Mental Health Unit 3

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alr
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Mental Health Unit 3
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2012-02-23 22:13:43
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depression bipolar personality disorders
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meds, terms, symptoms
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  1. Names of SSRI meds?
    What are they used for?
    What is the action?
    • used for depression
    • increase the concentration of norepinephreine, serotonin, and dopamine in the body by blocking the reuptake of the neurotransmitters

    • Fluxotine (Prozac) kids can use
    • escitalopram (Lexapro)
    • Sertraline (Zoloft)
    • Paroxotine (Paxil)
  2. Names of SNRI meds?
    What are they used for?
    What is the action?
    • used for depression
    • increase the concentration of norepinephreine, serotonin, and dopamine in the body by blocking the reuptake of the neurotransmitters

    Venlafaxine (Effexor)
  3. Names of hererocyclics?
    What are they used for?
    What is the action?
    • used for depression
    • increase the concentration of norepinephreine, serotonin, and dopamine in the body by blocking the reuptake of the neurotransmitters

    • Burpropion (Wellbutrin)
    • Trazadone (Deseryl)
  4. Names of Tricyclics (TCAs)?
    What are they used for?
    What is the action?
    • used for depression
    • increase the concentration of norepinephreine, serotonin, and dopamine in the body by blocking the reuptake of the neurotransmitters

    Amitriptoline (Elavil)
  5. Names of MAOIs?
    What are they used for?
    What is the action?
    • used for depression
    • increase the concentration of norepinephrine, serotonin, and dopamine in the body by inhibiting an enzyme called monoamine oxidase

    • Phenylzine (Nardil)
    • do not consume food that contains Tyramine
  6. Names of Antimanic meds?
    What are they used for?
    used for Bipolar disorder

    Lithium (Eskalith)
  7. Names of anticonvulsant meds?
    What are they used for?
    used for bipolar disorder

    • Valporic acid (Depakote)
    • Carbamazepine (Tegretol)
    • Lamotrigine (Lamictal)
  8. name of antisychotics?
    what are they used for?
    used for bipolar disorder

