ATI mental health proctored, ATI CMS EXAM
REVIEW
Lithium levels range
0.5-1.4
Sodium
135-145
potassium
3.5-5
Tricyclic Antidepressants
Sedation, urinary retention,
they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis,
and chronic pain and their overdose can be deadly
MAOI
inhibits breakdown of amine neurotransmitters, hypertensive crisis. avoid
pseudonephrine.
Chlorpromazine (thorazine)
Anticholinergic side effects constipation, urinary retention, blurred vision, dry mouth.
Suck on hard candy. It does not alter skin perfusion.
Lithium
maintain sodium levels watch for vomiting, diarrhea, sweating
Alcohol withdrawal
Naltroxone. 2-3 days after can be a seizure risk, hand tremors will occur, monitor bp
Difference between alzheimers and dementia
Alzheimers is progressive forgetfullness and dementia is rapid
Confabulation
Filling in gaps in memory bu fabrication
Delusion
false fixed belief seen in schizos
Child abuse pattern
inconsistency between history and child's injury
Maslow's hierarcy of needs
1. sleep, food 2. safety 3. love and belonging 4. self actualization
First priority for alcohol withdrawal
rest and nutrition
donepezil (aricept)
for alzheimers prolong time and functioning of individual in early stages of disease
Cocaine signs
dilated pupils
marijuana signs
bloodshot eyes
heroin signs
pinpoint eyes
pcp signs
rapid eye movement
agoraphobia
,fear of places or situations that might cause panic such as going outside
Conversion
physical complaints not true
grandiosity
"I am grand" narcissistic behavior
PTSD
nightmares, indecisive, lack of emotion during a event
Kubler ross stages of grief
1. denial 2. anger 3. bargaining 4. depression 5. acceptance
Alprazolam (xanax)
panic disorder med. anticholingeric
Benzo side effect
dizziness, sedation, drowsiness
OCD
set time limits , cannot have a pleasant moment
Borderline personality disorder
a personality disorder characterized by lack of stability in interpersonal relationships,
self-image, and emotion; impulsivity; angry outbursts; intense fear of abandonment;
recurring suicidal gestures, self mutilation
How often should provider renew restraints perscription
q4 hrs and follow up withing 1st hour of prescribing
Bupropion
for quitting nicotine
Buprenorphine
think phine for opioids withdrawal treatment
anorexia
An eating disorder characterized by an obstinate and willful refusal to eat, a distorted
body image, and an intense fear of being fat. Appearance of lanugo, amenorrhea,
intolerance to cold, bradycardia, dry skin, hypotension, occupied thoughts of food
Bulimia
An eating disorder characterized by episodes of overeating, usually of high-calorie
foods, followed by vomiting, laxative use, fasting, or excessive exercise. tooth erosion,
hand calluses, hypokalemia monitor patient 1 hour after eating
Lithium blood testing rules
8 hrs after last dose, 5 days after beginning dose, dosage changes, then testing for 6
months monthly
methylphenidate
improved attention
opioid use disorder
impaired coordination, euphoria, decreased respirations, drowsiness. think clumsy
sleepy person
For schizos what increases hallucinations?
anxiety
quetiapine
schizo med, monitor glucose
buspirone
,antianxiety, GAD, does not cause sedation, does not cause dependence, do not take as
PRN, and this med will become effective in 2-4 weeks
avolition
lack of emotion
delirium
rapid fluctuations of loc
chlordiazepoxide
is for alcohol use disorder
disulfram
alcohol use disorder
Amphetamine
paranoia AE akathisia-agitation, restlessness
Psychosocial History
Perception of own health, beliefs about illness and wellness
Activity/leisure activities, how the client passes time
Use of substances/substance use disorder
Stress level and coping abilities - usual coping strategies, support systems
Cultural beliefs and practices
Spiritual beliefs
mental health exam
Alert - The client is responsive and able to fully respond by opening her eyes and
attending
to a normal tone of voice and speech. The client answers questions spontaneously
and appropriately.
