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50 Cards in this Set
- Front
- Back
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What are the types of anxiety disorders?
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Phobias, panic attacks/panic disorders, GAD, OCD
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What is the definition of a phobia?
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an anxiety disorder masked by an inordiate fear of an object, a class of objects, or a situation, resulting in extreme avoidance behaviors.
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What is the treatment for a phobia?
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behavior therapy which includes systematic desensitization.
if it is truely bad then there may be medications involved. |
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What is a panic attack?
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a short episode characterized by physical sensations of lightheadedness, dizziness, hyperventilation, and numbness of the extremities; accompanied by an inexplicable terror, usually of a physical disaster such as death.
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What is panic disorder?
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An anxiety disorder in which the apprehension or experience of reocurring apnic attacks is so inense that normal functioning is impaired.
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What is generalied anxiety disorder?
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An anxiety disorder characterized as chronic stress.
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What are the common symptoms of GAD?
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faster heart rate, sweating, increased BP, muscle aches, intestinal pains, irrritability, sleep problems, and difficulty concentrating.
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What is the treatment for GAD?
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psychotherapy, behavioral therapy, and antianxiety drugs
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What is OCD?
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an anxiety disorder characterized by obsessions and/or compulsions that impair one's ability to function and form relationships.
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What is an obsession?
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a reoccuring thought, idea, or image
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What is a compulsion?
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Repetitive behavior performed according to certain rules or in a stereotyped fashion
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What is the treatment for OCD?
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cognitive therapy, behavioral therapy, mediactions
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What are the three etiological factors that go into the development of mood disorders?
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Biological- neurotransmitters, endocrine system, family/genetics, sleep dysfunction
Psychological- stressful life events, behavioral factors, cognitive factors, psychodynamic Social- support systems |
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What is dysthymia?
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Dysthymia is a chronic type of depression in which a person's moods are regularly low. However, it is not as extreme as other types of depression.
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What is euthymia?
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Euthymia is a word used for indicating a normal non-depressed, reasonably positive mood. It is distinguished from euphoria, which refers to an extreme of happiness, and dysthymia, which refers to a depressed mood. It is a term used frequently in mental status exams.
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What is cyclothymia?
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a mild form of bipolar disorder in which a person has mood swings from mild or moderate depression to euphoria and excitement, but stays connected to reality.
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What is bipolar type one?
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Bipolar type one includes pure mania (unipolar mania) or mixed episodes. The patients with mixed episodes have very high mania and very low depression. Unipolar bipolar ones get manic and then just go to baseline, but this is rare. Most people will have both.
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What is bipolar type two?
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These patients dont necessarily have mania, but have very low levels of mania (hypomania) along with major depression. These individuals can function when they are manic, in true mania the person cannot function.
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What are some signs and symptoms of mania?
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onset before age 30, mood is elated, expanisive, and irritable. Speech is loud, rapid, rhyming, punning, and vulger. They have grandiose delusions, and are easily distracted and hyperactive.
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What are some signs and symptoms of the depressive phase?
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Dysphoric, depressive, despairing mood. A low interest in pleasure, many negative views, fatigue, decreased libido and suicidal preoccupation.
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What are some pharmaceutical classes given for antidepressant therapy?
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MAOIs, tricyclics, SSRIs
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What are some medications given to stabilize mood?
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lithium, depakote, lamictal, tegretol
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What are some commonly prescribed anti-psychotics?
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haldol, trilafon, thorazine, mellaril, clozapine
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What drug class is given for anxiety and insomnia?
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benzodiazapines
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What are prodromal signs for shizophrenia?
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"he/she was weird, even as a child"
social isolation and withdrawl impairment in roles of normal function odd behavior and ideas blunted affect poor personal hygiene |
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What are positive symptoms of shizophrenia?
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delusions, hallucinations (most often audiotory), thought disorder, bizarre behavior
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What are negative symptoms of shizophrenia?
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decreased motivation/poor focus on tasks, diminished emotional expression, social withdrawal, flat afffected (blunted emotional responses), anhedonia
Alogia- reduced speech output |
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What are cognitive deficits in shizophrenia/
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impairments in attention, executive function, some types of memory
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What are some motor abnormalities in shizophrenia?
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posturing, impaired coordination, catatonia
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What are the subtypes of shizophrenia? (5)
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1. Paranoid- preoccupation with delusions or hallucinations, often with themes of persecution or grandiosity
2. Disorganized- disorganized speech or behavior, flat or innappropriate emotion 3. catatonic- immobility (or excessive, purposeless omvement), extreme negativism, and/or parrotlike repeating of anothers speech or movements 4. undifferentiated- many and varied symptoms 5. residual- withdrawal, after hallucinations and delusions have disappeared |
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What is the treatment for shizophrenia?
