NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
• Anxiety Disorders
• Anxiety Levels & Stages
o Mild: Everyday anxiety, better focusing, more alert
and in-tune with surroundings (nail biting, fidgeting,
foot tapping are common)
o Moderate: Narrowed perceptual field, hears/sees/grasps
less info. (Pacing, pounding heart, banging hands on
table)
o Severe: Cannot learn or problem solve. Confusion,
hyperventilation, making threats and feeling of
“impending doom”. (Stomach aches & physical
symptoms are common: dizziness, H/A, insomnia,
nausea)
o Panic: Extreme Anxiety. Cannot problem solve/learn,
Dilated Pupils, shouting, screaming, and
hallucinations. Lost touch with reality.
• Nursing Interventions for Anxiety
o Mild/Moderate: Be calm and listen! Find out what
worked before. Clarify, use open-ended questions,
have the patient NAME the anxiety/trigger, “what were
you thinking right before the attack?”.
o Severe/Panic: Firm, Short Answers, Set Limits (you
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
,NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
cannot hit me or anyone else), move patient to quiet
room, low pitch voice & speak slow, reinforce reality,
remain with the patient (don’t leave them alone),
Prevent dehydration & exhaustion (high calorie fluids).
Gross motor activities to drain some of the tension (ping
pong, dancing, etc)
• Anxiety/Depression Meds:
o Antidepressants - is a substance that
prevents/relieves depression.
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
,NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
▪ SSRI’s– (Ex: fluoxetine, citalopram, sertraline).
Black Box Warning: increased suicidal thoughts are
possible. Takes 2- 4 weeks to work. Helps treat
Depression, ETOH withdrawal, OCD,
▪ Side Effects: Anxiety, tremors, sexual
dysfunction, H/A, agitation, sleeplessness. Dry
mouth.
▪ S/Sx of Overdose: Serotonin Syndrome (fever,
Hyper-
Reflexia, sweating, high BP, delirium, hostility).
Wait 2 weeks before starting an MAOI or vice-
versa.
▪ Contraindications: Those who have attempted
suicide don’t use! Pregnancy, Renal/Liver
issues, Elderly (due to increase of
osteoporosis/fractures)
▪ Patient Teaching: OTC drug interactions, slow
standing, don’t take w/in 2 weeks of MAOI,
monitor for suicidal ideations
▪ Serotonin Syndrome Treatment:
• STOP medication. •Serotonin receptor
blockade: cyproheptadine, methysergide,
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
, NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
propranolol •Cooling blankets,
chlorpromazine for hyperthermia
•Dantrolene, diazepam for muscle rigidity or
rigors •Anticonvulsants •Artificial ventilation
• Paralysis
o TCA’s – Used for Depression, anorexia, insomnia,
ODC, Panic disorder, and neurogenic pain. Takes 10-
14 days to become effective. Provider will chose this
drug if (1) it worked on family member in past and (2)
severity of adverse effects. “Start low and go slow”
▪ Side Effects: Anticholinergic effects (urinary
retention, dry mouth, blurred vision, dizziness,
tachycardia, constipation, reflux), Postural
Hypotension.
▪ S/Sx of Overdose: tachycardia, MI,
heart block, dysrhythmias
▪ Contraindications: Elderly and those with Cardiac
Disease
▪ Patient Teaching: takes 6-8 for full effect, get
up slowly from sitting position, take at BEDTIME
to reduce side effects, good mouth care/lozenges
for dry mouth, don’t stop cold turkey
o MAOI–. (ex: Phenelzine/Nardil, Isocarboxazid, Parnate)
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
STUDY GIUDE DOWNLOAD A+
• Anxiety Disorders
• Anxiety Levels & Stages
o Mild: Everyday anxiety, better focusing, more alert
and in-tune with surroundings (nail biting, fidgeting,
foot tapping are common)
o Moderate: Narrowed perceptual field, hears/sees/grasps
less info. (Pacing, pounding heart, banging hands on
table)
o Severe: Cannot learn or problem solve. Confusion,
hyperventilation, making threats and feeling of
“impending doom”. (Stomach aches & physical
symptoms are common: dizziness, H/A, insomnia,
nausea)
o Panic: Extreme Anxiety. Cannot problem solve/learn,
Dilated Pupils, shouting, screaming, and
hallucinations. Lost touch with reality.
• Nursing Interventions for Anxiety
o Mild/Moderate: Be calm and listen! Find out what
worked before. Clarify, use open-ended questions,
have the patient NAME the anxiety/trigger, “what were
you thinking right before the attack?”.
o Severe/Panic: Firm, Short Answers, Set Limits (you
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
,NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
cannot hit me or anyone else), move patient to quiet
room, low pitch voice & speak slow, reinforce reality,
remain with the patient (don’t leave them alone),
Prevent dehydration & exhaustion (high calorie fluids).
Gross motor activities to drain some of the tension (ping
pong, dancing, etc)
• Anxiety/Depression Meds:
o Antidepressants - is a substance that
prevents/relieves depression.
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
,NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
▪ SSRI’s– (Ex: fluoxetine, citalopram, sertraline).
Black Box Warning: increased suicidal thoughts are
possible. Takes 2- 4 weeks to work. Helps treat
Depression, ETOH withdrawal, OCD,
▪ Side Effects: Anxiety, tremors, sexual
dysfunction, H/A, agitation, sleeplessness. Dry
mouth.
▪ S/Sx of Overdose: Serotonin Syndrome (fever,
Hyper-
Reflexia, sweating, high BP, delirium, hostility).
Wait 2 weeks before starting an MAOI or vice-
versa.
▪ Contraindications: Those who have attempted
suicide don’t use! Pregnancy, Renal/Liver
issues, Elderly (due to increase of
osteoporosis/fractures)
▪ Patient Teaching: OTC drug interactions, slow
standing, don’t take w/in 2 weeks of MAOI,
monitor for suicidal ideations
▪ Serotonin Syndrome Treatment:
• STOP medication. •Serotonin receptor
blockade: cyproheptadine, methysergide,
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
, NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
propranolol •Cooling blankets,
chlorpromazine for hyperthermia
•Dantrolene, diazepam for muscle rigidity or
rigors •Anticonvulsants •Artificial ventilation
• Paralysis
o TCA’s – Used for Depression, anorexia, insomnia,
ODC, Panic disorder, and neurogenic pain. Takes 10-
14 days to become effective. Provider will chose this
drug if (1) it worked on family member in past and (2)
severity of adverse effects. “Start low and go slow”
▪ Side Effects: Anticholinergic effects (urinary
retention, dry mouth, blurred vision, dizziness,
tachycardia, constipation, reflux), Postural
Hypotension.
▪ S/Sx of Overdose: tachycardia, MI,
heart block, dysrhythmias
▪ Contraindications: Elderly and those with Cardiac
Disease
▪ Patient Teaching: takes 6-8 for full effect, get
up slowly from sitting position, take at BEDTIME
to reduce side effects, good mouth care/lozenges
for dry mouth, don’t stop cold turkey
o MAOI–. (ex: Phenelzine/Nardil, Isocarboxazid, Parnate)
NUR2488 Mental Health Final Exam Review
STUDY GIUDE DOWNLOAD A+
