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emmylou
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When using therapeutic communication, what should everyone try to do?
put it in your own speech
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what does 2nd generation antipsychotic drugs do?
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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
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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
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what is a life threatening side effect of Elavil?
increase BP
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is doxepin addictive?
no, but takes a while to work
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are ambien, lunesta short acting or long acting?
short
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what does valium do?
calms you
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what are benzodiazepines used for?
sleep, but they get a bad rap cause they are addictive
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what does silenor do?
sleep induced
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what do patients need to have done to check med levels?
blood drawn
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is culture related to genetics?
yes
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what is pharmacokinetics?
response of drug by patient
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What is pharmacodynamics?
drug effect on body
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if depression runs in family and the child gets depression, could the same med the parent take be helpful in the child?
yes
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what part of brain is responsible for emotion?
limbic
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What type of communication is this? Nurse, "So we've been talking about your relationship with your mother."
reflecting
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What type of communication is this? Patient, "I'm not feeling well today." Nurse, "You're not feeling well today?"
restating
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What type of communication is this, "You're father is on the phone [with a tone like 'asshole is on the phone']"?
non-verbal
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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
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what is prevalence?
total case. new and existing
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What is incidence?
new number of case in population or defined time frame
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what does NAMI do?
refer to patients and consumer
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What does NAMI stand for?
national alliance of mental illness
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What is bipolar 1 and bipolar 2?
- 1-was first one identified, has psychosis
- 2-traits of bipolar but not psychotic, hyper-verbal
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What does NOS stand for?
not otherwise specified
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What do crisis stabilization units do?
keep patients overnight to get stabilized on meds
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what is dual disorder?
mental illness with something else like language barrier or pain ect.
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who are 50% of people in jail?
mentally ill
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What are negative symptoms?
things that are not there that should be there
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What are positive symptoms?
hearing voices. (things that are there that should not be there)
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What is NAMI?
group of advocates, recovery and putting patient in charge of their care and improvement
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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
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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
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What are integrated care centers?
holistic-not just psychiatric care
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What is outpatient care responsible for?
keeping them stable, watching for compliance, not taking their meds or not going to appts.
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What does mobile crisis do?
assess patient in ER and see if need to be hospitalized
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What does flight of ideas mean?
following scheme of thoughts, things that aren't related. common in bipolar and schizophrenia.
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What can other illnesses do to a mentally ill person?
exacerbate a condition. Example, not enough testosterone
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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
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what is 'Milieu'?
- "Mi" - middle
- "lieu" - place
- so means middle place (French)
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Drug/alcohol counselors role?
lead AA groups
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occupational therapists role?
nurses aid of psychiatry
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social workers role?
they know about TIN care, food stamps, nurses might be responsible for that too
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APRN, Nurse practitioners, RN, LPN, Psych tech's role?
similar to psychiatrist just not as in depth training
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psychologists role?
PhD NOT M.D. good at psychological testing. gets more of that than psychiatrist. good at therapy.
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where does emotional state start in brain?
brainstem
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can prednisone cause psychosis?
yes
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What does MRI see?
neurotransmitter activity
then I wrote "radioactive tag (glucose)"??
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CT and MRI examples:
tumors, infants to figure out why they might be in pain, edema
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what is GABA responsible for?
pain perception and anxity
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what hormone do stimulants increase?
dopamine
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what hormone is increased in schizophrenia?
dopamine
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unorganized thoughts-what disease is this?
schizophrenia
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basic drives- name examples:
- hypersexual/hyposexual
- eating a lot/no appetite
- sleeping 24/7/cant sleep
- ect.
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name steps of stress regarding hormones:
CRH>pituitary>corticotropin>adrenal glands>cortisol
overactive during anxiety and affects metnal and physical health
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what is emotionally labial?
laugh one minute and cry the next minute
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what do you want to make sure is congruent with patients verbal communication?
non-verbal communication
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can alcoholics mimic manic state?
yes
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why do you verify data with someone who is manic?
make sure its accuarate
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will doctor talk to parents of an older child?
no
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What is NANDA?
list of nursing diagnoses
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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
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what does working phase do in Hildegard and peplau?
improve how they feel
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what does orientation phase do in Hildegard and peplau?
its confidential
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what does preorientation phase do in Hildegard and peplau?
initial interview, probelm
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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
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who else do you include in care besides patient?
the patient's family
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what is artistic communication?
how you deliver communication when you talk
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What is a life-threatening withdrawel?
- alcohol withdrawel
- causes seizures and death. admitted to hospital and put on a drip
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what med do you give patients coming off withdrawels (opioids)?
vistarile (sp)
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do you need a doctor's order for seclusion?
yes
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is asburgers (sp) on the DSM-5 anymore?
no
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is our temperament genetic??
yes! (interesting)
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what is normalizing?
normalizing teens having sex by have daycares at school for teens mothers
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if pt says "im going to kill my mother" what is the nurses responsibility?
to tell their mother and PCP
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can meds be considered a chemical restraint?
yes
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discharge from hospital-what is unconditional discharge?
court ordered, against medical advice
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what is required to admit someone "involuntarily"
rakes 2 doctors to admit, and pt has to be a danger to self or others
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how long does temporary/emergency admissions last?
no longer than 5 days
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what is deinstitutionalization?
what has happened after shut down all hospitals
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what is writ of habeas corpus?
person wants to be set free
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people living in poverty are 2-3 times more likely to get mental illness. true or false
true
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can economics determine is pt gets help or not?
yesss
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would all cultures know what "are you feeling down" means"
no
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does eastern or western culture believe in reincarnation?
east
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what makes it difficult to categorize mental illnesses?
culture
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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
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do you ever want to confront a doctor about an issue in front of the patient?
no
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do you want to ask "why" questions very often? why or why not?
no. because it implies criticism
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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
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Stress causes increased serotonin. therefore antidepressants may not be helpful during stress. true or false
true
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does psychological and physical have same stress response?
yes
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do endorphins help relieve pain?
yes
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Stress can trigger a generic predisposition OR genetics trigger anyways without stress. true or false
true
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does stress predispose someone to a mental illness?
yes
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does ginko give you energy?
yes
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what is Valerian?
precursor to valium
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what is MOA of Ritalin?
stimulates dopamine
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are there genetic markers for ADHD now?
yes
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SE of Ritalin?
loss of appetite hence weight loss. Ritalin leaves body quickly and is oldest med for ADHD
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SE of 3rd generation antipsychotic drugs?
restless leg syndrome
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