Scc Mental Health 2008

Front 1

Alprazolam, Lorazepam, Oxazepam are all generic names of what class?

Back 1

benzodiazepines: antianxiety medication

Front 2

Xanax, Ativan, Serax are all trade names of what class?

Back 2

benzodiazepines: antianxiety medication

Front 3

what are some side effects of benzodiazepines?

Back 3

primarily related to the general sedative effects and include drowsiness, fatigue, dizziness, and psychomotor impairment.
Sedation usually disappears w/in one to two wks. of treatment

Front 4

It is important that you assess clients for any of their usual habits that may impact the effectiveness of their med. smoking does what when a person is on an antianxiety agent?

Back 4

increases the rate of metabolism contributing to a need for higher doses.

Front 5

this term is used to describe medications that affect cognitive function, emotions, and behavior.

Back 5

psychotropic medictions;

Front 6

Alprazolam, Lorazepam, Oxazepam are all generic names of what class?

Back 6

benzodiazepines: antianxiety medication

Front 7

Xanax, Ativan, Serax are all trade names of what class?

Back 7

benzodiazepines: antianxiety medication

Front 8

what are some side effects of benzodiazepines?

Back 8

primarily related to the general sedative effects and include drowsiness, fatigue, dizziness, and psychomotor impairment.
Sedation usually disappears w/in one to two wks. of treatment

Front 9

It is important that you assess clients for any of their usual habits that may impact the effectiveness of their med. smoking does what when a person is on an antianxiety agent?

Back 9

increases the rate of metabolism contributing to a need for higher doses.

Front 10

this term is used to describe medications that affect cognitive function, emotions, and behavior.

Back 10

psychotropic medications;

Front 11

psychotropic medications are categorized into classes:

Back 11

antipsychotic, antidepressant, mood-stabilizing, antianxiety, and stimulant medications. may be used alone or in combination w/ one another

Front 12

Symptoms of severe mental illness are classified as?

Back 12

positive or negative

Front 13

these symptoms are added behaviors that are not normally seen in mentally healthy adults, such as hallucinations, delusions, or loose associations

Back 13

Positive symptoms

Front 14

Positive symptoms are thought to be a result from an excess of what neurotransmitter?

Back 14

dopamine or from hypersensitive

Front 15

these symptoms are the absence of behaviors that are normally seen in mentally healthy adults, such as social withdrawal, minimal self-care concrete thinking, and flat affect

Back 15

Negative symptoms

Front 16

All the antianxiety medications may be taken orally. antacids interfere w/ the absorption of these medications and should not be taken until?

Back 16

several hours later

Front 17

Benzodiazepines should not be discontinued abruptly after 3 to 4 months of therapy because ?

Back 17

the risk of severe w/drawal symptoms, which include seizures, abdominal and other muscular cramps, vomiting, and insomnia. These medications must be gradually reduced very carefully

Front 18

this is the drug of choice for clients who are prone to substance abuse or those who require longterm treatment?

Back 18

BuSpar (buspirone)

Front 19

Symptoms of toxicity are primarily CNS effects, for anti-anxiety med. what are some symptoms of overdose?

Back 19

include respiratory depression, cold, and clammy skin, hypotension, weak and rapid pulse, dialted pupils, and coma.

Front 20

this is an uncomfortable feeling that occurs in response to the fear of being hurt or losing something valued.

Back 20

anxiety

Front 21

this is a feeling that arises from a concrete, real danger, ?

Back 21

fear

Front 22

this is a feeling that arises from an ambiguous unspecific cause or that is disproportionate to the danger?

Back 22

anxiety

Front 23

these are unconscious attempts to manage anxiety?

Back 23

defense mechanism

Front 24

this is the highest level of anxiety, characterized by disorganized thinking, feelings of terror and helplessness, and nonpurposeful behavior

Back 24

panic attack

Front 25

these are behavioral patterns that develop as a defense against anxiety?

Back 25

phobic disorders

Front 26

this is a fear of only one object or situation; it can arise after a single unpleasant experience

Back 26

specific phobia

Front 27

these are fears of most social situations and affect more than one in eight people. they are characterized by the fear of situations in which an individual fears humiliation or embarrassment when under the scrutiny of others?

Back 27

social phobias

Front 28

these are unwanted, repetitive thoughts that lead to feelings of fear, anxiety, or guilt, such s the thought of killing someone or of being contaminated w/ germs.

