Mental Health
Terms
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Milieu
- Creating a therapuetic evironment, nursing interventions
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Differential Diagnosis
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-Generalized Anxiety Disorder
-Panic Disorders
-Phobias
-Obsessive Compulsive Disorder
- Antimanic drugs (LITHIUM)
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Action: unknown
Uses: bipolar deprssn and manic depressive illness
Side effects: thirst, dry mouth, fatigue, abdominal pain
Examples: Ekalith, Lithonate
Nursing considerations:
monitor dosage, no exceed 1.5 (normal level is .4 to 1.0) toxic = confusion, muscle twitch, stuor, coma; educate no increase NA+ (salt) Bld monitor - Techniques used in psychotherapy
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-Free association (say what come to mind)
-Dream Analysis (dream log)
-Hypnosis (relaxation) - Antianxiety Agents (minor tranquilizers)
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Action: depress actv of cerebral cortex, habit forming
Uses: relieve stress, anxiety and neurotic behavior
Side Effects: unable to concentrate, headache, dizziness, lethargy, hypotension
Examples: (antihistamines, benzodiazapines) Librium, Valium, Buspar, Ativan, Xanax
Nuring Considerations: monitor BP, give at bedtime, Educate - Stimulants (Amphetamines)
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Action: direct stimulant of central nervous system
Uses: sleep disorders, and ADD in children
Side effects: irrregular heartbeat, dry mouth, depression
Examples: Ritalin, Dexatrim, OTC (cigs, sleep aid...)
Nursing considerations: Educate, frequent fluid - common side effects of Antidpressents
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-sedation
-dry mouth
-vertigo
-bld disease
-constipation
-sexual dysfunction
-low BP/hypotension - Psychotherapy
- Form of treatment chosen by psychologist/psychiatrist to treat an individual
- parkinsonism
- (ESPE)...drooling, fatique, mask-like facial expression, muscle rigidity
- psychoanalysis
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(Freud)
-attempt to take pt into past
-focus on cause of problem buried in unconscious - Antidepressant side effects show up in ? to ? to ?
- show in 2 to 3 wks
- Goals of Psychotherapy
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-Decrease emotional discomfort
-increase socail functions
-increase appropriate manner performance - Dystonia
- (EPSE)...distortions of muscle groups, muscle spasm (head and neck) and difficulty swallowing
- Humanistic Therapy
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(Person Centered Therapy)
(Maslow, Rogers)
-focus on whole person
-Work in present time - MAOI's or Monoamine Oxidase inhibitors (Tetracylic antidepressents)
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Action: prevent metabolism of monamine oxidase
Uses: Treat depression
Examples: Nardil, Marplan, Parnate
Side effects: High BP, headache, dizzy, wght gain...
Nursing considerations: AVOID food high in Tyrmine (aged cheese, eggs, soy sauce, yogurt, sour cream, certain beer and wines, bananasm avocados)which can lead to High BP crisis) - Behavior Modification
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(Skinner, Pavlov)
-decrease negative behavior
-replace negative with positive - Cylic (bicylic antidepressant...SRI's or serontonin reuptake inhibitors)
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Action: increase seretonin levels
Uses: treat depression
side effects: dependence, low BP, dry mouth, sedation, bld diseases
Examples: Prozac, zoloft, xanax, valium, librium, buspar, vistaril
Nursing Considerations: educate, monitor BP
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Electroconvulsive Therapy
(ECT) -
-pt is given a sedative
-last only a few minutes
-side effects: confusion, forgetfullness
- Threats/alterations in mental health
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-(causes)ADL's, self control and cognitive ability
-treatment: Meds in conjunction of therapy, control emotions, - Counseling
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-Facilitator guides a group
-can be formal and informal - EPSE's (extrapyradimal side effects) for Antipsychotics
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-Parkinsonism
-Akathesia
-Dystonia
-Tardive Dyskinesia - Uses of ECT
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Used when other therapies are unsuccessful
-Mainly used for depression and Schizophrenia -
Antidepressants (mood elavators)
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(3 catergories)
-Cylic
-Tricylic
-MAOI's - Cognitive Therapy
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(Rational Emotive Therapy)
-help rethink situations
-usually in groups
-ABC format -
Tricylic (antidepressents)
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Actions: increase serotonin and norepinephrine
Uses: treat depression
Examples: Elavil, Triavil, Tofranil, Pamelor
Nursing Considerations: educate - Goals of crisis intervention
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1 Ensure safety
2 Diffuse the situation
3 Determine problem
4 Decrease anxiety
5 Return pt to precrisis level - Akathesia
- (EPSE)...agitation, motor restlessness, continous movement of body(hands and mouth)
- Crisis intervention
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-body is out of Homeostasis
-risk for harm
-subjective
-5 phases/goals - Tardive Dyskinesia
- (EPSE)...IRREVERSIBLE (early detection can regain control with use of anticholergics), lack of voluntary movements, rythmic movements (chewing, sucking, frowning, licking, and blicking)
- Anticholinergics or Antiparkinsons drugs
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-combat side effects
-commonly used: Congentin, Artane and Akineton
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Antipsychotics (neuroleptics/
major tranquilizers) -
Class: Phenothiazines
Action: (CNS to block dopamine)...calms, control agitation, decrease hallucinations and delusions
Uses: psychoatic behavior, violent, SCHIZOPHRENIA
Side effects: bld diseases, photosensitivity, EPSE's(extrapyradimal side effects), weight gain, edema, constipation, decrease sex interest
Examples: Haldol, thorazine, Stelazine, Prolixin
Nursing considerations: Observation, watch for EPSE's, Educate patient