Nrsg 210 - Mental Health

Front 1

What is mental illness?

Back 1

A health problem that significantly affects how a person, feels, thinks, behaves and interacts with other people. It is diagnosed according to a standardized criteria.

Front 2

Define recovery

Back 2

”being able to live a meaningful and satisfying life in the presence or absence of symptoms”.

Front 3

what are risk factors?

Back 3

factors contributing to a person’s vulnerability to develop, exacerbate or relapse mental illness.

Front 4

what are protective factors?

Back 4

factors that can moderate the impact of stress and symptoms on holistic parts of a consumer’s life – reducing the likelihood of developing, exacerbating or relapsing mental illness.

Front 5

what information should you gather before an interview?

Back 5

Presenting data, socioeconomic, sexual history, A + OD history, medical history, psychiatric history, family history, forensic history, work history, vales and spirituality and a history from family and previous admission.

Front 6

what are hallucinations?

Back 6

a false sensory perception not involving real stimuli. Involves the senses.

Front 7

what are illusions?

Back 7

a misinterpretation of a real stimuli. Occurs in alcohol withdrawal.

Front 8

what are delusions?

Back 8

fixed false beliefs not shared by the gender population.

Front 9

what are some characteristics of a formal thought disorder?

Back 9

Word salad (uncoherent mixture of words or phrases),

neologisms (a new creation of a word),

clanging (word chosen for sound and not meaning),

punning (words that are clever or humorous)

echolalia (imitating words of others).

Front 10

how is risk identified?

Back 10

observations, threats, conversational themes, past history, information provided by services through frequent MSE.

Front 11

how is risk managed?

Back 11

de-stimulation of area, therapeutic intervention, observations, documentation, frequent staff communication.

Front 12

what is the mental health act?

Back 12

Legislative document which governs the treatment and protection of people with mental illness in Victoria.

Front 13

what is an advanced statement?

Back 13

set out individual preferences in relation to treatment in the event they become a MIH patient.

Must make reasonable efforts to enforce patient’s recommendations.

Front 14

what happens when a patient does not consent to treatment?

Back 14

Authorised psychiatrist may make treatment decision for patient if there is no less restrictive avenue for treatment.

Front 15

What is the Criteria for compulsory treatment

Back 15

Person has a mental illness and needs immediate treatment to prevent serious deterioration and harm.

There is no less restrictive means reasonably available for immediate treatment.

Front 16

what is an assessment order?

Back 16

A registered medical practitioner or mental health practitioner may make an assessment order.

Enables person to be taken to AHHS for assessment by psychiatrist for up to 72 hours.

Front 17

what is seclusion?

Back 17

Confinement of a person where windows and doors are locked from the outside.

Clinically observed 15/60 and reviewed 4/24.

Front 18

What are some strategies to reduce restrictive intervention?

Back 18

Staff skills: de-escalating and maintaining personal control.

Intervention: engage with client, decide when to intervene, ensure safe conditions, de-escalation strategy.

Observations and prompt limit setting.

? PRN medication.

Front 19

what is psychosis?

Back 19

Grossly impaired understanding of reality. Internal stimuli can be hard to distinguish from reality.

Symptoms include: hallucinations, delusions, thought organisational difficulties.

Front 20

what causes psychosis?

Back 20

Neurodevelopment: foetal brain injury, obstetric complications, low birth weight, CT/MRI abnormalities.

Cannabis.

Environment: socioeconomic deprivation, adverse life effects.

Front 21

what are characteristics of the prodrome?

Back 21

Pre-hallucinatory perception abnormalities.

Subtle changes in behaviour.

Social withdrawal.

Predelusional, unusual thoughts and beliefs. Speech and motor disturbance.

Impaired stress tolerance.

Front 22

how is psychosis diagnosed?

Back 22

Two or more of following: delusion, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour, negative symptoms.

Continuous disturbance lasting at least 6 months.

Front 23

what are positive symptoms?

Back 23

‘excess of’ or additional. Does not mean good. Responds well to unconventional antipsychotics.

Front 24

what are negative symptoms?

Back 24

described as withdrawal of normal everyday functioning.

Front 25

what are secondary negative symptoms?

Back 25

caused by unrelieved/untreated positive symptoms.

Front 26

what is schizoaffective disorder?

Back 26

An uninterrupted period of illness during which there is a major mood episode concurrent with criteria A of schizophrenia.

Delusions or hallucinations for 2 or more weeks. Disturbance is not attributed to the effects of a substance or illness.

Front 27

why would a patient's antipsychotics be changed?

Back 27

- Poor treatment response. - Intolerable adverse effects. - Request of patients/carers.

Front 28

what are some of the contraindications for changing antipsychotics?

Back 28

- Recently recovered from acute episode and taking a working antipsychotic drug.

- History of clinical instability due to poor adherence of oral antipsychotics.

- History of violence, self-harm and severe symptoms during psychotic episodes.

Front 29

how is depression diagnosed in the DSM-5?

