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239 Cards in this Set
- Front
- Back
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DEF: Splitting
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inability to integrate positive and negative qualities of oneself or others into a cohesive image.
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Splitting is particular to what disorder?
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Borderline personality disorder
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DEF: Circadian Rhythm
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'Sleep cylce" the cycle of sleep and wakefullness
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What variations are seen in circadian rhythm?
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changes in body temp, secretion of hormones
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DEF: Flight of ideas
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continuous flow of speech, person jumps rapidly from one topic to another
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DEF: Word salad
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sentences become mixed and incoherent
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Word salad is a _________ symptom of _________
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positive and Schizophrenia
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DEF: associated looseness
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disturbed thinking in which ideas shift from 1 subject to another in an oblique or unrealted manner
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Associated Looseness is a ________ symptom of _________
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positive and schizophrenia
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What is the purpose of the AIMS test?
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test how much EPS a pt has
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The AIMS test specifically tests which EPS?
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tardive dyskinesia
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The AIMS test measure what three things?
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1) facial and oral movements
2) extremity movements 3) trunk movements |
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Facial and oral movements
extremity movements Trunk movements are all tested by what test? |
AIMS test
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What is the purpose of the AIMS test?
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test EPS in a patient taking psychotropic drugs
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Bulemic patients can be described as...
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sneaky
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two characteristic actions of Bulemia are...
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vomiting and laxatives
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What are 2 key signs of bulemia?
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Dental Carries and enlarged parotid glands
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Dental carries and enlarged parotid glands are caused by...
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induced vomiting in Bulemic patients
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What is the Russell Sign?
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Scars on the fingers of a bulemic client
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Patients with Bulemia are at risk for which electrolyte imbalance?
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decreased K+ (potassium)
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DEF: anorexia
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biologica problem in the brain which causes the client to see themselves as fat
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What are 4 signs that a client may be anorexic?
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Organize food, OCD, over achievers, bright and intelligent
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A patient who Organize food, OCD, over achievers, bright and intelligent...may be at risk or suffering from :
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Anorexia
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What are the cardinal s/s of anorexia?
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clients period does not start or stops after it has already started, breasts diminsh
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Why do anorexic patients have increased lanugo?
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they have no fat in their bodies
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Because of reduced fat in the anorexic patient, you may see....
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Lanugo
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An anorexic patient will lose hair because....
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decreased protein
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Decreased protein in an anorexic patient will cause...
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hair loss
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What EKG changes will be seen with an anorexic patient?
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prolonged QT interval
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Prolonged QT interval will be seen in which psych patient?
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Those with severe anorexia
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What causes refeeding syndrome?
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the stomach can't handle food
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Refeeding syndrome is seen in which patients?
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anorexic
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IS refeeding syndrome serious?
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Yes,
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What is the biological process of refeeding syndrome?
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demands of a replenished circulatory system overwelm capacity of a nutritionally depleted cardiac muscle
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What is the life threatening risk of refeeding syndrome?
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cardio vascular collapse
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DEF: synergistic effect
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the capacity of 2 or more drugs acting together so that the total effecto f these drugs is greater than if taken alone
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Meperdine and Phenergen
ETOH and benzos are examples of what? |
synergistic effect
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DEF: Malingering
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a concious proccess of intentionally producing symptoms for an obvious environmental goal
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An employee who complains of back pain to get disability income is exhibiting what?
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malingering
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Malingering is a ________ _________
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Factious disorder
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DEF: somatoform disorders
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physical s/s suggest physical disorder for which there is no demonstrable base ( no proof)
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In a patient with somatoform disorder, the s/s are linked to a _________ __________
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psychological problem
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Somatoform disorder is different from malingering in that....
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somatoform disorder is non- intentional
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Hypochondriasis is a form of what disorder?
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somatoform disorder
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DEF: hypochondirasis
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preoccupied with fear of having/or idea of having a serious disease
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Which patients continue to worry desite medical tests and reassurances?
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hypochondriasis patients
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Hypochondriasis can be diganosed after symptoms have lasted how long?
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6 or more months
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What is the treatment for hypochondriases?
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psychotherapy
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Body Dysmorphic Disorder is a type of....
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somatoform disorder
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DEF:body dymorphic disorder
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preoccupied with some imagined defect in appearance; obsessional
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DID stands for?
