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Mental Health
Test 2
135
Nursing
Post-Graduate
10/26/2010

Additional Nursing Flashcards

 


 

Cards

Term
Extrapyramidal motor system
Definition
nerve trunk connecting thalmus to basal ganglia, controls muscle tone reflexes, automatic motor movements like walking- antipsychotic medications cause extrapyramidal symptoms (EPS) like hypertonicity, stiffness, tremors etc
Term
Brain stem
Definition
emits serotonin- depression & fibromyalgia, eating disorders
Term
frontal lobe
Definition
motor speech function, personality executive functions (plan & initiate actions)
Term
limbic
Definition
memory & emotional behavior
Term
limbic midbrain nuclei
Definition
pleasure center, may be involved in addiction
Term
plasticity
Definition
ability of the brain to change-synaptic pruning
Term
how does the brain compensate for loss of function in specific areas?
Definition
nerve signals rerouted,cells learn new functions,new tissues regenerated
Term
excitatory neurotransmitters
Definition
reduce the membrane potential and enhance the transmission of the signal between neurons
Term
inhibitory neurotransmitters
Definition
increase the membrane potential and depress the transmission of the signal between neurons
Term
Presynapse (axon)
Definition
stores neurotransmitters (monoamines) and releases neurotransmitters when excited
Term
Synapse (synaptic cleft or gap)
Definition
space between presynapse and postsynapse
Term
Postsynapse (dendrite)
Definition
receives impulse when transmitted and releases neurotransmitters after impulse is received
Term
dopamine (DA)
Definition
cognition, motor, involuntary motor movements, and neuroendocrine functions
Term
excessive dopamine
Definition
implicated in schizophrenia & other psychosis as well as release with cocaine and amphetamine use
Term
Serotonin (5-HT)
Definition
deals with appetite, sleep, mood, pain perception, vomiting, hallucinations
Term
under activity of serotonin
Definition
implicated in depression, bulimia & OCD
Term
disregulation of serotonin
Definition
implicated in anxiety, violence, schizoaffective and personality disorders
Term
disregulation of serotonin
Definition
implicated in anxiety, violence, schizoaffective and personality disorders
Term
norepinephrine (NE)
Definition
deals with mood states, learning & memory
Term
underactivity of norepinephrine
Definition
implicated in depression
Term
depleted norepinephrine
Definition
Alzheimer’s Disease and Korsakoffs’ syndrome
Term
impaired norepinephrine
Definition
in anxiety and addiction
Term
acetylcholine (Ach)
Definition
higher intellectual functioning & memory,

Under-activity implicated in Alzheimer’s disease
Term
melatonin
Definition
synthesized from serotonin


Shortage implicated in Seasonal Affective Disorder (SAD) & sleep/wake cycle
Term
Gamma-aminobutyric acid (GABA)
Definition
Inhibitory neurotransmitter (decreases neurotransmission Low levels of this receptors causes more susceptibility to anxiety disorders, seizures example- benzos
Term
alcohol
Definition
GABA action is destroyed by chronic use of what?
Term
Glutamate and Aspartate
Definition
excitatory neurotransmitters, implicated with kindling in bipolar disorder
Term
kindling in bipolar disorder
Definition
ability to handle stress is decreased with kindling

