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155 Cards in this Set

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low potency drugs (names)
chlorpromazine (Thorazine) and Thioridazine
high potency drugs (names)
haldol, prolixin
Atypical name
abilitify, clozaril, zyprexa, invega, seroquel, risperdal, geodon
High risk for EPSEs
Traditional High potency drugs and high doses of Risperdal (atypical)
High risk for dry mouth, constipation, blurred vision and other anticholinergic effects?
Traditional low potency drugs and Clozaril (atypicals)
Name the class and side effects associated with: Chlorpromazine
Traditional Antipsychotic: low potency, may cause moderate rate of EPSE and anticholinergic effects. High rate of orthostasis and weight gain.
Name the class and side effects associated with: Clozaril
Atypical Antipsychotic, may cause agranulocytosis, high rate of anti-chol effects, sedation and wt gain. Very expensive
Name the class and side effects associated with: abilify
Atypical antipsychotic, low risk of SEs
Name the class and side effects associated with: Prolixin
Tradiational antipsychotic: high potency, may cause high rate of EPSEs. Cheap
Name the class and side effects associated with: Haldol
Tradiational antipsychotic: high potency, may cause high rate of EPSEs. Cheap
Name the class and side effects associated with: Geodon
Atypical antipsychotic, risk of heart troubles. Expensive
Name the class and side effects associated with: Perphenazine (Ertafon, Trilafon)
Tradiational Antipsychotic, Moderate potency, may cause high rate of EPSEs and moderate sedation. 102$/mnth
Name the class and side effects associated with: Risperidone (Risperdal)
Atypical antipsychotic, most freq atypical prescribed. Orthostatic hypotension, sedation, wt gain (moderate rate)
Name the class and side effects associated with: (Seroquel) Quetiapine
Atypical antipsychotic, orthostatic hypotension, sedation, wt gain (similar to risperdal and Invega)
Name the class and side effects associated with: Thioridazine
Traditional antipsychotic: Low dose. High rate of antichol se, orthostasis, sedation, wt gain. cheap
Positive of negative symptom of schizophrenia: abnormal thoughts
pos
Positive of negative symptom of schizophrenia: alogia (poverty of speech)
neg
Positive of negative symptom of schizophrenia: Anergia (lack of energy)
neg
Positive of negative symptom of schizophrenia: Hostility
pos
Positive of negative symptom of schizophrenia: Feelings of persecution
pos
Positive of negative symptom of schizophrenia: difficulty with abstractions
neg
Positive of negative symptom of schizophrenia: avolition (lack of drive)
neg
Positive of negative symptom of schizophrenia: hallucinations
pos
Positive of negative symptom of schizophrenia: excitement
pos
Positive of negative symptom of schizophrenia: blunted affect
neg
Where is dopamine synthesized in the brain?
substantia nigra and ventral tegmental areas in the midbrain
Describe what the neuronal tract 1(nigrostriatal tract) for dopamine affects
Movement. Tradiational antipsychotic blockade can cause EPSEs
Neuronal tract 2 (tuberoinfundibular tract)
Pituitary fx. Traditional antipsychotic blockade can lead to elevation in prolactin levels
neuronal tract 3 (mesolimbic tract)
Emotional and sensory processes. Traditional antipsychotic blockade normalizes these processes in individuals with schizophrenia, relieving or eliminating hallucinations and delusions.
neuronal tract 4 (mesocortical tract )
-cognitive process. traditional antipsychotic blockade can intensify negative and cognitive problems
symptoms of neuroleptic malignant syndrome
high fever and rigidity
symptoms of anticholinergic side effects
constipation, decreased sweating, dilated pupils, dry mouth, slowed bowels and bladder
Name the anxiety level: feedling uncomfortable, on edge, keyed up, motivated to decrease anxiety, decreased confidence, difficulty concentrating, tangental, loose association, problem solving with effort or assistance.
Moderate: +2
Type of coping mech used by someone having moderate anxiety?
