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192 Cards in this Set
- Front
- Back
Attending
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Therapeutic benefit of being available & present for pt's.
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Clinical algorithms
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Written plan or "map" identifying predetermined times that specific nursing & med interventions will be implemented. Step by step guidelines
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Clinical practice guidelines
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Medical guideline-document w/ aim of guiding decisions & criteria re/ diagnosis, mgmt, & tx in specific areas of healthcare.
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Patient advocacy
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Protection, promotion, & optimization of health & abilities, prevention of illness & injury, alleviation of suffering through diagnosis & tx of human response, & advocacy in care of individuals, families, communities, and populations.
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Caring
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Displaying kindness and concern for others; work or practice of looking after those unable to care for themselves
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Clinical/critical pathways
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Map of preferred treatment/intervention activities. Outlines types of information needed to make decisions, the timelines for applying that information, and what action needs to be taken by whom.
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Evidence-based practice
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Care that integrates latest & best available research.
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Recovery model
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Conceptual model of psych illness stresses hope, living a full and productive life, and eventual recovery.
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Culture-related syndromes
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Sets of S/S common in limited # of cultures but virtually nonexistent in most other cultural groups.
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Multi-axial system
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Forces a diagnostician to consider a broad range of information.
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Stigma
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Negative attitudes or behaviors toward a person or group, based on belief that they possess negative traits.
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DSM
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Diagnostic and Statistical Manual of Mental Disorders: classification of mental disorders that includes descriptions of diagnostic categories.
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Resiliency
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The ability to adapt and cope, which helps people face tragedies, loss, trauma, and severe stress.
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GAF
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Global Assessment of Functioning
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Elopement
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Escape or leaving a psych treatment facility w/o medical authorization or recommendation.
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Occupational therapist
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Treat pts w/ injuries, illnesses, disabilities thru everyday activities. Help pts develop, recover, improve skills needed for ADL’s & working.
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Psychologist
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Therapist who evaluates, diagnoses, treats, and studies behavior and mental processes.
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Social worker
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Individual organizes work intended to advance social conditions of community, & especially disadvantaged- provide psych counseling, guidance, and assistance, especially in the form of social services.
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Mental health parity
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Recognition by health insurance companies that mental illnesses are debilitating & in need of proper tx as physical illness.
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Psychiatrist
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Med practitioner specializing in the diagnosis and treatment of mental illness.
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Recreational therapist
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Therapy based on engagement in rec activities (sports or music) to enhance functioning, independence, well-being of individuals affected w/ disabling condition
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Therapeutic milieu
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Therapeutic setting focuses on control of environment of individual.
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Assault
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Intentional threat designed to make victim fearful; produces reasonable apprehension of harm.
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Battery
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Harmful or offensive touching of another person.
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Fidelity
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Doing no wrong to the pt.
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Involuntary commitment
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Admission to psych facility w/o pt's consent.
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Justice
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Duty to distribute resources/care equally
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Veracity
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Duty to communicate truthfully
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Writ of Habeas Corpus
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Formal written order to "free the person".
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Riese
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Court ruled that absent judicial determination of incompetence, antipsychotic drugs cannot be given to involuntarily committed mental patients in non-emergency situations w/o informed consent.
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Autonomy
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Respecting the rights of others
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Beneficence
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Duty to promote the good of others
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Informed consent
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Person provided w/basic understanding of risks, benefits, alternatives & receiving tx voluntarily
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Least restrictive alternate doctrine
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Mandates that the least restrictive and least disruptive means be used to achieve a specific purpose.
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Malpractice
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Act or omission that breaches duty of due care and results in or responsible for person's injuries.
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Voluntary admission
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Inpatient care sought by the patient or the patient's guardian through a written application to the facility.
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Duty to warn
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Obligation may result in breach of confidentiality on part of health care worker to warn 3rd parties when may be in danger f/ pt.
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Duty to protect
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Ethical & legal obligations of health care workers to protect pts f/ physically harming themselves/ others.
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Tarasoff
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Ca court decision imposes duty on therapist to warn person/persons when therapist aware pt presents risk of harm to specific person/persons.
