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N221 Scott Gardner Winter 2006 Unit 2

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Terms

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Define Anhedonia.
Inability to experience or express pleasure.
Defina Aphasia.
A loss of the ability to understand or use language.
Define Apraxia.
An inability to carry out skilled and purposful movement. The inability to use ojbects properly.
Define Catatonia.
Position of the body in a fixed, wax-like state.
A phase of schizophrenia in which the patient is unresponsive, marked by the tendency to assume and remain in a fixed posture and the inability to move or talk.
Define Clang Association.
The rhyming of words in a sentence that make no sense.
Define Confabulation.
The filling in of memory gaps with imaginary information in an atempt to distract others from observing the deficit.
Define Delusional Ideation.
A false belief brought about without appropriate external stimulation and inconsistent with the individuals own knowledge and experience.
Define Echolalia.
An involuntary parrot-like repitition of words spoken by others.
Define Echopraxia.
Meaningless imitation of motions made by others
Define Hallucination.
A false sensory perception that may involve any of the five senses.
Define Illusion.
An inaccurate perception of misinterperpretation of sensory impressions.
Define Neologisms.
New words invented by a person that are meaningful only to that person.
Define Perservation phenonema.
Repetitive behaviors such as lip smacking, finger tapping, pacing, or echolalia.
Define psychosis.
A disorderly mental state in which a client has difficulty distinguishing reality from his or her own internal perceptions.
Define thought broadcast.
The delusional belief that others can hear ones thoughts.
Define thought control.
The delusional belief that others can control a persons thoughts against ones will.
Define thought insertion.
The delusional belief that others have the ability to put thoughts in a persons mind against ones will.
Define word salad.
The combining of words in a sentence that have no connection and make no sense.
What theory is Harry Stack Sullivan known for?
What does this theory mean?
Interpersonal theory.
Study of the perons in the context of relationships. Personality is manifested only in a persons interaction with other persons or groups.
What is the critical difference between a Nurse-Client relationship and a Social one?
The nurse client focuses on the clients needs. It exists for the client. It is therapeutic and not social.
What is the power component of the Nurse-Client relationship?
Who has the Locus of Control.
What is the physical component of the Nurse-Client relationship?
The act of performing procedures and technical skills.
What is the psychosocial component of the Nurse-Client relationship?
Responses to the client as one human being to another.
What is the Spiritual component of the Nurse-Client relationship?
The feeling of being connected.
What role does Genes play in mental health?
They only tell us about susceptibilty. It is thought that many different genes and the enviroment combine to cause mental illness.
Define Intellectualization.
A defense mechanism by which an emotional response that normally would normally accompany an uncomfortable or painful incident is evaded by the use of rational explanations that remove from the incident any personal significance and feelings.
Define Projection.
A defense mechanism in which blame is attached to others or the evnironment for unacceptable desires, thought, shortcomings, and mistakes.
Define Rationalization.
In psychology, a justification for an unreasonable or illogical act or idea to make it appear reasonable.
Define circumstantial speech.
Occurs when the person includes many unnecessary and insignificant ideas before arriving at the main idea.
Define Tangential speech.
When thoughts veer from the main idea and never get back to it.
Define Spirituality.
The part of use that deals with relationships and values and addresses questions of purpose and meaning in life.
What percetage of disabilities worldwide are based on mental illness?
40% (4 in 10)
Define anxiety.
Feeling of tension, distress, discomfort produced by a percieved or threatened loss of inner control, rather than from external danger.
Broadly define defense mechanisms.
They operate at an unconsious level and alleviate anxiety by denying, misinterpreting or distorting reality.
Who was Peplau?
Hildegard Peplau. A nursing educator (1909–1999) who developed the Theory of Interpersonal Relations in Nursing.
What are Circadian rhythms?
Regular fluctuations of a variety of physiological facgtors over a period of 24 hours.
What is the Therapeutic Relationship?
A client centered, goal specific, theory based relationship that is open to supervision by peers, instructors, and supervising nurses.
What are the three phases of the Nurse-Client Relationship?
Introductory
Working
Termination
What is client transference?
The unconsioius process of displacing feelings for significant people in the past onto the nurse in the present relationship.
What is countertransference?
