Mental Health & Substance Abuse

Front 1

Define Mental Health

Back 1

The ability to adjust to new situations, react to personal problems without marked distress and productively contributes to society

Front 2

Name 7 characteristics of mental health

Back 2

1. ability to accurately interpret reality
2. have a healthy self concept
3. ability to relate to others
4. achieve a sense of meaning in life
5. demonstrate creativisty and productivity
6.have control over their own behavior
7. adapt to change and conflict

Front 3

What is voluntary admission

Back 3

Person signs themselves into treatment and can leave at anytime

Front 4

What is involuntary commitment

Back 4

client is hospitalized without the individuals consent

Front 5

what criteria must be met to admit unvoluntary pt.

Back 5

pt must be mentally ill and as a result of the illness be dangerous to self or others, in need of treatment and unable to provide for their own basis needs

Front 6

what is outpatient commitment

Back 6

a court order requiring a mentally ill person to medication and comply with treatment plan as a condition of release

Front 7

what is a conditional release

Back 7

a committed client is released from the hospital in the condition that he or she participated in treatment in the community....if pt fails, pt goes back in to hospital

Front 8

what is personality theory

Back 8

the relatively stable way that a person thinks feels and behaves. Includes psychosocial traits and characteristics that make a person who they are

Front 9

How does personality theory devolope

Back 9

through out life based on genetic foundation and responses to challenges and experiences we live

Front 10

who was the founding father of psychoanalytic theory and what part of his theory is still used today

Back 10

Freud
theory that all behavior is motivate although the motivation is often not conscious

Front 11

Name 2nd Freud theory still used today

Back 11

Defense mechanisms, also called ego defense mechanism. Is thoughts and behaviors that distort reality to protect the sef from threatening realities or painful experiences

Front 12

what is free association and who created it

Back 12

Freud
idea that clients can talk about problems with therapist and could determine and understand reasons for anxiety and helping to resolve anxiety and conflict for themselves

Front 13

Who created the Ego theory

Back 13

Erikson

Front 14

Describe Eriksons theory

Back 14

developemental task of psychosocial development. personality developes over 8 stages, each stage represents core conflict that person must overcome at a critical peroid of development.
Accepted by nursing to help plan interventions and determine priorities

Front 15

What is cognitive theory

Back 15

concerned with way knowledge is acquired and processed. feels that that perception and thinking are at the center of what it means to be human. It seeks change thru thought process and finds new ways of thinking and problem solving

Front 16

who created cognitive theory

Back 16

Piaget

Front 17

What is behavioral theory

Back 17

behavior keeps on going with positive reinforment, personality shaped lifes experiences, new desired behaviors are rewared

Front 18

What is included in behavioral therepy

Back 18

assertiveness training,, desensitazation for phobias, relaxation training
Used with cognitive therapy

Front 19

What is humanist theory

Back 19

Based on Maslows pyramid.
based on human needs and most highly evolved states of human development

Front 20

Define schizophrenia

Back 20

a major brain disorder that alters a persons perception, thoughts, feelings, and behavior

Front 21

What is cause of schizophrenia

Back 21

combination of genetics and environmental influences. Genes start out normal and change abnormal under stress.
Changes lead to specific structural and functional changes in brain and nervous system

Front 22

Symptoms of Schizophrenia

Back 22

Positive symptoms
Disorganized symptoms
Negative symptoms

Front 23

What are positive symptoms of schizophrenia

Back 23

Excess or distortion of normal functions, hallucinations, delusions

Front 24

What are disorganized symptoms of schizophrenia

Back 24

disorganized thinking: inability to sort and interpret incoming sensory information causes an inability to respond appropriately- speech becomes disorganized with topics changing every few minutes
Disorganized behavior-- lack of goal orientation mades activities of daily living difficult. May develop unusual or purposeless behaviors like walking in circles or pacing. May include catatonic behavior=marked decrease in response to the environment- rigid postures often with bizarre positions

Front 25

What are negative symptoms of schizophrenia

Back 25

cause major source of disability including decreased normal function. flat effect, Algia, avolition, anhedonia

Front 26

define flat affect

Back 26

blunting or absenxe of nonverbal emotional expression

Front 27

define alogia

Back 27

decreased amount and richness of speech

Front 28

define avolition

Back 28

lack of motivation making it difficult to initiate and persist in goal directed activities. ex: go to work, care for self

Front 29

Define anhedonia

Back 29

lack of ability to feel pleasure

Front 30

List Dx of schizophrenia

Back 30

1) 2+ for 1+ month: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms
2) social/occupational dysfunction: problems with major area of function, last at least 6 months.
3) Exclusions: none can be based on other disorders

Front 31

Treatment of schizophrenia

Back 31

Acute phase- hospitalization
Psychosocial Rehab- milieu therapy
Case Manager- sets up community services

Front 32

What is Milieu therapy

Back 32

safe, simple, pleasant environment that the pt is responsible of environment and behavior

Front 33

What is main treatment of schizophrenia

Back 33

antipsychotic drugs (neuroleptics)
Takes a while to find correct med and amount

Front 34

Anitpschotic drugs

Back 34

1st generation: typical
2nd generation: atypical
3rd generation

Front 35

1st generation schizophrenia drug information

Back 35

decrease positive symptoms by blocking dopamine receptors. used in acute phase with agitation. Has no effect with negative Sx. Has extrapyrmidal side effects, interacts with other CNS depressants including alcohal, used less because of side effects, decrease effects on anticoagulants, increase effects of antihypertensives. Lower dose for elderly

Front 36

2nd generation schizophrenia drug information

Back 36

Seratonin-dopamine antagonists. treats both pos and neg symptoms.
Side effects.(another card)..increase effects of antihypertensives, additive effect with other CNS depressants and anticholinergics

