SBVC pt 086 final study guide review
Psychopharmacological interventions have been proven to be somewhat effective in treating anorexia nervosa. The atypical antipsychotic that is helpful in improving mood and decreasing obsessions and aids in weight gain is?
(Zyprexa)
studies show that an individual who has been awake for approximately 24 hours would have the same mental acuity of someone who has a BAL of
0.01mg%
Nursing Interventions for Antisocial Personality Disorder
1.) Maintain consistent rules/regulations (overly compliant and covertly noncompliant) 2.) Confront inappropriate behaviors without anger/punitiveness 3.) Be alert for flattery/verbal remarks 4.) Don't argue/bargain/rationalize 5.) Do not permit patient to dictate treatment 6.) Use behavioral contracts/relaxation techniques 7.) Work through transference/countertransference issues
Schizoid Personality Disorder has a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings beginning by early adulthood and present in a variety of contexts, as indicated by four or more of the following:
1.) Neither desires nor enjoys close relationships (being apart of a family) 2.) Almost always chooses solitary activities 3.) Has little interest in having sexual experiences with another person 4.) Takes pleasure in few activities 5.) Lacks close friends other than relatives (prefers to be friends with animals) 6.) Appears indifferent to praise/criticism 7.) Shows emotional coldness, detachment, or flattened affectivity
Schizoid Personality Disorder Nursing Interventions
1.) Remain calm, nonthreatening, and nonjudgmental in all interactions 2.) Accept person's beliefs but don't confirm/argue with them 3.) Maintain "business like atmosphere" (superficial but polite/curious) 4.) Give clear information regarding confidentiality 5.) Focus on feelings ("It must be distressing when...", "you see him as vindictive...")
Paranoid Personality disorder have a pervasive distrust/suspiciousness of others such that their motives are interpreted as malevolent, beginning by early childhood and present in a variety of contexts as indicated by four or more of the following:
1.) Suspects others that are exploiting, harming, or deceiving him/her 2.) Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends/associates 3.) Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him/her 4.) Reads hidden demeaning or threatening meanings into benign remarks or events 5.) Persistently bears grudges, is unforgiving of insults, injuries, or slights
Associate features of Antisocial Personality Disorder
1.) Unlawful behavior, destruction of property, stealing, harassing others, selling drugs 2.) May have many sexual partners/never in a monogamous relationship 3.) May be arrogant, excessively opinionated, self-assured, cocky, charming, manipulative, and have inflated self-esteem 4.) Repetitive liar, con artist, malingerer 5.) Have shorter life expectancies 6.) easily bored 7.) concrete thinking 8.) may have other psychiatric diagnoses
Wernicke's encephalopathy (WE) symptoms
1.) acute confusional state 2.) ophthalmoplegia (paralysis/weakness of the eye muscles) 3.) ataxia
Korsakoff Syndrome Symptoms
1.) amnesia 2.) confabulation 3.) psychosis
Antisocial Personality Disorder behaviors
1.) failure to conform to social norms resulting to arrest 2.) Repeated lying, use of aliases, conning others for profit/pleasure 3.) Impulsivity/failure to plan ahead 4.) Irritability/aggressiveness indicated by physical fights/assaults 5.) Disregard safety of self/others 6.) Consistent Irresponsibility/dishonors financial obligations 7.) Lack of remorse
A pervasive pattern of instability of interpersonal relationships, self-image, affects, marked impulsivity beginning by early adulthood and present in a variety of contexts as indicated by 5 or more of the following
1.) frantic attempts to avoid real imagined 2.) unstable and intense interpersonal relationships 3.) identity disturbance: unstable self-image/sense of self 4.) impulsivity: spending, sex, substance abuse, reckless driving, binge eating 5.) recurrent suicidal behaviors 6.) affective mood instability 7.) chronic feelings of emptiness/boredom 8.) inappropriate intense anger/difficulty controlling anger 9.) paranoid ideation/severe dissociative symptoms
Schizotypal Personality Disorder begins in early adulthood and may be indicated by five or more of the following:
1.) ideas of reference 2.) odd beliefs/magical thinking (superstitiousness, telepathy, 6th sense, bizarre fantasies) 3.) Bodily illusions 4.) depersonalization or derealization 5.) Suspiciousness or paranoid ideation 6.) inappropriate/constricted affect 7.) Behavior/appearance that is odd/eccentric/peculiar
Psychosocial treatment for Antisocial personality disorder
1.) long term in patient strictly structure 2.) group therapy 3.) substance abuse treatment 4.) tough love approach 5.) prevention in children/adolescents
Predisposing Factors of Antisocial Personality Disorder
1.) may come from stable/loving homes 2.) severe physical abuse growing up 3.) extreme poverty 4.) removal from the home 5.) growing up without parental figures of both sexes 6.) erratic/inconsistent methods of discipline 7.) being rescued when have gotten into trouble 8.) ADHD/Conduct Disorder before age of 10 9.) low levels of serotonin may cause aggression
Associated features of borderline personality disorder
1.) pattern of undermining themselves (dropping out just before graduation) 2.) recurrent job losses, broken marriages 3.) childhood history of abuse/neglect
There are _____ personality disorders
10
Prevalence is _______ of the general population may have a personality disorder
10-15%
Antisocial Personality Disorder individuals is at least
18 years old
The BMI range for normal weight is?