Back 29

5 or more of the following symptoms present for same two week period: depressed mood, diminished pleasure in activities, significant weight loss, insomnia, fatigue or loss of energy, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate and recurrent thoughts of death.

Front 30

what are the characteristics serotonin syndrome?

Back 30

Potentially fatal.

Must have three of the following symptoms for diagnosis: agitation, shivering, tremor, fever, muscle spasms, heavy sweating, overactive reflexes and changes in mental state.

Front 31

what are characteristics of a manic episode?

Back 31

Abnormally and persistently elevated, expansive and irritable mood, abnormally increased goal directed activity or energy.

Three or more of the following: inflated self-esteem, decreased need for sleep, more talkative than usual, flight of ideas, distractibility’s, excessive involvement in activities that have a high potential for painful consequences.

Front 32

what are some of the characteristics of a depressive episode?

Back 32

Five or more of the following symptoms present in same two week period and represent a change from normal functioning – depressed mood, diminished interest or pleasure, weight loss, insomnia or hypersomnia, psychomotor agitation, loss of energy, feelings of worthlessness, diminished ability to concentrate and recurrent thoughts of death.

Front 33

what is substance use?

Back 33

non problematic use of an illegal substance.

Front 34

what is substance misuse?

Back 34

use of a drug that is likely to cause harm.

Front 35

what is dependence?

Back 35

maladaptive pattern of substance use leading to clinically significant impairment or distress.

Front 36

what is addiction?

Back 36

misuse of substances related to an illness, state or biological malfunction.

Front 37

what are the categories of drug CNS effects?

Back 37

- Stimulants: boost energy and performance; reduce appetite.

- Depressants: impairs cognitive and co-ordination, induces sedation.

- Hallucinogens: sensory alterations.

Front 38

what is dual diagnosis?

Back 38

- A person diagnosed as having an alcohol or drug misuse problem, in conjunction with at least one other diagnosis.

-Psychiatric and substance abuse diagnoses exacerbate each other.

Front 39

what are some principles of effective treatment?

Back 39

- Right to treatment, no single treatment is appropriate for all, practical assistance and basic needs first, client-clinician relationship, long term on going contact, takes place in clients own environment, readily available, assessed and modified regularly, non-judgemental, clients own goals, focus on alternate activities, harm minimisation.

Front 40

Application of A + OD use

Back 40

- Pre-contemplation: people are happy/unconcerned about drug use and ignore advice.

- Contemplation: ambivalent about use. Enjoyable but some consequences.

- Preparation: time for change; costs outweigh benefits.

- Action: resolved to change, take active steps.

- Maintenance: drug use no longer a problem.

Front 41

what is intoxication? and what are it's diagnostic criteria?

Back 41

- Direct pharmacological effect of the drug on CNS.

- Diagnostic criteria: recent alcohol ingestion, clinically significant problematic behaviour and symptoms such as slurred speech and unsteady gait.

Front 42

cannabis

Back 42

- Some CNS depressant and hallucinogenic properties at high doses.

- People experience distortion of time, distance and some sensory input.

- Can cause: euphoria, decreased inhibitions and concentration, impaired memory and recall, detachment from reality, restlessness, anxiety and panic.

Front 43

crystal meth

Back 43

- Effects: hyperactive, disinhibited, sense of invincibility, irritability and hostility, hallucinations and paranoia, psychosis and panic attack, uncontrolled aggression and itching skin.

- Long term: insomnia, high excitation, skin issues, malnutrition, psychiatric disturbance, depression and memory loss.

Front 44

opiates

Back 44

- Implications: high risk addiction, mood swings, depression, chronic constipation, infection, overdose and death.

- Withdrawal: craving, restlessness, stomach and leg cramps, muscle spasms, anorexia, GI upset, increased irritability, insomnia and depression

Front 45

what is a model of healthcare?

Back 45

A system or structure that has been formally developed to organise, guide and explain the way in which health professionals deliver healthcare in a particular setting.

Front 46

what is recovery?

Back 46

- A personal process of changing ones attitudes, values, feelings, goals, skills and or roles. The development of new meaning and purpose of beyond the effects of psychiatric disability.

- Cannot be done to or for someone.

- Enables people to address the experience of loss and grief that are major components of mental illness.

Front 47

what is the mental health recovery star?

Back 47

- Holistic and personalised properties.

- 10 areas of personal life: managing mental health, physical health, living skills, social network, work, relationships, addictive behaviour, responsibilities, identity, self-esteem, trust and hope.

- Motivates individuals to make progress.

- Limitation: practitioner reluctance to change.

Front 48

what is hardiness?

Back 48

- Ability to resist illness when under stress.

- Commitment: active involvement in life activities.

- Control: ability to make appropriate decisions.

- Challenge: ability to achieve change as beneficial rather than stressful.

Front 49

what is anxiety?

Back 49

- “a state where a person feels a strong sense of dread, without having a specific source or reason for the behaviour”.

- A normal emotion experienced in varying degrees by everyone.

