N222 Mental health study guide
(Answered 2022/2023)
what are the only 3 reasons to put someone on hold?
DTS, DTO, GD
medications to treat EPS?
diphenhydramine
benztropine
Neuroleptic Malignant Syndrome
Life-threatening muscle rigidity, fever, and rhabdomyolysis.
how often should restraints be renewed for adults?
every 4 hours
how often should restraints be renewed for children/ adolescents?
every 2 hours
autocratic leadership
A form of leadership in which the leader makes decisions on his or her own and then
announces those decisions to the group.
democratic leadership
a leadership style in which managers work with employees to make decisions
Laize-faire leadership
no leadership intervention, members figure it out on their own
level of observation per patient?
the greater their risk for injury the greater the observation should be.
major concern for depression?
suicidal ideation
higher risk for suicide?
males, use more lethal means
higher risk single or married?
single is at higher risk
what age range are we worried about for higher suicide risk?
<18, 55+
what are we most concerned about manic phase of bipolar disorder?
rest and calorie intake
prevent harm and exhaustion
what are some nursing interventions for a client experiencing the manic phase of
bipolar disorder?
finger foods, decrease stimuli
what is the choice of treatment for bipolar disorder?
lithium 0.8-1.4 for manic phase
0.6-1.2 for maintenance phase
what are some signs or symptoms for lithium toxicity?
tremors, slurred speech, nausea, diarrhea
lithium level 2.0-2.5
,Extreme polyuria of dilute urine, tinnitus, giddiness, jerking movements, blurred vision,
ataxia, seizures, severe hypotension, stupor/coma, possible death from respiratory
complications
lithium level 2.5+
Severe toxicity = Coma, death
mild anxiety
client can still follow directions
moderate to panic state of anxiety
short commands
ensure safety
reduce their anxiety level
higher risk for being aggressive or assaultive
what is first line of treatments for anxiety disorders?
benzodiazepines
what is a nurse's responsibility with suspected abuse?>
report it
what is typically associated with dissociative identity disorder?
mental disconnect, typically seen with PTSD
treatments for depression?
SSRI main one
sexual dysfunction, serotonin syndrome, taper off, takes up 4-6 weeks, weight changes
TCA, MAOI
Dissociative Fugue Disorder
travel to a different area and cannot remember how they got there
mental status exam
assesses appearance and behavior, emotional state, thought, and cognitive functioning,
affect, dress, memory
what is somatic disorder
physical symptoms without medical cause
what is conversion disorder?
convert stress into physical symptoms (my parents yell at me everyday and now im
deaf)
ADHD characteristics
inattention, hyperactivity, impulsivity
Autism Spectrum Disorder characteristic
lack eye contact
become fixated to one thing
repetitive actions
delirium
rapid onset
reversible
medical emergency
ALOC
mood swings
neurocognitive disorders
,slow and progressive
irreversible
non-emergent
LOC unaltered
early alcohol withdrawal symptoms nursing interventions
hydration and rest
medication for alcohol abstinence
disulfiram, naltrexone, acamprosate
medication for alcohol withdrawal
Diazepam, carbamazepine, clonidine, chlordiazepoxide, phenobarbital, naltrexone
what is particular about anorexia nervosa?
below normal weight
Stages of greiving
denial, anger, bargaining, depression, acceptance
dysfunctional grieving examples
client who continues to refer to their lost one as still being alive, leaving their room
exactly how it is
what is reaction formation?
switching unacceptable impulses into their opposites
act like you hate someone but you actually have a crush on them
what is paradoxical reaction?
a reaction that causes an effect OPPOSITE of the intended effect
Therapeutic Milieu
A safe and secure structured environment that facilitates the therapeutic interaction
between clients and members of the professional team.