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Abstract thinking
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The ability to conceptualize ideas.
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Blunted affect
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Lack of emotional reactivity
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Circumstantial thinking
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Too much information; excessive amt. of details; A pattern of speech characterized by indirectness and delay before the person gets to the point or answers a question; the person gets caught up in countless details and explanations.
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Delusions
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False belief held to be true even w/ evidence to contrary.
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Flight of ideas
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Continuous flow of speech- person jumps rapidly from one topic to another. Sometimes listener can keep up w/ changes; other times, necessary to listen for themes in incessant talking. Themes often include grandiose & fantasized evaluation of personal sexual prowess, business ability, artistic talents and so forth.
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Ideas of reference
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The false impression that outside events have special meaning for oneself.
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Judgment
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The ability to make logical, rational decisions.
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Loose associations
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Pattern of thinking haphazard, illogical, confused & connections in thought interrupted; seen primarily in schizophrenic disorders.
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QSEN
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Quality & Safety Education for Nurses
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Thought broadcasting
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Delusional belief that others can hear or are aware of an individual's thoughts.
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Thought withdrawal
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Believe missing thoughts w/drawn f/ mind by outside agency
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Affect
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External manifestation of feeling/emotion manifested in facial expression, tone of voice, body language.
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Broad affect
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Norm range of body language that matches mood.
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Concrete thinking
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Thinking grounded in immediate experience rather than abstraction. There is an overemphasis on specific detail as opposed to general and abstract concepts.
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Flat affect
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Absence or near absence of facial expression.
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Hallucinations
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Sense perception for which no external stimulus exists. (Hearing voices, seeing people not there)
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Insight
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Understanding & awareness of reasons for & meaning behind one's motives and behavior
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Labile
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Rapid shifts in mood: laughing one minute & crying the next; unstable.
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MSE
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Mental status examination
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Tangential thinking
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Disturbance in associative thinking- goes off topic. If happens frequently & does not return to topic, interpersonal comm destroyed
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Thought insertion
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Delusion one's thoughts not one's own but placed into mind by external force.
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Word salad
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Mixture of words meaningless to listener & to speaker
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Congruence
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Body language matches mood stated by pt.
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Empathy
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Ability to get inside another’s world & see things f/other person’s perspective & communicate this to person.
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Orientation phase
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Phase of nurse-pt relationship which nurse & pt meet, nurse conducts initial interview.
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Rapport
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Relationship characterized by trust, support, understanding.
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Therapeutic relationship
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Relationship requiring nurse maximize comm skills, understanding of human behaviors, personal strengths to enhance personal growth in pt. Occurs all clinical settings, not just on psych unit.
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Values
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Abstract standards represent an ideal, either pos or neg.
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Countertransference
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The tendency of the nurse (therapist, social worker) to displace onto the patient feelings that are a response to people in the nurse’s past. Strong positive or strong negative reactions to a patient may indicate countertransference.
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Genuineness
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Honestly felt/ experienced; Sincere
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Termination phase
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The final, integral phase of the nurse-patient relationship.
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Transference
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Experiencing of thoughts/ feelings toward person (often therapist) originally held toward sig person in one’s past. Valuable tool by therapists in psychoanalytical therapy.
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Working phase
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Phase of nurse-pt relationship during which nurse & pt identify/ explore areas causing problems in pt’s life.
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Acting out
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Originate unconscious-reduce anxiety/ tension. Anxiety displaced f/ 1 sit to another in observable resp (ex anger, crying, violence).
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Denial
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Escaping unpleasant realities by ignoring existence.
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Dissociation
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Disruption in integrated functions of consciousness, memory, identity, perception of environment. Result in separation bw feeling & thought. Can manifest in compartmentalizing uncomfortable/ unpleasant aspects of one self.
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Passive aggression
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Indirect expression of anger or aggressive feelings. May seem passive but motivated by unconscious anger & often triggers anger/ frustration in others. Examples; being late, forgetting, making “mistakes”, acting obtuse.
