Upgrade to remove ads
Only $35.99/year

Community 1 Exam 2 (Mental Health)

Terms in this set (71)

denial
unconscious failure to acknowledge an event, thought, or feeling that is too painful for conscious awareness
displacement
the transference of feelings to another person or object
identification
attempt to be like someone or emulate the personality, traits, or behaviors of another person
intellectualization
using reason to avoid emotional conflicts
introjection
incorporation of values or qualities of an admired person or group into one's own ego structure
isolation
separation of an unacceptable feeling, idea, or impulse from one's thought process
passive-aggressive
indirectly expressing aggression toward others
a facade of overt compliance masks covert resentment
projection
attributing one's own thoughts or impulses to another person
rationalization
offering an acceptable, logical explanation to make unacceptable feelings and behavior acceptable
reaction formation
development of conscious attitudes and behaviors which are opposite of what is really felt
psychodynamic theory
ego cannot intervene bn ID and superego so there is maladaptive response to anxiety
cognitive theory
faulty/distorted/counterproductive thinking patterns that lead to anxiety and is maintained by mistaken appraisal of a situation
behavioral theory
Genetics
Hereditary factor may be involved
Biochemical influences
Deficiency of norepinephrine, serotonin, and dopamine has been implicated
Excessive cholinergic transmission may also be a factor
Systematic desensitization
Implosion therapy
biological aspects of anxiety
genetics, neuroanatomical, biochemical, neurochemical
panic disorder
recurrent panic attacks, onset unpredictable
s/s panic disorder
sweating, shaking, SOB, fear of losing control, dying
generalized anxiety
chronic, unrealistic, excessive anxiety and worry
6+ months
agoraphobia
fear of being in places that you cannot escape
social anxiety
fear of being in situations where you might be embarrassed
trichotillomania
hair pulling for relief
major depressive
Characterized by depressed mood
Loss of interest or pleasure in usual activities
Symptoms have been present for at least 2 weeks
No history of manic behavior
Cannot be attributed to use of substances or another medical condition
persistant depressive
Sad or "down in the dumps"
No evidence of psychotic symptoms
Essential feature is a chronically depressed mood for:
Most of the day
More days than not
For at least 2 years
premenstrual depressive
Depressed mood
Anxiety
Mood swings
Decreased interest in activities
Symptoms begin during week prior to menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses
postpartum depressive
May last for a few weeks to several months
Associated with hormonal changes, tryptophan metabolism, or cell alterations
s/s of postpartum depression
Fatigue, irritability
Loss of appetite
Sleep disturbances
Loss of libido
Concern about inability to care for infant
depression implications of 3 and younger
feeding problems
tantrums
do not want to play
do not show emotions
depression implications of 3-5 yrs
prone to accidents
phobias
excessive self reproach
depression implications of 6-8 yrs
physical complaints
aggressive
clingy
depression implications of 9-12 yrs
morbid thoughts
worries a lot
depression implications of adolescents
behavioral changes that last for several weeks
more likely for SI if abandoned
depression implications of senescence
bereavement overload
SI among elderly is high
watch for personality change, not just bc of aging
mild depression
s/s associated with normal grieving
Affective: anger, anxiety
Behavioral: tearful, regression
Cognitive: preoccupied with loss
Physiological: anorexia, insomnia
moderate depression
s/s associated with dysthymia (less severe depression)
Affective: helpless, powerless
Behavioral: sluggish physical movements, slumped posture, limited verbalization
Cognitive: slow thinking processes, difficulty with concentration
Physiological: anorexia or overeating, sleep disturbance, headaches
severe depression
includes s/s of major depressive disorder and bipolar disorder
Affective: feelings of total despair, worthlessness, flat affect
Behavioral: psychomotor retardation, curled-up position, absence of communication
Cognitive: irrelevant delusional thinking with delusions of persecution and somatic delusions, confusion, suicidal thoughts
Physiological: a general slow-down of the entire body
risk for suicide related to
Depressed mood
Feelings of worthlessness
Anger turned inward on the self
Misinterpretations of reality