    • Olanzapine (Zyprexa)
    • Rispiradone (Risperdal)
    • Chlorpromazine (Thorazine)
    • Aripirazole (Abilfy)
    • Ziprasidone (Geodon)
  9. What are TCAs contraindicated with?
    patients with myocardial infraction and angle closure glaucoma
  10. What meds produce these side effects?
    blurred vision
    constipation
    urinary retension
    orthostatic hypotension
    seizure
    tachycardia
    photosensitivity
    weight gain
    Tricyclics (TCA) and heterocyclics
  11. What meds produce these side effects?
    -insomnia
    -agitation
    -weight loss
    -sexual dysfunction
    -serotonin syndrome (change in mental status, tachycardia, restlessness, labile blood pressure, shivering, tremors)
    SNRI and SSRI
  12. What meds produce these side effects?
    -Hypertensive crisis with food containing tyramine
    - occiptital headache, palpitations, nausea/vomiting, nuchal rigidity, fever, sweating, increase in BP, chest pain and coma
    MAOIs
  13. What is the therapeutic drug serum level for lithium at maintancenc level and acute mania level?
    • maintance 0.6 to 1.2 mEq/L
    • acute mainia 1.0 to 1.5 mEq/L
  14. What is the lithium serum level with these side effects?
    blurred vision, ataxia, tinnitus, persistent nausea, and vomiting
    1.5 to 2.0 mEq/L
  15. What is the lithium serum level with these side effects?
    polyuria, tremors, muscular inrritabilitly, mental confusion and giddiness
    2.0 to 3.5 mEq/L
  16. What is the lithium serum level with these side effects?
    impaired consciousness, nystagmus, oliguria, seizures, anuria, MI and cardiovascular collapse
    aboue 3.5 mEq/L
  17. What meds have these side effects?
    nausea
    vomiting
    drowsiness
    dizziness
    blood dyscriasis
    increased bleeding time
    risk for suicide
    risk of severe rash with lamotrigine
    Anticonvulsants
  18. an alteration in mood that is expressed by feelings of sadness, despair, and pessimism. loss of interest in usual activities, and somatic symptoms may be evident
    depression
  19. type of depressive disorder?
    - depressed mood or loss of interest or pleasure in usual activities
    - impaired social and occupaitonal functioning
    - existed for at least 2 weeks
    - no history of manic behavior, and symptoms that can't be attributed to use of substances or general medical condition
    - weight loss or gain
    - insomnia or hypersomnia
    - psychomotor agitation or retardation
    - fatigue
    - worthlessness or excessive guilt
    - thoughts of death
    Major depressive disorder (MDD)
  20. type of depressive disorder?
    - milder than MDD
    - mood as sad or down in dumps
    - no evidence of psychotic symptoms
    - essential feature chronically depressed mood for most of the day for at leat 2 years
    - poor appetite or overeating
    - insomnia or hypersomnia
    - low energy or fatigue
    - low self esteem
    - poor concentration or difficutly making decisions
    - feelings of hopelessness
    dysthymic disorder
  21. type of depressive disorder?
    - markedly depressed mood
    - excessive anxiety
    - mood swings
    - decreased interest in activities during the week prior to menses and subsiding shortly after onset of menstruation
    - lack of energy or fatigue
    - food cravings
    - hypersominia or insomnia
    - overwhelmed
    - physical symptoms- headaches, bloating
    - interferes with work or school
    premenstrual dysphoric disorder
  22. etiological implications realated to biochemical influences?
    deficiency of neurotransmitters norepinepherine, serotonin, and dopamine
  23. What does cognitive therepy do for a depressed patient?
    focuses on helping the patient to alter mood by changing the way he or she thinks
  24. What is the only medication approved to treat depression in children and adolescents?
    Fluoxetine (Prozac)
  25. Type of post partum depression?
    - feeling of blues
    - tearfulnes, despondency, anxiety, and subjectively impaired concentration
    - begins withing 48 hours of delivery and lasts approximately 2 weeks
    maternity blues
  26. type of post partum depression?
    - worse toward evening and associated with fatigue, irritability, loss of appetite, sleep disturbances, loss of libido
    - concertn about inability to care for baby
    - begin later than maternity blues and takes a few weeks to several months to abate
    moderate postpartum depression
  27. type of postpartum depression?
    - depressed mood, agitation, indecision, lack of concentration, guilt and an abnormal attitude toward bodily functions
    - lack of interest or rejection of baby
    postpartum melancholia or depressive psychosis
  28. Nursing process type of depression?
    -symptoms subside relatively quickly- not necessarily dysfunctional
    - affetive: sadness, dejection, feeling down hearted, blues
    - behavioral: some crying possible
    - cognitive: some difficulty getting mind of one's disappointment
    - physiological: feeling tired and listless
    Tansient depresion
  29. Nursing process type of depression?
    - occurs when the grief process is triggered
    - associated with normal grieving
    - affective: denial of feelings, anger, anxiety, guilt, helplessness, sadness, dependency
    - behavioral: tearfulness, regression, restlessness, agitation, withdrawal
    - cognitive: preoccupation with the loss, self blame, ambivalence, blaming others
    - physiological: anorexia or overeating, insomnia or hypersomnia, headache, backache, chest pain, or other symptoms associatied with loss of significant other
    mild depression
  30. nursing process type of depression?
    - occurs when grief is prologed or exaggerated
    - fixed in stage of anger
    - unable to function without assistance
    - dysthymic disorder is an example
    - affective: feelings of sadness, dejection, helplesness, powerlessness, hopelessness, gloomy and pessimistic outlook, low self esteem, difficulty experiencing pleasure
    - behavioral: slowed physical movements, slumped posutre, slowed speech, rumination about failures or regrets, social isolation, increased use of substances, self destructive, decrease interest in hygiene and grooming
    - cognitive: retarded thinging processess, difficutly concentrating and directing attention, obsessive and repetitive thoughts, pesimism and negativism, verbalization and behavior reflecting suicidal ideation
    - physiological: anorexia or overeating, insomnia or hypersomnia, amenorrhea, decreased libido, headaches, backaches, chest pain, abdominal pain, low energy level, fatigue, feeling best in morning and continually worese as day progresses
    Moderate depression
  31. nursing process type of depresion?
    - intensification of symptoms
    - loss of contact with reality
    - complete lack of pleasure in all activities and rumination about suicide are common
    - major depressive disorder and bipolar are examples
    - affective: feelings of tatal despair, hopelessness, worthlessness, flat affect, feelings of nothingness and emptiness, apathy, loneliness, sadness, inability to feel pleasure
