Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
128 Cards in this Set
- Front
- Back
|
What are dissociative d/o?
|
occur when anxiety becomes overwhelming, causing the individuals identity, memory and consciousness to become disturbed or disorganized.
individual dissociates self from situation or experience too traumatic/or stressful to integrate with his conscious self. |
|
|
What are the causes of dissociative d/o?
|
high incidence of childhood abuse/trauma
overwhelming anxiety weak childhood caregiver may have comorbid d/o: substance abuse, depression, PTSD, cluster B personality d/o |
|
|
What is dissociative amnesia?
|
memory loss of important personal info, usually info is a traumatic event. individual is aware they cannot recall this info. onset is rapid, recovery is spontaneous and reoccurrence is rare after therapy
|
|
|
What is localized amnesia?
|
individual is unable to recall all info associated w/ traumatic even *before and after
|
|
|
What is selective amnesia?
|
remembers some events surrounding trauma
|
|
|
What is generalized amnesia?
|
forget who you are, entire lifetime
usually found after a traumatic event |
|
|
What is continuous amnesia?
|
can't form new memories after stressor for a few days
alert and aware |
|
|
What is the treatment for dissociative amnesia?
|
keep them stress free
watch for signs that they're ready to talk don't flood them, therapy starts when memory is back |
|
|
What is dissociative fugue?
|
the individual is in a fugue state and travels from home or work for days at a time. they are unable to recall personal identity and often assume a new identity. new ID may be opposite of their real ID
duration is brief- rarely months. recovery is rapid and complete. recurrences are not common |
|
|
What is the treatment for dissociative fugue?
|
crisis intervention
no flooding coping mechanisms |
|
|
What is dissociative identity d/o?
|
the presence of two or more distinct alternate personality or sub-personality states that take control of behavior. only one personality is evident at any given time and one of them is dominant most of the time over the course of the d/o
onset is usually during childhood, following incest and/or childhood abuse or other childhood trauma have a lot of somatic complaints, time lapses, hear voices each alter has a defining personality that can be different ages and genders often the original is religious and moralistic |
|
|
What is the treatment for dissociative d/o?
|
therapist has to believe it
provide a safe environment hypnosis, talk therapy |
|
|
What is depersonalization d/o?
|
the individual experiences a feeling of detachment from their mental process or body
may feel mechanical, dreamy, see self from a distance |
|
|
What is the treatment for depersonalization d/o?
|
find stressor
talk, listen |
|
|
What is malingering?
|
intentionally or consciously faking physical or psychological symptoms- motivated by external incentives
|
|
|
What is paraphilias?
|
unconventional sexual behaviors and when performed they receive sexual gratification, interferes w/ development of close intimate relationships
person has learned to associate sexual arousal with some environment stimulus, which triggers the unusual behavior behavior involves non-humans, may humiliate another, or evolves non-consenting individuals |
|
|
What is fetishism?
|
individual finds it necessary to have some external object present in fantasy or reality to be sexually satisfied
|
|
|
What is exhibitionism?
|
men with a powerful urge to expose genitals to strangers. this is an expression of anger and hostility. the expression of shock is what excites the exhibitionist
|
|
|
What is voyeurism?
|
a voyeur is someone who obtains sexual gratification from looking at others having sex or undressing
"peeping toms" shy, socially isolated, low confidence |
|
|
What is frotteurism?
|
rubbing onself against a non-consenting person
can lead to harm in crowded elevators |
|
|
What is pedophilia?
|
involves sexual activity of adults with children under age 13
|
|
|
What is the profile of a pedophile?
|
male, molested as a child
has difficulty with adult relationships suffers from depression is trusted by the child often married with own children often in a position to be around children usually begins before 18 |
|
|
What is masochism and sadism?
|
the giving (sadism) and receiving (masochism) of psychological or physical paint to obtain sexual satisfication
|
|
|
What are some risk factors for sexual deviations?
|
difficulty with relationships
increasing level of anxiety learned at a critical time in development |
|
|
What is the treatment for sexual d/o?
|
cognitive behavioral therapy
|
|
|
What is transexualism?
|
individuals have early and persistent feelings that they are trapped in the wrong body
|
|
|
What is an adjustment d/o?
|
a maladaptive reaction to an identifiable stressor. the reaction interferes with the individuals functioning or sense of wellbeing. stressor can be developmental, situational, or adventitious. frequently seen in adolescents
|
|
|
What are some common stressors identified with adjustment d/o?
|
adolescent: determine life after high school, parent's divorce, failure, move, death of loved one, identity disturbance
adult: loss of job, divorce, parenthood, empty nest, change in health status elderly: retirement, loss of independence, financial stress |
|
|
What are the classification of adjustment d/o?
