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