Back 28

Obsessions

Front 29

these are behaviors or thoughts used to decrease the fear or guilt associated w/ obsessions.

Back 29

compulsions

Front 30

silently counting or repeatedly thinking a sequence of words is an ex of ?

Back 30

cognitive compulsions

Front 31

when obsessive-compulsive thoughts and behaviors dominate a person's life, the person is described as having ?

Back 31

obsessive -compulsive disorder (OCD)

Front 32

Fear of dirt, germs, contamination,
fear of something dreadful happening,
constant doubting,
somatic concerns
aggressive and /or sexual thoughts
religious ideation are all ex of ?

Back 32

obsessions: unwanted repetitive thoughts

Front 33

Grooming, such as washing hands, showering, bathing, brushing teeth,
cleaning personal space,
repeating movt such as going in and out of doorways, getting in and out of chairs, touching objects,
ck. such as doors, locks, appliances, written work,
counting silently or out loud,
hoarding,
frequent confession (of anything)
the need to ask others fo rreassurance
the need to have objects in fixed and symmetrical positions are ex of?

Back 33

compulsions: behaviors or thoughts used to decrease fear or guilt associated w/ obsessions

Front 34

these are mechanisms that are conscious attempts to control anxiety, which if ineffective, contribute to a person's sense of competence and self-esteem?

Back 34

coping mechanisms

Front 35

these are the highest level of anxiety, are characterized by disorganized thinking, feelings, of terror and helplessness, and nonpurposeful behavior

Back 35

panic attacks

Front 36

this disorder is characterized by sudden and unexpected panic attacks, catastrophic thinking, phobic avoidance, anxiety, depression, and obsessions. It may or may not be accompanied by agoraphobia

Back 36

Panic disorders

Front 37

this is characterized by fear or being away from home and of being alone in public places when assistance might be needed

Back 37

agoraphobia

Front 38

what are the major defense mechanisms present in phobias ?

Back 38

are repression, displacement, sybolization, and avoidance

Front 39

advantages from or rewards for being ill are referred to as?

Back 39

secondary gains

Front 40

what are some techniques for reducing anxiety?

Back 40

include muscle relaxation, deep breathing, physical exercise, and distraction techniques

Front 41

what should you do when a person is experiencing a panic attack?

Back 41

stay w/ the person experienceing a panic state and speak slowly in short, simple sentences.

Front 42

journal keeping is an effective way for clients to ?

Back 42

keep track of their thoughts, feelings and memories

Front 43

what are some calming techniques?

Back 43

include deep breathing, muscle relaxation, changing sensory experiences, doing activites, and positive affirmations

Front 44

Nutritional interventions for someone w/ an anxiety disorder include?

Back 44

teaching clients to increase their intake of niacin and vitamin B6 which are necessary for the production of 5-HT

Front 45

what is the competency model of family nursing based on?

Back 45

the belief that all families are resourceful and have the capacity to grow and change

Front 46

this is measured by focusing on the family as a group w/ regard to their listening skills, speaking skills, self-disclosure, tracking, and ability to resolve conflict

Back 46

family communication

Front 47

what are boundaries and how are they described

Back 47

boundaries define the amt. and kind of contact allowable between family members and between the family outside systems
Boundaries are described as clear, rigid, or diffuse

Front 48

family cohesion (emotional bonding) ranges disengaged to ?

Back 48

separated to connected to enmeshed, w/ the central ranges being the most functional

Front 49

family flexibility inleadership, roles, and rules range from?

Back 49

rigid to structured to flexible to chaotic w/ the central ranges most functional

Front 50

Emotional availability is another way to describe the quality of parent-child interactions. What are some areas for assessment?

Back 50

include parental sensitivity, structuring, nonintrusiveness, and nonhostility.

Front 51

what is the overall level of distress experienced as a result of mental illness?

Back 51

family burden

Front 52

what are some objective family burden?

Back 52

includes managing symptomatic behaviors, caregiving responsibilities, and the experience of stigma

Front 53

What are some subjective family burden?

Back 53

includes feelings of grief and loss, a sense of chronic sorrow, and empathetic pain for the loved one

Front 54

what are the stages fo family recovery?

Back 54

are discovery and denial: recognition and acceptance: coping and competence: and personal and political advocacy

Front 55

the burden of family caregiving for adult children w/ mental disorders which include?

