NURSING 3012 EXAM 3 FOCUS TOPICS ANSWERED QUESTIONS RATED A+ GUARANTEED SUCCESS LATEST UPDATE 2022 (QUESTIONS & RATIONALES FROM PAGE 15)

NURSING 3012 EXAM 3 FOCUS TOPICS ANSWERED QUESTIONS RATED A+ GUARANTEED SUCCESS LATEST UPDATE 2022 (QUESTIONS & RATIONALES FROM PAGE 15) Exam covers Chapters 12, 13, 14, 22, 25, & 26 and content from weeks 7, 8, & 9 75 test questions, 4 Select all that apply Chapter 12 Schizophrenia & Schizophrenia Spectrum Disorders Auditory hallucinations - Hearing voices, noises, music or sounds that are not actually real Waxy flexibility - Extended maintenance of posture - Usually seen in catatonia -Nurse raises patients arm and the patient continues to hold position in statue like manner. Loose Associations - Communication pattern characterized by lack of clarity of connection between one thought and the next - Thoughts, speech jump around from topic to topic, and makes little to no sense Concrete thinking - Impaired ability to think abstractly - Resulting in interpreting or perceiving things in a literal manner - Difficulty responding to concepts like love or humor Neologism - Newly coined word expression - Made up word - Ex: headshoe= hat Command hallucinations - Disturbed auditory sensory perceptions demanding that client take action often to harm self or others - Considered dangerous - Often referred as voices Schizophrenia – outcomes; prodromal stage assessment findings - Prodromal stage oSymptoms are subtle but present - Affective Symptoms oinvolve emotions and expression ▪dysphoria ▪suicidality hopelessness ocognitive symptoms: subtle changes in memory or attention or thinking •inattention •poor problem-solving skills •poor decision-making skills •impaired judgement onegative symptoms ▪blunt affect ▪poverty of thought (alogia) ▪loss of motivation (avolition) ▪Inability to experience pleasure (anhedonia) oPositive Hallucinations ▪Delusions Disorganized speech Bizarre behavior What are interventions for delusions of persecution? - Give patient prepackaged food Chapter 13 Bipolar and Related Disorders Mood - Euphoric mood associated with mania is unstable - Overly joyous mood is out of proportion to what is going on and the cheerfulness may be inappropriate for the circumstances - Person will often give away money, prized possessions and expensive gifts Grandiosity - Exaggerated sense of superiority or self-importance - Beliefs that one holds special superpower, unique knowledge or is extremely important Acute mania – outcomes; interventions; associated nursing diagnoses; documentation in treatment plan - Interventions: depressive episodes- hospitalization for suicida, physchotic or catatonic sings oManic episodes: hospitalization for acute mania or bipolar 1 oMonitor fluid intake o Work with aggression o medication - Primary outcome: prevent injury oReflects both physiological and psychiatric issues - Dx: risk for injury, risk for other related violence, sleep deprivation, altered thought process, self-care deficit, impaired social interaction - Outcome: patient safety and medical stabilization Nsg diagnosis – - imbalanced nutrition: - less than body requirements; - disturbed sleep pattern; - risk for injury - ineffecgtive coping - care giver role strain - impaired social interaction - self care deficit What is cause of bipolar disorder? - Genetics - Neurotransmitters - Neuroendocrine oHypothyroidism - Environmental stressors - Psych factors oStressful event What are the genetic components involved in the development of bipolar disorder? - Women: more likely to internalize feelings and drink or do drugs - Men: externalize feelings and commit acts of violence. How do you counteract staff splitting? - Frequent staf f meetings to deal with patient behavior and staf f response - Set limits consistently What are complications of lithium (eg. Side effects/adverse effects)? - Hypothyroidism - Kidney Impairement - Contraindications oCardiovascular disease, brain damage, renal disease, thyroid disease, pregnancy, breastfeeding, children younger than 12 What elements are included in seclusion protocols? - Obtain seclusion/restraint prescription - Observe pt behavior Q15M - Offer food/fluids Q30-60M - Offer use of restroom Q1-2H - Measure vital signs Q1-2H Chapter 14 Depressive Disorders Major depressive disorder – interventions; lab tests a physician may order to rule out a medical condition; associated nursing diagnoses – situational low self-esteem -Interventions oAcute phase (6 to 12 weeks) o- Reduction of depressive symptoms & restoration of psychosocial & work function o- Hospitalization may be required o Continuation phase (4 to 9 months) o - Prevention of relapse o- Pharmacotherapy, psychotherapy, & education oMaintenance phase (1 year or more) o- Prevention of further episodes - Dx; o•Risk for suicide—safety is always the highest priority •Hopelessness •Ineffective coping •Social isolation •Spiritual distress •Self-care deficit - Lab test oThyroid Mood and affect - Affect; appearance of observable emotions - Mood: how the patient tells you they are feeling Anhedonia - Inability to feel pleasure What cautions are given to patients who start new SSRI therapy? - Increased risk for suicide when beginning to take What is the risk to the nurse who works with severely depressed patients? - Frustration and ineffectiveness due to patient not getting better What food is included on a tyramine-restricted diet? - Meat - Cheese - Beer - Wine - Fermented foods CBT – what does this type of therapy address? - Focuses on adherence to the medication regimen, early detection and intervention for manic or depressive episodes, stress and lifestyle management, and the treatment of depression and comorbid conditions. Chapter 22 Substance-Related and Addictive Disorders Alcohol tolerance - Patient demonstrates need for increasing amounts of alcohol in order to achieve the desired effect Codependence - Codependent people often demonstrate over responsible behaviors - Do for others what other could very well do for themselves - Often define self-worth in terms of caring for others without regard to their own needs Substance addiction - Alcoholism, drug abuse, smoking - It is a primary, chronic disease of brain reward, motivation, memory and related circuity - Chronic disease of brain reward, motivation, memory and related ciruitry Nursing diagnosis – risk for injury What is the most important finding for a patient in alcohol withdrawal? - Seizures may occur within 6-8 hours after cessation - Withdrawal delirium occurs within the 72 hours cessation - Tremors What medication is administered to a patient in acute alcohol withdrawal? - Diazepam - Disulfiram What medication is administered to a patient in acute opioid withdrawal? -Methadone What is the highest priority to assess for an opioid overdose patient? - Respiratory distress What is the highest priority to assess for a patient with an amphetamine overdose? - Monitoring vital signs How will a heroin user present? What should you see upon assessment for him/her? - Exhibit psychomotor retardation - Drowsiness - Slurred speech - Altered mood - Impaired memory and attention - Pupillary constriction - Intense drowsiness can lead to coma What is the primary neurotransmitter found in addiction and substance abuse patients? - dopamine Chapter 25 Suicide and Non-Suicidal Self-Injury Suicidal risk - adolescents are at high risk due to immature prefrontal cortex ocopycat suicide Primary prevention for suicide