The nurses emotional reaction to clients based on feelings for significant people in the past.
What is the primary goal of the termination phase of the therapeutic relationship?
To review the clients progress and plans for the immediate future.
What is one of the first goals of the initial interview with a client?
To establish rapport.
What are the six areas of assessment for a client with mental illness?
Behavior, Affect, Cogntion, Interpersonal relationships, Physiology.
What constitutes a family?
Families include couples, traditional families, lesbian and gay families, communal families, families with cohabiting parents, extended families, and even friends living together.
Describe the competency Model of family nunrsing.
The competency model of family nursing is based on the belief that all families are resourceful and have the capacity to grow and change.
How is family communication measured?
Family communication is measured by focusing on the family as a group with regard to their listening skills, speaking skills, self-disclosure, tracking, and ability to resolve conflict.
What are boundries? What are the three boundries?
Boundaries define the amount and kind of contact allowable between family members and between the family and outside systems. Boundaries are described as clear, rigid, or diffuse.
What is Family cohesion?
Family cohesion (emotional bonding) ranges from disengaged to separated to connected to enmeshed, with the central ranges being the most functional.
What is Family flexability?
Family flexibility in leadership, roles, and rules ranges from rigid to structured to flexible to chaotic, with the central ranges most functional.
What is Emotional Ability?
Emotional availability is another way to describe the quality of parent-child interactions. Areas for assessment include parental sensitivity, structuring, nonintrusiveness, and nonhostility.
Is care of the emotionally ill family or community based?
Care for the mentally ill has become as much family based as community based in the U.S.
What is Family Burden?
Family burden is the overall level of distress experienced as a result of mental illness.
What is Objective Family Burden?
Objective family burden includes managing symptom-atic behaviors, caregiving responsibilities, and the experience of stigma.
What is Subjective Family Burden?
Subjective family burden includes feelings of grief and loss, a sense of chronic sorrow, and empathetic pain for the loved one.
What are the stages of Family Recovery?
The stages of family recovery are discovery and denial; recognition and acceptance; coping and competence; and personal and political advocacy.
How does Pregnancy affect Mental Illness?
Pregnancy may precipitate the onset of a mental illness or contribute to the exacerbation of a disorder.
What are some problems that women with mental disorders face as new mothers?
Problems to be addressed are medications and fetal defects, inadequate prenatal care, inability to care for a newborn, and disruption of the family system.
What are some of the issues of families dealing with adult children with mental illness?
The burden of family caregiving for adult children with mental disorders includes daily caretaking, emotional drain, and financial strain.
What is Bereavement?
Bereavement is the feelings, thoughts, and responses that happen to us when a person dies.
What are some family coping stratagies?
Family coping strategies include reestablishing a stable equilibrium, realigning family roles, and communicating clearly.
What is Disenfranchised grief?
Disenfranchised grief means that the loss cannot be openly acknowledged, socially validated, or publicly mourned.
What is compliated Grief?
Complicated grief occurs when there is enormous social, psychological, and medical morbidity.
Medication noncompliance and substance abuse are other changeable factors related to relapse.
What is the Egocentric Self?
The egocentric self, usually found in Western industrialized societies, exhibits characteristics such as individualism, separateness, autonomy, competition, and mastery and control over one's environment.
What is the Sociocentric Self?
The sociocentric self, found in many non-Western societies, is interdependent and interconnected and values cooperation, cohesiveness, group identity, and harmony with one's environment.
What is Psychoeducation?
Psychoeducation includes illness education, conflict management skills, problem solving, and stress management.
What is Spiritual Caregiving?
Spiritual caregiving includes developing caring and thoughtful relationships, fostering positive family attitudes, helping people become active consumers and collaborators, and supporting families who seek ways to heal and achieve balance in their lives.
What are Grief and Mourning?
Grief and mourning are active processes of learning to adapt to the death or loss.
Describe client autonomy in treatment of mental illness.
Whenever possible, client autonomy and liberty must be ensured by treatment in the least restrictive setting and by active client participation in treatment decisions.
What is Voluntary Admission?
Voluntary admission occurs when a client consents to confinement in the hospital and signs a document indicating as much.
What needs to be proven for commitment?