Front 37

3rd generation schizophrenia drug information

Back 37

Aripiprazold (Abilify) a dopamine stabilizer, to stabilize mood. less side effect, same drug interaction

Front 38

What are side effects of 2nd generation schizophrenia drug

Back 38

weight gain, sedation, orthostatic hypotension, hyperglycemia. Increases risk of impaired glucose tolerance. EPS with Risperidone. Clozapine reserved as ;ast choice due to risk of agranulocytosis ( decrease in WBC)

Front 39

Extrapyramidal side effects caused by 1st gen meds used for schizophrenia

Back 39

Dystonia (muscle rigidity, abnormal muscle contraction and clenching) pseudoparkinsomism, akathisia ( restlessness, intense need to move, inability to sit still, inability to rest or sleep)
anticholonergic side effects

anticholonergics meds treat these symptoms

Front 40

what are anticholinergic side effects

Back 40

dry mouth, constipation, urinary retention, orthostatic hypotension, blurred vision, fatigue, weight gain

these will worsen if have to use with antipsych drugs

Front 41

Continued extrapyramidal side effects

Back 41

Tardive dyskinesia_ late onset of abnormal movements after extended use of 1st gen drugs.
lip smaking, tongue protrusion and writhing, blinking and other abnormal movements. No treatment, use lowest dose
Neuroleptic malignant syndrome: rare: high fevers, up to 108, muscle rigidity, unstable blood pressure, diaphoresis, delirium, tremors.
increases with dehydration, poor diet, medical illness.
STOP MED IF HAVE THESE

Front 42

Nursing Assessment for schizophrenia

Back 42

assess violence
limit to pertinent illness and current drugs, assess mental status (speech, behavior, thoughts)
assess cognitive ( memory, judgement, thinking abstract

Front 43

Nursing Care for schizophrenia

Back 43

speak gentle non confronting manner, listen without confirming or disapprove stories, non critical, honest praise, relaxation for anxiety, decrease environment stimuli, no touching during hallucinations

Front 44

Milieu

Back 44

inpatient "total environment", simple, pleasant safe place, assist pt to function highest level, allows pt to practice and receive feedback on behavior..
Based on 5 components

Front 45

List 5 components of Milieu

Back 45

Containment-safe environment
Structure- orderly, predictable patterns
Support- protection from self
Validation- affirming individual worth
Involvement- interaction with others

Front 46

Describe Major depressive episodes

Back 46

genetic and psychosocial components. Neurotransmitter serotonin reduced function. Women more prone, any age, precedes major life stressors, can be accompanied by psychotic Sx. Older pt have fewer physical Sx.

Front 47

Treatment of Major depressive episodes

Back 47

Medications, psychotherapy,
combination of above, ECT

Front 48

Tricycline antidepressants

Back 48

Block reuptake of serotonin and norepinephrine, making more available at brain synapses. 2 to 4 wks to work, increased suicide at beginning, anticholinergic side effects, weight gain and sexual dysfunction

Front 49

Tricycline antidepressants side effects

Back 49

anticholinergic side effects, weight gain and sexual dysfunction. carditoxic in overdose, no preg, caution in elderly, constipation

Front 50

Name some Tricycline antidepressants

Back 50

Amitriptyline (Elavil)
Imipramine (Tofranil)
Doxepin (Sinequan)

Front 51

SSRI

Back 51

Selective seratonin reuptake inhibitors.
1st line of treatment with fewer side effects, low potential overdose, no euphoria or phys. dependancy. dont give with other antidepressants, can cause toxicity and SE

Front 52

SSRI used for what disorders

Back 52

Depression, obsessive compulsive, panic disorders, social or generlized anxiety disorders, PTS, bulimia, and premenstrual dysphoric disorder

Front 53

Side effects of SSRI

Back 53

edation, headache, dizziness, sexual dysfunction, GI effects such as nausea, diarrhea, constipation, dry mouth, bruising, SE go away with time.

Front 54

Name some SSRI

Back 54

Citalopram (Celexa)
Paroxetine (Paxil)
Sertraline (Zoloft)

Front 55

What is Serotonin Syndrome

Back 55

potentially fatal syndrome resulting from mixing SSRI and MAOI.
Can also occur from combining OTC st john wort, and tryptophan (amino acid)

Front 56

symptoms of Serotonin Syndrome

Back 56

mental status changes, agitation, restlessness, muscle spasm, hyperreflexia, diaphoresis, tremors, abd cramps, nausea, diarrhea and headache

Front 57

Monoamine oxidase inhibitors (MAOI)

Back 57

inhibits the breakdown of monoamine neurotransmitters, making more serotonin, norepinephrine and dopamine available to the brain.
Has serious side effects and interactions, seldom used

Front 58

MAOI can cause hypertensive crisis when combined with what

Back 58

aged cheese, preserved meats such as liver an.
d organ meat, draft beer and red wine, soy sauce and yeast...also avoid caffeine

Front 59

MAOI drug interactions

Back 59

potentially fatal reaction when combined with SSRI, other MAOI, TCA, meperidine (Demerol), CNS agents, decongestants OTC cold, allergy and weight loss products, methylphenidate (Ritalin), bronchodilators, some antihypertensives.
Can cause death in overdose

Front 60

MAOI drugs names

Back 60

Marplan, Nardil, Parnate, selegine (Emsam) patch,

Front 61

Name some Serotonin and norepinephrine reuptake inhibitors

Back 61

duloxetine (Cymbalta)
venlafaxine (Effexor)

these are also used for incontinence, neuropathic pain, anxiety disorders

Front 62

Name Norepinephrine and dopamine reuptake inhibitors

Back 62

bupropion (Wellbutrin)

Has less sexual side effects, used for nicotine addiction, bipolar, ADHD