Shared Flashcard Set

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Psychology
Mental Health Nursing
60
Nursing
Undergraduate 3
04/02/2014

Additional Nursing Flashcards

 


 

Cards

Term
Bipolar I Disorder
Definition
  • at least one episode of mania alternating with major depression
  • more common in men

 

Term
Bipolar II Disorder
Definition
  • hypomanic episodes alternating with major depression
  • Manic-depressives - have highest rate of suicide of all psych illnesses
  • more common in females
Term
Specifiers of Bipolar Disorder
Definition
  • mixed episodes - criteria for both manic and depressive episodes met
  • hypomanic episode - same as manic but less than four days, do not impede the individual from functioning
  • secondary mania - caused by medical disorders of treatment
  • rapid cycling - four or more episodes within twelve months
Term
Clinical Course of Bipolar Disorder
Definition
  • chronic cyclic disorder
  • later episodes occur more frequently
  • interpersonal/occupational fxning are affected
  • patient has rapid clycling between mania, depression, and hypomania and depression.
Term
Rapid Cycling
Definition
  • four or more mood episodes that occur within a 12 month period
  • episodes must last a minumum of a few days and be distinct
  • women have more episodes than men
Term
Cyclothymia
Definition
  • hypomanic episodes alternating with minor depressive episodes
  • cycles between hypomania and dysthymia for at least two years
  • no delusions, not usually hospitalized, doesn't impair social, occupation or interpersonal fxning
Term
Epidemiology
Definition
  • lifetime prevalence of bipolar disorder in the US is 5.1%
  • Bipolar I - more common in males
  • Bipolar II - more common in females
  • Cyclothymia - begins in adolescence or early adulthood
Term
Epidemiology of Bipolar Disorder
Definition
  • 21-30 years, men and women affected equally
  • 10-15% of adolescents with recurrent depressive episodes develop bipolar I
  • tends to be comorbid to anxiety, substance and personality disorders
Term
S/S of Manic Phase
Definition
  • mood is elevated, irritated
  • speech is long and rapid, running, clanging and rhyming, vulgar
  • wt. loss, delusions, decreased sleep, flight of ideas
  • begins suddenly and escalates over period of a few days
Term
S/S of Depressive phase
Definition
  • dysphoric, depressive and despairing mood
  • no interest in please, negative thoughts, fatigue, loss of appetite, low libido
  • may be agitated or have movement retardation
Term
Characteristics of Mania
Definition
  • hyperactivity - nonstop activity, no eating, no sleeping, can lead to exhaustion
  • bizarre and colorful dress, highly distracted
  • impulsive spending, run up credit cards
  • increased energy - speech can't keep up with thoughts, clanging, rhyming words, nonsensical
Term
Interventions for Bipolar Disorder
Definition
  • prevent exhaustion, injury
  • quiet, calm environment
  • solitary, noncompetitive activities
  • 5-7 hours of sleep, high calorie and protein foods, keep hydrated
  • medication compliance
Term
Cognitive-behavioral therapy
Definition
  • understanding distortions in thought and activity
  • learn new ways to cope with illness
Term
Interpersonal and social rhythm therapy
Definition
  • focus on structured daily routines
  • stabilizing sleep/wake cycles
  • work out key relationship problems and issues
Term
ECT Therapy
Definition
  • only to be used as last resort option
  • patient will exhibit severe manic behavior, rapid unctrollable cycling, paranoid and destructive features, acutely suicidal behavior
Term
Restraints/Seclusion
Definition
  • used only in an emergency for clients when there is a clear risk of harm to client or others
  • client's behavior has continued despite use of less restrictive methods to keep client and others safe
  • shortest duration
Term
Bipolar disorders are _?_ to greater than _?_ heritable.
Definition
  • 80-90%

Term
Polygenic disease
Definition
  • a disease in which the number of genes contribute to its expression
Term
Both schizophrenia and bipolar disorder exhibit irregularities on chromosomes ___ and ___
Definition
  • 13 and 15
Term
Flight of Ideas
Definition
  • nearly continuous flow of accelerated speech with abrupt changes from topic to topic with play on words
Term
Clang Associations
Definition
  • stringing together words because of their rhyming sounds with no meaning
Term
Grandiosity
Definition
  • inflated self-regard
  • exaggeration of behavior, importance or achievement
Term
What are first line medications used for acute depressive episodes related to bipolar disorder?
Definition
  • Lithium
  • lamotrigine (Lamictal)
Term
Lithium Carbonate
Definition
  • LiCO3, Li+
  • effective for bipolar I acute and recurrent manic/depressive episodes
  • inhibits 80% of episodes within 10-21 days
  • less effective for mixed mania, rapid cycling and aytipical features
Term
Two major risks of lithium therapy are?
Definition
  • hypothyroidism
  • kidney impairment r/t ability to concentrate urine
Term
Expected Lithium Side Effects
Definition
  • 0.4-1.0 mEq/ml (therapuetic range)
  • hand tremors, polyuria, mild thirst
  • weight gain
Term
Early Signs of Lithium Toxicity
Definition
  • 1.5 mEq/ml
  • N/V, diarrhea, thirst, polyuria, slurred speech, muscle weakness
Term
Advanced Signs of Lithium Toxicity
Definition
  • 1.5-2.0 mEq/ml
  • GI upset, mental confusion, muscler hyperirritability, sedation, incoordination
Term
Severe Lithium Toxicity
Definition
  • 2.0-2.5 mEq/ml
  • ataxia, blurried vision, large amounts of dilute urine, hypotension, coma, death
Term
Lithium Toxicity >2.5 mEq/ml
Definition
  • convulsions, seizures, oliguria, death
Term
Anticonvulsant Drugs
Definition
  • demonstrate efficacy in treatment of mood disorders
  • helpful for cycling patients, schizoaffective patients, controlling mania and depression
Term
Valporate (divalproex sodium)
Definition
  • useful for non-lithium responders
  • used for acute mania, rapid cyclers
  • helps prevent future episodes
  • monitor liver fxn and platelet count
Term
Carbamazepine (Tegretol)
Definition
  • used for treatment-resistant bipolar disorder
  • helpful with rapid cycling, paranoid manias, dysphoric mania
  • check liver fxn and platelet count, blood levels every 8 wks
Term
Lamotrigine (Lamictal)
Definition
  • first line treatment for bipolar depression and acute therapy
  • monitor for rare, but life-threatening rash; seek medical attention immediately
Term
Electroconvulsant therapy (ECT)
Definition
  • used to subdue severe manic behavior with treatment resistant mania and rapid cycling (four or more episodes of illness a year)
Term
____ and ____ are never to be used as punishment or for the convenience of the staff.
Definition
  • Seclusion and Restraints
Term
Seclusion Protocol
Definition
  • documentation must be obtained in 15-30 minutes after seclusion
  • document patient behavior every 15 minutes
  • offer food and fluids every 30-60 minutes

