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57 Cards in this Set
- Front
- Back
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Primary prevention in mental health nursing
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(looking for stressors)
educational example: educational programs protective measures (like identifying potentially stressful conditions in the community and high risk populations) |
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secondary prevention in mental health
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(stressor known)
early detection and treatment (like - suicide prevention hotline - referring clients in need of treatment to facilities) |
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tertiary prevention in mental health
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(managing stressor)
- rahab and restorative - limit disability (like - monitoring follow-up care in a half-way house - staffing partial hospitalization programs) |
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DSM-IV
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Diagnostic and Statistical Manual
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axis I
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(identifies clinical disorders.
includes all the mental health conditions except personality disorders and mental retardation) (Depression, schizoaffective disorder) |
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Axis II in DSM-IV system
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identifies personality disorders and conditions od mental retardation
(personality disorder - boderline) |
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Axis III
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identifies general medical conditions
(diabetes, HTN, astma) |
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Axis IV
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identifies psychosocial and environmental factors affecting the person.
(divorce, situation with roommate and sister, transportation dificulties) |
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Axis V
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identifies GAF (Global Assessment of Functioning), the clinicians best guess of the client’s overall level of functioning.
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the word "Deffered" (otsrocennyi) in the Axis II means that
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there is no diagnosis for the client that falls under that category. Deferred diagnosis mean the person doesn't want to put a diagnosis down in that Axis category. Usually the reason for this is because the person is not qualified to give a diagnosis in this category.
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list of personality disorders:
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•Antisocial personality disorder
•Avoidant personality disorder •Borderline personality disorder •Dependent personality disorder •Histrionic personality disorder •Narcissistic personality disorder •Obsessive-compulsive personality disorder •Paranoid personality disorder •Schizoid personality disorder •Schizotypal personality disorder |
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Mental retardation is
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a generalized disorder, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors with onset before the age of 18
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Dissociative disorders are defined as
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conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception.
The hypothesis is that symptoms can result, to the extent of interfering with a person's general functioning, when one or more of these functions is disrupted |
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Psycosis is
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any severe mental disorder in which contact with reality is lost or highly distorted
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suppression (high addaptive level mechanism) is
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avoiding thinking about problem areas intentionally
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regression (mental inhibition mechanism) is
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unintentionally pushing back disturbing thoughts, desires, or experiences from the concious mind
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Conversion disorder is
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a condition in which a person has blindness,
paralysis, or other nervous system (neurologic) symptoms that cannot be explained. person may become "blind" to avoid a traumatic event |
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the best treatment for post-traumatic stress disorder is
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group therapy
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negative symptoms of schizophrenia:
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4A's:
avolition anhedonia affective/apathy alogia |
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avolution
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lack of motivation
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anhedonia
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inability to experience pleasant emotions
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affective
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flattering of emotions
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alogia
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poverty of speech
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cluster A ("strange", odd and eccentric)
personality disorders: |
paranoid (suspiciousness and distorted reality)
schizoid (blunted or restricted affect and social isolation) schizotypical personality disorder (social anxiety, eccentric behavior) |
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paranoid personality disorder
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people who are cold, mistrust, and suspicion of others; guarded (ostorojnye), irrational
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schizoid personality disorder
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detached from social relationships (few friends);
restricted affect (emotsionalinye reactsii) involved more with things than with people |
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schizotypical personality disorder
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acute discomfort in relationships
experience considerable social anxiety cognitive or perceptual distortions eccentric behavior |
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Clauster A (odd and eccentric) personality disorders:
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schizoid
schizotypal paranoid |
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Claster B (dramatic and emotional) personality disorders:
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borderline
narcissistic histrionic antisocial |
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Cluster C (anxiety and fear based) personality disorders:
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obsessive-compulsive
avoidant dependent |
