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74 Cards in this Set
- Front
- Back
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A significant difference between behavioral and psychiatric conditions and other medical emergencies is that most of your assessment and care will depend on your?
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People skills
P1487 |
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___________ and ___________ disorders incapacitate more people than all other health problems combined.
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Behavioral
Psychiatric P1488 |
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A common reason for EMS intervention in psychiatric illness is pts failure to take their?
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Psych meds
P1488 |
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The general causes of behavioral emergencies are?
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Biological
Psychosocial Sociocultural P1488 |
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Many psychiatric conditions do originate from alterations in?
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Brain chemistry
P1488 |
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Related to disease process or structual changes.
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Biological / organic
P1488 |
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Related to a pt's personality style, dynamics of unresolved conflict, or crisis management methods.
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Psychosocial
P1488 |
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____________ plays a large part in psychosocial development.
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Environment
P1489 |
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Related to the pt's actions and interactions with society.
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Sociocultural
P1489 |
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As with any call, determining ____________ is of the utmost importance.
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Scene safety
P1489 |
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The scene size-up also includes making observations that relate to?
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Pt care
P1489 |
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Be cautions of any overt behavior such as __________ or _____________.
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Posture
Hand gestures P1489 |
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Your exam of a pt experiencing a behavioral emergency is largely ________________.
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Conversational
P1490 |
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Pt's personal space
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3 ft
P1491 |
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Some schizophrenic pts may receive periodic injections of extremely long acting antipsychotics (for example ______________).
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Haloperidol deconoate
P1492 |
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Types of behavioral and psyc. emergencies
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Delerium
Dementia Shizophrenia Anxiety Mood Substances Somatoform Factitious Dissociative Eating Personality Impulse control |
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You should NOT try to diagnose beahvioral disorders because
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They have considerable overlap in symptoms from one disease to another
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Cognitive Disoreders
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Are organic cause of brain injury or diesease that includes conditions caused by metabolic disease, infections, neoplasm, endocrine,degenerative,nuerologic, and cardiovascular disease
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Delerium
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Pts suffer from inattention, memory impairment, disorientation and general clouding of consciousness.
(some cases individuals may expierience vivd visual hallucinations and may be reversible) |
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Causes of delerium
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Maybe due to a medical condition, substance intoxication, substance withdrawl, or multiple etiology. (Confusion is a hallmark)
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Dementia
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Conditon involving gradual development of memory impairment and cognitive disturbance
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Causes of dementia
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Alzhiemers
Vascular problems AIDS Head injury Parkinson's substance abuse |
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Dementia usually developes over ______ and is _____
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Months
irreversible |
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Cognitive disturbances such as ______ is involved with dementia
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Aphasia-Impaired ability to communicate
Apraxia-Impaired to carry out motor activities Agnosia-Failure to recognize objectes Disturbance in functioning- Imapaired ability to plan and recognize |
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Schizophrenia
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Effects about 1% of the US population it's a significant change in behavior and a loss of contact with reality
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Delusions
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Fixed, false beliefs that are not widely held in ones individual culture or religious group
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Symptoms of Schizophrenia
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Hallucenations-Sensory preceptions with no basis in reality
Disorganized speech- derailment or incoherence Catatonia- grossly disorganized behavior Flat affect- Negative symptoms |
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Types of Schizophrenia
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Paranoid
Disorganized Catatonic Undifferentiated |
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Anxiety
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A state of uneasiness, discomfort, apprehention, and restlessness. It affect about 2-4% of the population
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3 catagories of anxiety
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Panic disorder
Phobia's PTSD |
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Panic Attacks
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Extreme periods of anxiety resulting in a great emotional distress, they are symptoms of disease and are included among the criteria for other disorders
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Presentation of a panic attack
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Are usually unprovoked peaking within 10 mins of there onset and disapates in less than an hour. It may resemble a cardiac or respiratory condition
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Panic Attack Symptoms
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Palpataions
Sweating Trembling SOB Feeling of choking Chest pain/discomfort Neusea/ abd discomfort dizzy/ light headed Fear of lossing control fear of dying numbness/tingling chills/ hot flashes |
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Phobia's
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When a fear becomes excessive and interferes with functioning. Can be caused by Blood, Situational, or enviromental conditions
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PTSD
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Is a reaction to an extreme, usually life-threatning. Its characterized by a desire to avoid simular situations.
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Your approach to all behavioral emergencies should be
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Treat with respect , empathy, and support
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Hostility or rage to compensate for an underlying feeling of anxiety
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Anger
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Pervasive and sustained emotion that colors a person's perception of the world.
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Mood disorder
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Profound sadness or feeling of melancholy
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Depression
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Two mood disorders
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Depression and bipolar disorder
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Death of a loved one
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Bereavement
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Condition characterized by one or more manic episodes, with or without periods of depression.