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Dissociative Identity Disorder
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DEF: Dissociative Identity Disorder (DID)
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presence of 2 or more distinct personality states
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DEF: Primary personality
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the original personality of the host that is usually not aware of alter personalities
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Primary personality is seen in which disorder?
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Dissociative Identity Disorder
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Alter person is seen in which disorder?
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Dissociative Identity Disorder
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DEF: Alterperson
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subpersons that take control of behavior in a patient with Dissociative Identity Disorder
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Are alters aware of each other in Dissociative Identity Disorder?
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usually not
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What does methadone help treat?
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heroin addiction
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What drug is used for heroin addiction?
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Methadone
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What is the benefit of methadone?
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it is the only drug approved to treat a pregnant opiod addict
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What does methadone do?
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helps treat heroin addiction by action as a sunthetic opiod blocker which reduces cravings for and effects of heroin
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The purose of methadone is to...
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reduce cravings and block effects of heroin
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what are the dangers of methadone?
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heart arrhythmias
heart attack, valve damage cardio toxic highly addictive |
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heart arrhythmias
heart attack, valve damage cardio toxic highly addictive Are all dangers of what drug? |
methadone
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Cocain is a....
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stimulant
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what are the 2 main effects of cocaine?
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Numbing (anethetic)
Increased energy (stimulant) |
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Numbing (anethetic)
Increased energy (stimulant) are two effects of what drug? |
cocaine
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what are the 3 major symptoms of cocaine use?
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dilation of pupils
dryness of oronasal cavity incrased motor activity |
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dilation of pupils
dryness of oronasal cavity incrased motor activity are three sings or _____________ use |
cocaine
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what are the 7 withdrawal symptoms of cocaine?
(hint: DPLAINVS) Dear president, let all interested natives visit spain |
depression
paranoia lethargy anxiety Insomnia N/V Sweaty chills |
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Depression, paranoia, lethargy, ansiety, insomnia, n/v, and sweaty chills are all withrawal symptoms of what drug?
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cocaine
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Marijuana is what kind of drug?
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depressant and hallucinogenic
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What are s/s of marijuana use?
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Euphroia, detachment, relaxation, talkativeness, paroia, decreased perception of time, inappropriate hilarty, increased sensitivity to external stimuli, anxiety
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Euphroia, detachment, relaxation, talkativeness, paroia, decreased perception of time, inappropriate hilarty, increased sensitivity to external stimuli, anxiety
Are all signs of ____________ use |
marijuana
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what are the long term effects of marijuana use?
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lethargy, anhedonia, difficulty concentrating, memory loss
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lethargy, anhedonia, difficulty concentrating, memory loss
are all long term effects of ____________ use |
marijuana
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What effect do benzo's have on a person?
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they slow them down
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what are the signs of benzo withdrawal?
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patient will be all over the pace and highly irratable
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A patient who seems slowed down may be abusing ________
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benzos
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A patient who seems all over the place and who is highly irratibility may be experienceing withdrawal from,,,,
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benzos
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What is the safety priorty of the nurse?
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Protect:
Self Other patients Patient |
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Nurses have an obligation to report _________ of ______ or ________
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harm of self or others
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why does a patient with OCD continuosly do certain activities?
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to gain a senes of control and reduce/relieve their anxiety
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What is the most dangerous EPS?
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Tardive Dyskinesia
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What are s/s of PCP intoxication?
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acute anxiety to acute psychosis
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What do PCP's do?
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Produce general anesthesia and lessens sensation to touch and pain
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PCP intoxication is particularly difficult for staff to intervene because....
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the patient is less sensitive to touch and pain
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What is the risk of PCP?
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respiratory arrest
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Symptoms of acute anxiety to acute psychosis may be evidence of ______ intoxication
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PCP
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A patient is less sensitive to touch and pain when intoxicated with which drug?
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PCP
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What is a natural but non-FDA approved for HS sedation?
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melatonin
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What drugs may be used for short term HS sedation ?
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Benzodiazepines
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What drugs may be used for long term HS sedation?
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dalmane and doral
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To increase effective sleep a patient should.....
go to sleep at the _______ time and wake at the same ______ each day |
same; time
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To increase effective sleep a patient should.....
Practice _________ reduction and try to not take ________ to bed |
stress; worries
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To increase effective sleep a patient should.....
