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2013-11-28 22:43:32
defense mechanisms, crisis, anxiety disorders,
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  1. unconscious refusal to accept an unacceptable idea or behavior.
    open rejection of an obvious truth.
  2. explaining away an unacceptable behavior in a way that superficially makes sense, but actually avoids the true explanation for the behavior.
  3. voluntary exclusion of anxiety-provoking thoughts
  4. unconscious forgetting of painful events
  5. an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual process of logic, reasoning and analysis.
  6. an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires.
  7. feelings or impulses unacceptable to one's self are attributed to another person
  8. beliefs and values of another individual are internalized and symbolically become a part of the self, to the extent that the feeling of separateness or distinctness is lost
  9. involves overachieving in one area to compensate for failures or inadequacies in another
  10. preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
    reaction formation
  11. feelings are transferred from one target to another that is considered less threatening or neutral
  12. an unconscious physical response to anxiety, involving one of the senses
  13. engaging in behavior to atone or make up for an undesirable behavior
  14. the separation of a thought or memory from the feeling, tone, or emotions associated with it
  15. re-channeling of drives or impulses that are personally or socially unacceptable into activities that are more tolerable and constructive
  16. a retreat to an earlier level of development and the comfort measures associated with that level of functioning
  17. associated with normal phases of growth and development
    maturational crises
  18. occur in response to an event which can range from job change to catastrophic events
    situational crises
  19. step 1: assessment of the patient and the problem.
    step 2: planning and intervention
    step 3: implementation
    step 4: evaluation
    crisis intervention
  20. aware that they are experiencing distress, aware that behavior are maladaptive, unaware of any possible psychological causes of the distress, feel helpless to change their situation, no loss of contact with reality.
    ex. phobias, generalized anxiety disorder, post traumatic stress disorder, obsessive-compulsive disorder, panic disorder.
    anxiety disorders
  21. fears, such as fear of snakes, common
  22. afraid of being in a crowd and not able to get out
  23. characterized by unreasonable thoughts and fears that lead to repetitive behaviors
    obsessive-compulsive disorder
  24. repeated, persistent, and unwanted ideas, thoughts, images, or impulses.
    -fear of contamination or dirt.
    -preoccupation with order and symmetry.
    -thoughts of violence and harming loved ones.
    -fear of intruders.
  25. unwanted repetitive behavior patterns or mental acts.
    -repeating words silently
    -washing and cleaning
    -demanding reassurances
  26. manifested by intense apprehension, fear or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort
    panic disorder
  27. chronic, unrealistic, and excessive anxiety and worry
    generalized anxiety disorder
  28. develops after a  terrifying ordeal that involved physical harm or the threat of physical harm to self or to others
    post traumatic stress disorder
  29. disturbances in thought process and perception of reality, disturbances of affect or mood, disturbances in communication
    psychotic disorders
  30. exhibit minimal distress (emotional tone is flat, bland, inappropriate), unaware that behavior is maladaptive, unaware of any psychological problems, exhibiting a flight from reality into a less stressful world or into one which they are attempting to adapt
  31. most likely due to a combination of biological, psychological, and environmental factors.
    may be due to problems with certain naturally occurring brain chemicals, including the neurotransmitters dopamine and glutamate
  32. affect
    associative looseness
    4 A's of Schizophrenia
  33. affect and thought content are incongruent or contradictory
    inappropriate affect
  34. blunt, restricted, little or no  affective expression, void of emotional tone,lacking overt expression of feelings
    flat affect
  35. unpredictable train of thought, incoherence, not clear what the link or association is between words and ideas
    loose associations
  36. social withdrawal and loss of contact with reality
    autism withdrawal
  37. contradictory feelings about self and others,
    coexistence of opposite emotions toward the same object, person, or situation
  38. false personal beliefs, not consistent with a person's intelligence or cultural background
  39. misperception of real external stimuli
  40. false sensory perceptions not associated with real external stimuli.
    auditory, tactile, visual, olfactory,gustatory
  41. the belief that casual events, people's remarks, etc. are referring to one self when, in fact, they are not
    ideas of reference
  42. extreme suspiciousness that results in persecutory delusions and hallucinations of a threatening nature
  43. a state in which the individual ceases to perceive the reality of the self or environment. the patient feels that his or her body is unreal, is unchanging, or is dissolving; or that he or she is outside of the body.
  44. withdrawal into unreal world of fantasy
  45. the person believes that his or her thoughts or behaviors have control over specific situations or people
    magical thinking
  46. describes the behavior associated with an individual's state or emotional tone
  47. inability to experience pleasure
  48. passivity, lack of energy
  49. lack of motivation, inability to initiate tasks
  50. thinking is characterized by speech in which ideas shift from one unrelated subject to another
    associative looseness
  51. inability or refusal to speak
  52. invents new words that are meaningless to others but have symbolic meaning to the psychotic person
  53. repeat the words that he or she hears
  54. a group of words strung together in a random fashion, without any logical connection
    word salad
  55. choice of words is governed by sounds; dr.seuss
    clang association
  56. literal interpretations of the environment; inability to think in the abstract.
    ex. what brought you here to the hospital?
    -the cab (answers are literal)
    concrete thinking
  57. persistently repeats the same word or idea in response to different questions
  58. lack of speech due to poverty of thought, lack of energy, or slowed processing
  59. -avoid touching the patient without warning.
    -reinforce and focus on reality.
    -use same staff as much as possible.
    -avoid laughing, whispering, or talking when patient can see but cant hear what is being said.
    -have an attitude of acceptance.
    -try to distract the patient from the hallucination.
    therapeutic responses to delusions and hallucinations
  60. - successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms.