electrical stimulation leading to nerve depolarization and seizure activity, mood swings
Term
receptors
Definition
each neurotransmitter has one that only it will fit, drugs and disease can change the sensitivity of them
Term
Psychoneuroimmunology
Definition
Explores interaction between CNS, endocrine & immune systems; impact of stress on these interactions; & impact of psychological & medication interventions
Term
chronobiology
Definition
the study and measure of time structures or biologic rhythms
circadian rhythms
zeitgebers (time synchronizers like light or suprachiasmatic nuclei of the hypothalamus
Term
Phineas Gage
Definition
suffered from frontal lobe dysfunction after an iron rod propelled through his frontal lobe resulting in significant changes in his personality
Term
King George III
Definition
suffered from genetic disease called porphyria that effects the body's ability to make haem. Thought to be bipolar disease during his lifetime
Term
Cognitive Behavioral Therapy
Definition
used to alter distorted beleifs and problem behaviors by identifying and replacing negative and inaccurate thoughts and changing the rewards for behaviors
Term
Rational Emotive Behavior Therapy
Definition
changing irrational beliefs that cause distress using ABCDE
Term
Solution Focused Therapy
Definition
focuses on solutions rather than problems- positive, future oriented change
Term
cognitive triad
Definition
thought about oneself, the world, and the future
Term
schema
Definition
develop in early childhood and are fixed by middle childhood- life rules that act as a sieve or filter
Term
2 hours late
Definition
lithium dose should be skipped if after being how late?
Term
.5-1.5
Definition
what is the therapeutic level for lithium?
Term
renal function and TSH
Definition
with lithium use what should be monitored every 6 months?
Term
lithium side effects
Definition
tremors, muscle twitches, metallic taste, GI and GU distress (N/V/D), fatigue, lethargy, weight gain
Term
Lithium 300-600mg tid
Definition
used for bipolar for antimania, for slow cyclers (yearly or less)- inexpensive
Term
every week until stable and then every month or 3-6
Definition
how often should lithium levels be taken?
Term
overdose, fluid & electrolyte changes, diuretics, illness, renal dysfunction, NSAIDs, liver disease
Definition
causes of lithium overdose?
Term
flu-like, kidney damage, cardiac changes, decreased level of consciousness, seizures, coma, death.
Definition
signs of lithium toxicity?
Term
anticonvulsants(mood stabilizers)
Definition
Reduce repetitive firing of action potentials in the nerves
Term
1-4 hours
Definition
peak serum level for anticonvulsants?
Term
potential drug interactions, birth control
Definition
with anticonvulsant, what pt education is important?
Term
50-125mcg
Definition
depakote(anticonvulsant) therapeutic range?
Term
depakote
Definition
broad spectrum of efficacy, expensive, long periods of mood stabilization
Term
4-12 mg
Definition
tegretol therapeutic range?
Term
tegretol
Definition
anticonvulsant, Effective in patients who experience no response to lithium or patients with secondary mania
Term
AGRANULOCYTOSIS AND APLASTIC ANEMIA, dizziness, confusion, drowsiness, GI distress, blurred or double vision, photosensitivity, sunburns, hepatotoxicity
Definition
what are the side effects of tegretol?
Term
weekly for 3 months then monthly
Definition
how often should WBCs be monitored with tegretol use?
Term
2 weeks
Definition
how long should you wait to take tegretol after MAOIs use?
Term
tegretol
Definition
gradual discontinuation or risk for seizures with this anticonvulsant?
Term
lamictal
Definition
Effective for rapid cycling and in the depressed phase of bipolar illness
Term
benign skin rash, sedation, blurred or double vision, dizziness, nausea, vomiting, and other gastrointestinal symptoms
Definition
side effects of lamictal
Term
rash within 2-8 weeks of treatment, more common in children and should be immediately discontinued
Definition
severe, life-threatening side effect that can occur with lamictal
Term
vagus nerve stimulation
Definition
used for severe depression when 4 or more treatments have not worked
Term
transcranial magnetic stimulation
Definition
current sent through magnetic coil and into brain, alternative to ECT in helping with symptoms
Term
electroconvulsive therapy
Definition

Treatment for severe depression; used for mania and schizophrenia when other treatments have failed

Term

hypo- or hypertension,bradycardia or tachycardia, minor arrhythmias

 

headache, nausea, and muscle pain immediately after
Memory loss usually transient

 

