psychosocial exam 2
Terms
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- What is in the cluster A disorders?
- paranoid, schizotypal, schizoid
- which disorder from cluster A would be characterized by poor socialization, passiveness, and shyness?
- schizoid
- which disorder in cluster A would be characterized by: distrust, irritability, lack of feelings for others?
- paranoid
- which disorder from cluster A is the most serious?
- Schizotypal
- What could an over all description be of cluster B?
- disorders that are dramatic and emotional
- which disorder does this describe: no guilt, exploitive, disregard for others, illegal activites, initially charming,manipulative
- antisocial, cluster b
- describe what a person w/ borderline personality disorder would be like
- intense, chaotic, impulsive, black and white thinking, self-destruction, self mutilates, manipulative, (most common disorder)
- Which disorder from group B is colorful,dramatic,sexual, attention seeking, exhibitionistic, extroverted, requires constant approval, independant,seductive,distractable
- histrionic
- Which disorder has exaggerated view of self, lacks empathy, overly self centered, and sees themselves as superior?
- narcissistic
- How could cluster C be broadly defined?
- fearful/anxious
- Which cluster C disorder fears rejection, has low self esteem, is w/drawn, offended easily, has slow speech, often lonely, develops depression, anxiety and anger for failing to form social relationships
- avoidant
- The person w/ this disorder would be submissive, clingy, poor independant decision making, passive, do anything for acceptance
- dependant
- this cluster c disorder is characterized by preoccupation w/ perfection, rules, organization, and control.Is meticulous, self critical, inflexible, etc
- obsessive compulsive
- what type of therapy may be used to develop basic social skills?
- group therapy
- what type of therapy is needed for self insight and relationships?
- long term therapy
- what may be used to treat altered thoughts, paranoia, illusions?
- antipsychotics
- the core element of ...psychotherapy is the est. of an empathetic therapist
- interpersonal
- which type of therapy uses guided discovery in which the therapist functions as a role model for client
- interpersonal
- Interpersonal psychotherapy is suggested for what types of disorders?
- paranoid, schizoid, schizotypal, borderline, dependent, narcissistic, OCD
- what is the TX of choice for those w/ histrionic disorder?
- pscychoanalytical psychotherapy
- what type of tx focuses on unconscious motivation for seeking total satisfaction from others and for being unable to commit?
- psychoanalytical
- what type of therapy offers reinforcement for positive change?
- cognitive/behavioral
- what therapy helps clients recognize/correct inaccurate internal mental schema?
- cognitive/behavioral
- cognigtive/behavioral therapy is often helpful for whom?
- OCD, passive/aggressive, antisocial, avoidant
- which clients often benefit from antipscychotic meds?
- clients w/ paranoid, schizotypal, and borderline
- what sorts of things can antipsychotic meds help improve?
- illusions, ideas of reference, paranoid thinking, anxiety, hostility
- What type of drugs are successful in reducing anger, impulsiveness, and mood instability in boderline personality disorder?
- SSRI's
- the combination of lithium carbonate and propranolol may be useful for the violent episodes observed in whom?
- those w/ antisocial personalities
- what drugs are sometimes used for those w/ avoidant personalities?
- anxiolytics
- whay type of drugs may be useful for those w/ panic disorders?
- antidepressants
- what percentage of the population is bipolar?
- 10%
- what percent of those who are bipolar are women and what percentage are men?
-
10-25% (women)
5-12% (men) - the highest rates of bipolar are ?
- married women,single men, higher social class (esp pros and highly educated)
- what does the neurotransmitter deficit theory of biological theories of depresion postulate?
- that there is a deficit of norepi, serotonin, and dopamine
- the neuroendocrine dysregulation theory suggests what is/are predisposing factors of depression?
- hypothalamic/pitutitary/ adrenal axis has hyperactivity w/ elevated serum cortisol lvls
- what are the other biological theories of depression (other than neuroendocrine/ neuro transmitter)
- genetic and physiological illness and med. side effect and nutritional deficiencies
- what does the learning theory say about depression?