    -a state of well-being in which the individual realized his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.
    mental health
  61. maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individual's social, occupational, or physical functioning.
    mental illness
  62. -psychological mechanisms or coping mechanisms, aimed at reducing anxiety.
    -safeguard the mind against feelings and thoughts that are too difficult for the conscious mind to cope with.
    -used in response to mild to moderate anxiety.
    defense mechanisms
  63. -palpitations
    -chest pain
    -fear of losing control
    -fear of dying
    -chills/hot flashes
    -numbness/ tingling
    symptoms of panic disorder, must have 4 of this symptoms to be considered a true panic attack
  64. -excessive  anxiety and worry about a number of events that the individual finds difficult to control.
    -restlessness or feelings keyed up or on edge.
    -easily fatigued.
    -difficulty concentrating or mind "going blank".
    -muscle tension
    -sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep)
    symptoms of generalized anxiety disorder
  65. -flashbacks and nightmares
    -hyper vigilance or sleep difficulties
    -avoiding things that remind one of the trauma, and feeling detached or estranged from others.
    re-experiencing symptoms, hyperarousal symptoms, avoidance and numbning symptoms of PTSD
  66. -antidepressants
    -anti-anxiety drugs
    -beta blockers
    treatments for anxiety disorders
  67. -cognitive part helps people change the thinking that support their fears.
    -behavioral part helps people change the way they react to anxiety-provoking situations.
    cognitive-behavioral therapy
  68. with these disorders, there is a significant deficit in cognition and/or memory.
    a significant change occurs in the patient's level of functioning.
    delirium, dementia, and amnestic disorders
  69. disturbance of consciousness and a change in cognition that develops rapidly
  70. loss of previous levels of cognition, executive, and memory function in a state of full alertness
  71. inability to learn new information (short term deficit) despite normal attention, and an inability to recall previously learned information (long term)
    amnestic disorders
  72. -ensure safety
    -medication administration
    -knowing what to expect
    -provide family with information about the disease process.
    -provide information on support groups
    collaborative management of delirium, dementia, and amnestic disorders
  73. an individual's sustained emotional tone, which significantly influences behavior, personality and perception
    mood disorders
  74. characterized by depress mood or loss of interest or pleasure in usual activities. symptoms cant be attributed to use of substances or general medical condition
    major depressive disorder
  75. -manic-depression
    -characterized by mood swings from profound depression to extreme euphoria (mania) with intervening periods of normalcy
    -delusions and hallucinations may not be a part of the clinical picture, onset of symptoms may reflect a seasonal pattern
    bipolar disorder
  76. -hypomania
    -acute mania
    -delirious mania
    types of mania
  77. -mood
    -perception and cognition
    -activity and behavior
    characteristics of mania
  78. -cheerful and expansive (mood)
    -perception of self is exalted; ideas of great worth and ability (cognition/perception)
    -exhibit increased motor activity; perceived as extroverted and sociable. (activity/behavior)
  79. -is euphoric and elated (mood)
    -rapid thinking proceeds to racing and disjointed thoughts; hallucinations and delusions common (cognition/perception)
    -excessive psychomotor behavior, poor impulse control, excessive spending, sexually uninhibited, may go for days without sleep, neglect personal appearance (activity/behavior)
    acute mania
  80. -labile, rapid shifts from merriment and ecstasy to irritability and indifference; panic anxiety may be evident(mood)
    -extremely distractible and incoherent; may demonstrate religiosity, delusions of grandeur or persecution, auditory or visual hallucinations (cognition/perception)
    -psychomotor activity is frenzied, agitated, purposeless. (activity/behavior)
    delirious mania
  81. -educate the patient and their family on symptoms of the disease
    -provide education on medication
    -teach anger management
    -link the patient to support groups
    -assess severity of symptoms/needs for intervening
    collaborative management of patients with mood disorders
  82. -high level of anxiety
    -severe depression
    -hopelessness, helplessness, withdrawal
    -use of destructive coping mechanisms
    -substance abuse
    -previous suicide attempt
    -suicidal ideation
    risk factors for suicide
  83. -overindulgence in and dependence on a chemical substance
    -can occur in nurses, physicians, and other medical professionals
    -does not discriminate
    -involves both legal and illegal substance
    -excessive use of a chemical substance and the resulting physical and psychological dependence that interferes with life's activities
    -women usually abuse more than one drug
    substance abuse
  84. -biologic predisposition
    -stressors in the environment
    -lack of quality support
    risk factors of substance abuse
  85. -violence
    -crime (gangs, theft, homicide)
    -motor vehicle crashes
    -child abuse/neglect
    effects of substance abuse on society
  86. condition that causes a habitual, compulsive, and uncontrollable urge to use a substance
  87. use of chemicals for reasons other than their intended action
    substance misuse
  88. taking a chemical for pleasure without dependence, recreational
    substance use
  89. negative outcomes after abusers stop using substances
  90. symptoms that may result if the drug is eliminated suddenly
    withdrawal syndrome
  91. alcohol, nicotine, opioids (narcotics), stimulants, hallucinogens, depressants
    commonly abused substance categories
  92. - begin 4-12 hours after cessation or reduction in heavy and prolonged use.
    -tremor of hands, tongue, or eyelids; n/v, weakness, tachycardia, sweating, elevated BP, anxiety, depression, irritability, headache, insomnia, transient hallucination
    ETOH withdrawal
  93. -starts 2nd-3rd day
    -have auditory, visual, and tactile hallucinations, extreme disorientation, restlessness, and hyperactivity of the autonomic nervous system
    delirium tremens "DT's"
  94. -sedation with benzodiazepines
    -airway protection (intubation if needed)
    -correct any fluid and electrolyte imbalances (potassium especially)
    medical treatment for delirium tremens