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178 Cards in this Set
- Front
- Back
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Anticipatory grief |
To prepare oneself for the loss of a family member or loved one |
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Bereavement |
Common depressed reaction to the death of a loved one |
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Durable power of attorney |
A legal document must be notarized and that gives one or more individuals the right to make decisions on behalf of the person. |
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Dysfunctional grieving |
Unresolved grief or complicated mourning |
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Passive Euthanasia |
Treatments withheld that may have extended the patients life but result in death. |
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Living will |
Legal document that describes in detail what medical care a person wants if they become terminally ill. |
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Loss |
To no longer possess or have an object, person, or situation. |
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Maturational loss |
Loss resulting from normal life transitions |
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Morbidity |
Illness or abnormal condition or quality |
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Mortality |
Condition of being subject to death |
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Situational loss |
Loss occuring suddenly in response to a specific external event. |
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Thanatologist |
Person who studies death and dying |
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Stages of Death and Dying (Kubler-Ross) |
Denial Anger Bargaining Depression Acceptance |
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Signs and symptoms of pt. near death |
slow, weak thready pulse, decreased blood pressure, rapid, shallow, irregular, slow, respirations, mouth breathing. Detached look in eyes and pupils become fixed and dilated, skin becomes cold and clammy, profuse sweating..all signs of? |
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Clinical signs of death |
unresponsiveness, no movement, no reflexes, flat EKG, absence of apical pulse, cessation of respirations |
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Adaptation |
Ability to adjust to changing life situations using various strategies. |
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Affect |
Outward manifestation of a persons feeling or emotions |
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Anxiety |
Vague feeling of apprehension that results from a percieved threat to the self. |
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Behavior |
Manner of conducting oneself, ones actions |
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Blocking |
Cessation of thought production for no apparent reason, may stop and stare in the middle of a conversation, can be few of long duration or many of shorter duration (or any combination thereof) |
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Coping response |
Use to reduce anxiety brought on by stress, ie over eating, drinking, smoking.. |
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Crisis |
Time of change or turning point in life when patterns of living must be modified to prevent disorganization of the person or family |
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Defense mechanism |
Behavioral patterns that protect the individual against a real or perceived threat |
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De-institutionalization |
Release of institutionalized psychiatris patiens to be treated into the community setting |
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Delirium |
Change in consciousness that occurs over a short period of time, acute coginitive disorder that produces a marked change in mental status, reversible. |
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Delusion |
False beliefs, resistant to reasoning or change |
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Dementia |
A loss of multiple abilities, including long and short-term memory loss, language and the ability to understand changes in mental status is caused by physical changes in the brain, chronic, progresses slowly, irreversible |
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Dissociation |
Disconnection from full awareness of self, time, or external circumstances |
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Exhibitionism |
Exposure of ones genitals to an unsuspecting person followed by sexual arousal |
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Fetishism |
Use of objects for the purpose of sexual arousal |
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Flight of ideas |
Abrupt change of topic in a rapid flow of speech |
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Grandiosity or delusions of Grandeur |
A false belief in which ones own importance is greatly exaggerated |
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hallucination |
False sensory input with no external stimulus, usually in the form of smells , sounds , tastes, sight or touch |
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Illness |
State of homeostatic imbalance |
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Labile |
Dramatic changes in mood that can often be rapid in occurrence |
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LOOSE Association |
Thought disturbances in which the speaker rapidly shift topics from one unrelated area to another |
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Mania |
Extreme emotional state characterized by excitement, great elation, overly talkative, increased motor activity, fleeting grandiose ideas and agitated behaviors |