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Psychopharmacology
Psychotherapy Social Education |
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Define anorexia.
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Patient refuses to maintain normal body weight for age and height. The patient is terrified of becoming fat/gaining weight even though they are markedly underweight
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What is the medical criteria to define anorexia?
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weighs 85% or less than what is expected for age or height
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What will you find during the assessment of an anorexic patient?
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Less than 85% normal weight
VS: bradycardia/hypotension CV: arrythmias F&E- hypokalemia, hypocalcemia, dehydration hypoglycemia, hypothermia, amennhorea, lanugo, hair loss, osteoporosis, constipation |
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Define bulemia.
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Recurrent episodes of uncontrolled binging and purging.
Purging: vomiting, fasting, or excessive exercise Patients experience anxiety pre-binging, and binging leads to feelings of guilt, loss of control, depression, humuliation, and self-loathing. Pts maintain close to normal weight |
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What do you find during the assessment of the bulemic patient?
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VS: bradycardia, hypotension
CV: arrythmias F&E: hypokalemia, hyponatremia, dehydration, hypocalcemia irregular menses, hoarseness, dental caries, enlarged parotid glands, esophagitis, constipation |
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What are the major cognitive disorders?
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Delirium, dementia, and amnestic disorder
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What is a cogntivie disorder?
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a cogntive disorder involves problems in memory, orientation, level of conciousness, and other cogntivie functions. These difficulties are due to abnormalities in neural chemistry, structure, or physiology originating in the brain, or secondary to systemic illness. The patients show psychiatric symptoms secdonary to the cognitive problem (depression, anxiety, paranoia, hallucinations, and delusions)
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What is the hallmark symptom of delirium?
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Impaired conciousness.
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What is the hallmark symptom of dementia?
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Loss of memory and intellectual abilities
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What is the hallmark of amnestic disorder?
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Loss of memory with few other cognitive problems.
**patients commonly have a history of alcohol abuse |
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What are pharmacological interventions for alzheimers disease?
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Medications like Aricept can temporarily slow progression of the disease, but they CANNOT restore function already lost.
-Memantine, an NMDA antagonist, was recently approved to slow deterioration in patients with moderate to severe disease -Psychotropic agents are used to treat the associated symptoms of anxiety, depression and psychosis. |
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What is informed consent in phsyciatric nursing?
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Based on the principle of autonomy, informed consent is the acceptance of treatment based on both disclosure of pertinent information by the liscenced provider and comprehension by the patient of the situation and treatment options, to enable a voluntary and educated decision.
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What is involved with capacity/competency to consent?
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The patient must communicate a choice, undestand information (cognitive), appreciate the situation and its consequences (this adds an emotional component), and logically manipulate the information to reach rational conclusions (based on the patients value system)
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What is competance, and what is capacity?
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Both refer to the mental (cognitive/thinking) abilities required to make sound decisions.
Competence: legal term, designation can only be made by a judge Capacity: clinical term, may fluctuate over time, and is task-specific |
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Explain treatment refusal.
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It is implicit in the concept of informed consent, and is also based on the Principle of autonomy. Remember, patients have the right to make 'bad' decisions, and are allowed to refuse treatments that are clearly in their best interests!
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What is an advance directive?
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Witnessed, written, or oral statment expressing a persons health care preferences in anticipation of a need for a medical decision, should the patient lose capacity.
Types: living will, durable power of attorney |
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What is confidentiality?
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It is the clinician's obligation to prevent a patients protected health information from being divulged to 3rd parties. HIPAA prohibits disclosure without written consent of the patient, except in matters directly related to treatment, payment, and health care operations.
**confidentialty survives death |
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What is privilage?
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The patients right to prevent a physician from testifying in a legal proceeding about PHI (protected health information) material. If records are subpoenaed by an attorney, the MD should alert the patient, who can declined. However, if the subpoena is court-ordered from a judge, it overrides this privilage.
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What is the duty to warn/ Tarasoff duty?
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Duty to warn refers to the responsibility of a counselor or therapist to breach confidentiality if a client or other identifiable person is in clear or imminent danger. In situations where there is clear evidence of danger to the client or other persons, the counselor must determine the degree of seriousness of the threat and notify the person in danger and others who are in a position to protect that person from harm
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