Front 50

what are the levels of anxiety?

Back 50

- Mild: focus and goal directed. Complete task/deadlines.

- Moderate: can still process information; difficulty concentrating.

- Severe: cannot complete tasks or learn effectively.

- Panic: irrational thoughts, distorted perception.

Front 51

what causes anxiety?

Back 51

- Stress theory: alarm reaction, resistance exhaustion.

- Personality theory: personality / temperament. - Psychoanalytic theory: unacceptable thoughts and emotions are repressed; they emerge on anxiety.

- Behavioural theory: anxiety is learned and can be unearned.

Front 52

what characterises general anxiety disorders?

Back 52

- Excessive worrying more often than not for 6/12.

- Three or more of following: agitation, fatigue, poor concentration, irritability or sleep disturbance.

- Impairment in relation to social and occupational functioning.

Front 53

what is panic disorder?

Back 53

- ‘the presence of recurrent, un expected panic attacks followed by at least one month of persistent concern about having another panic attack.

Front 54

how is anxiety treated?

Back 54

- Conflict resolution, distraction, exercise, balance between work and leisure, slow breathing, relaxation and decreased alcohol.

- Counselling and psychotherapy, cognitive behaviour therapy, behavioural therapies, mindfulness, meditation, relaxation.

Front 55

what is a somataform disorder?

Back 55

- The tendency to experience, conceptualise and communicate mental states and distress as physical symptoms or altered body function.

- Symptoms unexplained by investigation but remain despite reassurance of no basis.

Front 56

how is a somataform disorder assessed and treated?

Back 56

- Assess and evaluate physical symptoms, appropriate diagnosis, psychotherapy and counselling, reassurance, medication, behavioural therapy.

Front 57

what is dissociative disorder?

Back 57

- disturbance of higher mental function ie cognition and memory.

- Mental functions appear to be split from consciousness.

Front 58

what are some characteristics of a personality disorder?

Back 58

- May be annoying to others or troubling to society.

- Resistance to help is strong. Rarely seek it voluntarily.

- Tendency to blame others for their behaviour.

Front 59

paranoid personality disorder

Back 59

- Pervasive distrust, bears grudges and perceives attacks on others.

Front 60

Schizoid personality disorders

Back 60

- Avoid close relationships, prefer solitary activities, indifferent praise or criticism and emotionally rigid.

Front 61

stereotypical personality disorder

Back 61

- Odd beliefs and thinking, some paranoid ideations, socially anxious and little social network / friends.

Front 62

what is antisocial personality disorder?

Back 62

- A pervasive pattern of disregard for and violation of the rights of others occurring since the age of 15 years.

- Evidence of CD with onset by 15.

- Occurrence if ASPD behaviour is not exclusively during course of schizophrenia or BPAD.

Front 63

how is BPD characterized in the DSM-5

Back 63

- A pervasive pattern of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood.

Front 64

what is histrionoic personality disorder?

Back 64

- Use speech to impress others.

- Prone to exaggeration.

- Easily led by others.

- Craves centre of attention.

Front 65

what sort of child behaviours should be assessed?

Back 65

Internalising problems, externalising behaviours, somatic complaints, delinquent behaviour, aggressive behaviour, social problems, withdrawal, thought disorders.

Front 66

what is in the MSE for children?

Back 66

Appearance, sensorimotor development, manner of relating to others, mood/ affect, capacity/ level of play, perceptual abilities, attention/ concentration, concept of self, thought process/ content, cognitive abilities, language/ speech and temperament.

Front 67

how does autism present?

Back 67

- Hyperactivity, short attention span, impulsiveness, sleeping issues, attachment to strange objects, aggressive behaviour, tantrums, sensory issues with food, repetitive behaviour and difficulty coping with change.

Front 68

how is autism treated?

Back 68

- Counselling, CBT, OT and physical therapy, medication, social skills training, speech therapy.

Front 69

how does asbergers disorder present/?

Back 69

obsessive interest in the mechanics of a certain object, no attempts to make friends, lack of understanding of social cues, lack of empathy, difficulty sharing, lacks imagination, appears odd or eccentric, victims of bullying and good verbal memory skills.

Front 70

Attention deficit hyperactive disorder (ADHD)

Back 70

- Characterised by patterns of behaviour that can result in performance issues in social, educational or work settings.

- Treatment: behavioural interventions, CBT, lifestyle changes, medications such as Ritalin.

Front 71

what are conduct disorders?

Back 71

- Characterised by persistent antisocial behaviour in children and adolescents that significantly impairs social, academic or occupational functioning.- Risk factors: poor parenting, abuse, poor peer relationships, low academic achievement and low self-esteem. - Treatment: parent education, family therapy etc.

Front 72

what is anorexia nervosa?

Back 72

- Risk factors: female, restrictive dieting, substance misuse, family history of obesity and low self-esteem.

- Causes: genetics, social pressure, low self-esteem and childhood trauma.

- Physical symptoms: weight loss 15%, amenorrhea, decreased body temp and constipation.