Back 55

daily caretaking, emotional drain, and financial strain

Front 56

this term is used as the feelings, thoughts, and responses that happen to us hen a person dies?

Back 56

bereavement

Front 57

what are active processes of learning to adapt to the death or loss?

Back 57

grief and mourning

Front 58

what are some family coping stragies for death and the family system?

Back 58

a stable equilibrium, realigning family roles, and communicating clearly

Front 59

this term means that the loss cannot be openly acknowledged, socially validated, or publicly mourned in ref. to death and the family system?

Back 59

disenfranchised grief

Front 60

this form of grief is when there is enormous social, psychological, and medical morbidity?

Back 60

complicated grief

Front 61

as a nurse educator who are the best judges for future direction ?

Back 61

clients and families know more about their lives and are the best judges for future direction

Front 62

what is the principle of normalization affirm ?

Back 62

that people w/ disabilities should be able to lead as normal a lie as possible through integration into the mainstream community and suppport of independence.

Front 63

what does the principle of contextualization mean?

Back 63

that clients are kept in as close contact as possible w/ their usual surrounding

Front 64

what are some types of residential facilities in ref. to treatment settings?

Back 64

halfway houses, longterm group residences, cooperative apartments, crisis community residences, foster care, and nursing homes

Front 65

what is the theory behind case management?

Back 65

it is effective collaboration w/ nursing medicine, home care, ambulatory care, and administration

Front 66

what is the role of case mangers?

Back 66

identify clients assess individual needs and strengths, broker for services, and provide direct care

Front 67

residential crisis services offer?

Back 67

a respite from the current living situation and provide intensive treatment in programs that utilize a variety of therapies

Front 68

what do community screening programs help provide?

Back 68

early identification of mental health problems

Front 69

Home treatment may be an alternative to inpatient treatment during what phase? and how does it work

Back 69

acute phase of a mental illness. This involves the provision of intensive support through home visits

Front 70

how do the nurses help the homeless population?

Back 70

through outreach, social support groups, case management, and provision of transitional housing

Front 71

Mental health services w/in school systems improve? to children and parents in need of service

Back 71

access adn affordability

Front 72

strategies to bridge inpatient w/ outpatient care include ?

Back 72

making the family a part of the treatment team, linking family to spport services, staff communication, and enabling clients to begin outpatient programs before discharge

Front 73

this allows consumers to live in their own communities while they receive the individual assistance they need?

Back 73

assertive community treatment (ACT)

Front 74

this is an outreach program for elderly residents in need of mental health services?

Back 74

Psychogeriatric Assessment and Treatment in City housing (PATCH)

Front 75

Social network interventions are designed to ?

Back 75

improve relationships that helps clients better adapt to change

Front 76

psychosocial rehabilitation emphasizes ?

Back 76

the development of skills and supports necessary for successful living, learning, and working in the community. it is anchored in the values of hope and power

Front 77

this refers to incorporating the disability as part of reality, modifying dreams and aspirations, exploring new ideas and eventually adapting to the disease?

Back 77

recovery

Front 78

what are the three types of educational programs for disabled persons?

Back 78

the self-contained classroom, the on-site support model, and the mobile support model

Front 79

this can provide needed structure and opportunity for socialization and meaningful activity

Back 79

employment

Front 80

the term which applies to when a person can't remember during a drinking period

Back 80

blackout

Front 81

overdose of cocaine happen because of ?

Back 81

vasoconstriction

Front 82

can withdrawal from alcohol be life threatening

Back 82

yes

Front 83

what are the main drugs used to facilitate withdrawal from alcohol?

Back 83

benzodiazepines

Front 84

the goal during withdrawal from alcohol is to mimize symptoms and decrease the rik of ?

Back 84

seziures and delerium tremors

Front 85

What is going to happen if you give natroxone (reVia to an somebody who uses alcohol and narcotic?

Back 85

it can put them into withdrawal

Front 86

w/ severe anxiety what happens to the body?

Back 86

fight or flight starts
eyes dilate
bld is redistributed
heart is working harder, bld glucose goes up

Front 87

panic level of anxiety what happens to the body

Back 87

body imobilizes, pale, dizziness, chest pain think your dying,

Front 88

all of us have ways of coping what are some conscious things that we may do?

Back 88

exercise, support groups, etc

Front 89

defense mechanisms are conscious or unconscious?