Sleep in ________ and ____________ clothes and bed |
loose and comfy
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To increase effective sleep a patient should.....
eliminate ________ and ____________ |
noise and bright lights
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To increase effective sleep a patient should.....
watch the environments _________ |
temperature
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To increase effective sleep a patient should.....
Drink no ___________ or __________ with in 6 hous of going to bed |
caffeine and alcohol
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To increase effective sleep a patient should.....
avoid ________ meals |
heavy
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To increase effective sleep a patient should.....
excerise _______ |
daily
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To increase effective sleep a patient should.....
take a _______ _______ before bed |
warm bath
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To increase effective sleep a patient should.....
avoid __________ during the day |
napping
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What are two forms of parasomnias?
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Nightmare disorder
sleep terror |
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Nightmare disorder and sleep terrors are forms of....
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parasomnias
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DEF: Nightmare disorder
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frighting dreams from which ppl awaken scared, almost always occur during REM late in night
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frighting dreams from which ppl awaken scared, almost always occur during REM late in night
are typical of what disorder? |
nightmare disorder
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Nightmare disorder can be lifelong frome ________-
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stress
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When do sleep terrors occur?
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during non-REM sleep
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Sleep terrors are most common in ....
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kids
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During REM...
Eyes dart _______ and _____ |
back and forth
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During REM...
_________ and __ __________ flutter |
breathing and heart rate
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During REM...
muscles are mostly ________ |
paralyzed
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During REM...
dreams are ___________ |
vivid
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During REM...
the mind works to _______ ________ |
problem solve
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During REM...
_______ and ________ are integrated into long term memories |
knowledge and experiences
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During REM...
there are _______ waves |
beta
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The Pittsburgh sleep quality index measures.....
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quality and patterns of sleep per patient
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quality and patterns of sleep per patient is measure by which index?
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The Pittsburgh Sleep Qulatiy Index
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Clozaril is what kind of drug?
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antipsychotic
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Clozaril is a unique antipsycotic because it is free of __________- ___________
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motor side effects
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What is a major risk when useing Clozaril to treat psychosis?
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Agranulocytosis
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What is Agranulocytosis?
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A fatal S.E that suppress bone marrow
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What are s/s of Agranulocytosis?
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fever, WBC count
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How often must you check for s/s of agranulosytosis when a patient is taking Clozaril?
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Regularly for the first 6 months then every other week
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What would you check to rule out fatal complications of clozaril
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check for fever and WBC counts
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Clozaril _________ the first choice for antisphsycotic drugs
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IS NOT
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Haldol use has a ________ incidence of EPS
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HIGH
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Haldol is the ______ sedating and has a _________ risk of lowered BP
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leaset and decreased
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What drug is used to treat Bipolar disorder?
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Lithium (mood stabalizer)
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Lithium is a _________ ___________ drug used to treat ________ _________
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mood stabalizer
bipolar disorder |
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What is the therapeutic level for lithium?
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0.8-1.4 mEq/L
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When does litium take affect?
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in 7-14 days
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what should be used to treat bipolar disorder until lithium takes affect?
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benzo's
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What is the danger of bipolar disorder?
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Mania with suicidal thoughts and plans
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What are long term risks of lithium use?
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Hypothyroidism, impaired kidney funtion, myasthenia gravis
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Hypothyroidism, impaired kidney funtion, myasthenia gravis
are all risks of what drug? |
lithium
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What should the nurse do during the Manic stage of Bipolar disorder?
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establish clear parameters for the client
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What should the nurse do during the aggressive stage of Bipolar disorder?
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facilitate expression of anger in a non-violent way
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What should the nurse do during the impulsive stage of Bipolar disorder?
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help pt with problem solving
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DEF: transsexualism
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person wishes to change his/her anatomical sexual characteristics to those of the opposite sex
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A patient who wishes to change his/her anatomical sexual characteristics to those of the opposite sex is showing _________________
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transsexualism
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What can be done to help with premature ejaculation?
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use cognitive measure to control by thinking of non-sexual things
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if a patient has ED and cardiac issues they cannot use what drug?
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Viagra
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Alzheimer's disease is _______ and ________
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terminal and progressive
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Fast onset, disturbances in consiousness, thinking, memory, attention, and perception are all signs of ________
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delireum
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With an Alzheimer's/delireum patient disorientation flucuates by...
