Psych Exam 1 NOTES

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emmylou
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Psych Exam 1 NOTES
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2015-01-31 16:48:25
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  1. When using therapeutic communication, what should everyone try to do?
    put it in your own speech
  2. what does 2nd generation antipsychotic drugs do?
  3. side effects of 1st generation antipsychotic drugs?
    milk production, gynecomastia, amenorrhea, motor issues, EPS (extrapyramidal symptoms), dyskinesia-have facial grimaces. once get EPS have it forever and elderly most commonly get it
  4. what is the MOA for MAOI's?
    monoamine oxidase enzyme destroys tyramine, tyramine causes vasoconstriction and causes hypertensive crisis and is destroyed by the liver. so know what foods contain tyramine and avoid them since on MOAI's
  5. what is a life threatening side effect of Elavil?
    increase BP
  6. is doxepin addictive?
    no, but takes a while to work
  7. are ambien, lunesta short acting or long acting?
    short
  8. what does valium do?
    calms you
  9. what are benzodiazepines used for?
    sleep, but they get a bad rap cause they are addictive
  10. what does silenor do?
    sleep induced
  11. what do patients need to have done to check med levels?
    blood drawn
  12. is culture related to genetics?
    yes
  13. what is pharmacokinetics?
    response of drug by patient
  14. What is pharmacodynamics?
    drug effect on body
  15. if depression runs in family and the child gets depression, could the same med the parent take be helpful in the child?
    yes
  16. what part of brain is responsible for emotion?
    limbic
  17. What type of communication is this? Nurse, "So we've been talking about your relationship with your mother."
    reflecting
  18. What type of communication is this? Patient, "I'm not feeling well today." Nurse, "You're not feeling well today?"
    restating
  19. What type of communication is this, "You're father is on the phone [with a tone like 'asshole is on the phone']"?
    non-verbal
  20. What is the axis system?
  21. 5 areas of functioning. not all psychiatrists use now.
    • Axis 1: psychiatric diagnoses (on the chart)
    • Axis 2: personality or developmental disorders (IDD a.k.a. down syndrome)
    • Axis 3: medical problem (diabetes)
    • Axis 4: any social stressors (recently divorced)
    • Axis 5: global assessment of functioning (high functioning score is 100)
    •  GAS - Global assessment of functioning         
    • HAF - high assessment of functioning
    •            LAF - low assessment of functioning
  22. what is prevalence?
    total case. new and existing
  23. What is incidence?
    new number of case in population or defined time frame
  24. what does NAMI do?
    refer to patients and consumer
  25. What does NAMI stand for?
    national alliance of mental illness
  26. What is bipolar 1 and bipolar 2?
    • 1-was first one identified, has psychosis
    • 2-traits of bipolar but not psychotic, hyper-verbal
  27. What does NOS stand for?
    not otherwise specified
  28. What do crisis stabilization units do?
    keep patients overnight to get stabilized on meds
  29. what is dual disorder?
    mental illness with something else like language barrier or pain ect.
  30. who are 50% of people in jail?
    mentally ill
  31. What are negative symptoms?
    things that are not there that should be there
  32. What are positive symptoms?
    hearing voices. (things that are there that should not be there)
  33. What is NAMI?
    group of advocates, recovery and putting patient in charge of their care and improvement
  34. concept of prevention: describe primary, secondary and tertiary
    • primary - who is predisposed to depression so that person needs to work on prevention of depression
    • secondary - screening early
    • tertiary - treatment and maintenance so doesn't get worse-intervene
  35. how do some patients feel about psychotic drug?
    they don't like the way they make them feel. they are in a fog, eat carbs, gain weight, sexual dysfunction-orgasm problems and erectile dysfunction
  36. What are integrated care centers?
    holistic-not just psychiatric care
  37. What is outpatient care responsible for?
    keeping them stable, watching for compliance, not taking their meds or not going to appts.
  38. What does mobile crisis do?
    assess patient in ER and see if need to be hospitalized
  39. What does flight of ideas mean?
    following scheme of thoughts, things that aren't related. common in bipolar and schizophrenia.
  40. What can other illnesses do to a mentally ill person?
    exacerbate a condition. Example, not enough testosterone
  41. What is it called when a mentally ill person doesn't seek help because they think there is nothing wrong with them?
    failure to get help
  42. what is 'Milieu'?
    • "Mi" - middle
    • "lieu" - place
    • so means middle place (French)
  43. Drug/alcohol counselors role?
    lead AA groups
  44. occupational therapists role?
    nurses aid of psychiatry
  45. social workers role?
    they know about TIN care, food stamps, nurses might be responsible for that too
  46. APRN, Nurse practitioners, RN, LPN, Psych tech's role?
    similar to psychiatrist just not as in depth training
  47. psychologists role?
    PhD NOT M.D. good at psychological testing. gets more of that than psychiatrist. good at therapy.
  48. where does emotional state start in brain?
    brainstem
  49. can prednisone cause psychosis?
    yes
  50. What does MRI see?
    neurotransmitter activity

