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145 Cards in this Set
- Front
- Back
What are the Diagnostic Criteria for Anorexia Nervoas? (5)
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-Body Weight < 85% Exptected
-Intense Fear of Gaining Weight -Distorted View of Own Body -Obsessive Exercise Routines -Amenorrhea for at least 3 Months |
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Define Restricting Type Anorexia Nervosa.
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Does not engage in binge eating or purging.
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Define Binge-Eating/Purings Anorexia Nervosa.
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Self Induces vomiting, laxatives, diuretics, enemas.
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What is Type I Anorexia?
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Chronic and Lifelong.
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What is Type II Anorexia?
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Short Course with complete recovery.
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What are the body weight characteristics of Bulimia clients?
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Body Weight usually normal.
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What are the Eating characteristics of Bulimia clients?
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Excessive craving of food, with Binging.
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What are the Elimination Techniques of Bulimia clients?
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Self Induced Vomiting, Laxatives, etc.
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What are the exercise characteristics of Bulimia clients?
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Sporadic Exercising
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What are the emotional characteristics of Bulimia clients?
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Sense of lack of control over eating behavior.
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What emotional concepts should be stressed for clients with eating disorders?
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Issues of enhanced concept of self and feelings of self worth.
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What happens to the HR during Anxiety?
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It Increases
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What happens to pupils during anxiety?
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They Dialate
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What happens to the immune response during anxiety?
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It is decreaed.
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What is a Panic Disorder?
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When a client has frequent Panic States.
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What is Mild Anxiety?
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Its Good. We need it to function and keep us motivated.
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What is Moderate Anxiety?
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It narrows the perceptual field.
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What is Severe Anxiety?
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It further decreased the perceptual field.
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What is happens at Panic Level Anxiety.
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The client is not able to function.
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How do you Grade Anxiety?
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On a scale of 0-10 like Pain.
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What is Free Floating Anxiety?
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Tabers:unrelated to an identifiable condition, situation, or cause.
Jeff Says "Restlessness, On Edge, Difficulty Sleeping, Hand Wringers" |
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What are the warning signs for when a client with Panic Disorder is about to have an attack?
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There is no warning.
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How often do clients with Panic Disorder experience trouble?
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Several times a weei.
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What are some sypmtoms that you might see in a client with Panic Disorder?
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SOB ** Vertigo ** Faintness -** Palpations - Shaking ** Sweating ** Choking ** Nauese ** Fear of Dying
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What is the main Intervention for someone with a Panic Disorder Attach?
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Reassure them, and remove from the Over Stimulating Environment.
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What is a Phobia?
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Tabers:
Any persistent and irrational fear of a specific object, activity, or situation that results in a compelling desire to avoid the feared stimulus. |
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What happens when a client experiences a Phobic trigger?
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It can produce the symptoms of a Panic Attack.
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Is a Phobic Client Really afraid of Clowns?
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Now, there is an underlying meaning that is displaced with the fear of the clown.
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Is a Phobia a Defense Mechanism?
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Jeff says the book says it is.
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Is the RN role in OCD to stop the behavior?
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No, it is to help the client make changes to function better in society.
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What is an Obsession?
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Tabers:
A persistent or recurring idea or feeling, esp. one that causes emotional distress or that interferes with effective living. |
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What is a Compulsion?
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Tabers:
A repetitive stereotyped act performed to relieve fear connected with obsession. |
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How can rituals of OCD be controlled?
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Through Behavior Modification or with AntiAnxiety Medications.
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If an RN sees a client washing his hands 25 times should they interrupt?
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No, it will only extend the compulsion until it can be completed. Focus should be on address the OCD afterwards to help deal better with it.
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What is PTSD?
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Post Traumatic Stress Disorder.
Tabers: Intense psychological distress, marked by horrifying memories, recurring fears, and feelings of helplessness that develop after a psychologically traumatic event, such as the experience of combat, criminal assault, life-threatening accidents, natural disasters, or rape. |
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What are PTSD Flashbacks?
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Events Persistently re-experienced with an emotional response on a regualr basis.
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How do PTSD clients avoid the problem?
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They self medicate or avoid sleeping to stave off nightmares.