Pallative coping mech
Nursing interventions for person experiencing moderate anxiety
decrease anxity w/ ventilation, crying, exercise, relaxation. Refocus attention; problem solve, oral meds if needed
Name the anxiety level: extreme discomfort, feeling of dread, hypersensitivity, defensiveness with threats, distorted perceptions, difficulty focusing, disorientation, delusions and hallucinations, suicidal or homicidal, poor eye contact, sleep disturbance
Severe: +3
Name the anxiety level: good eye contact, sligh irritablity, confident, alert, concentrated, attentive, logical reasoning, energetic
Mild: +1
Name the anxiety level: suicide attemts, eyes fixed, hysterical or mute, incoherent, rage, desperation, out of contact with reality, disorganization, neologisms, word salad
Panic: +4
Type of coping mech used by someone having mild anxiety?
Adaptive coping mech
Type of coping mech used by someone having severe anxiety?
Maladaptive coping mech
Type of coping mech used by someone having panic anxiety?
dysfunctional coping mech
Nursing intervention for mild anxiety?
discuss source of anxiety, problem solve, accept anxiety as natural
Nursing intervention for panic anxiety?
guide firmly, physically take control, give intramuscular med, order restraints if needed
Nursing intervention for severe anxiety?
decrease anxiety, stimuli and pressure. Use kind, firm, simple directions, use time outs (seclusion) give IM meds if needed
What is adaptive coping?
solves problem that is causing anxiety
What is pallitive coping?
temporarily decreases the anxiety but does not solve the problem, so anxiety usually returns
What is maladaptive coping?
unsuccessful attempts to decrease the anxiety without attempting to solve the problem
What is Dysfunctional coping?
is not successful in reducing anxiety or solving problems that even minimal fx beccomes difcult and creaste new problems.
What are Bleulers four As?
primary symptoms found in all pp with schizophrenia.
1. Associate looseness
2. Affective disturbance
3. Autism
4. ambivalence
What percentage of the schizophrenic population kills themselves?
10%
Define schizophrenia subtype:paranoid
preoccupation with hallucinations (auditory), delusions
Define schizophrenia subtype:disorganized
disorganized speech and behavior, flat or inappropriate affect
Define schizophrenia subtype: catatonic
at least two of the following:
A. motoric immobility, waxy flexability, stupor
B. Excessive motor activity (purposeless)
C. extreme negativism or mutism
D. Peculiar movements, stereotype of movements,
E. Echolalia or echopraxia
Define schizophrenia subtype: undifferentiated
have symptoms of schizophrenia, but does not meet criteria for paranoid, disorganized or catatonic subtypes
Define schizophrenia subtype:residual
continuing evidence for symptoms
Positive schizophrenia
increased dopamine. positive symptoms, use tradiational drugs.
Negative schizophrenia
decrease of dopamine or brain structure or vascular. neg symptoms, use atypical antipsychotics
Objective or subjective sign of schizophrenia? hostility
objective
Objective or subjective sign of schizophrenia? hallucinations
subjective
Objective or subjective sign of schizophrenia? illusions
subjective
Objective or subjective sign of schizophrenia? paranoid thinking
subjective
Objective or subjective sign of schizophrenia?withdrawal
objective
Objective or subjective sign of schizophrenia?decreased attention to appearance and social amentities related to introspection and autism
objective
Objective or subjective sign of schizophrenia? inadequate or inappropriate communication
objective
Objective or subjective sign of schizophrenia? exhopraxia
objective
Type of delusion: after med test confirms otherwise, pt still insists he has cancer.
somatic delusion
Type of delusion: "I am president"
grandiose delusion
Type of delusion: "The devil told me to kill my children."
Religious delusion
Type of delusion: "I am dead."
Nihilistic delusion
Type of delusion: "The TV is talking about me."
Delusions of reference
Type of delusion: "I can control her with my thoughts."
Delusions of influence
Type of delusion: "They all think that I am a homosexual."