Commitment, or involuntary admission, may be implemented on the basis of dangerousness to self or others. Some states also have the criterion of prevention of significant physical or mental deterioration for involuntary admission.
How long can Adult Clients be held before going before a judge?
Adult clients can be held temporarily (72 Hours in Washington) on an emergency basis until there is a court hearing determining the need for commitment.
What is the course of Commitment in Washington?
72 Hour Evaluation / Court Hearing allows 14 Days / Retrial adds another 90 days / Next Retrail adds 180 days with review every 180 days thereafter.
How can clients direct their longterm mental care while they are still healthy?
Clients can initiate advance directives to guide families and caregivers in making decisions when they are unable to make them for themselves.
Define Competency.
Competency is a legal determination that a client can make reasonable judgments and decisions about treatment and other significant areas of personal life.
How do competency and guardianship interact?
An adult is considered competent unless a court rules him or her incompetent. In such cases, a guardian is appointed to make decisions on that person's behalf.
Once a client is committed, are they still allowed to participate in their healthcare decision?
Clients who are committed are still capable of participating in health care decisions.
How is HIV/AIDS Confidentiallity handled in hospitalized patients with Mental Illness?
Some states require written consent before HIV tests may be performed. States have laws regarding when HIV test results or the diagnosis of AIDS may be disclosed.
Describe Informed Consent as it applies to mental illness.
Informed consent is a client's right not to be touched or treated without consent. Clients must be given enough information to make a decision, must be able to understand the information, and must communicate their decision to others.
How does Informed Consent work in an Emergency?
In an emergency situation with no time to obtain consent without endangering health or safety, a client may be treated without legal liability.
What happens to constutional rights when a client is admitted to a mental facility?
Clients do not lose their constitutional or legal rights when they are admitted to the hospital to treat a mental disorder.
Can a competent client refuse psychotripic medications?
Clients have the right to refuse psychotropic medications.
What about medication choices if a client is found to be incompetent?
If the court finds the client to be incompetent and medications are in the client's best interest, the judge may order the client to take the medications.
What is the nurses responsibilty in Child or Elder Abuse cases?
All states make it mandatory for nurses to report suspected cases of child abuse or neglect. Some states have enacted similar adult abuse laws.
What is Duty to Disclose?
The duty to disclose is the health care professional's obligation to warn identified individuals if a client has made a credible threat to kill them.
What is the Omnibus Mental Illness Recover Act?
This Act is a new initiative targeted to state legislatures to build a more comprehensive service-delivery program.
What is special about clients with Legal Charges?
Clients who have legal charges pending against them must be informed that the court may request their medical records.
What is Criminilization of Mental Illness?
Clients with mental disorders may be jailed because their symptoms are mistaken for criminal behavior or there may be no other agencies available to respond to their psychiatric emergency.
How are victim of criminilization further abused?
Clients with mental disorders who are imprisoned are vulnerable to abuse and victimization by other inmates and correction officers.
What is the percentage of suicide among inmates as related to the rest of the US Population?
The suicide rate among jail inmates is eight times that of the U.S. population.
Is congress involved in preventing criminilization?
Congress is examining strategies to create alternatives to incarceration for people who have been charged with nonviolent crimes and who are mentally ill.
List come Caring Behaviors
Caring behaviors include attentive listening; providing comfort, honesty, patience, and responsibility; providing adequate information, touch, sensitivity, and respect; and calling the client by name.
How do nurses values and lifestyle affect client treatments?
Nurses are required to make numerous ethical decisions every day. Client differences in values and lifestyles often present nurses with an ethical dilemma when clients are admitted to a mental health care facility.
What is Competent Care on the part of a HCP?
Competent care involves knowing what and how to do things, being open to criticism, and a willingness to admit to lack of knowledge or error when appropriate.
What protections are in place for clients considering participating in Nursing Research?
Clients who are considering participation in nursing research must be fully aware of what the protocols involve, what risks they will face, what options they have, and who they should contact with questions or issues as they arise.
Who may not give written notice of the intention of leaving the hospital after a voluntary admission?
A perosn less than 18 years of age.This is a minor who would require parental consent. Implementation; Psychosocial Integrity; Comprehension.
If you share confidential information about a client, what is the most severe consequence that can occur?