primary prevention
education, prevention, coping mechanisms
secondary prevention
screening and early detection
tertiary prevention
rehabilitation, health restoration, and palliative care
torts
legal wrongs committed against a person
(negligence, malpractice, false imprisonment, battery, assault)
Schizophrenia (negative symptoms)
blunted affect
alogia-poverty of thought
avolition-loss of motivation
anhedonia-inability to experience pleasure
anergia
ambivalence
affect disturbances-blunted, flat, inappropriate
restricted emotions
social withdrawal
dependency
, lack of self care
very hard to treat
Schizophrenia (positive symptoms)
hallucinations and delusions
word salad
jumble of incoherent speech as sometimes heard in schizophrenia
Echolalia
automatic and immediate repetition of what others say
neologism
new word
clang associations
rhythmic patterns associated with psychotic speech
delusion
A false belief or opinion
Halluciantions
false sensory experiences, such as seeing something in the absence of an external
visual stimulus
major focus with a patient with schizophrenia
safety
first generation antipsychotics
treats positive symptoms
ortho hypotension, anticholinergic, sexual dysfunct., weight gain, sedation
may cause EPS
haloperidol, chlorpromazine, fluphenazine, loxapine
second generation antipsychotics
treat both positive and negative symptoms
less EPS, ortho hypo, anticholinergic, sleep disturbance, weight gain, sexual dysfunct.
risperidone (pregn c), clozapine, olanzapine, quetiapine, aripiprazole
Antidepressants: SSRIs
fluoxetine (preg c), paroxetine, sertraline, citalopram, escitalopram
weight pain, sexual dysfunct., CNS stimulation
taper off, serotonin syndrome
do not take with MAOI, TCA, st. john's wort, lithium, NSAIDs
antidepressants: TCAs
Amitriptyline (preg c), Nortriptyline, Imipramine, Trimipramine
ortho hypo, anticholinergic, sedation
can cause seizures, do not use with MOAI's (htn)
antidepressants: MAOIs
selegiline, phenelzine (preg c), isocarboxazid, tranylcypromine
NO TYRAMINE (pickled foods, soy products, citrus)
CNS stimulation, ortho hypo, hypertensive crisis
do not use with ephedrine or amphetamines (hypertensive crisis), TCA or SSRI cause
serotonin syndrome
Mood Stabilizers: Lithium
Drink 1.5-3 L of water daily; don't take diuretics
Maintain normal sodium diet 2-3 grams
(Answered 2022/2023)
what are the only 3 reasons to put someone on hold?
DTS, DTO, GD
medications to treat EPS?
diphenhydramine
benztropine
Neuroleptic Malignant Syndrome
Life-threatening muscle rigidity, fever, and rhabdomyolysis.
how often should restraints be renewed for adults?
every 4 hours
how often should restraints be renewed for children/ adolescents?
every 2 hours
autocratic leadership
A form of leadership in which the leader makes decisions on his or her own and then
announces those decisions to the group.
democratic leadership
a leadership style in which managers work with employees to make decisions
Laize-faire leadership
no leadership intervention, members figure it out on their own
level of observation per patient?
the greater their risk for injury the greater the observation should be.
major concern for depression?
suicidal ideation
higher risk for suicide?
males, use more lethal means
higher risk single or married?
single is at higher risk
what age range are we worried about for higher suicide risk?
<18, 55+
what are we most concerned about manic phase of bipolar disorder?
rest and calorie intake
prevent harm and exhaustion
what are some nursing interventions for a client experiencing the manic phase of
bipolar disorder?
finger foods, decrease stimuli
what is the choice of treatment for bipolar disorder?
lithium 0.8-1.4 for manic phase
0.6-1.2 for maintenance phase
what are some signs or symptoms for lithium toxicity?
tremors, slurred speech, nausea, diarrhea
lithium level 2.0-2.5
,Extreme polyuria of dilute urine, tinnitus, giddiness, jerking movements, blurred vision,
ataxia, seizures, severe hypotension, stupor/coma, possible death from respiratory
complications
lithium level 2.5+
Severe toxicity = Coma, death
mild anxiety
client can still follow directions
moderate to panic state of anxiety
short commands
ensure safety
reduce their anxiety level
higher risk for being aggressive or assaultive
what is first line of treatments for anxiety disorders?
benzodiazepines
what is a nurse's responsibility with suspected abuse?>
report it
what is typically associated with dissociative identity disorder?
mental disconnect, typically seen with PTSD
treatments for depression?