Paranoid delusions
Axis I
Clinical disorders (e.g. schizophrenia)
Axis II
Personality or developmental disorder (e.g paranoid or mental retardation)
Axis III
General medical conditions (e.g diabetes)
Axis IV
Psychosocial and envt problems (e.g divorce, ecuagtion, housing, bankruptcy)
Axis V
Global assessment of functioning (scale of 0-100)
How do you manage milieu for: disruptive patients
set limits, decrease stimuli, intervene before acting out occurs, minimize objects that can be used as weapons, set boundaries, eval pt in restraints (nutrition, hydration, elimination needs, circulation)
How do you manage milieu for: Withdrawn pts
nonthreatening activities
semicircle seating arrangement
reinforce approriate grooming and hygiene
work on social skills
How do you manage milieu for: suspicious pts
be matter-of-fact
staff should not laugh or whisper unless pt can hear what is being said
don't touch
be consisten with activities (time, staff, approach)
Maintian eye contract
How do you manage milieu for: impaired communication
be patient
no group activities
How do you manage milieu for: pt with hallucinations
provide distracting activities
monitor TV selection
have real person available for pt to talk to
How do you manage milieu for: disorganized patients
low stimuli envt
calm envt
calm staff
safe and simple activities
what is schizoaffective disorder?
psychosis char by both affective (mood disorder) and schizophrenic (though disorder) symptoms
What is delusional disorder?
delusions based in reality. pt is relatively normal except in relation to delusion
What is brief psychotic disorder?
less than 1 month
What is schizophreniform disorder?
at least 1 month but no longer than 6 months
What is the most prevalent mental disorder in the US?
Anxiety disorder (18% of pop older than 17 yrs)
what does the continuum of care consist of?
Milieu mgnt, psychopharmacology, and nurse-pt relationship
What are the six environmental elements to milieu?
1. safety
2. structure: regs and schedules
3. norms: behavior expected
4. limit setting: enforeable limits
5. Balance: dep vs. indep
6. envt modification
What type of self help group is this an example of: AA, NA, Overeaters Anonymous
Addiction-based
What type of self help group is this an example of: Survivors of suicide, Incest Survivors, Adult children of alcoholics
Survivor-based
What type of self help group is this an example of: eating disorders, bipolar disorder, family and caregiver support grouip
Disorder-based group
What type of self help group is this an example of: grief, divorce
loss-based
What type of self help group is this an example of: lupus, cancer, aids, fatigue
medically-based
What type of self help group is this an example of: parenting, tough love
Prevention-based groups
What Assertive Community Treatment?
professionals provide 24/7 care to consumer. community based
Name the defense mechanism: unconscoius refusal to admit an unacceptable idea or behavior
denial
Name the defense mechanism: Ms. Young is a victim of incest and no longer remmbers the reason she always hated her uncle.
repression
Name the defense mechanism: conscious exclusion from awareness anxiety-producing feelings, ideas, and situations
supression
Name the defense mechanism: Mr jones has schizophrenia, states he cannot go to work b/c his co-workers are mean, instead of admitting htat his illness interferes with working.
rationalization
Name the defense mechanism: using only logical explanations without feelings or an affective component
intellectualization
Name the defense mechanism:separation of painful feelings and emotions from an unaccepatable idea, situatin, or object
dissociation
Name the defense mechanism: "When I get out of the hospital, I want to be a nurse just like you."
Identification
Name the defense mechanism: unconsciously incorporting values and attitudes of other as if they were your own
introjection
Name the defense mechanism: Pt is depressed and unable to share feelings so he writes expressive poetry
compensation
Name the defense mechanism:channeling instintual drives into acceptable activities
sublimation
Name the defense mechanism: unconsicouly wish mom was dead, continuously tells staff that her mother is wonderful.