Discipline from the state licensing board. This is the most severe consequence. It goes on your state board record.
You are sitting with the physician when he and a client, who is to receive electroconvulsive therapy, are discussing informed consent for the treatment. What would not be critical to informed consent?
The cost of the treatment. Clearly cost is important; however, it is not related to informed consent.
The Omnibus Mental Illness Recovery Act has recently served as a catalyst to improve comprehensive service-delivery systems for mental illness. Which of the following is not covered by this law?
Focus on psychotherapy rather than medication.
A client in the hospital threatens to kill his wife. What is the best action for you to take?
Discuss the concern with the client in treatment and evaluate this issue before discharging the client.
Mentally ill jail detainees have a right to mental health services. What legal support would you give to this statement?
The 14th Amendment to the Constitution. This amendment protects mentally ill detainees and their need for services.
Nursing is based on four principles that govern our behavior. What is the weakness of these principles?
Socioeconomic and cultural issues are ignored. This is the weakness, in addition to being too abstract to be applied to clinical practice.
The suicide rate among jail inmates is how much more common than that of the U.S. population?
It is eight times higher. The first 24 hours in jail is the highest risk period in jail. The mentally ill feel abandoned and ignored.
Which of the following does not best demonstrate nursing based on the ethics of caring?
You focus on the psychological and physiological factors related to the client's illness. When you include the client's perceptions about his/her life, you are providing care that is based on the ethic of caring.
During your orientation to your first job as a psychiatric nurse, you are told that clients have the right to participate in their own treatment. What is the strongest support for this statement?
The Patient Self-Determination Act This federal law passed in 1990 is the strongest support for client participation in treatment.
Mr. Smithson has been admitted with stage 3 Alzheimer's Disease. Which of the following symptoms is more common in this stage of the disease? [Hint]
Use of rationalization.
Wandering is a concern.
Poor impulse control.
Persever
Poor impulse control.
What is the best explanation for the need to treat concomittant depression when a client has Alzheimer's Disease?
-Depression should always be treated
-There is effective treatment for depression
-Depression usually resolves without treatm
Depression worsens with dementia.
When a client experiences the loss of the ability to understand or use language, the client is experiencing
-Agnosia.
-Alexia.
-Aphasia.
-Astereognosia.
Aphasia
Clients with Alzheimers experience a reduction in their neurotransmitters. Which neurotransmitter would be associated with increased anxiety, agitation, and psychosis?
-Serotonin.
-Melatonin
-Gama-aminobutyric.
-Dopamine.
Serotonin
If your client has delirium, why is it most important that the client receive treatment?
-The delirium will worsen.
-Brain damage or death may occur.
-The client is at risk for injury due to his behavior and confusion
-The delirium
Brain Damage or Death may occur.
Why is it preferable to administer haloperidol (Haldol) intravenously rather than intramuscularly for a client with delirium?-It is safer when administered intraveneously than intramuscularly.
-There are less side effects with this administration m
Increased predictability of absorption rate and decreased EPS side effects.
Mrs. Williams is experiencing delirium in the hospital after her surgery. Which of the following interventions would be ineffective in increasing her orientation?
-Repeat information.
-Provide reassurance regularly.
-Avoid asking Mrs. Wi
Decrease contact to reduce confusion.
-In your evaluation of a client with Alzheimer's Disease, what would be particularly important to include to ensure that the client receives optimum support?
-Determine if the client's family has the support that they need to deal with the illness.
Determine if the client's family has the support that they need to deal with the illness.
Which of the following statements is an accurate fact related to cognitive impairment disorders?
-Alzheimer's Disease is quite different from mood and schizophrenic disorders.
-Nutritional deficiencies are not similar to dementia.
-A cl
Arterioschlerosis can be misdiagnosed as Alzheimer's Disease.
What percentage of clients with AD live in the community and might be expected to receive home care?
50%
Your client has the nursing diagnosis of altered thought process related to disruptions in cognitive processes. The outcome is distorted thought process: self-restraint of disruption in perception, thought processes, and thought control. Which of the fol
Teaching Disease Process
P414
As you assess a new client with schizophrenia, you note that the client has positive symptoms and no negative symptoms. Which of the following would you not find in the client?
