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140 Cards in this Set
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A general concept referring to an individual's positive review of self, others, relationships, and the enviornment; it must be viewed in terms of degree as all individuals experience varying degrees of this at different times in their lives.
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Mental Health
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Presentation of clinically significant behavior or psychological syndrome or pattern as defined by the American Psychiatric Association.
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Mental Disorder
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Relationship theories consist of:
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Peplau's Theory of Interpersonal relatonships, Erikson, Tomlin, & Swian's Modeling and Role-Modeling
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Caring Theories include:
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Watson's Theory of Transpersonal Caring-Healing, Leininger's culture care theory, and Boykin and Schoenhofer's Theory of Nursing as caring.
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Theories based on the notion of when nursing is needed include:
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Orem's Self-Care Deficit Theory, Roy's Adaptation Model, and Neuman's Systems Model
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Theories of pyschosocial development
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Frued's theory of psychosexual development, Erikson's theory of psychosocial development, Sullivan's Interpersonal theory
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Theories of human cognitive development:
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Piaget's state theory of the cognitive development of children, Perry's theory of young adult cognitive development, Belenky et al's theory of the way women know
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Three phases of nurse-client relationship
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Orientation
Working Termination |
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Comprises all that is learned through socialization, shared by all group members, and associated with adaptation to the environmen. It includes knowledge beliefs, art, morals, law, and customs.
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Culture
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Best person to assist with interpreting for a non-English speaking client
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Cultural facilitator or cultural broker
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The study of causes and distribution of diseases in a population
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Epidmeiology
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Goal in epidemiology
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To better understand how frequently diseases occur in a population and in whom they are most likely to occur, and to document the natural history of the diseases
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This gives the nurse a method of evaluating an ethical dilemma before drawing conclusions about an issue.
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The Value Analysis Model
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In nursing, _____ is defined as as a critical situation, stage, or life event in which a person is called on to respond and adapt to the unexpected.
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Crisis
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Kind of crisis when an event poses a challenge to an individual
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Situational
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Kind of crisis in which a person's growth and development must adjust and adapt to new life patterns.
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Maturational
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Kind of crisis where a situation when a person experiences culture shock
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Cultural
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Kind of crisis of a proprotion to impact an entire community
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Community
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Each person has _____ energy. When it's used up the person is left in a state of ______.
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adaptive
exhausted |
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Which theory includes the adaptive potential assessment model, which provides the nurse language to describe the client's adaptation to stress.
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Modeling and Role-Modeling
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Which theory sugguests that listening to the client and understanding the person's subjective experience of the crisis is of the utmost importance.
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Watson's theory of caring
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What is the goal of crisis intervention?
Long term or short term? |
To return the person to normal life.
Short terms. |
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A subjective feeling of uneasiness associated with the autonomic nervous system
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Anxiety
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What is the difference in anxiety and fear?
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Anxiety - generalized response
Fear - to a specific object |
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Nursing theory that provides direction for nursing care, beginning with the need to establish trust and understand the client's subjective experience of emotion.
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Modeling and Role-Modeling
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An individual experienceing schizophrenia may present with:
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diosodered thoughts, imcomprehensible language, loss of function, delusions, and hallucinations.
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Positive symptoms of schizophrenia:
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Outward behaviors that clearly display pathology such as:
disordered thoughts delusions hallucinations |
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Negative symptoms of schizophrenia:
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Behaviors that represent a change from the individual's prior personality and lead to social isolation and anhedonia
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A generally irreversible condition characterized by memory loss
Onset Rapid or Slow? |
Dementia
Slow onset |
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A harbinger of an acute medical condition and is characterized by a clouding of consciousness.
Onset Rapid or Slow? |
Delirium
Rapid onset |
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True or False??
Intellectual function diminishes with age? |
False.
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True or False???
Confusion should not be used as a label for the behavioral manifestations or impairments in cognition or or memory loss. |
True.