- that there is a lack of social support during loss and a percieved lack of control over events causing learned helplessness
- Depression is a result of loss of loved object is what theory?
- psychoanalytical
- depression is a result of negative processing of thoughts w/ neg. expectaions of environ./self/ future is a description of what theory?
- cognitive theory of depression
- describe the three theories of bipolar disorder
-
genetics (increased in fam.s)
biochemical: excess of norepi and dopamine/ low seratonin
physiological: brain lesions/ med side effects - what is first when dealing w/ any patient?
- safety
- what are some symptoms of depression?
- anhedonia,loneliness, helplessness, worthlessness, decrease in decision making and concentration, flat affect, inability to focus, etc
- what are some symptoms of mania?
- euphoria, inflated self esteem, lack of sleep, racing thoughts, pressured speech, irritability, grandiosity, etc
- What are some treatments of depression?
- increase social interaction, increase activity and excersise, monitor sleep/ nutrition/ fluids, give positive input
- treatments of depression cont..
- encourage to express feelings, assess for suicidal ideations, increase choices w/ client improvement, medications or ECT treatment
- what are some treatments for mania?
- breif/direct interaction, assess fluids/nutrition, may need help w/ app. dress, make up and personal hygeine, sleep, medications
- What is the difference bet. bipolar I and bipolar II
- bipolar II does not have full manic episodes, but does have full depression
- ...describes an individuals sustained emotional tone, which influences behavior, personality and perception
- mood
- ..mood swings from depression to mania w/ intervening periods of normalcy. May or may not be psychotic
- bipolar
- ..type of bipolar disorder in which the predominant mood is elevated, expansive, or irritable?
- mania
- severe form of major depressive episode. symptoms are exaggerated/intereest or pleasure in virtually all activities is lost
- melancholia
- ..the psychological process through which the individual passes on the way to successful adaptation to the loss of a valued object
- grief
- ..a subjective state of emotional, physical, and social responses to an anticipated loss of a valued entity
- anticipatory grieving
- ..the absense of evidence of grief when it is ordinarily expected
- delayed grief
- ..an intensification of grief to the point that the person is overwhelmed, demonstrates prolonged maladaptive behavior
- delayed grief
- ..extreme slow down of physical movements. Posture slumps, speech is slowed, digestion sluggiesh. common in severe depression
- dysthymic disorder
- ..a disorder that is characterized by depressed mood, anixiety, mood swings, and decreased interest in activites during the week before menses and subsiding shortly after the onset of mentsruation
- premenstrual dysphoric disorder
- a mild form of mania. symptoms are excessive hyperactivity, but not severe enough to cause marked impairment of functioning
- hypomania
- chronic mood disturbance w/ numerous episodes of hypomania and depressed mood, not strong enough to be labled bipolar
- cychlothymic disorder
- type of therapy in which the individual is taught to control thought distortions that are considered to be a factor in the dev./maintenence of emotional disorders
- cognitive therapy
- an accumulation of grief that occurs when an individual experiences many loses over a short period of time, common among the elderly
- bereavement overload
- a grave form of mania characterized by severe clouding of conscience/ representing an intensification of the symptoms associated w/ acute mania
- delerious mania
- an amino acid that should not be taken w/ MAOI's
- tyramine
- what factors might increase suicide risk?
- alcohol, ill health, family or personal hx of suicide attempts, having a lethal plan, isolation, impulsivity or aggressiveness
- what are some demographics of those likely to commit suicide?
- adolescance or over 65, male, caucasion, single/divorced, low or high class, health care pro or business person, uses guns, protestant, family hx
- what disorders are the most common to precdede suicide?
- mood (bipolar/depression)
- what, other than bipolar and depression, are some psych. disorders that may precede suicide?
- anxiety, schizophrenia, borderline, antisocial
- after severe depression: sudden lift of mood and/or giving away cherished items could be a clue to what?
- a suicide attempt
- if a person is suicidal, what should you find out?
