Term
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Definition
| sudden feeling of impending doom. Recurrent episodes of panic attacks followed by at least one month of concern about another attack. Racing heart, sweating, choking sensation |
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Term
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Definition
| excessive anxiety or fear about being in public and around people. Avoidance of anxiety inducing areas or people |
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Term
| Panic Disorder Nursing Interventions |
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Definition
| Stay calm yourself, stay with, keep safe. Minimize stimuli, quieter environment. Give space. Don't minimize their thoughts. |
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Term
| Generalized Anxiety Disorder |
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Definition
| excessive anxiety or worry about numerous things that last for 6 months of longer. Worry is out of proportion with the true effect of the event or situation. |
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Term
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Definition
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Term
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Definition
| restlessness, easily FATIGUED, increased pulse and respirs, increase in activity, pressured speech, poor concentration, irritability, tension and sleep disturbance. |
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Term
| Nursing Interventions for GAD |
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Definition
| Guide them to think more logically, allow them to come to own conclusions. Challenge "all or none" thinking. Benzos on a short term basis. Journal triggers. |
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Term
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Definition
| persistent, irrational fear of a specific object activity, or situation that leads to avoidance of it. |
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Term
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Definition
| Very treatable, exposure therapy is very effective, Benzos or anti-depressants on a long term basis. |
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Term
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Definition
| defined as thoguhts, impluses, or images that persist and recur so that they cannot be dismissed from the mind. |
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Term
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Definition
| ritualistic behaviors that an individual feels driven to perform in an attempt to reduce anxiety. |
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Term
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Definition
| Axis I diagnosis. Know behavior is irrational and consumes most of time. Do not limit or stop ritual, it may increase anxiety. Gradually introduce anxiety-reducing techniques. Meds to bring anxiety down to a level where you can work with them. Benzos. |
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Term
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Definition
| Characterized by repeated re-experiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others. Individual responded with intense fear, helplessness or horror. Persistent re-experiencing, avoidance of stimuli associated with trauma, Numbing of general responses and arousal such as being on edge, trouble concentrating, exxagerated startled response. |
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Term
| PTSD Nursing Interventions |
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Definition
| GOAL: get them to verbalize feeliongs about the event. Reframe perception of the event, Get them out of the victim role, show them they are responsible for learning how to cope. May not recognize that they have PTSD. Helplessness and guilt are common themes. |
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Term
| DSM criteria for anorexia Nervose |
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Definition
| Body weight less than 85%. Fear of gaining weight, Inaccurate perception of self and weight. Amenorrhea:stop having menstraul period for at least 3 cycles due to loss of hormones. Hormones require a certain amount of body fat. |
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Term
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Definition
| engage in repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics,enemas, excessive exercise. Tend not to be as underweight. |
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Term
| Anorexia Nervose Signs and Symptoms |
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Definition
| Preoccupation with food, preoccupation with weight, views self as overweight, routine weigh ins, lanugo(fine hair on skin to keep warm), brittle hair, bradycardia, change in BP, electrolyte imbalances, osteoporosis, hematuria, proteinuria, mottled skin,cool skin, cachexia. |
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Term
| Anorexia Nervosa Assessment |
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Definition
| Emaciated, look older, depressed, anxious, can think logically but have cognitive distortion focused on food and weight. Don't usually believe they have a problem. Low self esteem, does not focus on relationships. Judge themselves by ability to lose weight. Perfectionistoc, try to please other people. |
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Term
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Definition
| Gain 2-3 pounds weekly, gradually. Reach 75% of ideal weight by discharge. Verbalize acceptance of new weight(long term.) Establish healthy eating patterns, verbalize feelings, demonstrate coping behaviors not related to food. Recognize issues and cope in healthy ways. |
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Term
| Anorexia Nervose Nursing Interventions |
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Definition
Daily weights for 1st week then 3x a week. Care of physical status: TPN/tube feedings, monitor cardiac status
Assist to establish healthy eating patterns:Introduce food gradually, discourage rituals, monitor during and after meals.
Assist to identify emotions and coping strategies:Fears of weight gain.