toil the patient every 1-2 hrs

Term
When is seclusion warranted?
Definition
  • substantial risk to self or others
  • patient cannot control actions
  • behavior excalates uncontrollably
  • all other measures have failed
Term

Problems of Mood Stabalizer

 

Definition
  • can cause weight gain, altered metabolism
  • put patients at risk for diabetes, HTN, dyslipidemia
Term
What symptom related to communication is likely to be present in a patient experiencing mania?
Definition
  • Verbosity
Term
For assessment purposes, the nurse should identify the body symstem most at risk for decompensation during a severe manic episode as?
Definition
  • Cardiac
Term
Mild Anxiety
Definition
  • normal every day life, helps to perceive reality
  • S/S - physical discomfort, restlessness, irritability, tension-relieving behaviors (foot tapping, nail biting)
Term
Moderate Anxiety
Definition
  • person sees, hears, and grasps less information
  • selective inattention, only certain things are seen or heard
  • S/S - pounding heartbeat, perspiration, tachypenia, headache, urinary urgency
Term
Severe Anxiety
Definition
  • person only focuses on one detail or scattered details, don't notice surrounding environment
  • Learning and problem solving are not possible; dazed and confused
  • S/S - trembling, shaking, hyperventilation, sense of impending doom, N/V, dizzy, headache
Term
Panic
Definition
  • most extreme level of anxiety
  • person is unable to process what is going on, can lose touch with reality
  • S/S - hallucinations, false sensory perception, screaming/shouting, erratic, uncoordinated, impulsive
  • can lead to exhaustion
Term
Defense Mechanism
Definition
  • automatic coping styles to protect people from anxiety and maintain self-image by blockng feelings, conflicts, and memories
Term
Adaptive use of defense mechanisms helps people to lower ____?
Definition
  • anxiety to achieve goals
Term
When evaluating if the use of defense mechanisms are adaptive or maladaptive, how do you determine?
Definition
  • frequency
  • intensity
  • duration
Term
Separation Anxiety
Definition
  • development of inappriopriate levels of concern over being away from a significant other
  • the fear that something horrible will appen to the other person
  • anxiety is so intense it distracts from ADLs, sleep
Term
How does separation anxiety develop?
Definition
  • after significant stress (death of relative or pet)
  • after illness
  • physical or sexual assault
Term
Characteristics of adult separation anxiety
Definition
  • avoidance
  • worry/shyness
  • fatigue
  • uncertainty
  • impairs social and occupational fxning
Term
Panic Disorder/Panic Attack
Definition
  • the sudden onset of extreme apprehension or fear, r/t feelings of impending doom
  • attacks seem to come out of nowhere, last ten minutes
Term
Signs and Symptoms of Panic Disorder
Definition
  • no normal fxning, misinterpretation of reality
  • SOB, choking, chills, N/V
  • may become avoidant of social situations, feelings of hopelessness, depressed mood
Term
Agoraphobia
Definition
  • intense, excessive anxiety and fear about being in places or situations from which escape might be difficult or not available
Term
Specific Phobia
Definition
  • persistent irriational fear of a specific object, activity or situation that leads to avoidance
  • cause high levels of anxiety
Term
Social Anxiety Disorder
Definition
  • also called social phobia
  • severe anxiety or fear of exposure to a social or performance situation
  • can cause high levels of anxiety, avoid social situations
Term
Generalized Anxiety Disorder
Definition
  • excessive worry
  • can cause restlessness, irritable, experience muscle tension, sleep disturbance
  • continually seeks reassurance and worries over minor details
Term
Obsessions and Compulsions
Definition
  • obsessions - thoughts, impulses or images that persist or recur and cannot be dismissed
  • compulsions - ritualistic behaviors that are driven to be performed in an attempt to reduce anxiety
Term
Body dysmorphic disorder
Definition
  • persons are preoccupied with an imagined defective body part and has obsessional thinking
  • false assumptions about the importance of appearance, fear of rejection, perfectionism
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