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Rationalization
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Justification of illogical/unreasonable ideas, actions, or feelings by development of acceptable explanations that satisfy teller & listener.
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Repression
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Unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas f/ conscious awareness; considered 1st line of psych defense.
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Somatization
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Tendency to experience & comm psychological distress in form of somatic symptoms & seek med help for them
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Undoing
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Act or behavior unconsciously designed to make up for or negate previous act/behavior (e.g., bringing boss present after talking about boss unfavorably to co-workers).
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Altruism
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Principle or practice of unselfish concern for or devotion to welfare of others
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Displacement
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Transfer of emotions associated w/ particular person, object, or situation to another person, object, or situation.
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Projection
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Unconscious attributing of one’s own intolerable wishes, emotions, or motivations to another.
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Reaction formation
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Overcompensationà The process of keeping unacceptable feelings or behaviors out of awareness by developing the opposite emotion or behavior.
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Regression
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In face of overwhelming anxiety, return to earlier, more comforting (although less mature) way of behaving.
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Splitting
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Inability to integrate pos & neg qualities of oneself or others into cohesive image. Aspects of the self and of others tend to alternate between opposite poles; for example, either good, loving, worthy and nurturing, or bad, hateful, destructive, rejecting, and worthlessness.
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Suppression
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Conscious removal from awareness of disturbing situations or feelings; only defense mechanism that operates on a conscious level.
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Sublimation
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Unconscious process substituting constructive & socially acceptable activities for strong impulses not acceptable in original form, such as strong aggressive or sexual drives.
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Automatic thoughts
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Rapid, unthinking responses based on schemas.
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Behavior therapy
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Based on the assumption that changes in maladaptive behavior can occur without insight into the underlying cause.
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Cognitive-behavioral therapy
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Based on both cognitive psychology and behavioral theory. How people feel and behave is largely determined by the way they think about the world and their place in it.
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Defense mechanism
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Ward off anxiety by preventing conscious awareness of threatening feelings.
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Differentiation
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The ability to develop a strong identity and sense of self while at the same time maintaining an emotional connectedness with one’s family of origin.
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Ego
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Is one’s sense of self and provides such functions as problem solving, mobilization of defense mechanisms, reality testing, and the capability of functioning independently. Mediator between ones primitive drives (id) and the internalized parental and social prohibitions (the superego).
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Hierarchy of needs
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Maslow conceptualized human motivation as a hierarchy of dynamic processes or needs that are critical for the development of all humans with the ultimate goal of self-transcendence.
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Kholberg, Lawrence
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6-stage theory of moral development provides framework for evaluating moral decisions. Pre conventional, conventional, post conventional
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Multi-generational issues
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Various family patterns passed down through the generations.
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Operant conditioning
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A type of behavior modification in which voluntary behaviors are increased or decreased through reinforcement or punishment.
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Piaget
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Provided a broad base for cognitive interventions, especially with patient with negative self-views.
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Scapegoating
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A member of a group or family who becomes the target of others’ aggression but who may not be the actual cause of their hostility or frustration.
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Autocratic leadership
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Exerts control over the group and does not encourage much interaction among members. Good in emergencies
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Boundaries
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Those functions that maintain a clear distinction among individuals within a family or group and between family members and the outside world. Boundaries may be clear, diffuse, rigid, or inconsistent.
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Clear Boundaries
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Balanced flow of energy between members
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Diffuse Boundaries
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Blending together of roles, thoughts and feelings of individuals- clear distinctions among family members fail to emerge.
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Rigid Boundaries
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Are those in which the rules and roles are adhered to no matter what.
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Cognitive distortions
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Inaccurate/ irrational automatic thoughts/ ideas lead to false assumptions & misinterpretations.
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Democratic leadership
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Supports extensive group interaction in the process of problem solving.
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Double bind
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Comm contains 2 contradictory messages given by same person at same time, receiver is expected to respond.
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Free association
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Requires full and honest disclosure of thoughts and feelings as they come to mind.
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Id
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The source of all primitive drives and instincts and is considered to be the reservoir of all psychic energy.