-Hyperactivity.
-Inappropriate affect.
-Loose associations.
Anhedonia
P397-398
Julio has just been told that he will be discharged in three days. He has been very eager to hear about his discharge date. When you tell him, he replies, "OK." There is no change in his facial expression, and he continues to sit and stare out
Flat
Page 399
Jane has been in and out of the hospital for treatment of her schizophrenia. The team is evaluating her progress and trying to predict her chance for further relapses and rehospitalizations. What would be the best indicator to predict her future illness
Her Social Functioning
Page 415-416
You are preparing to teach a client with schizophrenia about her illness. What would be the most important content to include?-Identification of early signs of relapse.
-Etiology of schizophrenia.
-Describe the typical disease process.
Identification of early signs of relapse
Page 416
Which of the following descriptions indicate the highest risk of developing schizophrenia?
-General population.
-Two parents with schizophrenia.
-Monozygotic twins.
-Dizygotic twins.
Monozygotic Twins
Page 406-407
Joe has had a difficult time with negative symptoms and also has had frequent problems with EPS effects. He has been taking haloperidol (Haldol). The physician is considering changing his medication. Which of the following might be a medication that will
Olanzapine (Zyprexia)
Page 398/409/Class Handout
Alice says, "I won't watch the TV anymore." You ask her, "You use to watch it a lot. What has changed?" "That's when I am told to hurt my daughter." What type of delusion is this?
-Somatic.
-Thought broadcasting.
Ideas of Reference
Page 401-402
John, who has schizophrenia, is beginning group therapy. What would be the main purpose of using this intervention?
-It will speed up his recovery.
-It is cheaper than individual psychotherapy.
-It helps prevent withdrawal and social iso
It helps prevent withdrawl and social isolation.
Page 410
What is the most common reason that clients with schizophrenia commit suicide?
-Command hallucinations.
-Limited support.
-Long-term hospitalization.
-Lack of treatment.
Command Hallucinations
Page 417
About what percentage of US Citizens have Schiz?
1%
Is schizophrenia best described as a disease?
No, better to say a syndrome because of broad range of Sx, physiological, etiologies and prognoses.
Define schizophrenia.
Schizophrenia is a syndrome characterized by disordered thinking, perceptual disturbances, behavioral abnormalities, affective disruptions, and impaired social competency.
When is schizophrenia most often first identified, and when are 10-15% identified?
Most in childhood and adolescence. 10-15% after the age of 45.
Describe Women and schizophrenia.
Later Onset
Better Tx Response
Less Frequent Relapses
Overall Higher Quality of Life
Define the Positive Sx of schizophrenia.
The positive symptoms of schizophrenia are added behaviors not normally seen, such as delusions, hallucinations, loose associations, disorganized thinking, suspiciousness, overreactive affect, hyperactivity, and bizarre behavior.
Define the Negative Sx of schizophrenia.
The negative symptoms of schizophrenia are the absence of normal behaviors, for example, flat affect, minimal self-care, social withdrawal, low energy level, concrete thinking, lack of insight, attention impairment, lack of motivation, and limited problem solving ability.
What is deficit syndrome?
A term proposed as a distinct subtype of schizophrenia characterized by significant and persistent negative sx.
Differentiate between Flat and Blunted Affect.
Flat is the absence of visible cues to the persons feelings.
Blunt describes dull emotional response to a situation.
What is a Hallucination?
The occurance of a sound, sight, touch, smell, or waste without external stimulus to the corresponding sensory organ.
What are the two most common type of hallucinations?
Visual followed by auditory.
Other than visual and auditory, what are three other types of hallucinations, and what are they generally caused from.
Tactile, olfactory, and gustatory hallucinations occur in people undergoing withdrawal from or abuse of alcohol and drugs.
What are delusions?
Delusions are false beliefs that cannot be changed by logical reasoning or evidence.
What is thought to cause delusions?
It is thought that they represent dysfunctions in the information-processing circuits between the hemispheres.
What is Selective perception?
The process whereby unnecessary or distracting information is filtered out of our consious thought through a serious of relay stations in the brain.
What is grandiosity, and what often accompanies it?
Delusions of grandure. An exaggerated sense of importance or self worth. Often accompanied by beliefs in magical thinking.