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In cluster B (dramatic and emotional) PD
antisocial personality has such features as: |
- failure to conform to social norms with respect to lawful behaviors (50% of prisoners have this disorder)
- pervasive pattern of disregard (пренебрежение) for and violation of other's rights - deceitful (лживый), irritable, impulsive (inability to delay gratification - удовлетворение), lack of remorse (угрызения совести), manipulation of others - appears "normal" (attempt to display emotions that place him in a favorable light) - views the world as cold and hostile - believes others are ruthless (жестокий) as he so trusts no one - trouble keeping jobs, being a parent, staying married |
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In cluster B (dramatic and emotional) PD
borderline pesonality has such features as: |
- fear of abandonment
- poor judgement: impulse in at least 2 self-damaging areas as spending, sex (unprotected), substance abuse (alchohol, drugs) - pervasive (распространяющийся) pattern of UNSTABLE interpersonal relationships, self-image, and affect - recurrent suicidal behavior, self-mutilation (увечье) (obsessive thoughts about abandonment, suicide, and self-harm) ASSESMENT: - unable to sit still, restless - dysphoric mood, unhappy - intense feeling of loneliness, boredom, frustration mood is labile and feelings are intense (crying, out of control) - belives problems are due to others "failing" themlying, shoplifting (магазинная кража), gambling |
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Cluster C (fear and anxiety based) PD:
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- inappropriate, intense anger
- unwillingness to get involved with people - perfectionism, ridgity |
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Cluster C (fear and anxiety based) PD:
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avoidant
dependent obsessive-compulsive |
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avoidant PD
(cluster C - fear and anxiety based) |
- social inhibition
- feeling of inadequancy - hypersensitivity to negative evaluation |
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dependent PD
(cluster C - fear and anxiety based) |
- submissive and clinging behavior,
- excessive need to be taken care of |
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obsessive-compulsive PD
(cluster C - fear and anxiety based) |
- preoccupation with orderliness
- perfectionism and control (they wash hands 100 times per day) |
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Patients with personality disorders are changing
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slowly yet "look"ike they are capable of better behavior.
Need LONG treatment |
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Patients with anxiety disorders may be need
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short treatment
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Extrapiramidal effects:
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akinesia (inability to initiate movement)
akathisia (inability to remain motionless) dystonia (spasms of the eye, neck, back, tongue; twisting of body parts). These symptoms are easily reversed by IM Benadryl or Cogentin tardive dyskinesia (запоздалoe расстройство координированных двигательных актов) - Pseudoparkinsonism: symptoms include decreased movements (bradykinesia, akinesia), muscle regidity,resting hand tremors, drooling, mask-like face, and shuffling gait |
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A cholinergic drug, also known as a parasympathomimetic drug, is
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any drug that functions to enhance the effects mediated by acetylcholine in the CNS, the peripheral nervous system, or both
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Side effects associated with receptor blockage
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dopamine:
extrapyramidal side effects cholinergic: dry mouth blurred vision sinus tachicardia constipation impaired memory/cognition alpha-adrenergic: orthostatic hypotension reflex tachicardia, dizziness Serotonin: weight gain GI upset sexual dysfunction |
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pseudoparkinsonism (EPSE)
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decreased movements (bradykinesia, akinesia), muscle rgidity, resting hand tremor, drooling, mask-like face, and shuffling gait
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EPSE like akinesia is often confused with what?
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with negative signs of psychosis - akinesia (inability to initiate movement)
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tardive dyskinesia manifests as
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abnormal movements of any voluntary muscle groups after prolonged period of dopamine blockade
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Lithium is a
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mood stabilizer.
most often is used for clients with bipolar disorders |
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tricyclics are
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first generation anti-depressant, "dirty drug", a lot of side effects, because it effect a lot of receptors:
anticholinergic (dry mouth) antihistamine (sedation, weight gain) alpha-adrenergic (dizziness) anti-dopamine (EPSE's, insomnia) Nortriptyline Amitriptyline Imipramine |
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MAOIs counteract with
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tyramine containing foods:
yeast in wine and beer aged cheese, avocados pseudoephedrine (OTC cold and wt reduction meds) Can cause hypertensive crisis |
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MAOIs counteract with
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narcotic analgesics and can cause hypotension, coma, convulsions
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MAOIs should be discontinued
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slowly (2 weeks). Drugs with known interactions should not be started until 14-21 days after last dose
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First choice of treatment of depression is
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SSRIs:
Prozac Zoloft Celexa Paxil Lexapro |
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Benedryl is
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anti-histamine
SE: drowsiness, anorexia |
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Anxiolitics are:
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benzodiazepines:
Lorazepam=Ativan, Clonazepam nonbenzodiazepines: Zolipidem=Ambien Lunesta |
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ECT increases
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norepinepherine and Serotonin levels
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anorexia nervosa onset
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14-18 years old
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bulemia onset
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18-19 years old
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withdrawal from opioids (heroin, morphine) resembles
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a severe case of influenza
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