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Laissez-faire leadership
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Allows the group members to behave in anyway they choose and does not attempt to control the direction of the group.
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Negative reinforcement
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Increasing the probability of a behavior by removing unpleasant consequences; it is not punishment.
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Peplau
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Cont’d work of Sullivan’s interpersonal theory. Developed 1st systematic theoretical framework for psych nursing. Established foundation for professional practice.
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Positive reinforcement
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The presentation of a reward immediately following a behavior, making the behavior more likely to occur in the future.
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Subconscious
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Experiences, thoughts, feelings, and desires that are not in immediate awareness but can be recalled to consciousness; often called the preconscious. The subconscious mind helps repress unpleasant thoughts or feelings.
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Superego
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The internal representative of the values, ideals and moral standards of society. The superego is said to be the moral arm of the personality.
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Systematic desensitization- Behavior therapy
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behavior modification therapy involves the development of behavioral tasks customized to the pt. specific fears. Pt. is incrementally exposed to the fear.
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Modeling- Behavior therapy
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Pt learns thru initiation
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Aversion- Behavior therapy
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Tx of choice when less drastic measures fail. Ex. put bad smell on finger nails if nail biter
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Cognitive theory- Beck
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How people feel/behave determined by way think. Schemata A + B = C, stimulus + Appraisal = Response, change by A + B + C = D
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Affect
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The external manifestation of feeling or emotion which s manifested in facial expression, tone of voice, and body language.
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Alogia
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Poverty of speech; poverty of content of speech
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Anhedonia
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The inability to experience pleasure
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Blocking
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A sudden obstruction or interruption in the spontaneous flow of thinking or speaking that is perceived as an absence or deprivation of thought.
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Concrete thinking
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Thinking grounded in immediate experience rather than abstraction. There is an overemphasis on specific detail as opposed to general and abstract concepts.
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Depersonalization
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A phenomenon whereby a person experiences a sense of unreality of or estrangement from the self (i.e., one may feel that limbs or extremities have changed, that one is seeing self and events from a distance, or that one is in a dream.
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Echolalia
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Repeating of the last words spoken by another; mimicry or imitation of the speech of another person.
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EPS
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Extrapyramidal side effects- a variety of signs and symptoms that are often side effects of the use of certain psychotropic drugs, particularly the phenothiazines. Three reversible eps side effects are acute dystonia, akathisia, and pseudoparkinsonism. A fourth tardive dyskinesia, is the most serious and is not reversible.
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Grandiosity
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Exaggerated belief in or claims about one’s importance or identity.
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Ideas of reference
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The false impression that outside events have special meaning for oneself.
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Negative symptoms
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The absence of something that should be present (e.g., apathy, lack of motivation, anhedonia, poor thought processes).
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Neurocognitive symptoms
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Causes difficulty with attention, memory and executive functions; impedes ability to manage their own health; generally devastates the person’s quality of life.
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Paranoia
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A state characterized by the presence of intense and strongly defended irrational suspicions. These ideas cannot be corrected by experience and cannot be modified by facts or reality.
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Pseudoparkinsonisms
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A medication-induced temporary constellation of symptoms associated with Parkinson’s disease: tremor, reduced accessory movements, impaired gait, and stiffening of muscles.
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Tardive dyskinesia
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A serious and irreversible side effect of the phenothiazines and related drugs; consists of involuntary tonic muscle spasms typically involving the tongue, fingers, toes, neck, trunk, or pelvis.
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Thought insertion
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Belief that thoughts of others are being inserted into one’s mind (e.g., “they make me think bad thoughts.”)
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Waxy flexibility
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Excessive maintenance of posture; i.e., after the arms or legs are placed in a certain position, the individual holds that same position for hours.
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Akathesia
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Regular rhythmic movements, usually of the lower limbs; constant pacing may also be seen; often noticed in people taking antipsychotic medication.
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Anergia
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Lack of energy; passivity.
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Avolition
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Lack of motivation
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Blunted affect
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Minimal emotional response.
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Clang associations
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The meaningless rhyming of words, often in a forceful manner.