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Memory deficits pose a serious threat to: ____ & ____
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Self esteem & identity.
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Risk factors for depression in the elderly
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multiple losses, financial strain, poor health
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Symptoms of depression in elderly
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insomnia & physical complaints
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Risk of suicide High or Low in elderly?
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High
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Axis one identifies:
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Clinical disorders such as Major depressive disorder recurrent
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Axis two identifes:
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Personality Disorders and conditions of mental retardation
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Axis three identifies:
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General Medical conditions
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Axis four identifies:
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Psychosocial and environmental factors: ex recent divorce
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Axis five identifies:
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Global Assessent functionaing (GAF)
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Public Space is:
Example |
12 Feet
Talking to a classroom |
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Social Space is:
Example |
9-12 Feet
Walking down street or in a restaurant |
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Personal Space is:
Example |
18 inches to 4 feet
Students in a classroom |
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Intimate Space is:
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Less than 18 inches
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Therapeutic communication techniques:
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Listening, Silence, Broad Openings, Restating, clarification, reflection, focusing, informing, suggesting, confronting.
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Defense mechanisms:
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Denial, projection, repression, rationalization, infrojection, displacement, reaction formation, regression, suppression, sublimation, symbolization
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Lets the client know that the nurse wants to listen and permit the client a wide range of responses.
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Broad Openings
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Repeats main message clinet has expressed. Also allows the nurse to verify understanding of the clients message
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Restating
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"Are you saying that?" Clients idea in a simple statement
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Clarification
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Powerful tool to bring out important aspects of the clients feelings and to put them in the context of when and where they occur. Use SPARINGLY!
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Reflection
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Nurse directs conversation to focus on topic of particular importance or relevance to client.
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Focusing
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Giving facts and information
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Informing
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Encourages clients to consider alternatives to be therapeutic, the nurse must not tell the client what to do or omplicitly take responsibility for the decision and outcome away from the client
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Suggesting
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Communication that points out inconsistencies or incongruencies between feelings, toughts, and actions.
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Confronting
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Negation of reality of threatening situations, depsite factual evidence.
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Denial
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Attribution of one's thoughts, feelings, or impulse to others.
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Projection
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Unconscious blocking form awareness material that is threatening or painful.
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Repression
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Intellectual explaining away of threatening circumstances
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Rationalization
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Incorporating, without exam or thought the qualities or attitudes of others
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Introjection
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Transfer of feelings or reactions evoked by one topic or event to another that is less threatening.
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Displacement
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Expression of a feeling that is opposite of one's authenic feeling or of feelings that would be appropriate in the situation. Ex. brings gift to nurse @ whom he's really mad at.
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Reaction formation
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Retreat to previous developmental level
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Regression
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Conscious or unconscious attempt to keep threatening material out of consciousness.
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Supression
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Channeling of social unacceptalbe impulses into socially acceptable activities
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Sublimation
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Use of object, idea, or act ot express emotion that is not expressed directly
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Symbolization
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5 aims of Erkison:
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1. Build Trust
2. Promote positive oreintation 3. promote perceived control 4. Promote strengths 5. Set mutual goals that are health directed. |
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Caplans stages of crisis:
Stage One: |
A situation or threat to individual, resulting in anxiety. uses coping mechanisms. If anxiety not reduced enters next stage.
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Caplans stages of crisis:
Stage Two: |
Anxiety increases and the persons ability to cope decreases. Person feels pressure and is unable to respond.
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Caplans stages of crisis:
Stage Three: |
Anxiety escalates. Uses every means available to bring anxiety level and the situation under control. If unable...next phase
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Caplans stages of crisis:
Stage Four: |
PANIC.. May exhibit depression or frank psychosis.
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A stimulus that an individual perceives as challenging or harmful.
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Stress
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Selye what theory??
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GAS General Adaptation Syndrome
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GAS involves what 3 phases?
