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56 Cards in this Set
- Front
- Back
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Explain oppositional defiant disorder |
Angry and irritable Defiant and vindictive behavior Social difficulties, conflict with authority, academic problems No friends and won’t accept help often |
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Explain intermittent explosive disorder |
Inability to control aggressive behavior and shows remorse Happens in adults Leads to relationship problems, work problems, and criminal behavior |
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Explain conduct disorder |
Abnormally aggressive Violence toward animals common with this Minimal to No remorse Jail, academic failure, drugs and alcohol |
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Explain the etiology of conduct disorder |
Changes in gray matter which decrease ability to feel remorse Dec In serotonin and testosterone Low self esteem Primitive response rationales |
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Implementation for conduct disorder |
Safety Rapport Clear limits Redirect negative behavior into positive activities |
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Med interventions for ODD/CD |
Tx comorbidities and symptomatic behaviors Primarily use second generation antipsychotics Risperdal and zyprexa Behavior modification |
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Med interventions for IED |
SSRI-Prozac Mood stabilizer-lithium Anticonvulsants, tricyclics or antipsychotics Avoid anxiolytics because they dec inhibitions |
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Explain addiction |
Primary chronic disease of the brain reward, motivation, memory, and related circuity Craving overcomes the control |
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Explain intoxication |
Using substance in excess Effects depend on substance abused Tolerance evident by functioning |
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Explain withdraw |
Physiological symptoms that begin as the concentration of the chemical decreases Agitation, VS changes, perceptual distortions, delirium Medical management necessary Benzodiazepines are DOC |
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Nursing diagnoses for substance abuse |
Risk for injury in acute setting Health maintenance in outpt setting |
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Explain narcissistic personality disorder |
Arrogant Inflated view of self worth Lack empathy Thought to result from childhood neglect and over criticism No medical tx CBT, family therapy and group therapy |
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Explain narcissistic personality disorder |
Arrogant Inflated view of self worth Lack empathy Thought to result from childhood neglect and over criticism No medical tx CBT, family therapy and group therapy |
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Explain obsessive compulsive personality disorder |
Perfectionist Rigid and inflexible Debilitating repetitiveness Gentically linked SSRI-fluoxetine Psychotherapy and group therapy |
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Explain antisocial personality disorder |
Antagonistic behavior up to criminal misconduct Driven by gaining personal power or pleasure Exploit others for own gain Lack empathy or remorse Manipulative Genetically linked No approved meds Mood stabilizers may help |
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Explain borderline personality disorder |
Emotionally labile Impulsive Splitting (I hate you-don’t leave me) Manipulative self harm Self destructive Highly genetic Anticonvulsants for mood stability Low dose antipsychotics Naltrexone has been shown to reduce self harm behaviors |
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Suicide risk factors |
Psychiatric disorder Alcohol or substance abuse Male gender Increasing age Terminal illness Race Religion Marriage Profession Physical health |
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Biological factors for suicide |
Genetic link Low serotonin levels |
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Assessment in suicidal pts |
Therapeutic rapport is very important Overt and covert statements Helplessness or hopelessness Lethality and means of suicide plan SAD PERSONS tool |
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SAD PERSONS scale |
Sex (male) Age 25-44 or 65+ Depression Previous attempt Ethanol use Rational thinking loss Social supports lacking not recent loss No spouse Sickness |
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SAD PERSONS scale |
Sex (male) Age 25-44 or 65+ Depression Previous attempt Ethanol use Rational thinking loss Social supports lacking not recent loss No spouse Sickness |
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Guidelines for sad persons scale |
0-2 send home with follow up 3-4 close follow up consider hospitalization 5-6 strongly consider hospitalization 7-10 hospitalize or commit |
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Interventions for suicide pt |
Safe environment Remove all harmful objects Appropriate level of monitoring Counseling Health teaching and promotion Case management |
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Med interventions for suicide pts |
Med compliance Low lethality prescriptions Avoid tricyclics and MAOI Monitor for suicide with new onset of antidepressant |
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Patient has a hx of suicide attempts, aggression, conflictual interpersonal relationships and says “if I have to stay here I’m going to kill myself”. What’s your nursing diagnosis |
Risk for suicide |
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Patient has rigid body posture, clenched fists and jaw, pacing, invades personal space of others, hx of cruelty to animals, fire setting, fx fights, hx of child abuse and states “that wimp better stay out of my way”. What’s your nursing diagnosis |