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Mental Health |
Ability to cope and adjust to recurrent stressors of everyday life |
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Mental Illness |
A pattern of behavior that is noticeable, threatning and disruptive to relationships or deviates significantly from behavrio that is considered socially and culturally acceptable. |
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Obsession |
Persistant, recurring inappropriate and distressing thoughts. |
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Orientation |
awareness of who you are, who others are around you, your surroundings and awareness of times |
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Personality |
Consistent sort of attitudes and behaviors particular to an individual |
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Phobia |
Unnatural fear of people, animals, objects, situations or occurrences, strong fear of something in particular |
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Psychotherapy |
Any large number of related methods of treating mental emotional disorders by psychological techniques rather than by physical means. |
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Psychosis |
State of being psychotic an alteration in mental status caused by loss of contact with reality |
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Seperation anxiety |
anxiety produced when seperated from source of security |
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Self concept |
Frame of reference individuals use for all they know and experience |
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Stress |
Nonspecific response of the body to any demand made on it |
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Stressor |
situation, activity or even that produces stress |
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Somatic therapy |
Treatment of an emotionally ill or incapacitated client by physiological means. |
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Mental Health |
Ones ability to cope with and adjust to recurrent stresses of everyday life. |
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Mental Illness |
A pettern of behavior that is conspicious, noticeable, threatning and disruptive of relationships or deviates significantly from behavior that is considered socially and culturally acceptable. |
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Basic factors affecting mental health |
inherited characteristics Childhood nurturing Life's circumstances May be positive or negative influences which determine response to change |
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Positive infuences regarding individuals response to daily stressors |
Adequate coping ability mother child bonding success in school Good health Financial security |
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Negative influences regarding individuals response to daily stressors. |
Cognitive impairment Schizophrenia Extreme sibling rivalry Parental rejection Deprivation of maternal love Poor physical health Poverty Broken/failed relationships |
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Factors affecting mental health in the US |
Geographic location and access to mental health care Changing family structure, smaller size mean less support and connection. Average size less than 3 people in 1995 More mobile and relocation stresses Same gender families Women under greater amounts of pressure Living longer |
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Risk factors influencing mental health |
Genetic Biologic Environmental Cultural Occupational |
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What are three factors that influence the way a person handles the stress of change? |
How a person views the stressor Number of stressors handled at one time Previous experiences with situation |
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Four parts of self |
Personal identity is the organizing principle of the self Body image is the picture of and the feelings toward the body Role performance is expected behavior of an individual in a social position. Can be ascribed, involves no personal choice. Can be assumed, selcted by the individual. Self esteem is the assesment made about personal growth |
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Use of defense mechanisms |
protect self in stressful situations useful in mild to moderate anxiety Unconscious reaction If used to extreme, can distort reality and create problems with relationships |
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Compensation |
An individual makes up for a deficiency in one area by excelling in another area. |
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Conversion |
Emotional conflicts are turned into a physical symptom, which provides the individual with some sort of benefit (secondary again). |
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Denial |
Reality is denied, it does not exist. Example: the patient who suffered a severe myocardial infarction is found by the nurse on the floor doing sit ups and push ups |
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Displacement |
Emotions are expressed towards some one or something other than the actual source of the emotion. |
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Dissociation |
Seperation and detachment of emotional significance and affect from an idea or situation. Example: the person who has been traumatically vicitmized retells her situation, while smiling and joking about it. |
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Identification |
Individual incorporates a characteristic through an individual or a group but does not give up personal identity. Example: a teenager who dresses like a favorite rock singer |