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alarm stage, stage of resistance, and stage of exhaustion
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Erikson and colleagues developed Adaptive Potential Assessment Model (APAM) to describe 3 states of coping potential. What are they?
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Arousal, Equilibrium, Impoverishment.
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Focus of crisis?
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Deal with the here and now.
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Goal of intervention with crisis?
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Reestablish equillibrium and balance.
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A state wherin a person feels a stong sense of dread, frequently accompanied by physical symptoms of inceased heart rate, respiratory rate, elevated BP, without having a specific source or reason for the emotions.
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Anxiety
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A state wherein a person feels a stong sense of dread, with autonomic nervous system responses that are focused on a specific object or event - f
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Fear
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Pwerful tool to accurately measure blood flow patterns in the brain.
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PET
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Important neurotransmitter in anxiety disorders
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GABA
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Stages of anxiety:
Tension of day to day living; alert perceptiion field, can motivate learning Example: |
Mild
Missing bus |
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Stages of anxiety:
Focuses on immediate concerns; perceptual field is narrowed; individual exhibits selective inattention Example |
Moderate
Taking exam |
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Stages of anxiety:
Focuses on specific detail. Perception field greatly narrowed Example |
Severe
Witnessing a car wreck |
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Stages of anxiety:
Individual experiences a sense of awe, dread, and/or terror; individual loses control, there is a disorganization of the personality Example |
Panic
Experiencing an earthquake and unable to cope. |
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Primary symptom of generalized anxiety disorder?
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Excessive anxeity or dread.
Considered excessive when present more days that not for a period of 6 mths or more |
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Genralized anxiety d/o must possess 3 or more of:
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restlessness, easy fatiue, diffiuclty concentrating, irritability, muscle tension, and sleep disturbances
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Condition characterized by discrete episodes of intense anxiety that begin abruptly and reach a peak within 10 minutes
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Panic Disorder
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With panic d/o must have 4 of these:
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palpitations or rapid heart rate, sweating, trembling, short of breath, sensation of choking, chest pain, nausea, dizziness, fear of losing control, fear of dying, numbness or tingling, chills or hot flashes, and some sense of altered reality.
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Fear of going out into public places?
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Agoraphobia
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Obsessions are:
Compulsions are: |
Thoughts
Actions |
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Examples of obessions:
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Fear of self-contamination, that forgot how to do something important, a need to have thins in ones life in a particular physcial arrangement
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Goal of compulsions:
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To reduce anxiety or distress.
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True or False
With OCD you can only have one or the other never both. |
False. You can have obsessions, compulsions, or both.
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With anxiety, according to Erikson's five things, which two are most important?
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1. Build trust
2. Modeling the clients world. |
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Clients who manifest with characteristics of manic depressive d/o and schizophrenia are diagnosed with:
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Schizoaffective disorder
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word thats made up
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neologistic words
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Going off the point or subject
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Derailment
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Failure to reach a goal or stick to the original point
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Tangentiality
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Speech that is not logically connected
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Incoherence
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Group of disconnected words
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Word salad
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A marked decrease in reactivity to the environment, sometimes reaching an extreme degree of complex unawareness, maintaining a rigid posture and resisting efforts to be moved the assumption of bizarre postures
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Catatonia
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Whats the major defining characteristic of pyschosis
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Delusions
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Type of delusion that involves perceptions of importance; often believe to have specific powers or religous messhiah's
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Grandiose
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Type of delusion where they believe others intend to do them harm.
Common example |
Persecutory or paranoid
food poisioning |
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Type of delusions that the client believes that common events, passages in songs, patterns of clouds in the sky, comments of passer-by refer specifically to them
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Referential
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Sensory experiences not perceptible to other nonpsychotic individuals.
Most commonly: |
Hallucination
Auditory |
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Positive Symptoms of Schizophrenia:
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disordered thoughts, delusions, hallucinations
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Negative symptoms of Schizophrenia:
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Flattened affect, alogia, avolition
anhedonia |
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tendency to speak little and when speaking openly, to use brief and often seemingly empty phrases.