Back 89

unconscious
(ex. denial of child being in a car accident not necessarily a bad thing at first bx it can be adaptive and helpful)

Front 90

the largest mental health problem is ?

Back 90

anxiety

Front 91

there is a high corralation w/ alcohol and ?

Back 91

depression

Front 92

specific disorders
GENERALIZED ANXIETY?

Back 92

typically chronic,
persists, might be triggered by stress or nothing, the person worries about everything consistently always thinking about a catastrophy that is going to happen

Front 93

specific disorder for generalized anxiety what might be some physical problems?

Back 93

fatigue, irritability, can't sleep well, suppress the immune system,

Front 94

panic attack and panic disorder who can have a panic attack?

Back 94

anybody (its our highest level of anxiety can't organize thoughts behavior is not purposeful they think they are going to die they are losing control very frightened happens to a lg. % of population) can panic disorder is repeatedly

Front 95

when is the onset of a panic attack

Back 95

no specific stimulus,
often they go to the ER where they might get tests done for MI

Front 96

how do people describe a panic attack?

Back 96

feel their heart is palpating, chest pain, trembling, depersonalization, their body feels unlike thier own body, they begin to fear having the panic attacks and some begin anticipating

Front 97

there are some medications or therapies used for a panic attack what are some?

Back 97

anti-anxiety, you might give them a benzodiazepam to calm them down and cognitive therapy,
they have to begin to believe that these symptoms are not going to hurt them, they learn to relax,

Front 98

panic attacks carry a high?

Back 98

suicide rate

Front 99

what are some social phobias?

Back 99

they fear to speak in public, going to public restrooms, they think they might look foolish, etc.

Front 100

a person gets to the point where they don't want to leave their home often?

Back 100

agoraphobia

Front 101

milder form of ? where they will go only during certain times; but the fear is being alone in a public place and they might not be able to escape

Back 101

agoraphobia

Front 102

what does HALT stand for ?
what is it's significance to substance abusers?

Back 102

Hungry, Angry, Lonely, Tired
describe how most substance abusers feel. Can identify w/ acronym

Front 103

a person can get into a very dependent behavior (for a person w/ anxiety) what is an ex.

Back 103

they won't go to games, or outside bx of spiders

Front 104

what is the term to describe a person usually knows its unreasonable but its difficult to get rid of the fear nonetheless

Back 104

egodystonic

Front 105

socially what can a fear (panic) do?
(going outside)

Back 105

impact the family system
you can't work, you can't go to games

Front 106

a person can even get into a point where they get secondary gains from their fear what does this mean?

Back 106

they don't have to do as much they don't have to be as responsible a lot of control over people

Front 107

with any kind of anxiety disorder what is helpful to control the anxiety?

Back 107

the idea is to learn to relax very well and you can decrease it or get rid of
PRACTICE

Front 108

cognitive theory is helpful in anxiety what does that mean?

Back 108

changing the way we think about things

Front 109

what are some drugs used to maintain abstinence from alcohol

Back 109

disulfiram (Antabuse)
Naltrexone (ReVia)
Acamprosate (Campral)

Front 110

the thought of you left the iron on is the thought; which is ?

Back 110

obsession

Front 111

you have to act to reduce the anxiety from the obsession for ex. ck to make sure the iron is off is?

Back 111

compulsive

Front 112

obsessive compulsive feels?

Back 112

forced

Front 113

people know they are rational or not this is the difference people obsessive compulsive and the

Back 113

obsessive disorder

Front 114

depending on the severity of OCD what should the therapy be?

Back 114

tell someone, the treatment is behavioral, they are going to learn relaxation, learn processing of how they think of things and then work on whatever it is that compels them to do; its a gradual process even if the thought comes into the head; support groups, med
ex washes hand 5 times maybe try 4

Front 115

what is the drug used for OCD which is an SSRI antidepressant?

Back 115

Luvox

Front 116

PTSD

Back 116

some kind of experience that is outside the normal and they can't control it (symptoms usually appear w/in a few months)

Front 117

paramedics, nurses, if exposed to traumatic disorders?

Back 117

Posttraumatic stress disorder

Front 118

they re-experience the trauma, these thoughts come into their head or nightmares its as if they are right there again, its not just a memory they are there feeling whatever it is they were feeling at the time, they think about what they did or what they didn't do; NUMBING they can't connect, they can't feel happy they can't enjoy themselves, they can't feel a range of emotions; and persistant state of arousal watching for something to happen, they have an exagerated response are all ex of ?

