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23 Cards in this Set
- Front
- Back
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Mood
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Subjective
sustained emotional tone over time |
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Affect
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Objective
what you observe |
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Depression
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persistant sad/empty mood
hopeless, pessimism,guilt, worthlessness, insomnia, change in appetite, difficulty concentrating, restless, irratable, thoughts of death or suicide |
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Mania
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inappropriate elation and irritability
severe insomnia, grandiose, hyperverbal, racing thoughts, increased energy and sexual desire, poor judgment |
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Client Safety Needs
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self-harm= suicide intervention strategies
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Rest and Activity Needs
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SLEEP DISTURBANCES, FATIGUE, LOW ENERGY/INACTIVITY
assess for exhaustion, promote exercise, warm bath, soft music, relaxation therapy, structured schedule |
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Nutrition and Elimiation Needs
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MALNUTRITION-anorexia, worthlessness
monitor intake, promote frequent and small portions, deal with worthlessness feelings |
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Hygeine Needs
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LACK OF ATTENTION TO ADLs
assess and encourage daily grooming, give feedback |
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Belonging/Affiliation Needs
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WITHDRAWL/ISOLATION
therapeutic use of self, establish strong nurse/patient relationship, listen, encourage group participation, avoid sustained isolation |
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Self-Esteem Needs
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LOW SELF-ESTEEM, GUILT, SELF DOUBT, WORTHLESSNESS
set graded, realistic goals, evaluate successes, encourage participation, give realistic reassurances, interrupt negative thinking |
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Security Needs
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DEPENDENCY, DEMANDING, MANIPULATION, HELPLESSNESS
provide help only where needed, be firm, calm and patient, reflect confidence in client's ability, do tasks along with client |
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Lithium Toxicity
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sluggishness, drowsy, lethargy, mild muscle weakness, mild ataxia, dimished concentration, slight muscle twitching, coarse hand tremors, severe diarrhea, tinnitus, nausea and vomitting, incoordination, slurred speech, blurred vision, nystagmus, dysarthria, oliguria/anuria, dyskinesia, coma or death, visual or tactile hallucinations, grand mal seizures
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Managing Lithium Side Effects
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TREMORS=eliminate caffeine, reduce dose, give more frequently or in slow-release form, if severe)betablocker-Propranolol)
NAUSEA/ABD DISCOMFORT/DIARRHEA= take with meals MUSCLE WEAKNESS/FATIGUE=alter dosage HYPOTHYROIDISM= reversible, replace thyroid hormone HAIR LOSS= check thyroid function, stop treatment |
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St. John's Wort
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DEPRESSION/ANXIETY
side effects= photosensitivity, GI disturbances DO NOT USE WITH OTHER ANTIDEPRESSANTS |
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Valerian
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MIGRAINE HEADACHES, CRAMPS, INSOMNIA
Side effects= headache, excitability, liver damage DO NOT USE WITH ALCOHOL, BENZODIAZEPINES, BARBITUATES |
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Kava
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ANXIETY/INSOMNIA
Side effects= EPS, dry skin, yellow dicoloration of skin DO NOT USE WITH ALCOHOL, BENZODIAZEPINES, ANTIPSYCHOTICS OR BARBITUATES |
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SAME
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DEPRESSION, ARTHRITIS, LIVER DISEASE
side effects= mild stomach upset |
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Suicide
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11th cause of death in US
firearms, suffocation, poisoning 20-40% with schizo attempt suicide |
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Dynamics of Suicide
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A way out - escape or solution to a problem
Expression of anger Skewed expectations of life after death Constricted/rigid thinking Life is intolerable with no hope of change Thought disorders or sensory perceptual discord |
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Psychotic Depression
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depression, social withdrawl, distorted guilt, delusions, paranoid thoughts, hopelessness, worthlessness
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Ambivalence
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coexistence of opposing thoughts/behaviors
Likely to be internal conficts |
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Affective Characteristics Associated with Suicide
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hopelessness, desolation/despair, guilt, feeling like a failure, shame, negativity, emotional detachment
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Neurobiological Findings
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low levels of 5-HIAA in CSF = suicide risk
post mortem reduced serotonin in pre frontal cortex area |