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Alogia
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Tendency to lack motivation for work or other goal-directed activities
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Avolition
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To diagnose Schizophrenia must have ____ postivie or negative symptoms for a significant portion of the time during a one month period with some associated social or occupational dysfunction.
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Two
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Major genetic components:
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Hippocampus smaller; ventricles larger
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What is the goal of Schizophrenia?
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To reduce both the positive and negative symptoms to maximize functional outcome.
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With Schizophrenia when is suicide more likely to occur?
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When positive symptoms are improving.
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Temporary and reversible, a disorder in thought and level of alertness.
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Delirium
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Chronic and mainly a disorder of memory, cognition, and behavior.
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Dementia
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Depression mistaken as dementia
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psuedodementia
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The process by which a person "knows the world" and interacts iwth it.
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Cognition
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Characterized by a disturbances of consciouness and a change in cognition that develops over a short period of time usually hours or days
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Delirium
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Delirium resluts from an abnormality in the ____ and person is disoriented to ____ & _____.
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CNS
Time and Place |
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Common causes of delirium:
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Infections, dehydration, adverse drug reactions, electrolyte imbalances, hypoglycemia, hypoxia.
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True or False:
Delirium is a medical emergency? |
True
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Characterived by development of multiple cognitive deficits that include an impairment of memory and at least one of the following:
aphasia, apraxia, agnosia |
Dementia
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Loss of ability to recognize objects:
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Agnosia
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Most common type of dementia
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Alzheimers
Cause unknown |
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2nd most common type of dementia is:
Greatest risk factors for it: |
Vasuclar - HTN and cardiovascular disease are greatest risk factors
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Which anxiety D/O am I?
Anxiety focused on a variety of life events or activities. Char by restlessness, fatigue, difficulty in concentrating, irritability, muscle tension, sleep disturbances |
Generalized anxiety disorder
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Which anxiety D/O am I?
Discrete episode of intesne anxiety that begin abruptly and reach a peak within about 10 mins. Char by palpitations, sweating, trembling, SOB, sensation of choking, chest pain, nausea, dizziness, fear of losing control, fear of dying, sense of altered reality |
Panic Disorder
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Which anxiety D/O am I?
Acute anxiety in crowds; fear of being alone; fear in any physical setting from which the individual may have trouble escaping. Char by intense feelings of anxiety and or fear of losing control that results in either refraining from going out or avoiding situations that may bring about anxiety. |
Agoraphobia
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Which anxiety D/O am I?
Persisten, excessive, or unreasonable fear of a specific object or situation . Char by fears that interfere markedly with life activities. |
Phobia
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Which anxiety D/O am I?
Occurrence of recurrent thoughts, images, and/or impulses that are intrusive and inappropriate, casuing anxiety and coupled with repetitive actions or behaviors performed to reduce anxiety. |
OCD
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Which anxiety D/O am I?
After exposure to a significant, life-threatening event, the experience of anxiety symptoms in which the event is reexperienced through recollections. Char by: recureent recollectioms, dreams, hallucinatory-like flashbacks, impairment of social functioning. |
Post Traumatic Stress Disorder
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Bleuler's 4 A's of Assessment
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Affect
Associative looseness Autism Ambivalence |
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3 reasons for emergency commitment:
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Harm to self
harm to others Proven they can't take care of self |
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Goal of ID
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minimize pain and maximize pleasure
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The superego is:
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logical and considers consequences (conscience)
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The ego is:
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the self
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Right protected by the U.S. Constitution that permits a speedy legal hearing and evaluation for any individual who claims he is being detained illegally.
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Habeas Corpus
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After the 48-72 hour period has lapsed, legally emepowered mental health providers can petition the court for a lengthier period of hospitalization known as:
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Civil commitments
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