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minute, hour, and day
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Delirium is ALWAYS caused by a ________ __________
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secondary issue
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What is the treatment for dilerium?
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ID the cause
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What is the #1 nursing diagnosis for delierium and alzheimer's patients?
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Risk for injury
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DEF: Dimentia
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Cognitive Disorder
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What are the s/s of dimentia?
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gradual onset, deterioration of memory, judgement, ability to think abstractly, orientation
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The difference betwee delirium and dimentia is that....
Delirium is a ________ onset while dimentia is a _______ onset |
quick and slow
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gradual onset, deterioration of memory, judgement, ability to think abstractly, orientation
are all signs of.... |
dimentia
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What is the first stage of Alzheimer's disease?
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Mild; forgetful, scattered, but still functional
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During stage 1 of alzheirmers are patients typically diagnosed?
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no
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A patient who is forgetful, scattered, but still functional is in what stage of alzheimers?
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1
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What is the second stage of alzheimers?
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Moderate; confusion
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the second stage of Alzheiumers is
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moderate
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the first stage of alzheimers is
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mild
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a patient who gets lost in a familiar area may be showing signs of which stage of alzheimer's?
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2
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The third stage of alzheimer's is considered....
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moderate-severe
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A patient in the third stage of alzheimer's will be _________ but also have __________
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ambulatory and dimentia
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when treating a patient in the third stage of alzheimer's focus on the...
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family
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What is the 4th stage of alzheimer's considered to be?
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late/end-stage
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A patient who reaquires tube feeds and lies in the fetal position is in what stage of alzheimers?
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fourth
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what are 2 drugs used to treat alzheimer's?
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cognex and aricept
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what is the #1 nursing dx for a patient with alzheimer's?
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safety
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when using Cognex and aricept to treat alzheimer's, what must you check yearly?
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liver enzymes
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Cognex and Aricept are used to treat....
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alzheimer's
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What drugs effects are increased by 50% in asians?
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haldol
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When giving Haldol why must you be careful if the patient is asian?
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effects are increased by 50%
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DEF: WIthdrawal
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after a long period of continued use, stopping or reducing drug results in specific physical and psychological s/s
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DEF: tolerance
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need for higher and higher doses to achieve the desired effect
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after a long period of continued use, stopping or reducing drug results in specific physical and psychological s/s
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withdrawal
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need for higher and higher doses to achieve the desired effect
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tolerance
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what is the #1 quesiton to ask an alcohol abuser?
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When was the last time you used?
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When will an alcohol abuser have symptoms of withdrawal?
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24-48 hours after last drink
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How long do DT's last in an patient experiencing alcohol withdrawal?
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2-3 days
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How do DT's/withrawal symptoms disappear?
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rapidly
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BAL
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blood Alcohol level
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What is the legal BAL?
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0.08 mg%
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How many drinks is 0.08 mg %?
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1.5-2 drinks in 3 hours
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what s/s will be seen in a patient with a BAL of 0.05?
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change in mood, behavior, impaired judgment
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what s/s will be seen in a patient with a BAL of 0.20?
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staggering, ataxia, highly emotional
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what s/s will be seen in a patient with a BAL of 0.40?
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Coma
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what s/s will be seen in a patient with a BAL of 0.50
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Death D/T respiratory depression
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A change in mood, behavior, impaired judgment is seen with what BAL?
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0.05
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Coma is seen with what BAL?
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0.40
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Death is seen in what BAL?
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0.50
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staggering, ataxia, highly emotional are seen with what BAL?
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0.20
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What is the key feature in a pt with alcohol delirium?
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fever of 100-103 degrees
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Withdrawal delirium is a....
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medical emergency
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When does Withdrawal delirium peak?
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2-3 days after cessation of ETOH consumption
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how long does withdrawal delirium last?
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2-3 days after peak
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Can a patient with Withdrawal delirium die?
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YES
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What are s/s of Withdrawal delirium ?
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tachycardia, diaphoresis, increased BP, disorientation, clouding, VH, TH, hyperexcitability --> lethargy
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tachycardia, diaphoresis, increased BP, disorientation, clouding, VH, TH, hyperexcitability --> lethargy
are all signs of.... |
tachycardia, diaphoresis, increased BP, disorientation, clouding, VH, TH, hyperexcitability --> lethargy
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What are the s/s of DT's?