- if he/she has a plan and means to carry it out and does the person have a support system
- what are precipitating life events that may lead to suicide?
- loss of loved one, probs in major relationships, changes in roles, serious illness
- anger turned inward is really, according to freud, what?
- directed toward others
- what is believed to be a central underlying factor to predisposition to suicide?
- hopelessness
- a hx of ....and...is thought to be an imp. factor underlying the suicidal behavior
- aggression and violence
- what is the principal stressor (in relation to suicide) in the 40-60 age group
- economics
- what plays a significant role in regard to suicide among those age 60+ and especially those over 80
- health
- the response of suicide in the individual who feels separate and apart from the main stream of society is--
- egoistic suicide
- a person who commits suicide that is excessively integrated into the group
- altruistic
- suicide in response to changes in an individuals life that disrupt feelings of relatedness to the group
- anomic suicide
- Which type of twins of a higher incidense of suicide between them?
- monozygotic (identical)
- what are some neurochemical factors related to suicide
- deficiency in seratonin, increases in beta adrenergic recepter binding, reductions in corticotrophin releasing factor binding
- what might be a good response to someone who lost someone dear to them?
- "you must be feeling very sad about your loss"
- If someone says that when they leave the psych unit they are going to try a no fail method of suicide, what might the nurse appropriately say?
- "what exactly do you plan to do?"
- what are some positive symptoms of schizophrenia?
- delusions, hallucinations, bizarre dress and behavior, disorganized thought, agressive, suicidal, idea of reference, disorganized speech
- what are some negative signs of schizophrenia?
- flat affect, poor eye contact, apathy, anhedonia, poverty of speech, poor grooming, apathy, no interest, disturbed relationships, isolation
- what is the percentage of schizophrenia in the population
- 1.5%
- when does schizophrenia usually begin?
- adolescence or early adulthood
- what percentage of siblings of offspring w/ schizophrenia share the diagnosis "schizophrenia"?
- 10%
- what is the percentage of twins that share the dx schizophrenia?
- 50%
- what is the psychoanalytic/developmental link to schizophrenia?
- distortion in mother/child relationship. anxious mothering and enmeshment faulty reality interpretation
- what is the dopamine hypothesis related to schizophrenia?
- dopamine is increased, seratonin decreased, norepi decreased
- what are the immunologic factors of schizophrenia?
- viral infection during 2nd trimester. Also malnutrition during pregnancy
- what disorders are the most common to precede suicide?
- mood (bipolar/depression)
- what are the developmental stressors predisposing an adolescant to suicide?
- conflict, separation, rejection
- what are the neurochemical factors related to suicide
- deficiency in serotonin in depressed clients, increases in B-adrenergic receptor binding; reduction in cortico trophon-releasing factor binding
- how does schizophrenia impact a persons life?
- no disorder is more crippling
- when does schizophrenia begin (developmentally)?
- late adolescence or early childhood
- what are some family factors influencing succeptiblity to schizophrenia?
- unhealthy adaptation esp if there are secrets and the child feels in a double bind or guilty or repressed unhappiness
- The incidence of schizophrenia is higher in what socioeconomic class?
- lower
- what can increase symptoms of schizophrenia?
- stressful life events
- describe disorganized(hebephrenic) schizophrenia?
- severe disintegration of personality, insidious and early (before 25) onset, poor prog, poor grooming, disorg. speech, rocking, grunting, grimacing, about age 7-8
- describe catatonic schizophrenia
- marked by abnormalities in motor behavior and may be manifested in the form of stupor or excitment
- what are some signs of catatonia?
- waxy flexibility, intense motor disturbance, sudden onset, can become malnurished, can hear but is mute, complete remission can be acheived
- describe paranoid schizophrenia
- presense of delusions of persecution or grandeur and auditory hallucinations related to a single theme
- what are the signs of paranoid schizophrenia?
- tense, suspicious, guarded, hostile, aggressive
- describe undifferentiated schizophrenia
- a pt that does not meet criteria for any of the subtypes or more than one subtype
- signs of undifferentiated schizophrenia?