What are delusions of persecution?
The belief that someone is trying to harm them. Personal failures become the fault of others.
What is loose association?
Having no apparent relationship between thoughts is referred to as loose association. Verbal ideas shift from one topic to another.
What is concrete thinking?
⬢ Concrete thinking is a focus on facts and details and an inability to generalize or think abstractly.
What is avolition?
Lack of motivation. The inability to persist in goal-directred activieties.
How are social skills affected by schizophrenia?
People with schizophrenia frequently have ineffective social skills, which increases their sense of isolation.
Who have more delusions and hallucinations but have fewer cognitive disruptions and negative symptoms.
Persons with Late Onset of Schizophrenia.
What percentage of the homeless population is thought to be schizophrenic?
About 1/3
What is the age limit to be Dx with Childhood schizophrenia?
Age 12
How does estrogen affect schizophrenia?
It help prevent nerve cell loss, and enhances the efficacy of antipsychotic drugs.
Why does smoking have an adverse affect on psychotic patients?
Smoking stimulates hepatic enzymes which cause the liver to metabolize the psychotropic meds faster.
What percentage of schizophrenic patients have suicidal ideation?
Aa many as one half.
Identify the abbreviations of:
DA
5-HT
NE
GABA
DA=Dopamine
5-HT=Serotonin
NE=Norepinephrine
GABA=Gama Aminobutyric Acid
What are hig levels of NE associated with in schitzophrenia?
Positive Sx.
What is TMS?
Transcranial Magnetic Stimulation. A magnetic field that passes thorough the skull. It may decrease the frequency and duration of auditory hallucinations and modulate other sx.
What is the only sensory pathway that opens directly into the brain?
The Olfactory receptors.
What are some Concomitant disorders?
Substance abuse, suicide, and depression.
What are some Neurobiological factors of schizophrenia?
Genetic defects, abnormal brain development, neurodegeneration, disordered neurotransmission, and abnormal brain structures.
Is the schizophrenic syndrome purely biological?
It is believed that biological vulnerabilities interact with developmental, environmental, and social processes to produce the disease.
What is the role of Group Tx in Schizophrenia?
Group therapy helps prevent the withdrawal and social isolation that may occur for people who are psychiatrically disabled.
What are ACT?
Assertive community treatment (ACT) programs deliver all services when and where the client needs them.
Other than TMS, what are some alternative therapies for schizophrenia?
Omega-3 fatty acids, and aromatherapy.
Who does the RN work with when doing the Nursing Assessment in schizophrenia?
Nursing assessment is based on interviews with clients, family members, friends, group home supervisors, or case managers.
Describe the role of safety in schizophrenia care.
A priority of care is client safety, which includes measures to prevent self-harm, suicide, physical exhaustion, and striking out to protect themselves from perceived danger.
Is medication important in schizophrenia care?
Helping clients understand the need for medication is an important nursing intervention.
What are some ways to reduce anxiety?
⬢ Reduction of anxiety may be accomplished with relaxation techniques, eliminating caffeine, moderating environmental stimuli, walking, or talking out feelings with another person.
What are some steps to take if you believe a client is having a hallucination?
Look and listen for clues that the person might be hallucinating; identify the needs that may be reflected in the hallucination, stay with the person, and speak in short, simple phrases. If asked, simply point out that you are not experiencing the same stimuli.
What are some interventions when a person is experiencing a delusion?
⬢ Interventions for people who are experiencing delusions include assessing the content, duration, and frequency of the delusion; correlating it with stressful situations; responding to underlying feelings; and providing distracting activities.
Should all clients be assessed on a fixed scale when determining the efficacy of Tx?
In evaluating clients' responses to nursing interventions, you should determine the appropriate intervals for measurement and documentation of the outcomes according to each individual's status.
What are some interventions for the family dealing with schizophrenia?
⬢
Family education includes knowledge about the disease, available treatment programs, how to manage on a day-to-day basis, early signs of relapse, and suicide precautions.
If you are working with a client in crisis, what is the maximum goal for the crisis intervention?
-Identify the cause of the crisis the client is experiencing.
-Identify what is expected of the client.
-Return the client to his/her precr
Develop more constructive coping skills and move to higher functioning.