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hyperaltertness, jerky movements, irritability, easily startled, "shaking inside"
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hyperaltertness, jerky movements, irritability, easily startled, "shaking inside"
are all signs of.... |
DT's
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What is the treatment for DT's?
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benzo's (valium) in high doses
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Benzo's (valium) in high doses is used to treat....
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DT's
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DEF: delusion
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false belief even with evidence that it isn't true
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a false belief even with evidence that it isn't true is a ________
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delusion
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DEF: Hallucination
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No real base,; audio, visual, tactile, or smell
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A patient with No real base to support audio, visual, tactile, or smell is experiencing _________
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hallucinations
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DEF: illusion
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misinterpretation of objects in environment. usually of a threatening nature.
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A patient who has a misinterpretation of objects in environment. usually of a threatening nature is experiencing....
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illusions
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DEF: waxy flexibility
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a patient can't put hands down and with "excssive mainainence of posture"
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A patient who holds unusual postures for a long period of time is experiencing....
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waxy flexibility
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DEF: Borderline Personality Disorder
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a pervasive pattern of instabiloity of interpsersonal relationship, self-image, and affects and makred impusivity beginning in the early adult
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When does Borderline personality disorder begin
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in the early adult
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Borderline Personality Disorder is considered a Cluster _____ peronality disorder
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Cluster B
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A patient who experiences a pervasive pattern of instabiloity of interpsersonal relationship, self-image, and affects and makred impusivity is suffering from...
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Borderline Personality Disorder
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"instability in affect, identity, and relsationships"
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Borderline personality disorder
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DEF: narcissistic Disorder
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gradiosity, need for admiration, lack of empathy
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A patient who shows gradiosity, need for admiration, lack of empathy may be suffering from
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narcissistic disorder
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Narcissistic disorder begins in what age?
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early addult
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A person with a Cluster B borderline personality disorder desperatly seeks _________ to avoid being _________
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relationships; alone
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A person who desperately seeks relationships to avoid being alone may suffer from
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borderline personality disorder
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What is an exampe of a Cluster A personality disorder?
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paranoid D/O
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Paranoid D/O is what thype of cluster personality disorder?
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Cluster A
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DEF: paranoid personality D/O
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pervasive distrust and suspiciousness of others such that their motives are interpreted as malevident
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A person who has a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevident
may have.... |
paranoid personality D/O
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Neuroleptic maignant synrome occurs in patients who have taken....
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anitpsychotic meds
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What are s/s of Neuroleptic maignant synrome?
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decreased LOC, increased muscle tone, autnomic dusfunction including hyperpyrexia, labile HTN, tachycaria and increased apnea, diaphore drooling
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A pt with decreased LOC, increased muscle tone, autnomic dusfunction including hyperpyrexia, labile HTN, tachycaria and increased apnea, diaphore drooling
May be suffering from: |
Neuroleptic maignant synrome
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What is the treatment for Neuroleptic maignant synrome?
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early detection, stop antipsychotics, manage fluid balance, and decrease temperature
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early detection, stop antipsychotics, manage fluid balance, and decrease temperature are interventions for a patient with----
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Neuroleptic maignant synrome
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What drugs are used to treat a mild case of Neuroleptic maignant synrome?
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parlodel
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Parlodel is used to treat a mild case of _________________________
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Neuroleptic maignant synrome
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What drugs are used to treat a severe case of Neuroleptic maignant synrome?
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Dantrium and ECT
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Dantrium and ECT are drugs used to treat a severe case of ______________
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Neuroleptic maignant synrome
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What is the most common type of hallucination?
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auditory
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What should the nurse when a patient is experiencing hallucination?
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maintain eye contact, call client by name, and speak simple but louder than voices
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maintain eye contact, call client by name, and speak simple but louder than voices are important nursing actions for the pt experiencing
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hallucinations
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What clues might incidcate that the patient is experienceing hallucinations?
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Eyes darting to one side, muttering, watching vacant areas
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Eyes darting to one side, muttering, watching vacant areas may be signs that a patient is experiencing....
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hallucinations
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When you patient experieriences hallucinations what should you say?
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DO NOT argue, say "I do not see/hear, but I underatnd how that upsets you."
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