- odd behavior over years of time, delusions, hallucinations, poor prognosis
- what is residual schizophrenia
- individual who has a hx of at least one previous episode of schizophrenia w/ prominent psychotic symptoms (many neg. few pos)--usually no hallucinations or delusions
- what is schizoaffective disorder?
- manifested by schizophrenic behaviors, w/ strong element of symptomatology associated w/ mood disorders.
- what are some symptoms of schizoaffective disorder?
- may appear depressed or euphoric but has schizophrenic symptoms. better prog/may have remissions
- what is schizophreniform?
- identical to schizophrenia, but lasts 1-6 months. may be able to function socially and occupationally
- define: neologism
- creating a new word that is not part of the language
- define echolalia:
- repeating the same word over and over after someone else says it first
- define: word salad
- words put together w/ no logical order
- define: magical thinking
- thoughts of being all knowing/all controlling/ all powerful
- define: flight of ideas
- abrupt change in topics w/ a rapid flow
- define: circumstantial
- many unnecessary details
- define: histrionic
- dramatic, over emotional behavior, attention seeking
- define: catalepsy
- waxy flexibility
- define: echopraxia
- imitating the movements of others
- define: hallucination
- a sensory perception involving one of the five senses
- define: delusion
- thoughts that are not open to reason and not reality based
- define: poverty of thought
- vague, disconnected thoughts
- define: thought blocking
- interruption in the flow of thoughts
- define: anhedonia
- loss of interest of pleasure in activities
- define: thought broadcasting
- some medium is broadcasting the person's thought to others
- define: idea of reference
- incorrect interpretation of incidents and external events
- define: Nihilism
- belief that existance is meaningless and useless
- define: psychosis
- a state in which one's capacity to recognize reality is limited
- define: apraxia
- loss of ability to carry out purposeful movements
- define: tangential
- irrelevant material
- A patient is delusional and wanting the nurse to participate in the delusion, what should the nurse respond to?
- he/she should respond only to reality
- What is a therapeutic technique for dealing w/ irrational beliefs?
- do not argue or deny the belief. Use reasonable doubt "I find that hard to believe"
- define: formication
- the sensation that something is crawling on or under the skin
- what is the most common type of hallucination?
- auditory
- the purpose of individual therapy for the schizophrenic is--
- decrease anxiety and increase trust
- what is the purpose of education for family members of schizophrenics?
- it is to help the client identify sources of real or percieved danger and ways of reacting appropriately
- what is the purpose of group therapy for schizophrenics?
- increase support (this is a long term therapy)
- common side effects of antypsychotic meds?
- dry mouth, blurred vision, constipation, urinary retention, nausea, GI upset, rash, sedation, orthostatic hypotension, photosensitivity
- common side effects of antipsychotic meds..
- , decreased libido, retrograde ejaculation, gynecomastia, amenorrhea, weight gain, reduction in seizure threshold, agranulocytosis
- common side effects of antipsychotic meds con...
- extrapyrimidal symptoms, tardive diskonesia, neuroleptic malignant syndrome
- how long does it take to see effects of antipsychotic meds?
- several weeks
- what question should one never ask a psych patient?
- "why"
- what is somatoform disorder?
- person has physical symptoms suggesting medical disease but w/o any organic pathophysiolgical condition to account for them
- what are predisposing factors for somatoform disorder?
- unable to express emotions; role modeling in fams; nurturing in fams is conditional
- what are some cultural and environmental factors of somatoform disorder?
- if not acceptable to have emotional probs, it becomes physical probs instead; appears more commonly in low socioeconmic/occup/ed status
- what are the symptoms of somatoform disorder?
- syndrome of multiple somatic symptoms before age 30 that occur over several years and cause impairment in social and occupational functioning
- symptoms of somatoform disorder cont...