Back 118

posttraumatic stress disorder

Front 119

Medications used for PTSD are?

Back 119

antidepressant and antianxiety most of the therapy is used in groups and they relive it and integrate it into their experience

Front 120

People w/ PTSD often exhibit a ? resulting from their need to constantly search the environment for danger.

Back 120

hyperalertness

Front 121

In addition to anxiety, tension, irritability, aggression, and guilt, there can be a ? of other emotions for people w/ PTSD

Back 121

numbing

Front 122

there is an acute distress disorder when does that begin

Back 122

within a month and goes away w/in four weeks

Front 123

what are some ex of pt. w/ an acute distress disorder

Back 123

9 11, people who have been raped,

Front 124

this is a disruption in the consciousness(ex. take yourself away from the classroom when your in the class), memory, identity, and perception of the environment

Back 124

dissociative disorder

Front 125

this diagnosis is given when at least tow personalities exist inthe same person. Each personality, or "alter" is integrated and complex; that is each has its own memory, value structure, behavioral pattern, and primary affective expression.

Back 125

dissociative identity disorder (DID) have many different identities its what they used to call multiple disorder personality

Front 126

these are characterized by an alteration in conscious awareness of behavior, affect, thoughts, and memories, and an alteration in identity, particularly in the consistency of personality

Back 126

dissociative disorders

Front 127

this is characterized by persistent or recurrent feelings of being detached from one's body or thoughts

Back 127

depersonalization disorder

Front 128

what are some ex. of positive affective characteristics ?

Back 128

include inappropriate affect, overreactive affect, and hostility.

Front 129

this occurs when the person's emotional tone is not related to the immediate circumstances

Back 129

inappropriate affect

Front 130

this is appropriate to the situation but out of proportion to it

Back 130

overreactive affect

Front 131

this describes a dulled emotional response to a situation?

Back 131

blunted affect

Front 132

this describes the absence of visible cues to the person's feelings.

Back 132

flat affect

Front 133

this is the inability to experience pleasure, causes many people w/ schizophrenia to feel emotionally barren

Back 133

anhedonia

Front 134

this is an example of what affect?
WHen told it's time to turn off the TV and go to bed, Joe begins to laugh uproariously

Back 134

inappropriate

Front 135

this is an example of what affect?
When Kathy wins at cards, she jumps up and down and does a cheer for herself

Back 135

overreactive

Front 136

this is an example of what affect?
Tom has been looking forward to his wife's visit. when she arrives on the unit, he is only able to give her a small smile

Back 136

blunted

Front 137

this is an example of what affect?
When Juanita's mother tells her that her favorite dog has died, Juanita simply says "Oh" and does not give any indication of an emotional response

Back 137

flat

Front 138

what are some examples of a positive symptoms; behavioral characteristic in somone w/ schizophrenia

Back 138

Hyperactive behavior most typically occurs during a period of relapse.
Bizarre behavior such as repeating rhythmic gestures, doing ritualistic postures, or demonstrating freakish facial or body mov't,
echopraxia or echolalia, decreased awareness of one's own behavior.

Front 139

what are some examples of a negative symptom ; behavioral characteristic in someone w/ schizo.

Back 139

are decreased activity level, limited speech, and minimal self-care.

Front 140

limited speech is also referred to as ?

Back 140

alogia, which makes it difficult for them to carry on a continuous conversation or say anything new.
this is a negative behavioral characteristic

Front 141

this is the inability to experience pleasure, causes many people w/ schizo. to feel emotionally barren

Back 141

anhedonia this is a negative symptom of an affective characteristic

Front 142

what are some positive affective characteristics?

Back 142

include inappropriate affect, overreactive affect, and hostility.

Front 143

this is the occurrence of a sound, sight, touch, smell, or taste w/out an external stimulus to the corresponding sensory organ

Back 143

hallucination

Front 144

this is a combination of disordered thinking, perceptual disturbances, behavioral abnormalities, affective disruptions, and impaired social competency

Back 144

schizophrenia

Front 145

when does the vast majority develop the disorder of schizo.?

Back 145

in adolescence or young adulthood, w/ only 10 or 15% of cases first diagnosed in people over the age of 45.

Front 146

In schizoaffective disorder, clients suffer from symptoms that appear to be a mixture fo schizo. and the mood disorders the person experiences one or more of the following?

