ip exam 1

stress hormone (fight or flight)
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Terms in this set (80)
neurotransmitter for anti-depressant drugs (2)Norepinephrine and serotoninneurotransmitter for Cholinesterase InhibitorAcetylcholinefluoxetine, setraline CC?SSRIs Anti-depressantsVenlafaxine/Desvenlafaxine CC?SNRIs Anti-depressantsNortriptyline/ Amitripyline CC?Tricyclic Anti-depressantsIsocarboxazid/ Phenelzine CC?MAOIs Anti-depressantsDiazepam/Lorazepam CC?Benzodiazepines, Anti-anxietyRamelton, Buspirone CC?Melatonic receptor agents, Anti-anxietyZolpidem, zaleplonshort-acting hypnotic sleep agents, Anti-anxietyLithium CC?mood stabilizersOlanzapine CC?Anti-psychotic•Valproate, Carbamazepine, Lamotrigine, and Gabapentin CC?Anti-convulsantsKeep the channel open, resulting in hyperpolarization of the neuronsBenzosPrevents reuptake, increasing the amount of NT in synaptic gapanti-depressantsdestroy NT in gapCholinesterase InhibitorsWorks on the electrical activity of the neuron, slowing the charge. Some block neuron transmissionmood stabilizersblock the receptorsanti-psychotics•2-4 weeks for clinical response •GI sx, HA, Sexual Dysfunction •Do Not stop abruptly; May increase suicidal thoughts •Avoid Alcohol •Know common drugs in this categorySSRIs and SNRIs•2-4 week clinical response •Can cause sedation and orthostatic hypotension. FALL RISK •OTC Drugs can interfere •Do Not stop abruptly •Highly lethal in overdoseTricyclic Antidepressants•2-4 week clinical response •Rarely used, requires close monitoring •Potential fatal drug and food interactions •Tyramine-Restricted Diet -No yeast products (alcohol), processed meats and cheeses, avocados -Most fresh fruits, vegetables and fresh meat is okayMAOIs•Benzos - Short acting, not for long-term maintenance of anxiety •FALL Risk, interferes with motor ability, reaction time, attention, and judgement •Avoid Alcohol useAnti-anxiety; Benzodiazepines, Sleep agents, Melatonin•10-21 days response time •Take with meals due to nausea •Common, fine hand tremors, nausea, polyuria •Can cause dehydration •Levels must be checked: •Therapeutic levels 0.6-1.2 mEg/L •Toxicity levels > 1.5 mEq/Lmood stabilizers, LithiumAnti-Psychotic Used to control hyperactivityOlanzapine (Zyprexa)regulates internal organs and vital functionscoreBasic drives and link between thought and emotion and function of internal organshypothalamusprocessing center for sensory informationbrainstem-Regulates skeletal muscle -Maintains equilibriumcerebellum-Mental activities -Conscious sense of being -Emotional status -Memory -Control of skeletal muscles—movement -Language and communicationcerebrumAbility and capacity to secure resources to support well-beingCharacterized by optimism, sense of mastery, competenceEssential to recoveryresiliencyachieving one's full potential, including creative activitiesSelf-Fulfillment needs, Top of pyramidMaslow's Hierarchy of Needs:-actualizationprestige and feeling of accomplishmentPsychological needs, 2nd from top of pyramidMaslow's Hierarchy of Needs: Esteem needsintimate relationships, friendsPsychological needs, 3rd from top of pyramidMaslow's Hierarchy of Needs: Belongingness and Love needssecurity, safetyBasic Needs, 4th from top of pyramidMaslow's Hierarchy of Needs: Safety needsfood, water, warmth, restBasic needs, bottom of pyramidMaslow's Hierarchy of Needs: Physiological needsGoal of self-care as integral practice of nursing Promoting self-care activities of the patientDorothea Orem, theoristCaring as a foundation for nursing Care and comforting interventions Nurse-patient relationship encourages nurses to provide caring and comforting interventions. She emphasizes the importance of the nurse-patient relationship and the importance of teaching and coaching the patient and bearing witness to suffering as the patient deals with illness.Patricia Benner, theoristInfancy, forming attachment with mother which lays the foundation for later trust in otherstrust vs mistrustEarly Childhood, gaining some basic control of self and environment (potty training)autonomy vs shame/doubtPreschool, becoming purposeful and directed (helping set the table)initiative vs guiltSchool Age, developing social, physical, and school skills (joining a sports team)industry vs inferiorityAdolescence (12-20), Making transition from childhood to adulthood (developing a sense of identity)identity vs role confusionEarly Adult (20-35), establishing intimate bonds of friendship and love; s/s of schizophrenia may have already appeared but this is the age that schizophrenia and schizoaffective disorder usually are apparent and diagnosedintimacy vs isolationMiddle Adult (35-65), fulfilling life's goals that involve family, career, and society; developing concerns that embrace future generationsGeneratively vs self-absorptionLater Years(65+)looking back over one's life and accepting its meaningintegrity vs despairRehabilitation and preservation of individualtertiary preventionEarly identification, screening with prompt and effective treatmentsecondary preventionTeaching coping strategies and providing psychosocial support to at risk individualsprimary preventionTo collect baseline data to aid in establishing the etiology, diagnosis, and prognosis. To evaluate the present state