John says, "I get so frustrated. Never feel like I have succeeded. I just want to give up on improving." Which of the following would be most important to include in psychoeducation for John?
-Setting of realistic expectations.
-Comm
Setting of realistic expectations.
Who is the most important person for a client who is in a 12-step program?
-The physician.
-The nurse.
-The sponsor.
-Client's family.
The Sponsor
What type of treatment approach is often preferred with children and adolescents?
-Individual psychotherapy.
-Family therapy.
-Group psychotherapy.
-Psychotropics.
Family therapy.
Why would play therapy be used with Jamie, a 7-year old who has exhibited signs of depression?
-Children like to play.
-It is less costly than individual psychotherapy.
-Children need immediate treatment and results.
-Children are
Children are less able to verbalize thoughts and feelings.
You are working with a family who has frequent arguments. Which of the following would be an inappropriate step for the family members to take?
-Clearly state your concern and make sure this is not forgotten.
-Identify specific problems.
Clearly state your concern and make sure this is not forgotten.
Which of the following is not one of the three typical reasons for using electroconvulsive therapy?
-Client has responded successfully in the past to ECT.
-Client is experiencing catatonia.
-Clients with predominate affective symptoms.
Psychotropic medications have been effective in the past.
Your client is receiving light therapy in his home. Why would he be receiving this treatment?
-To decrease his anxiety.
-To help control his aggressive behavior.
-To help with his seasonal affective disorder.
-To decrease his obses
Help with SAD.
The team is discussing the use of seclusion with Lee. He has been in and out of seclusion for several weeks. The team decides an analysis of the use of seclusion needs to be conducted. What reason would be an appropriate reason to use seclusion?
-To
To protect Lee from harming others on the unit.
Do MHP Heal?
No, People must and do heal themselves. The MHP provides support and guidance.
What is the Health Balance.
A balance between mind, body and spirit.
How does energy fit into maintaining health?
The flow of energy is a concept found in many alternative therapies. Illness and disease occur when energy is blocked, fixed, or unbalanced.
How does exercise play into psyshosocial Nursing Interventions?
What precautions should people taking psychotropic medications adhear to?
Physical exercise decreases anxiety and depression. Exercise also improves self-concept, body image, and cognitive processing.

Clients who are taking psychotropic medications should begin exercise at a low intensity because of the drug side effects.
What is reminesence therapy?
Reminiscence therapy helps older adults to gain self-awareness, adapt to stress, and improve self-esteem.
What are the difference between social skills, and Interpersonal skills?
Social skills training includes ADLs, vocational skills, and leisure time skills. Interpersonal skills include conversational skills, assertiveness training, conflict resolution, and problem solving.
When is sleep deprivation used?
Sleep deprivation is effective for some people who experience depression.
Light Therapy.
Light therapy is the treatment of choice for seasonal affective disorder.
What is Art Therapy.
Art therapy is a way for people to express what is contained in the unconscious.
What is play Therapy?
Play therapy is used to establish rapport with children, reveal feelings they are unable to verbalize, enable them to act out their feelings in a constructive manner, understand their relationships and interactions with others, and teach adaptive socialization skills.
What are neuroleptics used for?
Generally used to relieve psychotropic (Positive Symptoms) associated with Schizophrenia, psychotic depression, psychotic toxic reactions.
How is dosing established for neuroleptics?
They are used in the lowest possible dosage to control symptoms, and gradually increased.
Describe Chlorpromazine.
A Phenothiazine
Also called Thorazine.
First used in 1940's.
Short Acting
Used for Acute Episodes.
Describe Fluphenazine
A Phenothiazine.
Also called Prolixin
Long Acting 3 Week Duration IM
Describe Perphenazine.
A Phenothiazine
Also called Trilafon
What is EPS.
Extrapyramidal Side Effects.
Comes from blocked DA receptors causing a lowered ratio.
List some EPS and what they mean.
Akasthesia - Motor restlessness
Akinesia - Muscular Weakness
Parkinsonism - Tremors, shuffling, excessive salivation, drooling, pilling
Tartive Dyskinsia - Facial Grimace
Dystonia - Muscle Spasm of head and neck.
All are seen in first 5 days or when dosage is increased.