|
w/ depressed mood
w/ anxiety w/ conduct disturbance mixed w/ physical complaints |
|
|
What are the risk factors for developing adjustment d/o?
|
not good coping skills
support system cannot express feelings |
|
|
What are some nursing diagnosis for adjustment d/o?
|
risk for suicide
impaired adjustment anxiety ineffective coping dysfunctional grieving situational low self-esteem impaired social interaction hopelessness powerlessness |
|
|
What is the treatment for adjustment d/o?
|
assess for suicide
stressor is easy to identify sort out emotions identify crisis relieve symptoms get back to normal level of functioning groups coping skills family therapy meds not given unless symptoms are overwhelming |
|
|
What is intermittent explosive d/o?
|
a loss of control leads to aggressive behavior and results in assault to an individual or destruction of property
|
|
|
What are the risk factors for intermittent explosive d/o?
|
families with alcoholics, or abusive families
individuals with seizure d/o individuals who are unable to express anger adolescents d/t too much exposure to violence |
|
|
What is the treatment for intermittent explosive d/o?
|
teach acceptable outlets for anger
behavioral therapy, mood stabilizers- lithium, anti-convulsants |
|
|
What is kleptomania?
|
failure to resist the impulse to steal, usually the objects are not needed and the individual has money. stealing gives them an unconscious sense of relief or mental lift
|
|
|
What are the risk factors for kleptomania?
|
individual feels neglected, unwanted, lonely.. shoplifting gives them a way of managing unpleasant feelings.. build up on tension and release that comes with getting something without paying provides a high that becomes addictive. increased incidence in individuals trying to stop using drugs
women more than men |
|
|
What is the treatment for kleptomania?
|
therapy
|
|
|
What is pathological gambling?
|
impulse control d/o
preoccupation with gambling, worsens with increased stress which leads to increased gambling, increased debts, job loss, criminal behavior, family disruption |
|
|
What are the risk factors for becoming a pathological gambler?
|
learned, individual cannot delay gratification
"thrill seekers" |
|
|
What is the treatment for pathological gambling?
|
gamblers anonymous
|
|
|
What is pyromania?
|
inability to resist setting fires
individuals usually have poor impulse control in other areas like substance abuse or anger. behavior frequently begins in adolescent years |
|
|
What are the risk factors for pyromania?
|
need to release anger or rage
|
|
|
What is the treatment for pyromania?
|
difficult d/t lack of insight
|
|
|
What is trichotillomania?
|
inability to resist pulling out of one's hair- resulting in noticeable hair loss. individual has an increasing sense of tension immediately before pulling out the hair- stress reducing act and the individual feels pleasure, gratification or relief. hair loss is usually from the scalp, eye brows or eye lashes. some report going into "trance" like state where they are unaware of surroundings
|
|
|
What are some associated behaviors of trichotillomania?
|
childhood hx of self mutilation, symptoms of OCD, occurrence of depression
|
|
|
What are the risk factors for trichotillomania?
|
women
frequently a stressful event can be associated with the onset usually begins around age 12-13 may have a very controlling and passive parent |
|
|
What is the treatment for trichotillomania?
|
SSRIs for depression
Luvox for OCD behavior behavioral modification cognitive therapy family therapy OCD group |
|
|
What is somatization d/o?
|
chronic multiple somatic symptoms with no physiologic causes
individual has hx of several years seeking a diagnosis. can identify being under a lot of stress symptoms can be dramatic and individual can be dramatic begins before age 30 |
|
|
What is somatoform pain d/o?
|
severe and prolonged pain without medical explanation.
individuals have frequently been physically abused as children pain not relieved by analgesics most common in women in their 30s and 40s |
|
|
What is hypochondriasis?
|
preoccupation or unrealistic fear that they have a serious d/s and cannot be reassured despite repeated test. can have vague symptoms and may interpret normal body sensations as sighs of d/s. cannot identify stressor. men and women present with this d/o equally, onset in 20s and 30s. may do a lot of own testing (BP, temp, WBG)
|
|
|
What is conversion d/o?
|
sudden loss or change in bodily function because of psychological conflict. the loss is frequently neurological or sensory. there is no pain and the individual is not concerend about the change. almost seem relieved or comfortable with the loss. can occur as early as 10 years old
more common in women paralysis, cannot swallow, can't see, hear |
|
|
What is body dysmorphic d/o?