- 4 pain symptoms, 2 gi symptoms (nausea/vom), 1 sexual sym, 1 pseudo neurological symp (paralysis, blindness, deafness), anxiety and depression are often seen
- tx for somatoform disorder
- individual psychotherapy
- goal of individual psychotherapy for somatoform disorder?
- help clients to develop healthy and adaptive behaviors
- what is the purpose of group psychotherapy for somatoform disorder?
- it provides a setting where clients can share experiences, learn to verbalize,and can be confronted when they reject responsibility
- what is the tx of choice for somatoform disorder
- group pscychotherapy
- what type of therapy for somatoform disorder invloves working w/ clients family who may be perpetuating the disease?
- behavior therapy
- what type of pscyhopharmacology is appropriate for those w/ somatoform disorder?
- antidepressants (tricyclics & SSRI's)
- what is the essential feature of pain disorder?
- severe prolonged pain that causes clincally significant distress or impairment of social/occupational functioning
- what are the predisposing factors of pain disorder?
- symptoms enable the pt to avoid some unpleasant activity and promotes emotional support or attention
- what is the psychodynamic theory of pain disorder?
- pt may be expressing intrapsychic conflict through the body; they want more attention than their emotional pain will ellicit
- what is the behavior theory of pain disorder?
- the pt recieves reinforcement when they have increased attention and they get relief from responsibility
- what is the classical conditioning theory of pain disorder
- previously neutral stimulus may become a trigger for pain related behaviors when it becomes associated in the mind with a painful stimulus
- what is the operant conditioning theory of pain disorder?
- learning occurs when pain behaviors are positively or negatively reinforced.
- what is the family dynamics theory of pain disorder?
- symptoms may be used to coerce others or manipulate and gain advantage in personal relationships
- what is the neurophysiological theory of pain disorder?
- the cerebral cortex and medulla are involved in inhibiting the firing of afferent pain fibers
- what are the symptoms of pain disorder?
- dx is made when psychological factors have been judged to have a major role in the onset,severity, exacerbation, or mainteneance of the pain, even when the physical examination reveals patholgy that is associated w/ the pain
- Tx of pain disorder?
- behavior therapy or working w/ family who may provoke symptoms; also antidepressants and anticonvulsants (dilantin)
- the unrealistic or inaccurate interpretation of physical symptoms leading to preoccupation of having a serious illness even though appprpriate medical reassurance is given
- hypochondriasis
- what are the symptoms of hypochondriasis?
- the belief is not delusional and lasts for at least 6 months, OCD traits frequently occur
- transformation of aggressive hostile wishes toward others into physical complaints about the self that are more acceptable is what theory about hypochodriasis?
- psychodynamic theory
- what hypochondriasis theory says that hypoc. is the result of an expression of low self esteem b/c it's easeir to feel something is wrong w/ the body than the self
- psychodynamic theory
- the theory that hypochondriacs belive that physical suffering is deserved punishment required for atonement
- psychodynamic theory
- which theory of hypcondriasis states: bodily sensations are intensified and then faulty thinking causes neg. thoughts to be attached to the sensations
- cognitive theory
- describe the social learning theory of hypochondriasis
- somatic comlaints are reinforced when the sick role relieves the pt of needing to deal w/ stressful situation
- describe the 'past experiences w/ physical illnesses' theory of hypochondriasis
- person has had a life threatening illness in the past which causes them to worry that the illness will recur
- tx for hypochondriasis
- individual, group
- tx of choice for hypochodriasis and why it's the tx of choice
- group: it provides the social support and social interaction these clients need
- describe conversion disorder
- loss of or change in body function resulting from psychological conflict, the physical symptoms of which can't be explained by any known med disorder or conditon. clients unaware of psych. basis and can't control symptoms
- symptoms of conversion disorder
- one or more symptoms affecting voluntary motor or sensory function, psych factors ass. w/ symptom of deficit; disturbance in social/occ function; ignition of exacerbation of symptoms is preceded by stress
- psychoanalytical theory of conversion disorder?
- emotions associated w/ tramatic event are unacceptable to client so they convert them to physical symptoms
- familial factors r/t conversion disorder?