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Introjection |
A quality or attribute of another is internalized and becomes part of an individual. Example: The child who follows her parents instructions when the parents are not present. |
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Projection |
Attributing to other characteristics that the person does not want to admit to possessing and blaming shortcomings on some one else. Example: A student who fails during an exam and blames the test for being unfair and the teacher for not presenting the material correctly. |
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Rationalization |
The person denies actual thoughts and justifies actions by giving untrue, but seemingly more acceptable, reasons for behavior. |
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Reaction Formation |
The conscious behavior is completely opposite to the unconscious process. Example: A person who is excessively polite to an individual who is disliked. |
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Regression |
Behavior, thoughts, or feelings used at an earlier stage of development are exhibited. Example: 8 year old who reverts to bed wetting and thumb sucking while hospitalized. |
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Repression |
The unconsious process of barring from conscious thought, painful and disagreeable thoughts, experiences and or impulses. |
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Sublimation |
The discharge of sexual or aggressive energy and impulses in a socially acceptable way. |
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Suppression |
A conscious exclusion of painful thoughts, experiences or impulses. |
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Personality Disorder |
Inflexible, maladaptive patterns of behavior or thinking that accompany significant impairment of functioning |
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Characteristics of Personality Disorder |
poor impulse control, drinking, overeating, substance abuse, assaultive, self destructive, manipulation, inappropriate behavior, disregard for rules characteristics of... |
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Abusive Personality Disorder |
An individual who uses violent or abusive behavior to cope with anxiety-type of personality disorder |
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Dependent personality disorder |
An individual who is overcooperative from a deep fear of abandonment-unable to carry out a task alone, unable to take responsibility of his/her activities of daily living-type of personality disorder |
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Paranoid Personality disorder |
Characterized by suspicion, secretiveness, distortion of reality and over sensitivity, thinks that others are out to get him/her. -type of personality disorder |
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Borderline personality disorder |
Has not established self-idenity, fears being alone, experiences mood swings over a short period, relationships with others reveal rapid shifts from adoring to cruel and punishing, impulsing-type of personality disorder |
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Antisocial (personality disorder) |
has history of difficulties with personal relationships, does not proft from experience or punishment, has no loyalites to any person, group or code of ethics, has a tendency to rationalize behavior, relies on deceit and manipulation to get his/her way |
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Anxiety |
a normal response to stress or threat. A state or feeling of apprehension, uneasiness, agitation, uncertainty and fear resulting from the anticipation of some threat or danger |
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Signal Anxiety |
A learned response to an event such as test taking |
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Free-floating anxiety |
Associated with feelings of dread that are not possible to identify |
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Anxiety trait |
A learned aspect of personality. Anxious reactions to relatively non stressful event. |
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Types of Anxiety disorders |
Generalized Panic Phobias Obsessive compulsive Post-traumatic stress disorder |
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Generalized Anxiety |
steady, high degree, tends to worry over many things and find it difficult to concentrate on the task at hands, possible at any age, commonly occurs around ages 20 -30, lasts 6 mo or longer-what type of anxiety is this? |
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Panic-(Anxiety) |
attack of an acute, intense and overwhelming anxiety accompanied by a degree of personality disorganization i.e being unable to solve problems or think clearly Exhibits heart palpiations, sweating, trembling, feelins of dyspnea, chest pain, nausea, feeling dizzy/faint. onset late 20's |
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Phobia (Anxiety) |
Characterized by persistent and irrational fear of a specific object, situation, or acitvity |
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Agoraphobia (anxiety) |
A high anxiety brought on by situations in which a panic attack is possible
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Obsessive compulsive (Anxiety) |
Characterized by inability to stop persistent, irrational and uncontrollable acts (compulsions) or thoughts (obsessions) contrary to persons standards or judgement. |
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Drug used to treat OCD |
clomipramine (Anafamil) |
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Post Traumatic Stress Disorder (Anxiety) |
