloft Celexa Lexapro |
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What are the important TCAs for mood d/o?
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Elavil, Anafranil
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What are the other meds for mood d/o?
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Wellbutrin
Effexor Desyrel Serozone Remeron |
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How do antidepressants work?
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work on serotonin
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What are the s/e of antidepressants?
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orthostatic hypotension, HTN, arrhytmias, H/A, sedation in early use, dry mouth, constipation, fine tremors, urinary retention, lethargy, fatigue, blurred vision
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What are the MAOIs used for mood d/o?
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Nardil
Marplan Parnate |
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What is the therapuetic range or lithium?
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0.5-1.5
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What is the toxic range for lithium?
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2.0
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What are the anticonvulsants used for mood d/o?
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Klonopin
Tegretol Depakote Lamictal Neurontin Topamax Trileptal |
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Who should be cautioned before taking tegretol?
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anyone with liver/renal/cardiac disease
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Who should be cautioned before taking depakote?
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liver d/s
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What is an adverse effect of lamictal?
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stevens johnsons syndrome
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What are some nursing interventions for mania?
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decrease stimuli
provide structured/ predictable environment provide physical activities nurtrition set limits/ be consistent focus on feelings |
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What are the 10 major risk factors for suicide?
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sex males > females
age 15-24 25-40 > 65 depression previous attempts etoh or drug abuse rational thinking social support organized plan no spouse sickness |
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What are some suicide interventions?
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establish a therapuetic relationship
communicate the potential for suicide to team members stay with person accept the person listen to the person secure a no-suicide contract give the person a message of hope give the person something to do |
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What is the DSM criteria for schizo?
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psychotic symptoms for at least one week, deterioration in social and occupational functioning and self care symptoms for six months
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When is schizo diagnosed?
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males early 20s, females late 20s except paranoid
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What is phase I of schizo?
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schizoid personality, indifferent, cold and aloof, these individuals are loners. they do not enjoy close relationships with others
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What is the phase II of schizo?
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individuals are socially withdrawn and have behavior that is peculiar or eccentric. role functioning is impaired, personal hygiene is neglected, and disturbances exist in communication, ideation, and perception, affect blunted and bizarre
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What is phase III of schizo?
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psychotic symptoms are prominent
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What is phave IV of schizo?
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residual phase. symptoms similar to prodromal phase with flat affect and impairment in role functioning being prominent after medication
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What is disorganized schizo?
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chronic variety with flat or inappropriate affect. silliness and incongruous giggling is common. behavior is bizzare and social interaction is impaired
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What is catatonic schizo?
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extreme psychomotor retardation, mute, posturing is common
purposeless movements that must be curtailed to prevent injury to the client or others |
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What is paranoid schizo?
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paranoid delusions, can be developed in 30s w/o any other symptoms
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What is undifferentiated schizo?
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bizarre behavior that does not meet the criteria outlined for the other types of schizo, or may meet the criteria for more thatn one type, delusions and hallucinations are prominent.
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What is residual schizo?
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recovery, stage that follows an acute episode
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What is schizoaffective d/o?
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schizo symptoms accompained by a strong element of symtomatology associated with the mood d/o, either mania or depression
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What is brief psychotic d/o?
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sudden onset of psychotic symptoms following a severe psychosocial stressor. symptoms last less than 1 month and the individual returns to the full premorbid level of functioning
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What is schizophreniform d/o?
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same symptoms of schizo with the exception that the duration of the d/o has been at least 1 month but less than 6 months
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What is erotomanic type of delusional d/o?
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the individual believes that someone is in love with him or her that is not
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What is grandiose type of delusional d/o?
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irrational ideas regarding own worth, talent, knowledge, or power
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What is jealous type of delusional d/o?
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irrational idea that the person's sexual partner is unfaithful
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What is the persecutory type of delusional d/o?
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individual beleives he or she is being malevolently treated in some way
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What is the somatic type of delusional d/o?