Risk for other directed violence |
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Patient has hostile laughter, projects responsibility for behavior into others, difficulty establishing relationship. Your nursing diagnosis is? |
Defensive coping related to impulse control problems |
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Pt has Rejection of child or hostility toward child, unsafe home environment, abusive or neglectful, disturbed relationship between parent and child. Nursing diagnosis? |
Impaired parenting |
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Outcomes for risk for suicide |
Express feelings Verbalized suicidal ideas Refrains from attempting Plans for future |
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Outcomes for risk for other directed violence |
Id harmful behavior Control impulses Refrain from aggressive acts Id social support |
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Outcomes for defensive coping |
Id effective coping Use support system Use new coping strategies |
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Outcomes for defensive coping |
Id effective coping Use support system Use new coping strategies |
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Outcomes for impaired parenting |
Parent participates in therapeutic program Learns appropriate parenting skills |
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Explain tobacco |
Smoked, snorted, chewed Inc BP and HR COPD, cardiovascular disease, stroke, cancers, adverse pregnancy outcomes, addictions |
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Explain alcohol |
Low doses: euphoria, mild stimulation, relaxation, lowered inhibitions High doses: drowsiness, slurred speech, nausea, emotional volatility, loss of coordination, visual distortions, impaired memory, sexual dysfunction, loss of consciousness Inc risk of injury, violence, fetal damage, depression, Nuero defects, hypertension, liver and heart disease, addiction, overdose |
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Explain cannibinoids |
Euphoria, relaxation, slowed rx time, distorted perception, inc HR and appetite, impaired learning and memory Fx resp infections, addiction, mental health decline |
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Explain heroin |
Euphoria, drowsiness, impaired coordination, dizzy, confusion, nausea, sedation, heaviness, slowed breathing |
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Explain opium |
Constipation, endocarditis, hepatitis, HIV, addiction, overdose |
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Explain stimulants |
Cocaine, amphetamine, meth Inc HR, inc BP, inc temp, inc metabolism, exhilaration, inc energy, tremors, reduced appetite, irritable, anxious, panic, paranoia, violent behavior, psychosis Weight loss, insomnia, cardiac complications, stroke, seizures, addiction Nasal damage with cocaine Bad teeth from meth |
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Explain dissociative drugs |
Ketamine, PCP, salvia divinorum, DXM Out of body feeling, impaired motor fx, impaired memory, delirium, resp depression, death Anxiety, tremors, numbness, memory loss |
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Explain hallucinogens |
LSD, mescaline, psilocybin Altered states of perception, hallucinations, nausea, inc temp, inc HR, inc BP, loss of appetite, sweating, sleeplessness, numbness, dizziness, weakness, tremors, impulsive behavior Flashbacks, hallucinogen persisting perception disorder |
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S/s of blood alcohol level 20-100 |
Mood change Reduced coordination Can’t drive car |
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S/s of blood alcohol level 20-100 |
Mood change Reduced coordination Can’t drive car |
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S/s blood alcohol level 101-200 |
Reduced coordination of most things Speech impairment Trouble walking |
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S/s of blood alcohol level 20-100 |
Mood change Reduced coordination Can’t drive car |
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S/s blood alcohol level 101-200 |
Reduced coordination of most things Speech impairment Trouble walking |
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S/s blood alcohol level 201-300 |
Marked thinking impairment Marked reduction in alertness Blackouts N&v |
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S/s of blood alcohol level 20-100 |
Mood change Reduced coordination Can’t drive car |
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S/s blood alcohol level 101-200 |
Reduced coordination of most things Speech impairment Trouble walking |
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S/s blood alcohol level 201-300 |
Marked thinking impairment Marked reduction in alertness Blackouts N&v |
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S/s blood alcohol level 301-400 |
Reduced temp and BP Excessive sleepiness Amnesia |
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S/s of blood alcohol level 20-100 |
Mood change Reduced coordination Can’t drive car |
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S/s blood alcohol level 101-200 |
Reduced coordination of most things Speech impairment Trouble walking |
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S/s blood alcohol level 201-300 |
Marked thinking impairment Marked reduction in alertness Blackouts N&v |
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S/s blood alcohol level 301-400 |
Reduced temp and BP Excessive sleepiness Amnesia |
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S/s blood alcohol level 401-800 |
Coma Serious dec in temp, HR, BP, RR Incontinence Death |