- occurs more often in relatives
- behavioral theory r/t conversion disorder
- the individual uses physical symptoms to communicate helplessness, gain attention or support
- nueruophysiological theroy r/t conversion disorder
- central nervous system involvement due to excessive cortical arousal
- describe body dysmorphic disorder
- characterized by the exaggerated belief that the body is deformed or defective in some specific way
- symptoms of body dysmorphic disorder
- exaggerated belief that body is deformed; common belief in flaws in face or head, interferes w/ social/occ functioning
- predisposing factors of body dysmorphic disorder
- etiology is unknown, belief may be due to schizophrenia or anxiety, may be similar to hypochondriasis or phobia
- define insomina
- difficulty w/ initiating or maintaining sleep
- define hypersomnia
- excessive sleepiness or seeking excessive amounts of sleep
- define narcolepsy
- sleep attacks that the person can't prevent. Also sudden loss of muscle tone
- define parasomina
- unusual to undesirable behaviors that occur during sleep (nightmare, night terror, sleep walking)
- define circadian rhythm sleep disorder
- a misalignment between sleep and wake behaviors (shift work, jet lag, delayed sleep phase)
- what are predisposing factors of sleep disorders?
- genetic, medical, anxiety/depression, minor abnormalities in temporal lobe, alcohol or other CNS depressant
- psychosocial influences of cancer (???)
- type C personality; extreme suppresion of emotions; pos correlation bt stress and tumors
- tx modalities for cancer
- relaxation/mental imagry; teaching indiv w/ C personality; immune responses are enhanced when there is a greater feeling of well-being
- coronary heart disease, psychosocial influences
- type A personality; easily hostile, aggressive/ ambitious; no hobbies/must do more; struggles to acheive
- tx modalities for coronary heart disease
- progressive relaxation/ auto hypnosis/meditation/ biofeedback/group therapy; reduction of type A behavior
- How can reduction of type A behavior be accomplished?
- education, interpersonal counseling, behavior mod therapy
- psychosocial influences w/ peptic ulcer
- hostility increases gastric secretions, link b/w ulcers and stress
- psychosocial influences for essential hypertension
- congeinal, compliant, compulsive, inhibited rage
- tx modalities for essential hypertension
- meditation, yoga, hypnosis, biofeedback reduce bp; supportive therapy where the indiv. is encouraged to express honest feelings (particularly anger)
- psychosocial influences of migrane headaches
- perfectionist, overly conciencious, inflexible; meticlous, hard workers, neat; intelligent, repressed anger, emotional stress
- tx modalities for migranes
- help to recognize stressors; help cope w/ feelings of insecurity dependancy depression; help express feelings of repressed anger
- rheumatoid arthritis psychosocial influences
- self sacrificing, masochistic, conforming, self conscious, perfectionist, inability to express anger; emotional decompensation may exacerbate ra
- tx modalities for rheumatoid arthritis
- encourage to function as independantly as possible; focus on cure should be deflected to a foucs on control of the disease and prevention of disability
- psychosocial influences on ulcerative colitis
- compulsivity, mother child relationship resulting in feelings of helplessness/ hopelessness; onset associated w/ stressful life events
- tx modalities for ulcerative colitis
- help recognize stressors, help cope w/ insecurity dependancy depression; help express feelings of of repressed or suppressed anger and hostility
- After ECT, how long should the client remain in the recovery room?
- 1-3 hours, until vital signs are stable and the client is alert, oriented, and able to walk w/o assistance.
- what are the most common side effects of ECT?
- headache and memory loss
- if a client has a headache after ECT, what might he/she be instructed to do?
- take a mild analgesic and rest
- what does the nurse do for a client who have undergone ECT?
- allays fears and concerns, takes vital signs, offers support/comfort/reassurance, repetative teaching for those w/ memory loss.