60-70% of those who talk about suicide attempt within 6 months
70% has one or more chronic illness
risk for suicide
male
18-30 and >65
depression
previous attempt
alcohol abuse
loss of rational thinking
social supports lacking
organized plan
availability of means
single
chronic illness
client and family education related to antidepressants
Therapeutic effect may not be seen for as long as 4 weeks
Do not discontinue use of the drug abruptly
Avoid smoking and drinking alcohol
Be aware of risks of taking antidepressants during pregnancy
when taking MAOIs avoid foods high in
tyramine
mild anxiety
seldom a problem
adaptive
can provide motivation for survival
intervention with mild anxiety
open ended questions
stress management
problem solving
moderate anxiety
perceptual field diminishes
interventions with moderate anxiety
encourage verbalization of feelings
BE CALM
sever anxiety
perceptual field is so diminished that can only concentrate on one detail or many extraneous details
interventions with sever anxiety
structured tasks
point out reality
use short, firm, simple statements
panic
most intense state
if prolonged, may lead to exhaustion
intervention with panic state
SAFETY
medical conditions that may produce anxiety
cardiac
endocrine
respiratory
neurological
anxiety is an ____ process
where as fear/stress is a ____ process
anxiety is an emotional process
where as fear/stress is a cognitive process
adaptation is determined by
the extent to which the thoughts, feelings, and behaviors interfere with one's functionality
anxiety at the moderate to severe level that remains unresolved over a period of time can lead to
physiological disorders
such as migraines, IBS, and arrhythmias
types of benzodiazepines
xanax
ativan
valium
what do benzos act on
GABA
effects felt quickly
unique about BuSpar
2-4 weeks to show results
lower risk for dependency/abuse
SSRIs used for
antidepressive
panic disorders
beta blockers uses for
HTN
anxiety
bipolar I disorder
client is experiencing or has experienced a full syndrome of manic or mixed symptoms or depression
bipolar II disorder
characterized by bouts of major depression with episodic occurrences of hypomania
has never met criteria for full manic episode
cyclothymic disorder
chronic mood disturbances
at least 2 year duration
numerous episode of hypomania and depression of insufficient severity to meet the criteria for either I or II
stage I: hypomania
s/s not sufficiently severe to cause marked impairment in social or occupational functioning or to require hospitalization
cheerful mood
rapid flow of ideas
heightened perception
increased motor activity
stage II: acute mania
marked impairment in functioning
usually requires hospitalization
elation and euphoria
flight of ideas
accelerated, pressured speech
hallucinations/delusions
excessive psychomotor activity
social/sexual inhibition
little need for sleep
stage III: delirious mania
grave form of the disorder characterized by an intensification of the symptoms associated with acute mania
rare since the advent of antipsychotic medication
labile mood
panic anxiety
clouding of consciousness
disorientation
frenzied psychomotor activity
exhaustion
possibly death without intervention
in the initial stages of caring for a client experiencing an acute manic episode, what should the nurse consider to be the priority nursing diagnosis?
Risk for injury related to excessive hyperactivity
drugs for mania
Lithium carbonate
Anticonvulsants
Verapamil
Antipsychotics
drugs for depressive phase
use of antidepressants with care (may trigger mania)
takes lithium 7-14 days to
reach therapeutic level
lithium toxicity
blurred vision
ataxia
tinnitus
persistent N/V
severe diarrhea
what should you be aware of when taking lithium
exercise and heat may affect levels
monitor for SE of lithium
Drowsiness, dizziness, headache
Dry mouth, thirst, GI upset, nausea/vomiting
Fine hand tremors
Hypotension, arrhythmias, pulse irregularities
Polyuria, dehydration
Weight gain
Potential for toxicity
monitor SE of anticonvulsants
Nausea and vomiting
Drowsiness, dizziness
Blood dyscrasias
Prolonged bleeding time (with valproic acid)
Risk of severe rash (with lamotrigine)
Decreased effectiveness of oral contraceptives (with topiramate)
Risk of suicide with all antiepileptic drugs (FDA warning, December 2008)
SE with verapamil
Drowsiness, dizziness
Hypotension, bradycardia
Nausea
Constipation
SE with antipsychotics
Drowsiness, dizziness
Dry mouth, constipation
Increased appetite, weight gain
ECG changes
Extrapyramidal symptoms
Hyperglycemia and diabetes
Sets found in the same folder