NURS 124 - Mental Health Quiz 2 Study Guide

Mental Health Quiz 2 25 questions - 20 Multiple choice/1 Fill in/ 4 SATA Phases Of Schizophrenia - Phase 1: - Prodromal(Onset) - Social Withdrawal - Prodromal has Negative symptoms - Acute - Exacerbation of symptoms: Hallucination, Delusion, Bizarre behavior - Goal: Patient safety and medical stabilization - Phase 2: Stabilization - Symptoms are diminishing - Goal: to help patients understand illness and treatment - Phase 3: Maintenance or Residual - At or near baseline functioning and new baseline is established - Goal:To maintain achievement and treatment Plan Assessment of Schizophrenia Positive - Delusion: False Fixed belief - Hallucination: Something that isn’t there - Experience 1) Auditory 2) Command 3) Visual - If patient is having auditory hallucinations, offer patient to sit with them. Say I will sit with you, what are the voices telling you - Illusion: Something there, but distorted - Neologism - Hitting the Nurse - Disorganized thinking/thought - Speech - Flight of ideas - Alterations in Speech - Word salad: Jumble of words meaningless to the listener - Clang Association: Words based on sound/rhythm; oh fox, box and lox - Neologism: Make up words by the client - Echolalia: Repetition of words - Echopraxia: Imitation of body Movement This study source was downloaded by from CourseH on :06:12 GMT -05:00 - Pressured Speech: Speech that has a sense of urgency and deliver at a fast pace due to overflow of ideas - Tangentiality: Question never fully answered. Avoid questions - EX: Nurse: How are you” Patient: I like carrots and playing games - Symbolic Speech: Using symbols instead of direct speech - Ex: The demon or devil is taking me - Disorder or distortions of Thoughts - Thought Blocking: A reduction or stoppage of thought caused by hallucination - Thought insertion: Belief that someone else has inserted thoughts into their brain - Thought Deletion: A belief that thoughts have been taken or are missing - Magical thinking: GOAL SETTING Belief that thoughts/action affect other consequences - EX: Wearing a certain hat makes him invisible to others - Paranoia: Irrational fear - Depersonalization: “I am me but i feel like someone else” - Derealization: “I’m in space” or “I see legs but they’re not mine” - Alterations in Thoughts - Ideas of Reference: Misconstrues others behavior - Ex: Believe people are talking about you when they are discussing about something else - Persecution/Persecutory: Being followed/watch by FBI - Tell them “It sounds like you are concerned about your safety” - Grandeur: Believe that you’re superior like a god, queen or king - Somatic Delusion: Body is changing like growing an extra arm - Jealousy: Believe S/O is cheating with no factual basis Negative Symptoms - 5A’s: Affect(Outward expression), Alogia(Inability to speak), Anergia(Lack of Energy), Anhedonia(Lack of pleasure), Avolition(Lack of motivation) - Disheveled appearance - Flat affect(Diminished emotional expression) - Social withdrawal - Affective blunting: Slight Grim This study source was downloaded by from CourseH on :06:12 GMT -05:00 Bipolar(3 questions including 1 med) - Mania Patient should be kept away from nursing station and in a quiet low stimuli area so they are not disturbing other patients - Possess echopraxia behavior like repetitive movement - Administer Valproic/Lithium Carbonate Hyperprolactinemia - Syndrome Called “nesting” - Monitor for - 1)Amenorrhea(absent period) - 2) Galactorrhea(milky nipple discharge) - 3) Gynecomastia (enlargement of breast in males) - May cause metabolic Syndrome - Weight gain, Metabolic derangement, Increased Lipids, Type 2 DM Cognitive Disorder(2 Questions) - Make sure to do a mental health exam to rule out any medical issues like drug - Impaired memory, Impaired information processing, concrete thinking and impaired executive functioning(Ability to make decisions) Major Depressive Disorder(1 Question) - Result in patient needing more time to respond - Accompanied by at least 5 specific clinical findings - Occur almost every day for a minimum of 2 weeks and last most of the day - Body posture is important, keep feet on the floor, keep hands on lap, do not cross arms or put them in your pocket Depression(1 Question) - Patients who have depression will be complaining of interrupted sleep. - Will tell you they wake up and can't fall back asleep - Often suicidal - At risk for self harm and injury - Antidepressants will be used to treat patients - Administer Paroxetine This study source was downloaded by from CourseH on :06:12 GMT -05:00 - Used temporarily to treat depression - Monitor for self harm ideations because this medication can increase thoughts of self harm, at least in the start - Have patient taper medication and not stop it abruptly because it can lead to discontinuation syndrome - Keep these patients close to the nursing station - Sit down with patients and talk to them as much as you can Restraints(1 Question) - Mechanical is last resort - Assess every 15 minutes - Require a one on one interaction Medications – 10 questions Geodon (ziprasidone) (1 question) SECOND GENERATION - Obtain baseline EKG before Administration - Teach pt to take pills with food to avoid nausea - Causes weight gain - 350-500 cal of food to help with absorption - Can cause ECG, or Q level extensions - Can cause heart dysrhythmias - Monitor patients pulse, heart rate, monitor for palpitations. Risperidone (1 question) SECOND GENERATION - Use the AIMS scale to monitor movement - EPS→ TD Assess AIM Scale before 1st dose - Avoid alcohol - Monitor blood glucose daily - Should not be used in clients who has dementia - Comes in oral disintegrating tablets Haldol (Haloperidol) (4 questions) FIRST GENERATION - Extrapyramidal side effects: Dystonia, Akathisia (inability to relax and rest), Pseudoparkinsonism (muscle tremors), tardive dyskinesia(uncontrolled chewing and grimacing) - Gynecomastia in men (man boobs) - Neuroleptic Malignant Syndrome (NMS) – High fever, high BP - Make sure to keep hydrated, check vital signs, and test for muscle rigidity Clozapine (1 question) SECOND GENERATION This study source was downloaded by from CourseH on :06:12