    - behavioral: psychomotor retardation may come to standstill or rapid agitated, purposeless movements; slumped posutre, sitting in curled up position, walking slowly, non existent communication, no personal hygiene and grooming, social isolation
    - cognitive: delusional thingking, with delusions of persecution and somatic delusions being most common, confusion, indecisiveness, and inability to concentrate; hallucinations reflecting misinterpretations of the environment; excessive self deprecation, slef blame, thoughts of suicide
    - physiological: slowdown of entire body, reflected in sluggish digestion, constipation and urinary retention, amenorrhea, impotence; decreased libido, anorexia, wheight loss, difficulty falling asleep and awakkening; feeling worse in morning and somewht better as day progresses
    Severe depression
  32. Therapy type?
    provides an atmosphere in which individuals may discuss issues in their lives that cause, maintain, or arise out of having a serious affective disorder
    group therapy
  33. type of therapy?
    working with families of pts with mood disorders are to resolve the symptoms and initiate or restore adaptive family functioning
    family therapy
  34. type of therapy?
    - individual is taught to control thought distoritions that are considered to be a factor in development and maintenance of mood disorders
    - general goal: obtain symptom relief as quickly as possible, to assist the pt in identifying dysfunctional patterns of thinking and behaving, and to guide the pt to evidence and logic that effectively tests the validity of the dysfuncitonal thinking
    cognitive therapy
  35. type of therapy?
    - induction of a grand mal seizure throught the application of electrical current to the brain
    - S/E: temporary memory loss and confusion
    Electroconvulsive therapy
  36. characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy
    delusions and hallucinations may or may not be present
    may reflect seasonal pattern
    bipolar disorder
  37. - pt who is experiencing, or has experienced, a full syndrome of manic or mixed symptoms
    - may have experienced episodes of depression
    - diagnosis is further specified by the current or most recent behavioral episode experienced
    Bipolar I disorder
  38. - charaterized by recurrent bouts of major deression with episodic occurrence of hypomania
    - never experienced an episode that meets the full criteria for mania or mixed syptomatology
    Bipolar II disorder
  39. - chronic mood disturbance of at least a 2 year duration involving numerous episodes of hypomania and depressed mood of insufficient severity or duration
    - is never without hypomanic or depressive symptoms for more than 2 years
    Cyclothic disorder
  40. biochemical etiological implications for bipolar disorder?
    excess of norepinephrine and dopamine
  41. Nursing process to bipolar disorder
    - not sufficiently severe to cause marked impairment in social or occupaitonal functioning or to require hospitalization
    - mood: cheerful and expansive; underlying irritability that surfaces rapidly
    - cognition and perception: perceptions of self are exalted ideas of great worth and ability. thinking is flighty, with rapid flow of ideas. easily distracted
    - activity and behavior: increased motor activity; very extroverted and sociable. lack depth of personality and warmth to formulate close friendships. talk and laugh a great deal, usually very load and inappropriate. increased libido. anorexia and weight loss. inappropriate behaviors, such as phoning president or buying huge amounts on credit card with out having money to pay for it
    Stage I - hypomania
  42. Nursing process to bipolar disorder
    - intensification of hypomania
    - marked by impairment in functionaing and require hospitalization
    - mood: euphoria and elation; on continuous high; easily chaging to irritability and anger or even sadness and crying
    - cognition and perception: psychotic; rapid thinking proceeds to racing and disjointed thinking with continuous flow of accelerated, pressured speech with abrupt changes in topic. distractibility becomes all pervasive; hallucination and delusions common
    - activity and behavior: psychomotor is excessive, sexual interest is increased, poor impulse control, excessive spending, ability to manipulate others, energy seems inexhaustible and need for sleep diminished. hygiene and grooming may be neglected. dress may be disorganized, flamboyant, or bizarre, excessive make up or jewelry
    Stage II - acute mania
  43. Nursing process to bipolar disorder
    - severe clouding of consciousness
    - mood: very labile; feelings of despair, quickly converting to unrestrained merriment and ecstasy or becoming irritable or totally indifferent to the environment; panic anxiety
    - cognition and perception: clouding of consciousness, confusion, disorientation, and somethimes stupor; religiosity, dleusions of grandeur or persecution, and auditory or visual hallucinations; extreamly distractible and incoherent
    - activity and behavior: psychomotor activity is frenzied, agitated, purposeless movements; safety is at stake. exhaustion, injury to self or others, and eventually death could occur without intervention
    Stage III - delirious mania
  44. type of therapy for bipolar disorder?
    - once acute pahse is passsed, groups can provide an atmosphere in which pts may discuss issues in their lives that cause, maintain, or arise out of having a serious affective disorder
    - helps members gain sense of perspective on their condition and tangibly encourage them to link up with others who have common problems
    - self help groups offer supplementary support that frequently enhances compliance with medical regimen
    group therapy
  45. type of therapy for bipolar disorder?
    - ultimate objectives are to resolve symptoms and initiate or restore adaptive family functioning
    family therapy
  46. type of therapy for bipolar disorder?
    - individaul is taught to control thought distortions that are considered to be a factor in the development and maintenance of mood disorders
    - individual with mania perceives the self as highly valued and powerful
    - general goal is to obtain symptom relief quickly as possible, to assist pt in identifying dyfunctional patterns of thinking and behaving and to guide the pt to evidence and logic that effectively tests the validity of the dyfunctional thinking
    cognitive therapy
  47. type of therapy for bipolar disorder?
    - used when pt fails to respond to lithium or other drug or when life is threatened by dangerous behavior or exhaustion
    electroconvulsive therapy
  48. What medication for bipolar produces these S/E?
    - drowsiness
    - dizziness
    - dry mouth
    - constipation
    - increased apetite
    - weight gain
    - ECG changes
    - EPS symptoms
    - hyperglycemia
    - diabetes
    antipsychotics