SSRI main one
sexual dysfunction, serotonin syndrome, taper off, takes up 4-6 weeks, weight changes
TCA, MAOI
Dissociative Fugue Disorder
travel to a different area and cannot remember how they got there
mental status exam
assesses appearance and behavior, emotional state, thought, and cognitive functioning,
affect, dress, memory
what is somatic disorder
physical symptoms without medical cause
what is conversion disorder?
convert stress into physical symptoms (my parents yell at me everyday and now im
deaf)
ADHD characteristics
inattention, hyperactivity, impulsivity
Autism Spectrum Disorder characteristic
lack eye contact
become fixated to one thing
repetitive actions
delirium
rapid onset
reversible
medical emergency
ALOC
mood swings
neurocognitive disorders
,slow and progressive
irreversible
non-emergent
LOC unaltered
early alcohol withdrawal symptoms nursing interventions
hydration and rest
medication for alcohol abstinence
disulfiram, naltrexone, acamprosate
medication for alcohol withdrawal
Diazepam, carbamazepine, clonidine, chlordiazepoxide, phenobarbital, naltrexone
what is particular about anorexia nervosa?
below normal weight
Stages of greiving
denial, anger, bargaining, depression, acceptance
dysfunctional grieving examples
client who continues to refer to their lost one as still being alive, leaving their room
exactly how it is
what is reaction formation?
switching unacceptable impulses into their opposites
act like you hate someone but you actually have a crush on them
what is paradoxical reaction?
a reaction that causes an effect OPPOSITE of the intended effect
Therapeutic Milieu
A safe and secure structured environment that facilitates the therapeutic interaction
between clients and members of the professional team.
primary prevention
education, prevention, coping mechanisms
secondary prevention
screening and early detection
tertiary prevention
rehabilitation, health restoration, and palliative care
torts
legal wrongs committed against a person
(negligence, malpractice, false imprisonment, battery, assault)
Schizophrenia (negative symptoms)
blunted affect
alogia-poverty of thought
avolition-loss of motivation
anhedonia-inability to experience pleasure
anergia
ambivalence
affect disturbances-blunted, flat, inappropriate
restricted emotions
social withdrawal
dependency
, lack of self care
very hard to treat
Schizophrenia (positive symptoms)
hallucinations and delusions
word salad
jumble of incoherent speech as sometimes heard in schizophrenia
Echolalia
automatic and immediate repetition of what others say
neologism
new word
clang associations
rhythmic patterns associated with psychotic speech
delusion
A false belief or opinion
Halluciantions
false sensory experiences, such as seeing something in the absence of an external
visual stimulus
major focus with a patient with schizophrenia
safety
first generation antipsychotics
treats positive symptoms
ortho hypotension, anticholinergic, sexual dysfunct., weight gain, sedation
may cause EPS
haloperidol, chlorpromazine, fluphenazine, loxapine
second generation antipsychotics
treat both positive and negative symptoms
less EPS, ortho hypo, anticholinergic, sleep disturbance, weight gain, sexual dysfunct.
risperidone (pregn c), clozapine, olanzapine, quetiapine, aripiprazole
Antidepressants: SSRIs
fluoxetine (preg c), paroxetine, sertraline, citalopram, escitalopram
weight pain, sexual dysfunct., CNS stimulation
taper off, serotonin syndrome
do not take with MAOI, TCA, st. john's wort, lithium, NSAIDs
antidepressants: TCAs
Amitriptyline (preg c), Nortriptyline, Imipramine, Trimipramine
ortho hypo, anticholinergic, sedation
can cause seizures, do not use with MOAI's (htn)
antidepressants: MAOIs
selegiline, phenelzine (preg c), isocarboxazid, tranylcypromine
NO TYRAMINE (pickled foods, soy products, citrus)
CNS stimulation, ortho hypo, hypertensive crisis
do not use with ephedrine or amphetamines (hypertensive crisis), TCA or SSRI cause
serotonin syndrome
Mood Stabilizers: Lithium
Drink 1.5-3 L of water daily; don't take diuretics
Maintain normal sodium diet 2-3 grams