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What is Hypervilligance in PTSD?
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The feeling that someone is always after them.
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How does low self esteem play into combat issues of PTSD?
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Survivor asks "Why did I live"
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What is the Primary Intervenion used today to help prevent PTSD Sx?
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Immediately debrief of all exposed is "best" intervention which will speed the griefing process.
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Other than debrief, what is another intervention for PTSD clients.
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Begin Tx ASAP before other things like ETOH coping can take hold.
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What is a Dissociative Disorder?
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Tabers:
A sudden, temporary alteration in the normal functions of consciousness, identity, or motor behavior Jeff Slide: Alteration in consious awareness of behavior, affect, thought or memories. |
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What is dissociative identity disorder?
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Formerly known as “multiple personality disorder,” a rare, but increasingly reported, psychiatric illness in which a person has two (or more) distinct personalities.
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How does Dissociative Disorder affect many of us each day? Give Three.
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-Day Dreaming
-"How did I get here" after driving 30 miles. -Tune out a nagging partner. |
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What is Dissociative Amnesia?
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Tabers:
Inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. Jeff: Memory loss NOT ORGANIC associated with a traumatic event. |
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What is DID?
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Dissociative Identity Disorder.
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What generally causes DID?
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Severe childhood Abuse.
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What is unique about the Host Personality in DID?
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May have at best only partial awareness of the other personalities.
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What is a Somatoform Disorder?
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Tabers:
A psychological disorder in which the physical symptoms suggest a general medical condition and are not explained by another condition such as a medication or another mental disorder. Jeff: Unconsious use of physical Sx to manage conflicting issues. |
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What is Conversion Disorder?
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Tabers:
A psychological disorder marked by symptoms or deficits affecting motor or sensory function that mimic a neurological or general medical disease Jeff: Loss of function secondary to traumatic event |
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What is La belle indifference?
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Tabers:
[Fr., beautiful indifference] A disproportionate degree of indifference to, or complacency about, symptoms such as paralysis or loss of sensation in a part of the body. Jeff: The loss of eyesight is no big deal. The primary gain is dec Anxiety and inc attention. |
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What is Hypochondriasis?
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Tabers:
An abnormal concern about one's health, with the false belief of suffering from some disease, despite medical reassurance to the contrary. Jeff: Preoccupation with fear of death/serious illness. Believe they have severe disease even with good test results. |
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What happens with physical sensations in hypochondriasis?
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They are exagerated.
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What type of contracting might be done with Hypochondriasis?
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Set contracts for pre-determined attention periods.
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What might be an underlying problem in Hypochondriasis?
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Does the client have an unmet need?
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How do hypochondriaic clients interact with providers?
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They may change providers in order to maintain their system of denial.
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Are there many Tx options for hypochondriasis?
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No, generally not a good prognosis.
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What is a major and common problem for all somataform disorders?
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Denial.
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Describe Crisis Theory.
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Something occurs that upsets equilibrium -> normal problem solving fails -> reach lower functionion level, continue interplay with problem solving. Soon will reach crisis level.
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What type of threats create crisis?
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Real or Percieved.
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When can Crisis causing events have happened?
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A recent or distant event, might have been days or weeks ago.
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What are the cognative characteristics of Crisis?
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Confused.
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What is Tabers Crisis defination?
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In counseling, an unstable period in a person's life characterized by inability to adapt to a change resulting from a precipitating event.
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What are some assessment questions to ascertain during a crisis?
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-What can RN do to help, and what must refer for further help?
-What was the precipitating event? -What is patients perception of the event. -What strengths and coping mechanisms has clients used in the past? |
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What is the RN role during the 4th Level of Anxiety (Crisis)?
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Take control and leave questions for later.
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What is the general rule of interventions for Crisis?
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The Greater the Severity of the Crisis, the fewer the resources, the more direct the intervention.
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What is the General Goal for a Crisis Intervention?
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To return to Pre-Crisis Levelof Function.
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What is the immediate goal of a crisis intervention?
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Establish Equilibirim, Get past the Immediate Crisis.
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Can all problems be solved in a crisis intervention?
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No, cant solve all the problems, just what can be done immediately.