    • zyprexa
    • abilify
    • thorazine
    • risperdal
    • geodon
  49. What cluster of personality disorders is characterized by behaviors are odd or eccentric?
    cluster A

    • paranoid
    • schizoid
    • schizotypical
  50. What cluster of personality disorders is characterized by behaviors are dramatic, emotional, or erratic?
    cluster B

    • antisocial
    • borderline
    • histrionic
    • narcissistic
  51. what cluster of personality disorders is characterized by behaviors are anxious or fearful?
    Cluster C

    • avoidant
    • dependent
    • obsessive compulsive
    • passive aggresive
  52. Type of personality disorder?
    - distrust and suspiciousness of others sucha that their motives are interepreted as malevolent, beginning by early adulthood and present in a variety of contexts
    - seldom seek assistance for problem
    - more common in men
    - constantly on guard, hyperviligilant, and ready for any real or imagined threat
    - appear tense or irritable
    -immune or insensitive to others feelings
    - avoid interactions with people
    - feel that others are there to take advantage of them
    - constantly testing honesty of others
    - do not accept responsibility for own behavior and feelings and project responsibility on others
    - envious and hositile toward others who are highly successful
    - constantly on defense
    - possible loss of control can cuase aggression and violence
    - possible heredity link
    - learned to perceive world as harsh and unkind
    paranoid personality disorder
  53. type of personality disorder?
    - defect in ability to form personal relationships or to respond to others in any meaningful emotial way
    - social withdrawal and discomfort with human interaction is apparent
    - diagnosed more frequently in men
    - appear cold, aloof, and indifferent to others
    - prefer to work in isolation and are unsociable
    - little need or desire for emotional ties
    - in presence of others appear shy, anxious, uneasy
    - difficulty acting in a lighthearted manner
    - unable to experience pleasure, affect is bland and constricted
    - childhood = bleack, cold, notiably lacking empathy and nurturing
    schizoid personality disorder
  54. type of personality disorder?
    - "latent schizophrenics"
    - behavior is odd and ecentric but does not decompensate to level of schizophrenia
    - less severe schizoid personality pattern
    - aloof and isolated and behave in a bland and apathetic manner
    - magical thinking, ideas of reference, illusions and depersonalization are part of everyday world
    - belief in clairvoyancy, telepathy, "others can feel my feelings"
    - speech pattern bizarre
    - cannot orient thoughts logically
    - seem vague, digressive and not pertinent to topic
    - under stress- may decompensate and demonstrate psychotic symptoms such as delusions, hallucinations, or bizarre behaviors
    - affect is balnd or inappropriate, sucha s laughing at problem or at sad situations
    -early family dynamisc may have been characterized by indifference, impassivity, or formality, leading to pattern of discomfort with personal affection and closeness
    schizotypal personality disorder
  55. type of personality disorder?
    - colorful, dramatic and extroverted behavior in excitable, emotioanl people
    - difficulty maintaining long lating relationships
    - require constant affirmation of approval and acceptance from others
    - more common in women
    - self dramatizing, attention seeking, overly gregarious and seductive
    - use manipulative and exhibitionistic behviors
    - center of attention
    - want to be well liked, successful, popular, extroverted, attractive and sociable
    - evoke affection or attract attention at all costs
    - highly distractible and flighty by nature
    - highly suggestible, imperssionable, and easily influenced by others
    - strongly dependent
    - lacks ability ot provide another with genuinely sustainded affection
    - somatic compliants common
    - psychosis may appear dureing extreme stress
    - as child rarely received positive or negative feedback; parental acceptance and approval came inconsistently and only when behaviors met parental expectations
    Histrionic personality disorder
  56. type of personality disorder?
    - exaggerated sense of self worth
    - lack of empathy and are hypersensitivie to evaluation of others
    - right to receive special consideration
    - justification for possessing whatever the seek
    - more common in men
    - appear to lack humility, being overly self centered and exploiting others to fulfill their own desires
    - view self as "superior"
    - believe they are entitled to special rights and privileges
    - mood usually optimistic, relaxed, cheerful and carefree
    - mood can easily change because of fragile self esteem
    - respond to criticism with rage, shame, humiliation or dejection
    - impaired interpersonal relationships
    - in selecting mate, frequently choose a person who will provide them with praise and positive feedback that they require and who will not ask much from thier partner in return