Definition
side effects of electroconvulsive therapy
Term
PET scan of frontal lobe
Definition

shows glucose hypometabolism in depression w/

rt side mania

lt side depression

Term
Neurobiologic hypotheses of depression
Definition
involves serotonin (most antidepressants), norepinephrine & dopamine
Term
Neuroendocrine and neuropeptide hypotheses of depression
Definition
hypothalmic adrenal pituitary dysfunction with possible control by neurotransmitters   
Term
Psychoneuroimmunology hypothesis of depression
Definition

cytokines (protein messengers) signal the brain mediate immune responses- role unknown

Term
Seasonal Pattern Depression
Definition
2 episodes in 2 consecutive years treated with light therapy
Term
Postpartum Depression
Definition

within 4 weeks of giving birth

 

1 in 1000 will have psychotic features 

 

depression can range from moderate to severe

Term
children with depression
Definition

less likely to have psychosis but more likely to have anxiety and somatic symptoms and behavioral changes

 

mood may be more irritable than sad

Term
elderly with depression
Definition
highest rates of suicide
Term
Major Depressive Disorder
Definition
depressed mood/loss of interest with 4 other symptoms for at least 2 weeks
Term
Dysthymic Disorder
Definition

depressed mood most day for 2 years with at least 2 other symptoms

 (Only in depression you get interest deficit, psychomotor changes & suicidality)

Term
mood disorders
Definition
The WHO predicts that what will be the number one public health problem in the 21st century?
Term
depression
Definition
the number one cause of disability
Term
SSRIs
Definition
most commonly used in treatment of depression and OCD
Term
SSRIs
Definition
very low anticholinergic and sedative effects with this depression med
Term
SSRIs
Definition

Pro Zolo Packed His Celebrated Lexus

 

Prozac, Zoloft, Paxil, Celexa, Lexapro

Term

nervousness, anxiety, HA, insomnia, drowsiness, fatigue, tremor, diaphoresis, dizziness, rash, hives, nausea, and diarrhea

 

usually lessen or stop in first few weeks of use

Definition
SSRIs side effects
Term
Serotonin Syndrome
Definition
life threatening emergency caused by combining more than one SSRI, MAOI, St. John's Wort, or TCAs
Term
mild symptoms of serotonin syndrome
Definition
time limited, self resolving & includes sx of tremor, myoclonus, diaphoresis & restlessness
Term
moderate symptoms of serotonin syndrome
Definition
diminished consciousness including coma, elevated mood, shivering & rigidity
Term
severe symptoms of serotonin syndrome (toxic state)
Definition
coma, generalized tonic clonic seizures, high fever (can exceed 104 F)
Term
TCAs
Definition
As effective as SSRIs, but have more serious side effects and a higher lethal potential
Term
TCAs
Definition
Blocks reuptake of NE &/or 5HT by the axon (presynapse) correcting the deficit of NE & 5HT
Term
elavil and tofranil
Definition
examples of TCAs
Term
anticholinergic effects, sedation, drowsiness, dizziness, weight gain, n/v/d,sexual dysfunction, orthostatic hypotension
Definition
TCA side effects
Term
TCAs
Definition
antidepressant with high potential for overdose so only one week supplies at a time
Term
MAOIs
Definition
risk of hypertensive crisis if you don't follow tyramine diet with this antidepressant
Term
MAOIs
Definition
Nardil and Parnate
Term
Over the counter cold and weight reduction medications, aged cheeses, red wine, sherry, draft beer, pepperoni, salami, pickled herring, sauerkraut
Definition
what foods should be avoided with MAOIs?
Term
chocolate, raisins, yogurt, avocado, aspartame, cottage and cream cheeses
Definition
what foods should be used in moderation with MAOIs?
Term
SARI- Serotonin antagonist reuptake inhibitors
Definition
selectively block reuptake of serotonin - fewer anticholinergic GU & neurologic effects than SSRIs
ex. trazodone
Term
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Definition
Low dose inhibits serotonin uptake, mod to high dose inhibits norepinephrine uptake, higher doses dopamine uptake is added
Term
Effexor, Cymbalta,Serzone, Norpramin
Definition
SNRIs
Term
Norepinephrine-Dopamine Reuptake Inhibitor (NDRI)
Definition
wellbutrin- smoking cessation
Term
tetracyclic antidepressants
Definition
Mirtazapine and Maprotoline Hydrochloride
Term
limbic system
Definition
"fight or flight"
Term
hypothalamus
Definition
regulate emotions
Term
bipolar disorders diagnosis
Definition
manic episode with at least 3 symptoms, 4 if irritable for at least 1 week
Term
bipolar type I
Definition
Combinations of major depression and full manic episode