|
exaggerated belief that your body is deformed or defective in some specific way- most common complaint is face. often use avoidance to cope, resutling in social isolation. individual is willing to explore the possibility that this is an exaggeration and stress induced. rare d/o. frequently abused as children or come from alcoholic families. focus on defect is anxiety reducing.
|
|
|
What is the treatment for body dysmorphic d/o?
|
OCD group therapy
SSRIs neuroleptics adult children of alcoholics cognitive-behavioral therapy |
|
|
What would be some nursing diagnosis for body dysmorphic d/o?
|
impaired body imagine
social isolation ineffective coping |
|
|
What is muscle dysmorphic d/o?
|
looking for the perfect body- increasing in incidence. individual is distressed by body shape and spend hours at gym trying to change it- interferes with social/occupational functioning. may use anabolic steroids
"gym rats" |
|
|
What is the treatment for somatoform d/o except dysmorphic?
|
difficult b/c symptoms are real
don't focus on physical symptoms try not to use benzo d/t addiction unconditional positive regard explore coping mechanisms/support system family practitioners assertiveness training stress management cognitive therapy to increase self-esteem. learn connection of mind and body. psychotropic meds. antidepressants |
|
|
Psychosomatic illnesses?
GI CV Skin Resp Musco other |
real illnesses diagnosed d/t stress
ulcers, IBS HTN dermititis asthma arthritis lupus, thyroid problems |
|
|
What is factitious d/o?
|
playing sick
|
|
|
What is munchausen's?
|
consciously faking physical symptoms for secondary gain from caregiver
|
|
|
What is munchausen syndrome by proxy?
|
caregivers injure their victims in order to gain sympathy or attention for themselves
mom appears to care for child except when alone want a relationship w/ medical professionals |
|
|
What is personality?
|
unconscious, fixed psychological characteristic or behavior
it is an expression of our self and how others view us usually set as teenager d/o not diagnosed until 18 |
|
|
What do personality d/o frequently coexist with?
|
mood, anxiety and substance abuse
|
|
|
What is a personality d/o?
|
the individual has traits that are rigid and inflexible and they cannot adapt in interpersonal and occupational situations. they lack insight of the impact their behaviors have on others. when stressed the individuals try to change the environment instead of changing themselves, and they fail to accept the consequences of their own behavior
|
|
|
What drugs are used to treat the severity of the symptoms associated with personality d/o?
aggression unstable moods anxiety depression |
antipsychotics
anticonvulsants/lithium anxiolytics antidepressants |
|
|
What are the d/o under cluster A?
|
paranoid
schizoid schizotypal |
|
|
What are the d/o under cluster B?
|
antisocial
borderline histrionic narcissistic |
|
|
What are the d/o under cluster C?
|
avoidant
dependent obsessive-compulsive passive-aggressive |
|
|
What is the paranoid personality?
|
odd, suspicious, mistrustful, jealous, envious, usually loners
may be shy or hostile use projection frequently feeling people are out to get them |
|
|
What is the treatment for paranoid personality?
|
involved into treatment plan
straight forward approach try to teach them to trust |
|
|
What is the schizoid personality?
|
socially unliked, unable to have a personal relationship
withdrawn, loners, cold don't care if people don't like them nothing excites them work hard, take life serious |
|
|
What is the treatment for schizoid personality?
|
antidepressants, groups- 12 step, social
|
|
|
What is schizotypal personality?
|
mild schizophrenia: loners, withdrawn, eccentric
magical thinking, bizarre speech, weird tangential thinking, compulsions, hypersensitive to others emotions |
|
|
What is the treatment for schizotypal personality
|
neuroleptics, antidepressants, group homes
|
|
|
What is antisocial personality?
|
guiltless, no conscious, blaming, excitement seekers, manipulative, charming, restless, irritable, easily bored, need instant gratification, aggressive, sees self as victim
poor relationships, lack empathy and remorse, conduct d/o abusive, rapist, use "we" a lot, flattery, charming |
|
|
What is the treatment for antisocial personality?
|
mood stabilizer to take impulse of anger away
nurses have to be on same page- set a lot of limits watch for manipulation will rule the unit peaks in late 20s not a lot after 40s d/t often dead, jail, burned out and marry women who have dependent personalities |
|
|
What is borderline personality?
|
on border of psychosis and nuerosis, many suffer depression
unstable, chaotic relationships unclear sense of self or life goals don't like to be alone, cling to people self destructive behavior |
|
|
What is splitting?
|
playing people against each other
|
|
|
What is the treatment for borderline personality?
|
control behavior by setting limits
talk about expression of anger talk about triggers relaxation techniques talk about self mutilation watch for counter-transference rotate nurses frequently meetings about pt mood stabilizers, antidepressants talk about abuse groups |
|
|
What is histrionic personality?