■■ Lethargy - The client is able to open her eyes and respond but is drowsy and falls
asleep readily.
■■ Stupor - The client requires vigorous or painful stimuli (pinching a tendon or rubbing
the sternum)
to elicit a brief response. She may not be able to respond verbally.
■■ Coma - No response can be achieved from repeated painful stimuli.
Alturism
Dealing with anxiety by reaching
out to others. Person who lost spouse in fire is a firefighter
sumblimination
hidden feelings about someone and then goes to work out to release the anger
orientation phase
set boundaries and expectations, determine client's needs
operant conditioning
positive reinforcement
aversion therapy
use bad stimuli if patient does something bag like dog chewing on cord and you put
bitter apple on the cord and the dog pulls away
Cluster A
Odd or ecentric. Schizo paranoid
Cluster B
, Dramatic, emotional, erratic. Antisocial-Characterized by disregard for others with
exploitation, repeated unlawful actions,
deceit, and failure to accept personal responsibility, borderline-Characterized by
instability of affect, identity, and relationships, as well as splitting
behaviors, manipulation, impulsiveness, and fear of abandonment,
Cluster C
Anxious, fearful. Avoidant, dependent, OCD
paradoxical response
insomnia, excitation, urgency
LOC - ALERT
patient is responsive
opens eyes spontaneously
answers questions appropriately
LOC - LETHARGIC
patient can open eyes and respond to questions
falls asleep easily
LOC - OBTUNDED
patient responds to light shaking
is confused
slow to respond
LOC - STUPOROUS
patient barely responds to painful stimuli
example
rubbing sternum
LOC - COMATOSE
patient is unresponsive
abnormal posturing may be present
DECORTICATE POSTURING
arms flexed/internally rotated
legs extended/internally rotated
DECEREBRATE POSTURING
head arched back
arms/legs extended
AUTONOMY
patient has the right to make their own decisions even if not in their best interest
BENEFICENCE
REVIEW
Lithium levels range
0.5-1.4
Sodium
135-145
potassium
3.5-5
Tricyclic Antidepressants
Sedation, urinary retention,
they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis,
and chronic pain and their overdose can be deadly
MAOI
inhibits breakdown of amine neurotransmitters, hypertensive crisis. avoid
pseudonephrine.
Chlorpromazine (thorazine)
Anticholinergic side effects constipation, urinary retention, blurred vision, dry mouth.
Suck on hard candy. It does not alter skin perfusion.
Lithium
maintain sodium levels watch for vomiting, diarrhea, sweating
Alcohol withdrawal
Naltroxone. 2-3 days after can be a seizure risk, hand tremors will occur, monitor bp
Difference between alzheimers and dementia
Alzheimers is progressive forgetfullness and dementia is rapid
Confabulation
Filling in gaps in memory bu fabrication
Delusion
false fixed belief seen in schizos
Child abuse pattern
inconsistency between history and child's injury
Maslow's hierarcy of needs
1. sleep, food 2. safety 3. love and belonging 4. self actualization
First priority for alcohol withdrawal
rest and nutrition
donepezil (aricept)
for alzheimers prolong time and functioning of individual in early stages of disease
Cocaine signs
dilated pupils
marijuana signs
bloodshot eyes
heroin signs
pinpoint eyes
pcp signs
rapid eye movement
agoraphobia
,fear of places or situations that might cause panic such as going outside
Conversion
physical complaints not true
grandiosity
"I am grand" narcissistic behavior
PTSD
nightmares, indecisive, lack of emotion during a event
Kubler ross stages of grief
1. denial 2. anger 3. bargaining 4. depression 5. acceptance
Alprazolam (xanax)
panic disorder med. anticholingeric
Benzo side effect
dizziness, sedation, drowsiness
OCD
set time limits , cannot have a pleasant moment
Borderline personality disorder
a personality disorder characterized by lack of stability in interpersonal relationships,
self-image, and emotion; impulsivity; angry outbursts; intense fear of abandonment;
recurring suicidal gestures, self mutilation
How often should provider renew restraints perscription
q4 hrs and follow up withing 1st hour of prescribing
Bupropion
for quitting nicotine
Buprenorphine
think phine for opioids withdrawal treatment
anorexia
An eating disorder characterized by an obstinate and willful refusal to eat, a distorted
body image, and an intense fear of being fat. Appearance of lanugo, amenorrhea,
intolerance to cold, bradycardia, dry skin, hypotension, occupied thoughts of food
Bulimia
An eating disorder characterized by episodes of overeating, usually of high-calorie
foods, followed by vomiting, laxative use, fasting, or excessive exercise. tooth erosion,
hand calluses, hypokalemia monitor patient 1 hour after eating
Lithium blood testing rules
8 hrs after last dose, 5 days after beginning dose, dosage changes, then testing for 6
months monthly
methylphenidate
improved attention
opioid use disorder
impaired coordination, euphoria, decreased respirations, drowsiness. think clumsy
sleepy person
For schizos what increases hallucinations?