reaction formation
Name the defense mechanism: consciously doing something to counteract or make up for a transgression or wrongdoing
undoing
Name the defense mechanism: unconciously discharging pent-up feelings to less threatening object
displacement
Name the defense mechanism: blaming someone else
projection
Name the defense mechanism: unconscious expression of intrapsychiic conflict symbolically through physical symptoms
conversion
Name the defense mechanism: wetting bed at night since birth of baby sister
regression
Which Erikson's stgs of development: 7 yrs old
industry vs inferiority
Which Erikson's stgs of development: 16 yrs
Identity vs. role diffusion
Which Erikson's stgs of development: 12 mo
trust v. mistrust
Which Erikson's stgs of development: 3 yrs
autonomy v. shame and doubt
Which Erikson's stgs of development: 4 yrs
initiative v. guilt
Which Erikson's stgs of development: 20
intimacy isolation
Which Erikson's stgs of development:40
generative v stagnation
Which Erikson's stgs of development: 70 yrs
integrity v. despair
Which Erikson's stgs of development: values one life
integrity (65 yrs to death)
Which Erikson's stgs of development: productive, constructive, responsible
generative lifestyle (30-65 yrs)
Which Erikson's stgs of development: seeking of intimacy through casual sexual encounters, possessive, jealous, loss of interest in marriage, prejudicse against others
isolation (18-25 or 30 years)
Which Erikson's stgs of development: self-control and willpower, pride, simple cooperativeness, knows when to give and take, delayed gratification when necessary
autonomy(18mo-3yr)
Which Erikson's stgs of development: naive and gullible, dependence on others for approval, feeling of being exposed or attacked
shame and doubt (18mo-3yr)
Which Erikson's stgs of development: feeling too old to start over
despair (65 yr to death)
Which Erikson's stgs of development: ability to give and receive love, commitments and mutuality with others, sacrificing for others, responsible sexual behaviors
intimacy (18-25 yrs)
Which Erikson's stgs of development: realistic trust, confidence in others, optimism and hope, saring openly with others
trust (0-18mo)
Which Erikson's stgs of development: sense of competence, comletion of projects, sense of diretion, balance work and play
industry (6-12 yrs)
Which stage of Stress-adaptation syndrome:
decreased immune response, wt loss, enlarged LN, possible organ failure if stressors continue, disorganized thinking, disorganized personality, stupor or violence
Stg III: stg of exhaustion
Which stage of Stress-adaptation syndrome:
increased and intensified use of coping mechanisms, tendency to rely on defense-oriented behavior, psychosomatic symptoms deelop, wt returns to normal, hormone levels readjust, LN are normal size
Stg II: Stage of resistance
Which stage of Stress-adaptation syndrome:
release of NE and epi, increase hormones, wt loss, irritation of gastric lining, alert, task-oreinted, inefficient or maladaptive behavior might occur
Stg I:Alarm Reaction
Name the therapeutic technique: Pt: “I feel like such a failure in the eyes of my
family.”
Ns: “You feel like such a failure in the eyes of
your family.
restatement
Name the therapeutic technique:
Pt: “I feel like such a failure in the eyes of my
family.”
Ns: “You feel as though you have let your family
down.”
paraphrase
Name the therapeutic technique: Pt: “Do you think I should leave my husband?”
Ns: “You sound like you are feeling uncertain.”
reflection of feeling
Name the therapeutic technique: Pt: “School is such a waste of time.”
Ns: “What about school don’t you like?”
open direct question
Name the therapeutic technique:Pt: “School is such a waste of time.”
Ns: “Tell me more about your feelings about
school.
open indirect question
Name the therapeutic technique:Pt. “My father is such a jerk.”
Ns. “What about your father upsets you?”
focusing
Name the therapeutic technique:Pt. “My mom makes me so sad.”
Ns. “Tell me more about your relationship with
your mother.”
exploring
Name the therapeutic technique:Pt. “The head of the FBI wants me dead.” (Pt.
with paranoid schizophrenia)
Ns. “I find that hard to believe.”
voicing doubt
Name the therapeutic technique:“My sweet puppy died last week.” (tears in
eyes)
Ns. “It’s really hard to lose something you care
a lot about.”
empathy
What are the 4 phases of n-pt relationship
1. preinteraction (obtain pt info)
2. orientation (est trust, contract, assess)
3. working phase (maintin trust, problem-solve, continue to eval)
4. Termination phase (goals et, plan for aftercare, feelings regarding termination explored)
Which phase of n-pt relationship: goals have been met
termination phase
Which phase of n-pt relationship: nurse gets report
preinteraction phase
Which phase of n-pt relationship: pt and nurse set goals together
Oreintation or introductory phase
Which phase of n-pt relationship: after diagnosing the problem, the nurse an dpt explore ways to cope with problem.
Working phase
These skills demonstrate what sort of communication: empathy, relect of feeling, silence, paraphrase, restatement, feedback
active listening skills
Tarasoff vs. the regents of university of california
duty to warn
M'Naghten Rule:
cognitive standard
Wyatt v. Stickey
right to tx
rogers v. okin
right to refuse tx
tortes law:
neglect, malpractice, duty to warn, assualt/battery/false imprisonment
statutory law:
us constitution
Administrative law:
state nursing boards, medicare, medicaid (interest of public safety)