    - as children - they had fears, failures or dependency needs responded to with criticism, disdain or neglect
    - parents were demanding, perfectionaistic, and critical and they placed unrealistic expectations on child
    Narcissistic personality disorders
  57. type of personality disorder?
    - extremely sensitive to rejectiona dn because of this may lead a socially withdrawn life
    - may be a strong desire for companionship
    - extreme shyness and fear of rejection
    - awkward and uncomfortable in socail situation
    - timid, withdrawn or cold and strange
    - sensitivities, touchiness, evasiveness, and mistrustful
    - speech slow and constrained with frequent hesitaitons, fragmentary though sequences, and occasional confused and irrelevent digression
    - often lonely and feeling of being unwanted
    - view others as critical, betraying, and humiliting
    - depression, anxiety, anger at oneself for failing to develop social relations
    - parental rejection and censure
    - belittled, abondeoned and criticized
    Avoidant personality disorder
  58. type of personality disorder?
    - need to be taken care of that leads to submissive and clinging behavior and fear of separation
    - allow others to make decisions, feel helpless when alone, act submissively, tolerate mistreatment, demean onself to gain acceptance and fail to function adequately in situations that require assertive or dominate behavior
    - common in women and younest child
    - lack self confidence
    - overly generous and thoughful and underplay thier own attractiveness and achievements
    - feel pessimistic, discouraged and dejected
    - suffering done in silence
    - feel incapable of caring for self
    - avoid positons of responsibility and become anxious when forced into them
    - low self worth and easily hurt by criticism and disapproval
    - do anything to earn acceptance from others
    - stimulation and nuturance comes from one source
    - parent becomes overprotective and discourages independent behaviors
    dependent personality disorder
  59. type of personality disorder?
    - serious and formal and have difficulty expressing emotions
    - overly disciplined, perfectionistic, pereoccupied with rules
    - inflexible
    - ntense fear of making mistakes leads to difficulty making decisions
    - common in men and oldest child
    - concern with organization and efficiency
    - rank concious
    - see selves as conscientious, loal, dependable, and responsible, and are contempturous of people whose behaviors they consider frivolous and impusive
    - emotional behavior immature and irresponsible
    - commonly use defense mechanism reaction formation
    - parents expect child to live up to their imosed standards of conduct and condem them if do not
    obssessive compulsive
  60. type of personality disorder?
    - pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance in social and occupational situations
    - feel cheated and unappreciated
    - express envy and resentment over "easy life"
    - go to great lengths to seek retribution or get even but always in subtle and passive manner rather than discussing feeling with person
    - gain attention, reassuracne, and dependancy they crave
    - parental responses are inconsistent and unpredictable
    passive aggresive
  61. type of personality disorder?
    - pattern of intense and chaotic relationships, with affective instability and fluctuating attitudes toward other people
    - impusive, directly and indirectly self destructive, lack clear sense of identlity
    - most commom peronality disorder
    - common in women
    - always seem to be in state of crisis
    - affet is one of extreme intensity
    - changes occur with in days, hours, or minutes
    - chronic depression
    - inability to be alone
    - clinging and distancing
    - splitting
    - self destructive behaviors
    - impusivity- substance abuse, gambling
    borderline personality disorder
  62. type of personality disorder?
    - socially irresponsible, exploitative and guitless behavior that reflects disregaurd for rights of others
    - exploit and manipulative others for personal gain
    - disregard for the law
    - difficulty sustaining consistent employment and developing stable relationships
    - more common in men and lower socioeconomic
    - admittted to hospital by court
    - group therapy works best
    - irresponible, eploitive and guiltless behavior
    - appear cold and callous
    - tend to be argumentative, cruel and malicious
    - lack warmth and compassion
    - very low tolerance for frustration, act impetuously and unable to delay gratification
    - restless and easily bored, often taking chances and seeking thrills
    - believe good guys conme in last
    - exploit others to fulfill own desines showing no trace of shame or guilt
    - see self as victim, using projection as primary ego defense
    - place trust only in themselves
    - tendency to ignore converntional authority and rules
    - frequently arisis from chaotic home environment
    antisocial personality

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