Cognitive Behavioral therapy to change perceptions. |
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Term
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Definition
| Eating Attitudes Test for addressing anorexia and bulemia. |
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Term
| Medications for Anorexia Nervosa |
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Definition
| SSRIs for depression management. Antipsychotics. Olanzapine(Zyprexa) helps with distorted body image. s/e WEIGHT GAIN |
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Term
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Definition
| Recurrent episode at least twice a week for at least 2-3 months. Lack of control over the eating. |
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Term
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Definition
| Binge eating and Purging behaviors often done in secret, impulsive behaviors, normal to slightly low weight, Dental cavaties, electrolyte imbalances(K+ lost in Gi tract), Cv abnormalities(ECG changes, work overload on the heart). Parotid gland swelling related to repeated vomiting. |
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Term
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Definition
| Intake restriction to hunger, to binging, to purging, to guilt, to repitition of cycle. |
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Term
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Definition
| Demonstration ability to regulate eating patterns, reduce purging behaviors(keep diary of triggers), maintain electrolytes and VS within normal limits, express satisfaction with body appearance, express expectation of a positive future. |
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Term
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Definition
| can decrease binging and decrease craving for carbohydrates. |
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Term
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Definition
| Occur at expected stages throughout the lifespan where formally used coping styles are no longer appropriate. Ex: Marriage, birth of a child, retirement. |
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Term
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Definition
| arise from an external source, usually unanticipated. Ex: loss of job, death of loved one, unwanted pregnancy, divorce. |
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Term
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Definition
| external events that are not typical to many people. Ex:natural disaster, terrorism, crime/violence. |
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Term
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Definition
Phase I-Anxiety
Phase II-Trial and Error
Phase III-Fight or Flight
Phase IV-Personality Disorganization |
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Term
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Definition
| Increased feelings of anxiety, Stimulates the use of problem-solving techniques and defense mechanisms to decrease anxiety. |
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Term
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Definition
| Trial and Error attempts at solving the problem and restoring a normal balance begin |
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Term
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Definition
| Anxiety can escalate to severe and panic levels and the person mobilizes automatic relief behaviors such as withdrawal or flight. Some form of resolution may be needed in this phase. Negative coping may begin ex:substance abuse. |
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Term
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Definition
| Anxiety can overwhelm a person and lead to serious personality disorganization, depression, confusion, violence or suicidal behavior. |
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Term
| Nursing Interventions for Crisis |
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Definition
Safety-assess for suicidal/homicidal thoughts and plans.
Anxiety reduction. Nurse plays active role. Assess support systems, identify coping skills(what has worked, what will work now, plan a follow-up apt. |
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Term
| Risk Factors for anger and aggression |
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Definition
Demographic risk factors include MALE, 14-24years old, low socioeconomic status, low social supports,
Mental disorders(dementia, substance abuse, paranoia, delusional), Chaotic environment(often at change of shift), Overcrowding, staff inexperience, inappropriate interventions, poor limit setting. |
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Term
| Assessment of Anger and Aggression |
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Definition
| History of violence is single best predictor, hyperactive/impulsive, predisposed to irritability, Does patient have intent to harm with a plan and have the means to do so?, lack of coping skills, assess for triggers, asses nurses personal sense of competence |
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Term
| Nursing Interventions for Anger and Aggression |
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Definition
| INTERVENE EARLY. Ensure your safety first, arms length or longer, position between patient and the door, Set limits(Direct approach:Violence is unacceptable, Indirect approach:give choices)Do not touch patient. Offer to take them to a quiet place. Meds may include Ativan, Haldol, anti-psychotics. |
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Term
| Medications for Acute aggression |
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Definition
Antipsychotics-Risperidol,Olanzapine,Ziprasidone IM, Haloperidol IM
Benzodiazepines- Lorazepam |
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Term
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Definition
Pattern of assualtive and coercive behaviors including physical, sexual, and psychological attacks as well as economic coercion.