of psychological functioning. To evaluate changes in the individual's emotional, intellectual, motor and perceptual responses. To determine the guidelines of the treatment plan To determine if psychopathological response is in fact, a disorder of a sensory organ (a deaf person appearing hostile, depressed or suspicious). To document altered mental status for legal records.Purpose of metal status examCorrection of learned maladaptive behavior Therapist role: Active, directive teacher PTSD, OCD, Panic DisorderShort-term (5-20 sessions) May consist of Modeling, Operant Conditioning, Systematic Desensitization, Aversion Therapy, and BiofeedbackBehavioral therapyEvaluation and modification of thoughts and behaviors Therapist role: Active, directive, and challenging Depression, Eating, Anxiety/PanicShort-term (5-20 sessions)cognitive- behavioral therapyprevent injuryacute phase of lvls of interventionrelapse preventioncontinuation phase of levels of interventionlimits severity and duration of future episodesmaintenance phase of levels of interventionExcessive questioningGiving approval or disapprovalGiving adviceAsking "why" questionsnon-therapeutic communicationThe individual has made a suicide attempt w/in the past 2 years. The criterion for non-suicidal self-injurious behavior is not met during the aforementioned suicide attempts. The diagnosis is not applied to preparation for a suicidal attempt or suicidal ideation. The act was not attempted during an altered mental state, such as delirium or "confusion". The act was not ideologically motivated- e.g.- religious or political.DSM-5 criteria to be suicidalMaintain clients dignity and self esteem, Maintain calmness, Assess the client and situation, Identify stressors, Respond early, Use a calm/clear voice, Invest time, Remain honest, Determine client need, Identify goals, Avoid invading personal space, Avoid arguing, Use empathyde-escalation techniquesAny manual method, physical or mechanical device, material, or equipment that restricts freedom of movementrestraintInvoluntary confinement alone in a room that the patient is physically prevented from leavingseclusionIndications for use: to protect the patient from themselves or to prevent the pt. from assaulting someone else Legal requirements: Must have an order, must let them know prior to, it is d/c asap Documentation: what caused the need for them, least restrictive means, interventions, pt. response, Ongoing eval Clinical assessments: pt. mental status at time of restraint, Physical exam, need for restraints Observation: constant view, chart every 15, ROM, VS, check hands/feet and skin under restraint Release procedure: pt. must follow commands and stay in control, terminate restraints, debrief with ptGuidelines for Use of Mechanical RestraintsConsider their own needs more important than the needs of others Controlling Poor social skills Extreme pathological jealousy May control family financescharacteristics of perpetratorsPregnancy may trigger or increase violence Violence may escalate when wife makes move toward independence Greatest risk for violence when the woman attempts to leave the relationshipCharacteristics of Vulnerable Persons: WomenYounger than 3 years Perceived as different Remind parents of someone they do not like Product of an unwanted pregnancy Interference with emotional bonding between parent and childCharacteristics of Vulnerable Persons: ChildrenPoor mental or physical health Dependent on perpetratorFemale, older than 75 years, white, living with a relative Elderly father cared for by a daughter he abused as a child Elderly woman cared for by a husband who has abused her in the pastCharacteristics of Vulnerable Persons: Older AdultsOccurs when one or more body senses experience over-stimulation from the environment. Who is affected: •Person's with sensory processing disorders such as autism, •Young children/babies or older adults. •Those in unfamiliar situationssensory overloadOccurs in with the loss of stimuli to one or more senses. Can be extremely anxiety provoking. •Loss of sight or hearing •Isolation or solitary confinement •Paralysis Can sometimes be beneficial... Induced coma to calm the senses and help the brain heal.sensory deprivationalways assess culture prior to?interventioncan show the brain and the layers of the brain. can detect lesions, abrasions, infarcts, edema, and infection..Structual imaging which are CTs andwill show actual physiological activity in the brain- Nuclear imaging techniques can show chemical changes as they are occurring. Example: In a patient with schizophrenia the scans might show a decreased use of glucose in certain parts of the brain.Functional imaging like pet scansscans shows how blood flows through arteries and veins in brain showing vascular insults/patterns and areas of the brain that might be more or less active such as when diagnosing dementiaFunctional imaging SPECT scanstalking or writing about death, making comments about being hopeless, helpless or worthless, expressions of having no reason to live, increased alcohol or drug use, withdrawal from friends and family, reckless/more risky behaviors, dramatic mood change, talking about feeling trapped or being a burden, giving away prized possessionswarning signs for suicide