Mixed episodes: alternating between manic and depressive episodes
Term
bipolar type II
Definition
Combination of major depression and hypomania (less severe form of mania)
Term
mixed episode BD
Definition
Criteria for both a manic episode and a major depressive episode are met and are present for at least 1 week
Term
hypomanic episode in BD
Definition
Same as for a manic episode, except that the time criterion is at least 4 days, rather than 1 week. Definite change in function perceived by others but no psychosis, hospitalization, or impact on social, occupational functionin
Term
cyclothymic disorder
Definition
Presence for at least 2 years of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet full criteria for a major depressive episode
Term
intense rage (2-3 hours)
Definition
hallmark of childhood and adolescent bipolar disorder?
Term
depression
Definition
in children with bipolar disorder, which mood is present first?
Term
irritability and emotional lability
Definition
younger children with bipolar disorder expereince more?
Term
more classic symptoms with euphoria and grandiosity
Definition
what symptoms do older children with bipolar disorder experience?
Term
poorer prognosis bc of co-morbidity, more confusion and disorientation, late on-set usually related to medical illness or substance abuse
Definition
elderly with bipolar disorder?
Term
24% lifetime risk
Definition
genetic risk of bipolar disorder?
Term
mood stabilizers
Definition
in bipolar depression, antidepressants are combined with what to prevent mani switch?
Term
being in a treatment relationship
Definition
the best predictor of positive outcomes for bipolar pts is?
Term
antipsychotics
Definition
bipolar pts who are psychotic or do not tolerate mood stabilizers may be prescribed what?
Term
best research, clinical expertise, and patient values
Definition
evidenced based nursing includes?
Term
infant
Definition
Erikson's basic trust vs mistrust
Term
toddler
Definition
Erikson's autonomy vs shame and doubt
Term
preschool-aged child
Definition
initiative vs guilt
Term
school aged child
Definition
industry vs inferiority
Term
adolescence
Definition
identity vs role diffusion
Term
young adult
Definition
intimacy vs isolation
Term
adulthood
Definition
generativity vs stagnation
Term
maturity
Definition
ego integrity vs despair
Term
Id(libido)
Definition
instincts, disregard for others, pleasure
Term
Ego
Definition
use of reason and intellect to meet demands of Id
Term
Superego
Definition
conscience, moral, judging behavior
Term
transference
Definition
the patients unconscious feelings towards others that originally were with important people in the persons life
Term
countertransference
Definition
the nurses unconscious feelings toward a patient based on the nurses previous life experience. Can impair nurse patient relationship.
Term
Karen Horney: feminine psychology
Definition
rejected penis envy, Women are at a disadvantage because of authoritarian culture
Term
Melanie Klein
Definition
play therapy techniques, a child patterns self after another person
Term
Peplau
Definition
influenced by Sullivan, self is anti-anxiety system, nurse-patient relationships
Term
Carol Gilligan & Jean Baker Miller
Definition
girls development is more related to attachment within relationships than boys
Term
Madeleine Leininger
Definition
Sunrise Model, transcultural nursing, directed toward holistic, congruent, and beneficent care
Term
psychoanalysis
Definition
accessing the unconscious and resolving the conflicts that originated inchildhood with a mature adult mind
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