anxiety
quetiapine
schizo med, monitor glucose
buspirone
,antianxiety, GAD, does not cause sedation, does not cause dependence, do not take as
PRN, and this med will become effective in 2-4 weeks
avolition
lack of emotion
delirium
rapid fluctuations of loc
chlordiazepoxide
is for alcohol use disorder
disulfram
alcohol use disorder
Amphetamine
paranoia AE akathisia-agitation, restlessness
Psychosocial History
Perception of own health, beliefs about illness and wellness
Activity/leisure activities, how the client passes time
Use of substances/substance use disorder
Stress level and coping abilities - usual coping strategies, support systems
Cultural beliefs and practices
Spiritual beliefs
mental health exam
Alert - The client is responsive and able to fully respond by opening her eyes and
attending
to a normal tone of voice and speech. The client answers questions spontaneously
and appropriately.
■■ Lethargy - The client is able to open her eyes and respond but is drowsy and falls
asleep readily.
■■ Stupor - The client requires vigorous or painful stimuli (pinching a tendon or rubbing
the sternum)
to elicit a brief response. She may not be able to respond verbally.
■■ Coma - No response can be achieved from repeated painful stimuli.
Alturism
Dealing with anxiety by reaching
out to others. Person who lost spouse in fire is a firefighter
sumblimination
hidden feelings about someone and then goes to work out to release the anger
orientation phase
set boundaries and expectations, determine client's needs
operant conditioning
positive reinforcement
aversion therapy
use bad stimuli if patient does something bag like dog chewing on cord and you put
bitter apple on the cord and the dog pulls away
Cluster A
Odd or ecentric. Schizo paranoid
Cluster B
, Dramatic, emotional, erratic. Antisocial-Characterized by disregard for others with
exploitation, repeated unlawful actions,
deceit, and failure to accept personal responsibility, borderline-Characterized by
instability of affect, identity, and relationships, as well as splitting
behaviors, manipulation, impulsiveness, and fear of abandonment,
Cluster C
Anxious, fearful. Avoidant, dependent, OCD
paradoxical response
insomnia, excitation, urgency
LOC - ALERT
patient is responsive
opens eyes spontaneously
answers questions appropriately
LOC - LETHARGIC
patient can open eyes and respond to questions
falls asleep easily
LOC - OBTUNDED
patient responds to light shaking
is confused
slow to respond
LOC - STUPOROUS
patient barely responds to painful stimuli
example
rubbing sternum
LOC - COMATOSE
patient is unresponsive
abnormal posturing may be present
DECORTICATE POSTURING
arms flexed/internally rotated
legs extended/internally rotated
DECEREBRATE POSTURING
head arched back
arms/legs extended
AUTONOMY
patient has the right to make their own decisions even if not in their best interest
BENEFICENCE