Back 146

delusions, hallucinations, disorganized speech, disrganized behavior, or negative symptoms. In addition , the person experiences symptoms fo the mood disorders, which may be major depressive symptoms, manic symptoms, or mixed symptoms

Front 147

In brief psychotic disorder, there is a rapid onset of at least ?

Back 147

delusions, hallucinations, disorganized speech, or by disorganized behavior

Front 148

a brain disease w/ unknown etiology?

Back 148

schizophrenia a chronic illness that lasts a long time different degress of illness
not a split personality, not a multiple personality, worldwide problem 1 out of 100 people

Front 149

this lasts at least one month and less than six months? schizo?

Back 149

schizophreniform disorder

Front 150

what's the exact age of onset and why of schi.?

Back 150

16-26 and 17-27 bx during that age group the normal development group is finding yourself, starting a career, establishing yourself as an independent person

Front 151

how do people get this disease?

Back 151

genetic vulnurability, plus some type of environmentally distresses, not 100% genetic

Front 152

what are some causative theories for schizophrenia?

Back 152

a genetic defect may contribute to abnormal development fo the brain or a neurochemical malfunction, while in other cases factors such as nutrition, toxins, or trauma might interact in a genetically vulerable person

Front 153

where a person's body part stays in the position you put it in they are unaware

Back 153

waxy flexibility

Front 154

what are some different types of schizophrenia?

Back 154

catatonic, paranoid, disorganized, undifferentiated, residual

Front 155

this type of schizophrenia, has non mov't, excessive motor activity, extreme negativism, peculiar mov't, echolalia or echopraxia

Back 155

catatonic

Front 156

this type of schizophrenia includes delusions, organized around a theme, persecutory, grandiose, hallucinations, anger, argumentativeness, violence

Back 156

paranoid

Front 157

this type of schizophrenia is fragmented delusions or hallucinations, disorganized behavior, (odd behaviors -mannerisms) extreme social w/drawal, disorganized speech, flat, inappropriate, or silly affect

Back 157

disorganized

Front 158

this is where pt's have psychotic symptoms, mixed schizo symptoms

Back 158

undifferentiated

Front 159

this form of schizophrenia is when there is absensce of prominent delusions/hallucinations
emotional blunting, social w/drawal, eccentric behavior, illogical thinking, loose associations, flight of ideas

Back 159

residual

Front 160

what are some characteristics of schizophrenia

Back 160

affect/ emotional tone of one's reaction to persons or events

Front 161

what are some forms of affect w/ a pt w/ schizo?

Back 161

blunt affect, flat affect, inappropriate affect, ambivalent affect

Front 162

this term is used to describe the emotional tone of one's rxn. to persons or events

Back 162

affect

Front 163

this term is used to describe the a characteristic of a pt. w/ schizo. ;its a reduced expression

Back 163

blunt

Front 164

totally blank expression;
emotional impoverishment

Back 164

flat

Front 165

incongruence between emotions and situation;
ex you might tell them something sad and they laugh

Back 165

inappropriate affect

Front 166

this is the opposite emotions toward the same person or situation:
ex. pt says he's happy is going to have visitors today but i hate them i don't want them to come in; ex. i want to go to group therapy or no i don't want to go

Back 166

ambivalent affect

Front 167

schizophrenia does not effect what ?

Back 167

intellectually or your memory; not everything they say is psychotic

Front 168

what does shizophrenia effect?

Back 168

your function even thou they might have shreds of reality the illess takes over

Front 169

what kind of hallucinations would you assess?

Back 169

command

Front 170

this is when you think something like the tv is sending you messages

Back 170

ideas of reference its a delusion;

Front 171

what are some negative symptoms of a pt. w/ schizo?

Back 171

social withdrawal,apathy, lack of motivation, emotional unresponsiveness

Front 172

what are some positive symptoms of a pt. w/ schizo?

Back 172

delusions, hallucinations, disordered thinking and speech,

Front 173

false belief that cannot be changed by logical reasoning or evidence

Back 173

delusions

Front 174

these occur when the person believes that feelings, impulses, thoughts, or actions are not one's own but are being imposed by some external force

Back 174

delusions of control

Front 175

people w/ schizo. may experience this, they may believe someone is trying to harm them and, therefore any personal failures in life are the fault of these harmful others

Back 175

delusions of persecution

Front 176

There are a number of delusional types what are some ex?