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Bipolar disorder
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Characterized by excessive excitement or activity(mania)
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Manic
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Diagnostic criteria for major depressive disorder require 5 or more symptoms in the same 2 week peroid.
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Acronym IN SAD CAGES
Interest Sleep Appetite Depressed Mood Concentration Activity Guilt Energy Suicide |
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Bipolar disorder was also known as
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Manic-depressive
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Depression is more prevalent in which gender?
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Female and is spread evenly throughout there life span.
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Bipolar is often treated with what drug that has a very narrow therapeutic index?
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Lithium
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Condition characterized by physical symptoms that have no apparent physiological cause and are attributable to psychological factors
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Somatoform disorder
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List of Somatoform disorders
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Somatization Disorder
Conversion Disorder Hypochondriasis Body dysmorphic disorder Pain Disorder |
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The pt is preoccupied with physical symptoms is what disorder?
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Somatization disorder
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The pt sustains a loss of function, usually involving the nervous system(blindness,paralysis) unexplained by any medical illness is what disorder?
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Conversion disorder
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What disorder is exaggerated interpretation of physical symptoms as a serious illness?
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Hypochondriasis
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A person believes he has a defect in physical appearance is affected by what disorder?
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Body dysmorphic disorder
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When a pt suffers from pain, usually severe, that is unexplained by a physical ailment, they have what disorder?
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Pain disorder
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Condition in which the pt feigns illness in order to assume the sick role
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Factitious disorder
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Condition in which the individual avoids stress by seperating from his core personality.
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Dissociative disorder
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Dissociative Disorders listed
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Psychogenic amnesia
Fugue State Multiple personality disorder Depersonalization |
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Failure to recall, as opposed to inability to recall.
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Psychogenic Amnesia
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Condition in which an amnesiac pt physically flees.
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Fugue state
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Manifestation of two or more complete systems of personality.
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Multiple personality disorder
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Feeling detached from oneself
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Depersonalization
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List two eating disorders
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Anorexia nervosa
Bulimia nervosa |
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Psychological disorder characterized by voluntary refusal to eat.
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Anorexia nervosa
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Name the 3 broad types of personality disorders
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*Cluster A
*Cluster B Cluster C p1499 |
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CLUSTER A personality disorder
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*often act odd or eccentric
*Paranoid- distrust and suspiciousness *Schizoid-detachment from social relationships *Schizotypal-acute discomfort in close relationships, cognitive distortions, and eccentric behavior p1499 |
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CLUSTER B personality disorder
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*dramatic, emotional, fearful
*Antisocial-disregard for the rights of others *Borderline-instability of interpersonal relationships, self-image, impulsivity *Histronic-excessive emotions and attention seeking *Narcissistic-grandiosity, need for admiration, and lack of empathy p1499 |
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CLUSTER C personality disorder
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*appear anxious and fearful
*Avoidant personality disorder-social inhibition, feelings of inadequacy, hypersensitivity to criticism *Dependent-submissive and clinging behavior, excessive need to be cared for *Obsessive-compulsive-preoccupation w/ orderliness, perfectionalism and control p1499-50 |
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Name the 5 types of Impulsive Control Disorders
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*Kleptomania
*Pyromania *Pathological Gambling *Trichotillomania-pulling one's hair *Intermittent explosive disorder p1450 |
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What is the 9th leading cause of death overall, and the 3rd leading cause in 15-24 year age group
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Suicide
p1500 |
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Name the 5 most common methods of suicide
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1-Bullet Wound 60%
2-Poisoning 18% 3-Strangulation 15% 4-Cutting 1% 5-Other, unspecified 6% p1500 |
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Common physical problems among the elderly
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*Dementia
*Chronic lillness *diminished eyesight/hearing *depression p1501 |
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Management of Behavorial Emergencies
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1-Ensure scene safety and use Standard Precautions
2-Provide supportive and calm environment 3-treat existing medical conditions 4-do not allow pt to be alone 5-do not confront or argue with pt 6-provide realistic reassurance 7-respond to pt in a direct, simple manner 8-transport to appropriate facility ****Remember to treat the whole pt*** Never overlook any serious, or potentially serious, medical complaints while focusing on psychiatric assessment p1502 |
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Medical care may include treatment for _____
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*overdose
*lacerations *toxic inhalation *hypoxia *metabolic conditions p1502 |
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Methods of restraint:
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Verbal de-escalation - talk them down
Physical - Soft restraints, 4 pt restraints, 5 ppl to restrain PT, avoid positional asphyxia (Britt has to breathe!) no hog tie, Chemical - Butyrophones (Haldol) or Benzos (diazepam, midazolam, lorazapam) |