|
women, dramatic, flashy extroverted, attention seeking, vain, shallow
difficult being affectionate to others but needs constant approval and acceptance from others, thrive on attention |
|
|
What is the treatment for histrionic personality?
|
want anyone to like them
scare people, want to work w/ men never in groups |
|
|
What is narcissistic personality?
|
males, increased sense of self worth and privilege, arrogant, self-centered, boast til they bore you
afraid to grow old, envious of others, lack empathy, use others, exaggerate achievements and talents |
|
|
What is the treatment for narcissistic personality?
|
groups
antidepressants work on low self-esteem |
|
|
What is avoidant personality?
|
avoid people so they don't face rejection, criticism, humiliation
withdrawn, social isolated want companionship, feel lonely |
|
|
What is the treatment for avoidant personality?
|
support groups
assertiveness training buspar |
|
|
what is dependent personality?
|
rely on others for support and decision making, lack self-confidence, need to be liked, allow self to be mistreated, cannot function w/o someone else
passive in relationships, avoid responsibility see themselves as stupid clingy married to alcoholic or antisocial |
|
|
What is the treatment for dependent personality?
|
cognitive therapy, antidepressants, AL-ANON, assertiveness training
|
|
|
What is obsessive-compulsive personality?
|
perfectionist lives
rigid about rules, meticulous, organized, punctual, order in all areas of life serious, not spontaneous afraid to fail, repressed anger not generous with money, time, self workaholics |
|
|
What is the treatment for obsessive-compulsive personality?
|
family therapy, short term anxiolytics, cognitive-behavioral therapy
|
|
|
What is passive-aggressive personality?
|
whiners and complainers
hostility expressed as procrastination, obstructions, inefficiency, forgetfulness, lateness frequent axis 1 depression unhappy and looking for someone to make them happy |
|
|
What is the treatment for passive-aggressive personality?
|
assertiveness training to direct emotions
|
|
|
What is mental retardation?
|
IQ 70 or below and impairments in self-care and social skills and motor skills
|
|
|
What are the symptoms of autism?
|
difficulty with verbal communication, including problems using and understanding language, may develop own language
unusual ways of playing with toys and other objects, such as only lining them up a certain way fixate on things that spin lack of imagination have horrible tantrums if there is a change in normal routine do a lot of rocking or tapping can have self destructive behavior that doesn't seem to cause pain loud music and noises bother them may have unusual talents like water a lot |
|
|
What are the symptoms of asperger syndrome?
|
abnormal nonverbal communication, such as problems with eye contact, facial expressions, body postures or gestures
failure to develop peer relationships known as weird or strange repetitive finger flapping, twisting, or whole body movements unusually intense preoccupation with narrow areas of interest, such as obsession with train schedules, phone books, or collections of objects and may talk unusually while playing with these things ackward motor skills |
|
|
What is the treatment of developmental d/o?
|
early diagnosis
earlier development of language center specialty programs speech therapy behavioral modification for family and support groups |
|
|
What meds may be used for developmental d/o?
|
PRN neuroleptics- Haldol, thorazine or routinely at low doses for aggression
Depakote, Adderall |
|
|
What is ADHD?
|
a persistent pattern of inattention and/or hyperactivity that is not typical at a comparable level of development
highly distractive, excessive motor activity, easily frustrated difficulty forming friendships/frequently having learning difficulties |
|
|
What is the treatment for ADHD?
|
look at whole picture
diet behavioral therapy check for learning d/o patience, small, realistic goals organized and predictable teachers support groups for parents CNS stimulants- Riddalin, Cylert, Adderall, Concerta, Sarterra tolerance can occur with meds drug holidays |
|
|
What are the s/s of CNS stimulants given for ADHD?
|
anorexia, decreased growth and development, insomnia
|
|
|
What is a conduct d/o?
|
behavior that violates rules or the rights of others
frequently display physical aggression and have poor peer relationships substance use, running away, skipping shcool, bullying, budding antisocials |
|
|
What is the treatment for conduct d/o?
|
set limits on inappropriate behavior
behavioral modification outlets for anger identify feelings therapist that is a good role model adolescent groups, book therapy, art therapy |
|
|
What is oppositional defiant d/o?
|
pattern of defiant, disobedient, and hostile behavior toward authority figures. observed more frequently than in individuals of comparable age and interferes with social, academic or occupational functioning
|
|
|
What is the treatment for oppositional defiant d/o?
|
good therapist
male, good role model |
|
|
What is separation anxiety?
|
excessive anxiety concerning seperation from home or from those to whom the child is attached. may refuse to go to school/friends.