Back 176

grandiosity (delusions of grandeur), persecution, control, somatic, religious, erotomanic, ideas of reference, thought broadcasting, thought withdrawal, and thought insertion

Front 177

what are some forms of hallucinations?

Back 177

most common is auditory hallucinations, visual, tactile, olfactory, gustatory

Front 178

this is lack of awareness of one's own mental illness, is more comon in people w/ schizo.

Back 178

poor insight, or lack of insight

Front 179

this occurs when people believe that their thoughts can be heard by others

Back 179

thought broadcasting

Front 180

this is the belief that others are able to remove thoughts from one's mind

Back 180

thought of withdrawal

Front 181

this is the belief that others are able to put thoughts into one's mind

Back 181

thought insertion

Front 182

this occurs when people believe something and dangerous is happening to their bodies

Back 182

somatic delusions

Front 183

this is characterized by a focus on facts and details and an inabilty to generalize or think abstractly

Back 183

concrete thinking
normal people think abstractly ex. little boy that looks down after someone says he grew a foot

Front 184

what are some major goals for pt w/ schizo?

Back 184

focus on the here and now, med, safety, if they think the food is being poisoned what might you do? taste it for them not feeding into the delusion but it must be scary for you to feel that way. reality, allow them to make decisions

Front 185

what are some nursing diagnosis for schizo?

Back 185

sensory-perceptual alteration, alteration in thought processes, social isolation, self esteem disturbance, self-care deficit, alteration in family process, knowledge deficit

Front 186

how do you manage delusions?

Back 186

empathy, assess triggers (stress), respond to feelings, diversional activites

Front 187

what are some family considerations for someone w/ schizo?

Back 187

education, support programs (NAMI)

Front 188

what are some therapeutic approaches for pts w/ schizo?

Back 188

individual therapy, group therapy, family therapy, milieu therapy, rehab, psychotropic medications

Front 189

this is muscular weakness or a partial loss of muscular movement?

Back 189

akinesia

Front 190

this is the inability to sit or stand still, along w/ an intense feeling of anxiety?

Back 190

akathisia

Front 191

conventional antipsychotic med. provide relief from the symptoms of severe mental illness for many people, but side effects are common what are some ex.

Back 191

some are bothersome (eg. dry mouth), some affect mood (eg. akathisia), some are disfiguring (eg. tardive dyskinesia), some are frightening (eg dystonia) and others are dangerous (eg neuroleptic malignant syndrome)

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this is a form of EPS occurs in 20-40% of clients who take conventional antipsychotoic med. for over two yrs. symptoms include: frowning , blinking, grimacing, puckering, blowing, smacking, licking, chewing, tongue protrusion, and spastic facial distortions

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tardive dyskinesia

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what are some long-acting injectable medications for schizo.?

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Prolaxin (fluphenazine),
Decanoate, and Haldol (haloperidol)

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Prolaxin (fluphenazine),
Decanoate, and Haldol (haloperidol) these drugs are helpful for pts w/ schizo bx of what?

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its a helpful regimen for clients who have difficulty remembering to take medications daily

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Among the newer antipsychotic, this med. has the most significant side effect in that aboout .5% of those taking this drug develop agranulocytosis. This carries a 40% fatality rate, usually from an overwhelming infections.

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Clozaril (clozapine)

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what are some newer antipsychotics?

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Generic Name: Trade Name:
Aripiprazole Abilitat
Clozapine Clozaril
Olanzapine Zyprexa
Quetiapine Seroquel
Risperidone Risperdal
Sertindole Serlect
Ziprasidone Geodon

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What are the most common side effects of conventional antipsychotic medications?

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include anticholinergic effects, photosensitivity, weight gain, sexual difficulties, and extrapyramidal side effects

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these side effects are more bothersome than anything else adn include dry mouth, blurry vision, trouble urinating, constipation, memory difficulties, and confusion

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anticholinergic side effects

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this is the increased sensitivity of the skin to sunlight. Relatively brief exposure to sunlight may cause edema, rashes, or severe burns.

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photosensitivity

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Smooth body mov't and body posture depend on a critical ratio of DA to acetylcholine in the brain. When med. block DA receptors, they lower this ratio, adn extrapyramidal side effects (EPS) occur which include?

