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Mental Health Lecture 01-26-06 (MDH)


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"The world would be better off if I was dead."
This is an example of what type of statement?
Covert statement
If a person has formed a suicide plan, what does this indicate?
The person is more likely to actually kill himself/herself
If a patient's lethality is found to be low, how often should the nurse check on him or her?
Every 10 minutes
If a patient's lethality is high, what kind of supervision is required?
One on one supervision: someone must stay with the patient at all times
List the DSM-IV-TR criteria for substance abuse patients:
1. Recurrent use of substance resulting in failure to fulfill major roles (work, school, home, etc.)
2. Use in situations that are physically hazardous (driving, etc.)
3. Substance-related legal problems
4. Continued use despite social or interpersonal problems caused by the effects of the substance
What are the 4 phases of alcohol abuse?
1. Pre-alcoholic
2. Early alcoholic
3. Crucial phase
4. Chronic phase
Describe the pre-alcoholic phase of alcohol abuse:
Alcohol is consumed to relieve every-day stress
Describe the early alcoholic phase of alcohol abuse:
Alcohol becomes a requirement for day-to-day functioning (alcoholics usually begin to experience blackouts in this phase)
Describe the crucial phase of alcohol abuse:
Complete physical dependence
Describe the chronic phase of alcohol abuse:
Emotional and physical degeneration; person is intoxicated most of the time
What is alcoholic myopathy?
Weakening of the muscles due to alcohol abuse
What is Wernicke's Encephalopathy?
A dangerously low level of vitamin B1 (thiamin)
What is the most serious effect of alcohol abuse?
Wernicke's Encephalopathy
What symptoms would indicate Karsakoff's Psychosis?
Confusion and loss of recent memory
What are the chief concerns for a patient who is experiencing withdrawal from alcohol?
* Safety
* Monitor vital signs
What types of medications are given to alcoholic patients during withdrawal/detoxification?
* Benzodiazepines
* Ativan
* Librium
* Valium
List the 4 groups of antidepressant agents:
1. Tricyclic/cyclic antidepressants
2. Selective Seratonin Reuptake Inhibitors (SSRI's)
3. Monoamine Oxidase Inhibitors (MAOI's)
4. Others
How do SSRI's work?
Block the re-uptake of seratonin
How do cyclic antidepressants work?
Block the re-uptake of norepinephrine (and seratonin to some degree)
How do MAOI's work?
Interfere with enzyme metabolism
What are the common side effects of SSRI's?
* Anxiety
* Agitation
* Akathisia
* Nausea
* Insomnia
* Sexual dysfunction
* Weight gain
What is Akathisia?
List some SSRI's:
What are the common side effects of MAOI's?
* Daytime sedation
* Insomnia
* Weight gain
* Dry mouth
* Ortho. hypertension
* Sexual dysfunction
* Hypertensive crisis
What causes hypertensive crisis?
Occurs when tryamine-containing foods are consumed with MAOI's or other contra-indicated substances
List some common tryamine-containing foods:
* aged cheeses
* aged meats
* Italian beers & microbrewery beers
* saurkraut, soy products, or marmite (concentrated yeast)
List some MAOI's:
What are the common side effects of cyclic antidepressants?
* Dry mouth
* Constipation
* Urinary hesitancy/retention
* Dry nasal passages
* Blurred vision
* Agitation
* Delirium
* Intestinal obstruction (ileus)
List some cyclic antidepressants:

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