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Family is homeless. Living in a car, no insurance, no food or water for infant. What is the focus of the crisis intervention?
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Get food and water for the infant, then refer for assistance with housing, and insurance, and helping the clients learn problems solving skills to prevent further problems.
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What percentage of clients have genes making them sensetive to stress?
Genes protecting from stress? |
17% Stress Causing
32$ Strews Protecting 51% Have Neither. |
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How does Unipolar Depression affect sleep?
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Causes Restlessness.
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What is the appearence of a Unipolar client?
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Dejected with Blunt affect.
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How does Unipolar Depression affect psychomoter skills?
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They are retarded with a slow gate.
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What is Dysphoria?
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A long-lasting mood disorder marked by depression and unrest without apparent cause; a mood of general dissatisfaction, restlessness, anxiety, discomfort, and unhappiness.
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How does Unipolar Depression affect attention span?
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Decreased.
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How does Unipolar Depression affect Problem solving?
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Unable to problem solve.
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What type of hallucinations are seen in Unipolar Depression?
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Auditory and Somatic.
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What is the clients longterm outlook with Unipolar Depression?
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Does not feel ike they will ever get better.
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Is Unipolar or BiPolar Disease more common?
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UniPolar.
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How does Unipolar differ from Bipolar disease?
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Unipolar does not have Mania Perios.
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What two things are important for an RN to avoid when dealing with a depressed client?
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-False Reassurances
-Dependancy Relationship by the client on the RN |
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What is Mania?
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Tabers:
Mental disorder characterized by excessive excitement. 2. A form of psychosis characterized by exalted feelings, delusions of grandeur, elevation of mood, psychomotor overactivity, and overproduction of ideas. |
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What is Hypomania?
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Tabers:
Mild mania and excitement, with a moderate change in behavior. |
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Match:
Bipolar I Mania BIpolar II Hypomania |
Bipolar I - Mania
Bipolar II - Hypomania |
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Which is more severe Bipolar I or Bipolar II?
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Bipolar I because of Mania rather than Hypomania.
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What are the manifestiations of the Manic phase of a bipolar client?
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-Psychomotor acceleration
-Expressions of Self Inflated Esteem -Destructive Behavior |
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What is the drug of choice for the Manic Stage of a Bipolar client?
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Lithium.
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What are some problems with Lithium?
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Narrow therapeutic range, GI/Bloating/N-V/Diahrreah/Nephrotoxic
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What nutrition interventions might be planned for a client in a manic phase?
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Finger food.
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Should you be competative with a client in a manic phase?
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No. Recognize with self esteem building.
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What is an important intervention to take with a manic client who had managed to stay on task?
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Praise them.
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What kinds of choices should be given to a manic client?
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Don't offer choices. They raise anxiety in a manic client.
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What is important to recognize in assessing a manic client.
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S/Sx of escalation.
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Is depression always recognized in the elderly?
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No, it can be discounted as dementia in the elderly.
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How do psychotic Symptoms differ between Demenia and Depression?
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Dementia VH
Depression AH |
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How do somatic complaints differ between Demenia and Depression?
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Dementia Hard to pin down-vague.
Depression No sleep. Low Energy Low Appatite |
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How do orientation Symptoms differ between Demenia and Depression?
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Depressed clients are easilly reoriented, demented are not.
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How does judgement differ between Demenia and Depression?
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Dementia lacks judgement. Depression not impaired, just slow to respond.
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How does memory differ between Demenia and Depression?
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Dementia Cant
Depression Wont |
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Define dysthymic disorder.
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Tabers:
A chronically depressed mood that is present more than 50% of the time for at least 2 years in adults or 1 year for children or adolescents. Jeff: Chronic non-psychotic depression for 2 years. |
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What determines treatment for Dysthymia?
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The level of functional ability.
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What is Cyclothymic Disorder?
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Tabers:
A diagnosis of exclusion in which for at least 2 years there has been the presence of numerous periods of hypomanic symptoms and numerous periods with depressive symptoms that do not meet the criteria for major depressive episode. Jeff: Chronic 2 years mild sx of depression and manic. |
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Who has SAD more Men or Women?
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Women
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What seasons does SAD present?