Primary Prevention-Teach about healthy relationships
Secondary Prevention-Intervening and asking questions of high risk populations
Tertiary Prevention-Counseling |
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Term
| Intimate Partner Violence |
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Definition
| emotional, physical, or sexual abuse between current or former partners. An abusive relationship is all about instilling fear wand wanting to have power and control in the relationship. Partner is always slowly progressive in abuse. |
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Term
| Risk factors for intimate partner violence |
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Definition
| low self esteem, low income, young age, pregnant, drugs and alcohol, believe in strict gender roles, experienced poor parenting, economic stress, low academic achievement. |
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Term
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Definition
Abuser is edgy, has minor explosions, becomes verbally abusive possibly minor hitting. abuser becomes critical of the way partner dresses, cares for the home, etc. Or becomes unreasonably jealous, possesive, and watchful.
Victim feels tense and helpless, becomes compliant and accepts blame. |
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Term
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Definition
| Serious incident, tension becomes unbearable, victim may provoke incident to get it over with. Victim may cover up or look for help. |
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Term
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Definition
| Loving behavior, such as bringing gifts, promising to change, and apologizing. Victim is trusting and hopes for change. |
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Term
| Basic Intimate partner violence safety plan |
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Definition
| move to a room with more than one exit, know the quickest route out of your home and workplace,pack a bag with essential clothes, valuables and documents for you and children, keep hidden. Tell neighbors and ask to call when they hear a disturbance, have a code word to use with friends and family when you need help. have a safe place to go. |
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Term
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Definition
| Any type of sexual activity that victim does not agree to. Most under reported crime. Crime of control, humiliation and violence. Not about sex. |
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Term
| Victim vulnerability factors |
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Definition
| Women, under 18, poverty, substance abuse, past history of rape, drugs and alcohol use, high rish sexual behavior. |
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Term
| Rape Trauma Syndrome acute phase |
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Definition
| immediately after event. Shock, numbness, disbelief. May appear self contained and calm, or hysterical and crying. Person may have difficulty making decisions, solving problems, or concentrating. Traumatic injury, bruising, pain. Self blame, or anger. |
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Term
| Rape Trauma syndrome Long term phase |
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Definition
| Re-experiencing the trauma(nightmares,flashbacks, intrusive thoughts), social withdrawal, avoidance behaviors and actions of anything that could recall the crisis. Increased Psychological Arousal Characteristics-Exaggerated startled response, sleep disorders, hyper-vigilance, fear of being alone, sex. |
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Term
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Definition
| Do not leave patient alone, Approach in a non-judgemental manner. Stress confidentiality. Explain signs and symptoms to be expected. Do not press the patient to talk. Stress that the patient did the right thing. Get permission to take photos. Offer prophylaxis for pregnancy and STD treatment. Arrange for follow up |
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Term
| Addiction Biological THeory |
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Definition
| Addiction is a disease involving chemical changes in the brain. Brain reward mechanism(Limbic system)releases dopamine and results in addiction. |
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Term
| Addiction Psychological Theory |
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Definition
| Looks at emotions and personality. Predisposed are Low self esteem, lack of tolerance for frustration and pain, impulsiveness, those in need of control |
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Term
| Addiction Sociocultural Theory |
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Definition
| Addiction is a choice instead of a disease. Lower in chinese cultures, higher in Native american. Peer pressure. |
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Term
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Definition
| In a 12 month period: Maladaptive pattern of substance use which affects a person's role performance(parent, employee). Involves hazardous situations when impaired(driving.) Legal and interpersonal problems. Continues to use despite these problems. |
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Term
| substance DEPENDENCE criteria |
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Definition
Focus on withdrawal symptoms. At least 3 in a 12 month period. Increased Tolerance
Withdrawal
More or longer than intended
Unable to cut down
Use despite knowledge of problems.
Focused on substance(How to obtain)
Impaired relationships, work, leisure activities |
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Term
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Definition
Cut down-Have you ever felt you ought to cut down on your drinking or drug use?
Annoyed-Have people annoyed you by criticizing your drinking or drug use?
Guilty-Have you ever felt bad or guilty about your drinking or drug use?