A response to an intense traumatic experience that is beyond the usual range of human experiences that evoke feelings of terror and helplessness i.e. war, rape, major car accident, observing tortures, witnessing a violent death. |
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3 kinds of PTSd |
Acute: Occurs within 6 months of event Chronic: lasts more than 6 months Delayed: Starts 6 months or more after the event |
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Benzodiazapines |
Management of various forms of anxiety, including generalized anxiety disorder (GAD) intermittent or short term: Benzodiazepines Long-term: Buspirone, Paroxetine, Venlafaxine |
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Action of Benzos |
Exert tranquilizing effect by potentiating the effects of GABA, an inhibitory transmitter, cause generalized CNS depression, potential for psychological or physical dependence...what type of drug? |
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Examples of Benzos |
Xanax Librium Valium Ativan Versed Serax |
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Misc. Anti anxiety drugs |
BuSpar Sinequan Atarax Hydroxine |
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Anti-anxiety side effects |
dizziness, drowsiness, blurred vision |
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Psychosomatic illness |
a physical disorder arising as a result of a psychological trigger |
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Psychophyscial illness |
addresses the stress-related problems that have the potential to result in physical signs and symptoms GI suffers most |
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mood |
a prolonged emotional state that influences the persons whole personality and life functioning |
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Depression |
Exaggerated feelings of sadness, despair, lowered self esteem, loss of interest in former activities and pessimistic thoughts |
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Mood disorders |
any of a group of psychotic disorders characterized by severe and inappropriate emotional response, by prolonged and persistent disturbances of mood and related thought distortions and by other symptoms associated with either depressed or manic states |
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Mania |
Persistent, abnormal over activity and a euphoric state |
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Dysthymic Disorder |
Daily moderate depression that lasts more than 2 years. This disorder often ends up as a lifestyle in which the individual can function but does not enjoy life |
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Cyclothymic Disorder |
Pattern that involves repeated mood swings of hypomania and depression but are less intense. There are no periods of normal function with his condition |
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Hypomanic episode |
The early phase of a manic episode when symptoms are not severe |
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Major depressive disorder (unipolar) |
Repeating, severe depressive episodes lasting more than 2 years |
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Bipolar disorder (manic-depressive) |
Exhibit sudden shifts of emotional extremities from depression to mania |
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Characteristics of Mood disorderss |
severe and inappropriate emotional response Prolonged and persistent disturbances of mood Related thought distortions Other symptoms associated with either depressed or manic states |
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Mood as defined by DSM-IV-TR |
A prolonged emotion that affects a persons psyche. Extremes in mood range from depression to mania |
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Medical treatments for Mood Disorders |
Antidepressants: Prozac, Desyrel, Elavil, Effector
Other: Lithium Electrovonculsive therapy Psychotherapy |
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Normal lithium levels |
1-1.5 mEq normal range of...? Maintenance range 0.6-1.2 mEq |
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How long does it take for antidepressant medications to take to show effects? |
2 - 4 weeks |
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TCA-Tricyclic Antidepressants |
Inhibit the re-uptake of norepinephrine and serotonin by the presynaptic neurons in the CNS Increase time that norepinephrine and serotonin are available to the postynaptic receptors |
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Serious effects of TCA's |
Dysrhythmias, Tachycardia, myocardial infarction, heart block |
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Full effect for TCA's? |
6-8 weeks..full effect for what ? *and major symptoms subside |
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TCA meds |
Amittriptyline (Elavil) Doxepin (Sinequan) Imipramine (Tofranil) Desipramine (Norpramine) Nortriptyline (Pamelor) |
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Action MAOIs |
Prevent breakdown of norepinephrine, serotonin and dopamine in the brain, there by increasing the levels of these brain amines and resulting in increased mood. Demonstrates proven benefits for patients who have not responded to other meds or ECT Inhibits breakdown of tyramine |
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Foods that contain tyramine |
Avacados, Fermented bean curd, fermented soybean, figs, bananas, meast (fermented), bolgona, cheese, yeast, beers, protein...all contain what? *avoid eating when taking MAOI's |
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MAOI medications |
Isocarboxazid (Marplan) Phenelzine (Nardil) Tranylcypromine (Parnate) Drowsiness, Dry mouth, Over activity, insomnia, orthostatic hypotension, nausea, anorexia, constipation |