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akinesia, akathisia, parkinsonism, dystonia, oculogyric crisis, and tardive dyskinesia

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what are the advantages of clozapine (clozaril)

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may be most effective, especially for negative symptoms and cognitive deficiencies, does not cause mov't disorders, may lower the risk of drug and alcohol abuse

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what are the side effects of Clozapine (Clozaril)

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agranulocytosis
Drowsiness,dizziness, drooling,
seizures (in 1-5% of pt.)
muscle weakness,
wt. gain,
diabetes,
rapid w/drawal may lead to psychosis

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What are some advantages of taking Risperidone (Risperdal)?

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outperforms conventional drugs,
no seizures or drooling,
mov't disorders uncommon

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What are some side effects of Risperidone (Risperdal)?

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dizziness, drowsiness, dry mouth, rapid heartbeat, some mov't disorders at high doses, wt. gain, diabetes

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what are some advantages of Olanzapine (Zyprexa)?

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outperforms conventional drugs, overall low rate of side effects, no seizures or drooling, mov't disorders uncommon, can be injected for gradual absorption (up to 1 mo)

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What are some side effects of Olanzapine (Zyprexa)

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dizziness,
drowsiness,
dry mouth,
substantial weight gain,
diabetes

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what are some advantages of Quetiapine (Seroquel)

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Similar to Risperidone and Olazapine, but little risk of dry mouth or dizziness

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WHat is the side effects of Quetiapine (Serquel)?

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drowsiness,
substantial wt. gain,
diabetes,
occasional mov't disorders,
cataracts reported in animals given high doses

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What are some advantages of Ziprasidone (Geodon)

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no mov't disorders,
apparently little wt. gain,
may be helpful for depression and anxiety

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individual therapy for someone whith schizophrenia is only good for?

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if its supportive therapy its good, if its in depth psychotherapy it is not helpful.

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what are some side effects of Ziprasidone (Geodon)

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headaches,
nausea,
drowsiness,
Dizziness,
rash,
can slow electrical conduction through the heart

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what are some nursing implications w/ someone w/ schizo.?

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Safe environment,
Therapeutic communication,
promote socialization,
reduce anxiety,
teaching -disease process,
med. compliance, self care

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what are some anticholinergic effects?

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dry mouth, constipation, urinary retention, blurry vision, memory difficulties, confusion

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what are some advantages of conventional drugs? schizo.

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well known; proven effective for positive symptoms, cause less wt. gain adn diabetes than novel drugs, some can be injected for gradual absorption (long lasting effects) (Haldol Decanoate, Prolixin Decanoate -IM every 2-6wk)

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What are some side effect of conventional drugs? schizo.

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constipation,
dry mouth,
blurred vision,
dizziness,
mov't disorders (some have high incidence),
little effect on negative symptoms

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this drug was developed in the 50's it was discovered as an accident bx it was used for surgery and its the oldest psychotic drugs

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thorazine, also called conventional drugs

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tindal, thorazine, prolaxin, permitil, serentil, trilafon, mellaril, stelazine, suptazine are all ex. of ?

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older drugs also called conventional drugs the class is phenothiazines

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do pts develop a tolerance level on these conventional drugs?

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no they don't have a tolerance level they can be on the same dose for a long period of time

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Haldol is an older drug its also used as a PRN drug used for?

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agitation, sometimes elderly or pt's w/ dementia, its fast acting and can be given IM

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newer medications are called

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atypical or unconventional antipsychotic

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while on this antipsychotic drug monitoring white blood count weekly for the first six mo. and then every other week, is required to admin this drug safely?

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clozaril (clozapine)

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a muscle restlessness they can't sit still (motor restlessness)

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akathisia

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this is evidenced in client's stooped posture and shuffling gait, their faces resemble masks, and they may drool. They experience tremors and pill rolling motions of the thumb and fingers at rest

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parkinsonism used to be called the thorazine shuffle

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this is a potentially fatal side effect related to sympathetic nervous systom hyperactivity. Symptoms develop suddenly and include muscle rigidity, fever, and resp. problems. There is no specific treatments for NMS other than discontinuation of the med. and supportive measures in the intensive care setting

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Neuroleptic malignant syndrome

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what are some advantages of the older antipsychotic meds

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proven effective, less wt. gain,no proven diabetes

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what is the nursing intervention for someone who is newly prescribed haldol?

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give it them po first and make sure they can tolerate the med and the side effects are minimal bx if you were to give it to them IM the side effects would last throughout the entire regimen