What is agranulocytosis?
Depressed bone marrow production.
What are the anticolinergenic side effects?
Dry Mouth
Constipation
Skin Rash
What are some other side effects of antidepressents.
Sexual Side Affects and Weight Gain.
What is NMS?
Neuroleptic Malignant Syndrome. Hyperactivity, fevers, HTN, muscle rigidity, tachycardia, respiratory problems, urinary incont, delerium and confusion.
What is displacement?
Transference of emotion from the original idea with which it was associated to a different idea, thus allowing the patient to avoid acknowledging the original source.
What is repression?
In psychology, the refusal to entertain distressing or painful ideas.
What is Reaction-Formation?
A psychological defense mechanism by which an objectionable impulse is expressed in an opposite or contrasting behavior. React opposite of how they feel.
What is somatization.
The process of expressing a mental condition as a disturbed bodily function. In psychiatry, the conversion of anxiety into physical symptoms.
What is undoing?
Appease guilting feelings. Bring the child a present the night after they get a spanking.
Define Passive Agressive.
habitual passive resistance to demands for adequate performance in occupational or social situations.
What is dissociation.
A defense mechanism in which specific, anxiety-provoking thoughts, emotions, or physical sensations are separated from the rest of the psyche.
What is projection?
The attribution of one's own attitudes, feelings, or suppositions to others
What is alturism?
Unselfish concern for the welfare of others; selflessness.
What is sublimation.
An unconscious defense mechanism in which unacceptable instinctual drives and wishes are modified into more personally and socially acceptable channels.
Define akathisia.
Motor restlessness; intolerance of inactivity.
Define Dyskinesia.
A defect in the ability to perform voluntary movement.
Define Neologism.
A nonsensical word, or verbal tic, the use of which is sometimes associated with neuropsychiatric disorders, such as psychoses or Tourette's syndrome.
Define Delusion.
A false belief brought about without appropriate external stimulation and inconsistent with the individual's own knowledge and experience.
Name the three cyclic anti-depressents.
Amitriptyline or Elavil
Imipramine - Tofranil®
Desipramine - Norpramin®
What is the MAO Antidepressent called?
Phenelzine - Nardil
There are two SSRI. Name them.
Fluoxetine - Prozac
Sertraline - Zoloft
What are the side effects of Anitdepressants?
Dry Mouth
Constipation
Orthostatic Hypotention
Lethargy
Hypertensive Crisis (MAO)
What class of antidepressents need to avoid certain foods? What is that ingredient, and name some foods.
MAO
Tyramine
Cheese, yeast, wine, chocolate, chicken livers.
Name three Anti-Manic Drugs.
Lithium Carbonate
Carbamazepine - Tegratol
Valproate - Depakote
What is therapeutic range for Lithium?
0.5 - 1.5 mEq/L
What are the side effects of Lithium?
Nephrotoxic, Neurotopic, Lethargy, Muscle Twitching, Hand Tremors.
List the Four Antianxiety Meds.
Chlordiazepoxide - Librium®
Clonazepam - Klonopin®
Diazepam - Valium
Buspirone - BuSpar®
Who long do Antidepressents take to start. How long do you need to ween off of them.
Start in 2-4 weeks.
Not physically addictive, so can stop at any time.
What are the three Atypical Neuoleptics?
Clozapine - Clozaril®
Olanzapine - Zyprexa®
Risperidone - Risperdal
What is a common side effect of the Atypical Neroleptics?
It causes aggranulocytosis, which is depressed bone marrow.
What three meds can be given to relieve EPS?
Benztropine - Cogentin
Diphenhydramine - Benadryl
Trihexyphenidyl - Artane®
There are two types of traditional neuroleptics. Name them.
Phenothiazines and Thioxanthenes.
Name the three Phenothiazines.
Chlopramazine - Thorazine
Fluphenazine - Prolixin (IM)
Perphenazine - Trilafon®
List the three Thioxanthnes.
Chlorprothixene - Taractan
Thiothixene - Navane
Halperidol - Haldol
Which of the two traditional neuroleptics are given IM, and how long do they traditinally last?
Prolixin and Halperidol
Why are neuroleptics traditionally given?
To relieve Positive symptoms.
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