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SSRI |
Selectively block the neuronal uptake of serotonin, thereby leaving more serotonin available at the synaptic site. Treatment of depressive disorders |
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Common SSRIs |
Fluoxtine (Prozac) Sertraline (Zoloft) Paroxetine (Paxil) Citalipram (Celexa) Escitalopram (Lexapro) Duloxetine (Cymbalta) |
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Lithium |
Used to reduce: elation, grandiosity and expansiveness, flight of ideas, irritability and manipulation, anxiety, takes 7 -14 days to reach therapeutic levels. |
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Expected side effects of Lithium at a therapeutic level |
Fine hand tremor, polyuria, mild thirst, mild nausea, weight gain, (0.4. to 1 mEq/L) |
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Early signs of Lithium toxicity |
(<1.5mEq/L) Nausea Vomiting Diarrhea Thirst Polyuria Slurred speech muscle weakness |
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Advanced signs of Lithium toxicitiy |
(1.5 to 2 mEq/L) Course hand tremor Persistent GI upset Mental confusion Muscle hyperirritability ECG changes |
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Severe signs of lithium toxicity |
(2 to 2.5 mEq/L) Ataxia Serious ECG changes Blurred vision Clonic movements Large output of dilute urine Tinnitus Seizures Stupr Severe hypotension |
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Drug used with lithium for mood disorderes |
Depakote (anticonvulsant) |
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Atypical antipsychotics |
Abilify Clozaril Risperdal Zyprexa Seroquel Geodon |
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Calcium channel blockers |
Calan Adalat Porcardia |
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The usual course of treatment for ECT |
2 to 3 treatments per week for a total of 6 to 12 txs |
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Delerium |
rapid change in consciousness that occurs over a short time. It can occur at any age, possible causes are hypoxia, electrolyte imbalance, drugs, pain, fatigue, and infections-reversible |
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Dementia |
an irreversible medical condition that causes chronic confusion secondary to cerebral disease, slow and progressive |
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Delusion |
fixed, false belief that cannot be corrected by feedback and is not accepted as true by others in the culture |
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Most common type of hallucinations |
Auditory hallucinations |
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Schizophrenia |
any one of a large group of psychotic disorders whose defining characteristics are distortion of reality, disturbance of language and communication, withdrawal from social interaction, and the disorganization and fragmentation of thought, perception and emotional reaction. |
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manifestations of schizophrenia |
ventricles of brain larger, left larger than right. Excess of dopamine levels in center of brain and lower in prefontal cortex region...characteristics of what d/o? |
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Positive behavior patterns of Schizophrenia |
Delusions, hallucinations, formal thought disorder, repeated instances of bizarre behavior, disordered thinking |
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Negative behavior patterns of Schizophrenia |
Apathy, Social withdrawl, Alogia, Flat affect, Anhedonia |
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5 types of schizophrenia |
disorganized, Paranoid, catatonic, undifferentiated, Residual |
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Disorganized Schizo |
Type of Schizo-flat or inappropriate affect, incoherence, prognosis is poor |
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Paranoid type schizo |
delusions audtiory hallucinations, prognosis, suspicsiousness |
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Catatonic type schizo |
stupor, negativism, rigidty, excitment, posturing, prognosis fair |
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Undifferentiated type schizo |
delusions, hallucinations, incoherence, gross disorganization |
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Residual type schizo |
Demonstrates typical signs and symptoms associated with schizo wi/o displaying evidence of gross disorganization, incoherence, delusions, and hallucinations, prognosis is poor |
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Prodromal stage of Shizo |
begins in adolescence with a lack of energy or motivation and withdrawal. Other symptoms at this stage include blunted effect, odd beliefs, and ideas, excessive interes in philosophy ... |
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Pre-psychotic Phase |
Presents as a desire to be left alone. Appears quiet and passive. Hallucinations and delusions may be present. The family usually recognizes that the individual has changed or is acting oddly. |
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Acute Phase |
Signs and symptoms may vary widely but disturbances in thought, perception, emotion, and behavior are apparent. Often the individual loses contact with reality and is unable to function in the most basic ways. |
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Residual Phase |
Symptoms resemble those of the prodromal phase, often during this phase there is a period of remission wherein the individual is able to experience some relief of symptoms and manage some baisc activities in life. |
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Antipsychotics |
Haldol Thorazine Compazine Clozaril Risperdal |