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Delusions
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A false belief held to be true even with evidence to the contrary (e.g., the false belief that one is being singled out for harm by others).
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Dystonia
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Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuroleptic medication, in which it manifests as muscle spasms of the face, head, neck and back.
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Echopraxia
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Mimicry or imitation of the movements of another person
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Flat affect
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Absence or near absence of facial expression
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Hallucination
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A sense perception (seeing, hearing, tasting, smelling or touching) for which no external stimulus exists (e.g., hearing voices when none are present).
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Illusion
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An error in the perception of a sensory stimulus (e.g., a person may mistake polka dots on a pillow for hairy spiders).
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Neologisms
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A word a person makes up that has meaning only for that person; often part of a delusional system.
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Neuroleptic malignant syndrome
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A rare and sometimes fatal reaction to high-potancy neuroleptic drugs. S/S include muscle rigidity, fever, and elevated WBC. It is thought to result from dopamine blockage at the basal ganglia and hypothalamus.
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Positive symptoms
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The presence of something that is not normally present (e.g., hallucinations, delusions, bizarre behavior, paranoia).
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Tangential
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A disturbance in associative thinking in which the speaker goes off the topic. Whenit happens frequently and the speaker does not return to the topic, interpersonal communication is destroyed.
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Thought broadcasting
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Belief that one’s thoughts can be heard by others (e.g., “My brain is connected to the world mind. I can control all heads of state through my thoughts.”)
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Thought withdrawal
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Belief that thoughts have been removed from ones mind by an outside agency (e.g., “The devil takes my thoughts away and leaves me empty.”)
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Word salad
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A mixture of words meaningless to the listener and to the speaker as well.
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Acetylcholine
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Stimulates parasympathetic nervous system; role in learning & memory; regulates mood (mania, sexual aggression); affects sexual and aggressive behavior. Receptor sites are Nicotini, muscarinic. Associated w/¯alzheimer’s, ¯huntington’s, ¯parkinsons disease; And depression.
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Adrenergic
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Sympathetic Nervous System
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Antagonist
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Drugs that block or depress the normal response of a specific receptor by only partly fitting the receptor site.
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Antipsychotic
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Drugs used to decrease psychotic symptoms (hallucinations, delusions and disorganized thinking) & increase mood and motivation.
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Typical antipsychotics
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Target the neurotransmitter dopamine.
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Atypical antipsychotics
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Target dopamine and other neurotransmitters, including serotonin.
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Anxiolytic
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Antianxiety drug that inhibits anxiety by slowing the limbic system
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Depot injection or decanoate injection
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Decanoate is a typical antipsychotic medication (brand name Haldol Decanoate; generic haloperidol).
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Dystonia
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Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuroleptic (antipsychotic) medication, in which it manifests as muscle spasms of the face, head, neck and back.
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Extrapyramidal symptoms
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Acute dystonia, akathisia, pseudoparkinsonism, tardive dyskinesia (most serious/irreversible).
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Glutamate
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Receptor sites NMDA & AMPA. Is excitatory; AMPA plays a role in learning and memory. NMDA psychosis, ¯NMDA neurotoxicity & Alzheimer’s, AMPA improved cognitive & behavioral tasks.
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MAOI’s
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Monoamine oxidase inhibitors- antidepressants that inhibit monoamine oxidase preventing the breakdown of amines such as serotonin and norepinephrine. TYRAMINE-FREE DIET
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Neuroleptic malignant syndrome
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NMS- rare and sometimes fatal reaction to high potency neuroleptic drugs. S/S Severe, EPS’s, muscle rigidity, fever, autonomic dysfunction (hypertension, tachycardia, diaphoresis, incontinence), reduces consciousness, and elevated WBC. Results from dopamine blockage at basal ganglia and hypothalamus.
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Norepinephrine
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Receptor sites are Alpha (1 & 2) and Beta (1&2). Effects mood, attention, & arousal. Stimulates the sympathetic nervous system. Associated with ¯Depression, mania, anxiety, & Schizophrenia.