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the individual has an irrational belief that he or she has some physical defect, d/o or disease
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What is shared psychotic d/o?
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a delusional system develops in a second person as a result of a close relationship with another person who already has a psychotic d/o with prominent delusions. like in cults
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What are the positive symptoms of schizo?
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hallucinations, delusions, disorganized speech, disorganized behavior, illusions
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What are hallucinations?
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person senses things that aren't really there
hearing voices, seeing things, smelling things, tastings things that is not there |
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What are delusions?
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beliefs of a paranoid or bizarre nature that are untrue, but believed by the person experienceing them to be very real
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What is an illusion?
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there is something there but their interpretation is different
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What is echopraxia?
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repeating gestures or motions in a bizarre manner
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What are the negative symptoms of schizo?
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lack of motivation, social withdrawl, poverty of speech, diffculty concentrating, diffculty showing or feeling emotion
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What is circcumstantial?
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thought and speech are excessive and include unnecessary detail that is usually irrelevant to answering question
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What are flight of ideas?
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over productive speech characterized by rapid shifting from one topic to another. includes fragmented ideas. may include punning, rhyming, clang associationg, and may demonstrate disstractibility as well
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What is loose associations?
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lack of logical relationship b/t thoughts and ideas
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What is mutism?
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valid assessment only when no reponse is given even though client appears alert and aware of the environment
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What is neologisms?
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new word or words created by client
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What is preserveration?
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repetition of sounds, words, or phrases despite efforts to create a new response
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What is tangential?
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person never returns to the central point and never answers the orignial question
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What is thought blocking?
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sudden stoppage in train of thought or in midst of a sentence
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What is echolalia?
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imitation of speech of another person
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What are delusions of reference?
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belief that public events or people are directly related to the individual
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What somatic delusions?
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belief that one's body is altered from normal structure or function
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What is thought broadcasting?
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belief that one's unspoken thoughts can be heard
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What are delusions of control?
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belief that one's actions or thought are controlled by an external person or force
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What of delusions of grandier?
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belief that one has special powers
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What is the main neurotransmitter associated with schzio?
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dopamine
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What is the treatment for schizo?
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neuroleptics, individual therapy, day programs, PACT, family therapy, boarding homes
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What are the convential antipsychotics used to treat schizo?
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thorazine
prolixin haldol |
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Why is thorazine not used very often?
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horrible s/e
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Why would prolixin or haldol be given IM?
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noncompliance
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What are the atypical antipsychotics given to treat schizo?
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clozaril
risperdal zyprexa seroquel geodon |
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What is the new generation antipyschotic used to treat schizo?
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abilify
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What are the antiparkinsonian agents used to treat EPS?
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cogentin
artane benadryl |
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What is pseudoparkinsonism?
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stooped posture
shuffling gait rigidity bradykinesia tremors at rest pill-rolling motion of hand |
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What is acute dystonia?
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facial grimacing
involuntary upward eye movement muscle spasms of the tongue, face, neck and back laryngeal spams- IV valium |
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What is akathisia?
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restless
trouble standing still paces the floor feet in constant motion, rocking back and forth |
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What is tardive dyskinsesia?
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protrusion and rolling of the tongue
sucking and smacking movements of the lips chewing motion facial dyskinesia involuntary movements of the body and extremeties |
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What is neuroleptic malignant syndrome?
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muslce rigidity
altered levels of consciousness, hyperthermia, tachycardia, increased BP, diaphoresis demands immediate treatment |
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What is agranulocytosis?
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extreme low leves of WBC
sore throat, fever and malaise |
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Which drugs for schizo have to have a WBC before giving?
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risperidal
cloazril |
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What would be a nursing diagnosis for a pt having a delusion?
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altered thought process
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What would be a nursing diagnosis for a pt having a hallucination/illusion?
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altered-perceptual alteration
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What are some nursing diagnosis for a pt with schizo?
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social isolation
risk for violence to self or others imparied verbal communication risk for noncompliance self care deficit ineffective family coping: disabling |