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Nueroleptic malignant syndrome |
a potentially life threatning adverese effect that may include high fever, unstable blood pressure, and myoglobinemia. |
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Extrapyramidal symptoms |
involuntary motor symptoms similar to those associated with Parkinsons disease |
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Addiction |
Substance dependence that is serious enough to call it a disease |
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4 elements of addiction |
Excessive use or abuse Display of psychological disturbance Decline of social and economic function Uncontrollable consumption indicating dependence |
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Alcoholism |
Primary chronic disease with genetic, psychological and environmental factors influencing its development and manifestations |
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Dependence |
Physiological state of adaption to the specific psychoactive substance |
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Withdrawal |
Physiological state that occurs when the substance of which a person is dependent upon no longer used |
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Tolerance |
Characteristic of drug addiction that referes to a progressive need for more of the abused substance to achieve the desired effect |
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CAGE |
an acronym for four questions, answering yes or no to one or more questions indicate that alcohol usage is likely |
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C for CAge |
have you ever felt that you ought to CUT down on your drinking |
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A for Cage |
Have people Annoyed you by criticizing your drinking |
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G for Cage |
Have you every felt bad or GUILTY about your drinking? |
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E for Cage |
Have you ever had a drink first think in the morning to steady you nerves or get rid of a hangover EYE OPENER? |
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Most commonly abused drugs |
Alcohol Benzos Barbituates Chloral hydrate Cocaine GHB Heroin Ketamine LSD Marijuana METH |
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Early stage of substance/chemical abuse |
Amount a frequency of substance use increases to achieve the desired effect Changes may occur causing user to experience unpleasant effects Denial **what stage of substance abuse? |
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MIddle stage of substance/chemical abuse |
moderate impairment might see signs and symptoms of withdrawal self medicates pattern of use established May see estrangement from significant other family negative behaviors associated with addiction are seen physical health affected suffer blackouts financial/legal problems Occupational problems prognosis poor without tx **what stage of substance abuse? |
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Late stage of substance/chemical abuse |
level of functioning is severely impaired Habitual abuse, cannot achieve normal worsening medical problems organ system involvment malnutition Problem solving/judgment impaired Denial Manipulative behavior Severe occupational problems, possibly unemployment |
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How soon after last drink alcohol withdrawal symptoms occur? |
6-48 hours, may last 3 - 5 days Diaphoresis, tachycardia, hypertension, tremors, nausea/vomiting, anorexia, restlessness, disorientation, hallucinations |
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Delirium Tremens |
acute psychotic reaction to withdrawal of alcohol, usually occurs 1 - 4 days after alocohol consumption, lasting from 2 days to 1 week increased activity to extreme agitation, disorientation, fear, panic, hallucinations |
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Fetal alcohol syndrome |
frequently seen in newborns whose mothers drank heavily during preg. Mental retardation Growth disorders wide set eyes malformed body part-spontaneous abortion or stillborn |
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Kersakoffs psychosis and Wernickes Encephalopathy |
two brain disorders that sometimes occur in chronic alcoholics K:short term memory loss Disorientation muttering delerium W:occurs in association with thiamine defieciency, causes brain damage in the temporal lobes of the brain memory loss aphasia lack of muscle coordination |
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Medications to reduce withdrawal symptoms |
Chlordiazepoxide (librium) Naltrexone (Revia) both work in reducing symptoms of? |
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Autocratic leadership |
leader retains all authority and responsibility Leader assigns clearly defined tasks and establishes one-way communication with the group Leader is firm, insistent and demanding |
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Democratoc leadership |
People centered approach allowing employees more control and participation in the decision making process Emphasis on team building and a spirit of collaboration |
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Laissez-Faire leadership |
French translation is to allow them to do Because there is no direction or guidance in a laissez faire system, person often are confused and unsure of what is expected of them-more effective in highly motivated professional groups |
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Situational style |
use of different leadership styles as needed Effective leaders select aspects from several styles as the situation requires They realize both tasks and persons involved are important |