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Fall & Winter
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What happens in SAD in the Spring and SUmmer?
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Euphoria.
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What is thought to be the reason for SAD?
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Amout of light
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What is seen when clients are affected SAD?
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Fatigue, Decreased Activity, irritability.
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What is the most common form of Domestic Violence?
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Sibling Abuse
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How many states require child abuse reporting?
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All
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How many states require elder abuse reporting?
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Unknown, but not all. It is reportable in WA at 1-866-ENDHARM
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What percentage of psych clients have a substance abuse problem?
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50%
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What is the term when a client has a psych problem and substance abuse?
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Dual Dx.
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Define Substance Abuse
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Self medication. Purposful use of drug for 1 month that results in adverse affects to ones self or others.
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Define Substance Dependence.
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No longer under the control of the individual and they continue to use depsite adverse affects.
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Define Tabers Dual Diagnosis
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The presence of mental illness in a patient with a history of concurrent substance abuse.
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What is a danger with dual diagnosis and treatment?
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Cant treat one without the other.
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How do interventions with substance abuse differ from metnal illness?
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Substance abuse is a more "In your face" approach. Mentally ill clients need more caring and non-intimidating.
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What is dual diagnosis treatment Ping-Pong?
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Going back and forth between substance abuse and mental health treatment facilities.
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Define Cluster A
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Odd, Excentric Features
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Define Cluster B
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Dramatic, Emotional, erratic
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Define Cluster C
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Anxious and Fearful.
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Are personality disorders short-term actions?
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No, they are lifelong, and become the primary behavior.
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What differentiates between Antisocial Disorder and Condust Disorder?
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Before Age 15 is Conduct Disorder, then becomes AntiSocial Disorder.
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What are some symptoms of AntiSocial/Conduct Disorder?
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-Agression towards People & Animals
-Bully with a Weapon or Intimidation -Destruction of Property, Mailboxes, FireSetting -Decite or Theft -Serious Violation of Rules despite partental involvement. |
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What is Borderline Personality Disorder?
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Alternating between Love and Hate.
Unstabel, Intense Interpersonal Relationships of Idealization and Devaluation. |
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What are some other aspects of Borderline Personality Disorder?
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-Feelings of Abandonment
-Feelings of Emptiness -Inpulsivity -Self Mutalation -Problems with Anger Control -Manipulative |
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What is the steps in Suicide Assessment?
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-Do you have thoughts of Killing Yourself?
-If Yes, Do you have a plan? -Judge the Lethality *How Quickly will it kill *Are there provisions for Rescue? |
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What are two feelings that might lead to Suicide.
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Hoplessness
Helplessness |
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Can you give the idea of Suicide to a person not already considering it?
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No
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What word is Interchangable for Violence?
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Abuse
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What are Five types of Abuse/Violence?
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-Physical
-Psychological-Words as Weapons -Physiological -Sexual - Non Consenting Acts -Exploitation - Financial Gains |
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What is the Name of the Triangle?
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Karpman
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What are the 3 faces of the Victim in the Karpman Triangle?
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Victim
Persecutor Rescuer |
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What previous psychological study produced the Karpman Triangle?
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Transactional Analysis.
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What is the Stockholm Syndrome?
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Tabers:
The emotional involvement between a hostage and the person holding him or her captive. |
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What are the behaviors of the Victim in the Karpman Triangle?
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They have a One Down Position
Greatest Fear "I Cant Make it" Need someone more capable to carry them. |
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What is Bettered Woman Syndrome?
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A woman continues to return to the same or different abuses.
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Which piece of the Karpman Triangle is optional?
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None, all must exist to support the others.
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What is the greatest fear of a Rescurer?
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None one out there for them to rescue.
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What is the Generation of Abuse?
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When a child becomes an adult abuser.
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When is risk to an abused person highest?
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When Victim threatens to leave.
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What are two things you can encourage a victim to have ready in case of an emergency?
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A Safe Plan with where to go.
A Safe List with numbers of people and agencies who can help. |
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If you believe that a client is being abused by someone who brings them to you what might you do.
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Split them. "We have to give him a test in a special lead lined room. Please wait here."
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What is the most important intervention in child abuse cases.
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Assure the safety of the child.
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