E-Eye opener-have you ever had a drink or used drugs first thing in the morning to steady nerves or get rid of hangover?Any positive score suggests need for further evaluation |
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Term
| CNS Depressants Intoxication |
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Definition
Alcohol, Benzos, Baibituates:
Slurred speech, incoordination, unsteady gait, drowsiness, decreased blood pressure, Disinhibition of sexual or aggressive drives, impaired judgement |
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Term
| CNS depressants Overdose effects |
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Definition
| cardiovascular or respiratory depression, coma, shock, convulsions, death. Alcohol poisoning because it is absorbed so readily. |
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Term
| CNS Depressants withdrawal |
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Definition
| Can last 72 hrs. Anxious, insomnia, very diaphoretic, elevated vitals, hyperalert, jerky movements and irritability, startle easily, feel as if they are shaking inside. Grandmal seizures, illusions. |
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Term
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Definition
| Life threatening. Withdrawal symptoms are magnified. Vital signs out of control, Hallucination/Delusions usually tactile, Past history predisposes someone to Dts |
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Term
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Definition
| Withdrawal of alcohol scare. <10=minimal withdrawal. 10-15 is moderate withdrawal. >15 is severe |
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Term
| Medications for alcohol withdrawal |
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Definition
Assess for the need for these using CIWA scale
Benzos to mimic alcohol action on GABA. Used in decreasing doses.
Thiamine & Magnesium Sulfate to replace deficiencies. Anticonvulsants.
Folic Acid. Multivitamins, clonidine to lower BP |
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Term
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Definition
| To maintain sobriety. Get very sick if mixed with alcohol. Taken daily. not effective in late stages. |
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Term
| acamprosate calcium(Campral) |
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Definition
| Helps with alcohol craving. Restores GABA. Reduces physical/emotional state |
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Term
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Definition
| helps with craving of both alcohol and opioids |
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Term
| CNS stimulants INtoxication |
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Definition
| Cocaine/crack, Amphetamines, methamphetamines. Very high potential for abuse. Tachycardia, dilated pupils, Increased BP, Assualtiveness, Grandiosity, Euphoria. |
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Term
| CNS stimulants withdrawal effects |
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Definition
| "cocaine crash" Fatigue, depression, agitation, anxiety, sleeplessness |
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Term
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Definition
| Morphine, Demerol, Heroin. cause sleep, stupor, constricted pupils, decreased respirations, drowsiness |
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Term
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Definition
| can reverse opiate overdose, reduce respiratory depression |
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Term
| Meds for opiate addiction |
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Definition
methadone(Dolophine)
buprenorphine/naloxone(Suboxone) |
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Term
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Definition
| Highly communicable disease cause by bacillus, myobacterium tuberculosis, a gram positive, acid fast organism. Transmitted via aerosolization(airborne route). When an active person coughs, laughs, sneezes, whistles, or sings. |
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Term
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Definition
| Primary lesion visible on X-ray indicates Caesation necrosis(Neucrotic tissue being turned into a granular mass). If lesion liquifies and can form in other lung cavities. |
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Term
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Definition
| Disease becomes disseminated and involves other organs via the blood stream |
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Term
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Definition
| persistent, productive cough with blood tinged sputum, NIGHT SWEATS, fatigue, weight loss, temperature elevation in the afternoon or evening. |
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Term
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Definition
| TST-look within 48-72 hrs. Positive reaction indicated by induration(HARD,raised, reddened area) >10mm. >5 for HIV. Confirmed active with sputum culture, if unavailable, chest x-ray. |
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Term
| BCG(Bacillus Calmate-Guerin) Vaccine |
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Definition
| Used in other countries. WIll test positive on TST. |
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Term
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Definition
| First line drug. Used alone for Prophylaxis. Used in combination for active TB. Take drug on empty stomach, avoid antacids and alcohol. Take pyradoxene vit b6 to prevent peripheral neuritis. |
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Term
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Definition
| Avoid Alcohol, GET A BASELINE eye exam before starting due to s/e of optic neuritis. |
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Term
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Definition
| First line treatment.Body secretions become reddish-orange. |
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Term
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Definition
| watch for hepatotoxic effects |
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Term
Rifabutin(Mycobutin)
Rifapentene(Priftin) |
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Definition
| can be used 2x a week instead of daily |
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Term
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Definition
| well ventilated room. Negative pressure room. barrier protections. |
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Term
| Streptomycin- aminoglycoside |
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Definition
| used for multi-drug resistent TB. Major s/e is ototoxicity and nephrotoxicity. |
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Term
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Definition
| Directly observed therapy to assure they are taking all of their drugs for Extra drug resistent TB |
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