- describe seasonal affective disorder
- major depresion (uni or bipolar) at a particular time each year. Pattern must be evident for 2 consecutive years w/ no intervening non seasonal episodes. Seasonal episodes outnumber any nonseasonal episodes over a lifetime
- when do clients w/ Seasonal Affective Disorder (SAD) often develop depression? When does it often remit
- depression occurs during oct/nov and remits in march/april
- what sort of pattern does bipolar II and bipolar I disorder sometimes have?
- bipolar II sometimes has a seasonal pattern in which increased light triggers manic or hypomanic episodes
- what is a tx that is often used w/ SAD?
- phototherapy
- describe some aspects of phototherapy
- minimum of 2500 lux admin. on waking for 30 minutes
- what is the mechanism of action for phototherapy
- it's mechanism is unclear; it's thought that exposure to morning light causes circadian rhythm shift that regulates the normal relationship bet. sleep and circadian rhythm
- what are the side effects of phototherapy?
- they are rare, so report: irritability, hyperactivity, or insomnia
- describe psychomotor retardation
- client appears slowed down, depressed, dissheveled, stooped posture, little eye contact, increased need for naps
- what are the interventions for psychomotor retardation
- same as depression: increase social interaction, min. isolation, increase activity/ excersise, monitor sleep/ nutrition, positive input, new coping skills, assess for suicide, increase choices w/ improvement, medication or ECT
- defintion of adjustment disorder
- short term disturbance in mood or behavior w/ non psychotic manifestations resulting from identifiable stressors. Seen in people experiencing life transitions
- describe the realtionship bet. adjustment disorder and depression
- can have w/ or w/o major depression; symptoms may abate w/ time; may lead to more serious mental health problems
- define: suicidal ideation
- thoughts or fantasies of suicide can be expressed through writing or artwork
- define: suicide threats
- verbal or written w/o action
- define: suicide gestures
- minor or no injury to self, no intention to die
- define suicide attempts:
- serious actions resulting in minor or major injury. Gestures and attempts are sometimes called parasuicidal behavior
- interventions for delusional thoughts and hallucinations (continued over 3 cards)
- intensive psychopharmacological tx, supportive and directive communication; clear concrete statement,
- interventions for delusional thoughts (2/3)
- praise for reality based perceptions/reduction in aggressive behaviors, and appropriate social interaction and group participation
- interventions for delusional thoughts (3/3)
- psychiatric, medical, and neurological evaluation
- all known antipsychotics are .....blockers (think neuro transmitter)
- dopamine
- currently available newer antipsychotics block...to a greater degree than dopamine
- seratonin
- what are the neurotransmitters associated w/ schizophrenia?
- dopamine(incr), seratonin (dec), acetylcholine(dec), Norepi(dec), Cholecystokinin (dec), glutamate (dec), aminobutyric
- what are some atypical antipsychotics
- risperdal, zyprexia, clozaril, seroquel, geodon
- what are some mood stabilizers
- lithium and anticonvulsants
- what are some causes of relapse of schizophrenia
- poor insight leading to denial of illness, nonadherence to tx, lack of fam. support, inability to cope w/ complex mental health system, failure of meds to maintain their efficacy in the long term, high cost of meds
- during the coconut grove fire of 1942, what did eric lindmann find helped people prevent later psychologic difficulties
- helping bereaved people through the mourning process
- what are some interventions for people dealing w/ crisis?
- listen/observe/ask questions to categorize nature of event, remove danger, coordinate w/ other agencies, anticipate future needs and develop a plan for the client that meets those needs
- describe sitiational crisis
- crisis that is apparent to another observer and viewed as something that is liekly to cause a threat to safety
- name some examples of situational crisis
- terrorism, disasters, loss of a job, a spousal affair, serious medical condition
- why should the nurse use anticipatory teaching w/ a person experiencing a situational crisis?
- sometimes the crisis appears settled, but psychiatric symptoms occur later
- what sorts of questions would the nurse ask in a crisis intervention?
- cheif complaint, hx of present illness, family hx, past medical hx, drug/alcohol hx, cultural/spiritual issues, coping skills