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Pseudoparkinsonisms
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A medication-induced temporary constellation of symptoms associated with Parkinson’s disease: masklike face, tremor, reduced accessory movements, impaired/shuffling gait, drooling, stiffening of muscles, stooped posture, and “pill-rolling”.
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Reticular activating system
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RAS- the part of the brain stem that mediates alertness, arousal, and motivation; serves to filter out repetitive stimuli to prevent overload.
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Reuptake
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The return of neurotransmitters to the presynaptic cell after communication with receptors on the postsynaptic cell.
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SPECT scan
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Single photon emission computed tomography. Imaging that can detect circulation of cerebrospinal fluid; similar functions to PET.
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Tardive dyskinesia
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A serious and irreversible side effect of the phenothiazine’s and related drugs; consists of involuntary tonic muscle spasms typically involving the tongue (lip smacking or thrusting), fingers, toes, neck, trunk, or pelvis.
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Akathisia
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Regular rhythmic movements usually of the lower limbs; rocking; tapping foot; sense of inner restlessness; constant pacing may also be seen; often noticed in people taking antipsychotic medication.
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Agonist
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A drug or other chemical that can combine with a receptor on a cell to produce a physiologic reaction typical of a naturally occurring substance.
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Anticholinergic
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Shut-down of the cholinergic nervous system.
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Anticholinergic Side Effects
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Side effects of neuroleptic and tricyclic antidepressants. S/S include Dry mouth, urinary retention, constipation, blurred vision, dry eyes, inhibition of ejaculation, photosensitivity.
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Antidepressant
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Drugs predominantly used to elevate mood in people who are depressed.
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Basal ganglia
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Pockets of integrating gray matter deep within the cerebrum; involved in the regulation of movement, emotions, and basic drives.
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Dopamine
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Receptor sites D (1-5). Involved in fine muscle movement, integration of emotions & thoughts, decision making; stimulates hypothalamus to release hormones. DA associated with Schizophrenia & Mania. ¯DA associated with Parkinson’s and Depression.
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Epinephrine
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A catecholamine secreted by the adrenal gland and by fibers of the sympathetic nervous system. It is responsible for many of the physical manifestations of fear and anxiety.
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GABA
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Gamma-Aminobutyric Acid- The major inhibitory neurotransmitter in the central nervous system; Anticonvulsant and muscle relaxing properties; may impair cognition and psychomotor functioning. ¯of GABA associated w/ anxiety disorders, schizophrenia, mania & huntingtons disease. of GABA associated with Anxiety reduction. Receptor sites GABA (A & B).
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Limbic system
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The part of the brain that is related to emotions and is referred to by some as the “emotional Brain”. It is involved in the mediation of fear and anxiety; anger and aggression; love, joy, and hope; and sexuality and social behavior.
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Neuroimagining
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Two types are functional (PET & SPECT) and structural (CT & MRI).
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Neurotransmitter
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A chemical substance that functions as a neural messenger. Neurotransmitters are released from the axon terminal of the presynaptic neuron when stimulated by an electrical impulse.
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PET scan
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Imaging that looks at how brain is working. Can detect possible schizophrenia, Mood disorders and Adult ADHD by looking at the Oxygen utilization, glucose metabolism, blood flow and neurotransmitter/receptor interaction.
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Psychotropic drugs
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Drugs that have an effect on psychic function, behavior or experience.
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Receptors
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Protein molecules located within or on the outer membrane of cells of various tissues, such as neurons, muscle, and blood vessels. A receptor receives chemical stimulation that causes a chemical reaction resulting in either stimulation or inhibition of the activity of the cell.
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Serotonin syndrome
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S/S= hyperactivity or restlessness; tachycardia; Fever; elevated blood pressure; altered mental states (delirium); irrationality, mood swings, hostility; seizures; myoclonus, incoordination, tonic rigidity; Abdominal pain, diarrhea, bloating; apnea. (my book 265).
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Synapse
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The gap between the membrane of one neuron and the membrane of another neuron. The synapse is the point at which the transmission of the nerve impulse occurs.
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Therapeutic index
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The ratio of the therapeutic dose of a drug and the toxic dose of a drug.
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