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67 Cards in this Set

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Atropine sulfate -ECT
given prior to ECT to decrease secretion and increase heart rae
Succinylcholine- ECT
muscle relaxant given to prevent bone fractures
Thiopental Sodium
administered as a short acting anesthetic
only absolute contraindication for ECT
intracranial pressure
most common side effect of ECT
temporary memory loss & confusion
Major Depression
Major indication for ECT
Oxygen
Administered prior to, during, and after ECT
Informed Consent
required before ECT can be initialted
Norepinephrine and serotonin
thought to be increased by ECT
Recent Myocardial Infarction
most common cause of mortality associated with ECT
the average number of ECT treatments given and the timing of administration
one treatment every other day for a total of 6 to 12
priority nursing intervention before starting ECT
ensure the consent form has been signed
insulin coma therapy
the induction of a hypoglycemic coma aimed at alleviating psychotic symptoms; a dangerous procedure, questionably effective, no longer used in psychiatry
pharmacoconvulsant therapy
no longer used; IM injections like pentylenetetrazol (metrazol) or inhalant flurothyl
hypomania
milder degree of manic episode in bipolar disorders; no psychotic symptoms
Bipolar disorder I vs II
I: with mania
II with hypomania
Cyclothymic disorder
chronic mood disturbance >2yrs
hypomania, lesser severity of depression; never without mood disturbance for more than 2 months
substance induced mood disorders
-intoxication
-withdrawal
-heavy metal and toxins
-medications
biological influence to depressive illness
biogenic amines: neurotransmitter depression of norepinephrine, serotonin, dopamine, and receptor sites
neurological disorders that may affect mood
-CVA, Brain tumors, Alzheimer's Parkinsons, Huntingtons, MS
electrolyte disturbances that affect mood
(+) sodium bicarb, calcium,
(-) magnesium, sodium
(+,-) potassium
hormonal disturbances for mood
adrenal cortexes: addison's, cushing's
thyroid
estrogen, progestrone
nutritional deficiencies that affect mood
vita B12, B6, B1, noacin , vita C, iron, folic acis, zinc, calcium, potassium
indicator that differentiates mood disorder form the typical stormy behavior of adolescence
visible manifestation of behavioral change that lasts for several weeks
Fluoxetine (Prozac)
the only medication approved to treat depression in children and adolescence
most common psychiatric disorder in elderly
depression
bereavement overload predisposes this group to depressive illness
elderly
symptoms of depression in elderly are often misdiagnosed as this
senile dementia: b/c of memory loss, confusion, apathy
medications commonly used by elderly that can produce depressant effect
antihypertensives, corticosteroids, analgesics
safest most effective treatment of depression in the elderly
ECT if acute suicidal risk or can't tolerate meds
the "blues"
associated with postpartum depression
therapeutic range for acute mania with lithium
1.0 to 1.5 mEq/L
a drug that's effective in the treatment of bipolar mania
Carbamezepine (Tegretol)
Anticonvulsants used to treat bipolar disorder
-carbamazepine (Tegretol)
-clonazepam (Klonopin)
-valproic acid (depakote)
-lamotrigine (Lamictal)
-gabapentin (Neuronitin)
-topirimate (Topamax)
-oxcarbazepine (Trileptal)
biological influences to bipolar disorder
elevated intracellular calcium
existing medical conditions that may be factor of bipolar
electrolyte imbalances, cerebral lesions, med side effects
frequent use of this med may be factor to bipolar
steroid for M.S or lupus, other somatic illnesses;
amphetamines, antidepressants, anticonvulsants, carcotics
most common comorbid condition in children and adolescence with bipolar
ADHD, stimulants can exacerbate mania
feelings of blues in response to everyday disappointments
transient depression
clouding of consciousness occurs
delirious mania
outlook is gloomy and pessimistic
dysthmic disorder
characterized by mood swings between hypomania and mild depressiveness
cyclothymic disorder
feelings of total depsair and hopelessness
Major Depressive disorder
physical mvmnt may come to a standstill
Major Depressive d/o
paranoid and grandiose delusions are common
BIpolar d/o (mania)
client feels best in the morning and worse as day progresses
dysthmic disorder
excessive interest in sexuality
bipolar d/o (mania)
able to carry out thoughts of destructive behavior
dysthymic d/o
Accelerated pressure speech
bipolar mania (mania)
frenzied motor activity characterized by agitated purposeless mvmnt
delirious mania
transient depression
life's everyday disappointements
mild depression
normal grief response
moderate depression
dysthymic d/o
severe depression
major depressive d/o
3 stages of mania
stage 1, hypomania
stage 2, acute mania
stage 3, delirious mania
lithium treatment for bipolar requires what to be monitored
s & s of toxicity: n &v, stomach pains, dizziness, weakness, tremors, ataxia, nystagmus, slurred speech, seizures
CHECK blood levels once a month
pharm t/x of depressive d/o
SSRU- most widely used: inhibits cns uptake
MAOI- developed for TB
TCA- developed (but ineffective) for schizophrenia
SSRI's
citalopram (Celexa), escitalopram (Lexapro,) fluvoxamine (Luvox),
serotonin syndrome s&s
s &s - 1. confusion, agitation, tachycardia, hypertension, nausea, abdominal pain, myoclonus, muscle rigidity, fever swetaing, tremor ->>rhabydomyolysis, cardivascular collapse, coma, death
serotonin syndrome t/x
d/c drug, monitor v/s, use cooling blanket, cyproheptadine, and dantrolene
amoxapine - heterocyclic, t/x for depression
can cause NMS and tardive dyskinesia
heterocyclics:
bupropion, maprotiline
trazadone
risk of seizures
risk of priapism
first line to treat major depressive d/o
SSRI, SNRI
second line to treat major depressive d/o
tricyclics
third line to treat major depressive d/o
MAOI
lithium level for maintenance
0.6 to 1.2 mEq/L
lithium toxicity
monitored weekly initialliy, than monthly for maintanence
s & s blurred vision, tinnitus, n/v, diarrhea
eliminated by kidneys