    then I wrote "radioactive tag (glucose)"??
  51. CT and MRI examples:
    tumors, infants to figure out why they might be in pain, edema
  52. what is GABA responsible for?
    pain perception and anxity
  53. what hormone do stimulants increase?
    dopamine
  54. what hormone is increased in schizophrenia?
    dopamine
  55. unorganized thoughts-what disease is this?
    schizophrenia
  56. basic drives- name examples:
    • hypersexual/hyposexual
    • eating a lot/no appetite
    • sleeping 24/7/cant sleep
    • ect.
  57. name steps of stress regarding hormones:
    CRH>pituitary>corticotropin>adrenal glands>cortisol

    overactive during anxiety and affects metnal and physical health
  58. what is emotionally labial?
    laugh one minute and cry the next minute
  59. what do you want to make sure is congruent with patients verbal communication?
    non-verbal communication
  60. can alcoholics mimic manic state?
    yes
  61. why do you verify data with someone who is manic?
    make sure its accuarate
  62. will doctor talk to parents of an older child?
    no
  63. What is NANDA?
    list of nursing diagnoses
  64. what does termination phase do in Hildegard and peplau?
    validate person and make them feel capable. it is important to be genuine, body language is important, eye contact and be non-judgemental
  65. what does working phase do in Hildegard and peplau?
    improve how they feel
  66. what does orientation phase do in Hildegard and peplau?
    its confidential
  67. what does preorientation phase do in Hildegard and peplau?
    initial interview, probelm
  68. what boundaries do you never cross with patients?
    don't give details about your life, don't accept gifts, don't accept flowers or say "will share with staff", don't make eye contact with patient on unit that had in psych unit or out in public from therapy
  69. who else do you include in care besides patient?
    the patient's family
  70. what is artistic communication?
    how you deliver communication when you talk
  71. What is a life-threatening withdrawel?
    • alcohol withdrawel
    • causes seizures and death. admitted to hospital and put on a drip
  72. what med do you give patients coming off withdrawels (opioids)?
    vistarile (sp)
  73. do you need a doctor's order for seclusion?
    yes
  74. is asburgers (sp) on the DSM-5 anymore?
    no
  75. is our temperament genetic??
    yes! (interesting)
  76. what is normalizing?
    normalizing teens having sex by have daycares at school for teens mothers
  77. if pt says "im going to kill my mother" what is the nurses responsibility?
    to tell their mother and PCP
  78. can meds be considered a chemical restraint?
    yes
  79. discharge from hospital-what is unconditional discharge?
    court ordered, against medical advice
  80. what is required to admit someone "involuntarily"
    rakes 2 doctors to admit, and pt has to be a danger to self or others
  81. how long does temporary/emergency admissions last?
    no longer than 5 days
  82. what is deinstitutionalization?
    what has happened after shut down all hospitals
  83. what is writ of habeas corpus?
    person wants to be set free
  84. people living in poverty are 2-3 times more likely to get mental illness. true or false
    true
  85. can economics determine is pt gets help or not?
    yesss
  86. would all cultures know what "are you feeling down" means"
    no
  87. does eastern or western culture believe in reincarnation?
    east
  88. what makes it difficult to categorize mental illnesses?
    culture
  89. when walking into a room by yourself with a patient, who should walk in first and who should sit In the back of the room?
    let patient walk in first (never have back turned to pt) and have pt sit in back of room so youre never trapped in the room with the pt
  90. do you ever want to confront a doctor about an issue in front of the patient?
    no
  91. do you want to ask "why" questions very often? why or why not?
    no. because it implies criticism
  92. what is this... daughter is hanging out with friends and mother says "ohh.. well hope you have fun.." but with a tone like shes sad her daughter wont be with her.
    double bind
  93. Stress causes increased serotonin. therefore antidepressants may not be helpful during stress. true or false
    true
  94. does psychological and physical have same stress response?
    yes
  95. do endorphins help relieve pain?
    yes
  96. Stress can trigger a generic predisposition OR genetics trigger anyways without stress. true or false
    true
  97. does stress predispose someone to a mental illness?
    yes
  98. does ginko give you energy?
    yes
  99. what is Valerian?
    precursor to valium
  100. what is MOA of Ritalin?
    stimulates dopamine
  101. are there genetic markers for ADHD now?
    yes
  102. SE of Ritalin?
    loss of appetite hence weight loss. Ritalin leaves body quickly and is oldest med for ADHD
  103. SE of 3rd generation antipsychotic drugs?
    restless leg syndrome

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