may develop GAD as adult |
|
|
What is the treatment of separation anxiety?
|
small goals of separation
|
|
|
What is over anxious?
|
unrealistic worry about everything. kids want to be perfect and excel in all areas of their life. frequently have somatic complaints and/or nervous habits. common in eldest child/high socio-economical families/ high achievement expectations. also seen in children with unrealistic responsibilities
may develop GAD as adults |
|
|
What is the treatment for over anxious?
|
figure out what's going on in family
|
|
|
What is OCD in adolescents?
|
strep can cause OCD
|
|
|
What is tourette's?
|
individual has tics. a tic is a sudden, rapid, recurrent motor movement or vocalization
|
|
|
What are motor tics?
|
blinking, hopping, sniffing, hitting, spitting
|
|
|
What are vocal tics?
|
grunts, barks, loud shouts of obscenitites
|
|
|
What is the treatment for tourette's?
|
neuroleptic- risperdal
|
|
|
What is anorexia?
|
introverted, gifted attractive and terrified of being fat
15% below body weight/height- grossly distorted body image |
|
|
What are the external symptoms of anorexia?
|
hair loss, lanugo, dry skin, brittle bones and nails, fainting spells, SOB, cold hands and feet, swollen joints, muscle wasting, may see compulsive behavior, affect flat
|
|
|
What are the internal symptoms of anorexia?
|
hypothermia, bradycardia, hypotension, hypokalemia, hypochloremia, hypocalcemia, constipation, loss of menstruation, depleted protein and fat stores, high incidence of suicide
|
|
|
What is bulimia?
|
no excessive weight loss
eats in binges, then purges extroverted, poor self control, impulsive difficulty with expressing emotions family extremely critical |
|
|
What are the external symptoms of bulimia?
|
blood shot eyes, tooth and gum erosion, hoarseness, sore throats, swollen neck and glands
bloating, brittle bones, skin rashes high incidence of substance abuse poor relationships, mood swings |
|
|
What are the internal effects of bulimia?
|
esophigitis, dehydration, indigestion, heartburn, constipation, gastric and intestinal ulcers
electrolyte imbalances, cardiac arrhythmias kidney, liver and bowel damage irregular menstruation |
|
|
What is the treatment for eating d/o?
|
restore nutritional status- IV, tube feedings
include into treatment plan behavioral therapy- positive reinforcement cognitive therapy- journaling, positive thoughts, assertiveness training assess for depression or anxiety d/o bulimia- SSRIs anorexia- anxiolytics before meals (Xanax) education on healthy exercise family therapy support groups treatment centers |
|
|
What is binge eating?
|
axis III- obesity
response to stress binge large quanities of junk food usually when your stressed binge alone always on a diet |
|
|
What is the treatment for binge eating?
|
antidepressants
cognitive-behvioral therapy address underlying problems |
|
|
What are the risk factors for adolescent suicide?
|
loss of significant relationship with friend, family member or pet
suicide of a friend, relative, or public figure homophobic response of family members to an adolescent sexual preference divorce of parents, abusive family break-up with a girl or boyfriend unattainment of significant goal sees suicide as glamorous lacking spirtiuality parent committed suicide |
|
|
What are warning of suicide?
|
drastic changes in behavior
stated feeling of despair increased impulsive risk taking behaviors giving away possessions or returning borrowed things preoccupation with death sudden changes in personal apperance and hygiene previous suicide gestures/attempts direct comments anhendona |
|
|
What are some nursing interventions to prevent suicide?
|
take seriously the expression of a wish to die
provide a safe environment/ crisis intervention obtain a no harm/kill myself contract frequent checks of feelings assess spirituality |
|
|
What is cutting?
|
early teens, girls
disruptive home life poorly in school lonely emotions are very intense, dramatic usually very bright arms, inner thighs cut to feel more or less don't feel physical pain but feel emotional pain endorphines are released "cut to know they're alive" response to anxiety, stress, depression |
|
|
What is the treatment for cutting?
|
keep off websites
don't punish behvioral therapy cognitive therapy understand physical consequences determine any sexual abuse |
|
|
What are some basics in adolescent therapy?
|
confidentality
involved in treatment set limits understand adolescent is thriving for autonomy peer group is most important influence adolescents are confused, egocentric hormone changes |
|
|
What are some effective parenting skills?
|
find a mentor- seeek their advice
get involved, but not too much msgs of good luck post it notes very effective kids do what you do decrease TV time teach them to be kind by respecting others show them how to cope communicate-listen consistent rules but not rigid accountability apologize spirituality decrease realistic expectations all kids are different luck |