20 to 24.9
early signs of withdrawal develop within a few hours after cessation or reduction of alcohol use, then peaks after
24-48 hours
Antisocial Personality Disorder prevalence:
3% of males and 1% of females
Ecstacy (MDMA, XTC, molly); a substitute amphetamine
3,4-methylenedioxy-methamphetamine
MDMA/ecstacy/molly
3,4-methylenedioxy-methamphetamine
Children between this age ranges are the most abused?
3-6 years
Prevalence of Schizotypal Personality Disorder occur approximately in
3.9-4.6% of the population; slightly more common in males
Obesity has been defined as a body mass index of ?
30 or greater
Children of alcoholic parents
4x more likely to develop alcoholism than those of nonalcoholic parents
The maximum dosage of aripiprazole (Abilify) given to treat irritability in autism spectrum disorder is
5mg/day
a blood alcohol level (BAL) of 0.45 mg% indicates that the intoxicated person has consumed
9-20 drinks
Which of the following is a principle related to dual diagnosis that the psych tech must be aware of ?
The substance use disorder and the psychiatric disorder are both considered primary and need simultaneous treatment
Dissociative Disorders
A disruption in the functions of consciousness, memory, and identity; statistically rare and common in young female adults
One of the main purposes of psychoeducation group is:
To prepare clients to live outside of an institution.
Dissociative Identity Disorder (DID)
To protect personality, existence of two or more personalities form within a single individual
Treatment for Alcohol Cardiomyopathy
Total permanent abstinence from ETOH Congestive Heart Failure; rest, oxygen, digitalization, sodium restriction, and diuretics
This disorder is characterized by the presence of multiple motor tics and one or more vocal tics?
Tourette's syndrome
Flashbacks
Transitory recurrences of perceptual disturbances reminiscent of disturbances experience in earlier hallucinogenic intoxication
Individuals with anorexia nervosa can literally starve themselves to death?
True
Dissociative Fugue
Type of amnesia in which there is sudden unexpected travel away from home with the inability to recall some/all of one's past
The Rogerian concept that consists of accepting the person without judging and evaulating is referred as:
Unconditional positive regard.
The focus in the laissez-faire group would be:
Undetermined
Illness Anxiety Disorder
Unrealistic/inaccurate interpretation of physical symptoms or sensations leading to preoccupation and fear of having a serious disease, even when there is no medical evidence
Sleep-wake disturbance
Unusual or undesirable phenomenon that occurs suddenly during sleep or at the threshold between waking or sleeping
During a group therapy session a client address the group saying, "I've been thinking about the way I feel about my husband; I'm angry with him. He has no right to hit me or call me names, I feel hurt too. I wonder what I've done to deserve this abuse. The client begins to sob. This can be assessed as:
Ventilation
Which of the following activities would be most appropriate for a client with attention deficit hyperactivity disorder?
Volleyball
The drug vitamin B-1 (thiamine) prevents this condition when treating alcohol withdrawal delirium ?
Wernicke-Korsakoff encephalopathy
A client referred to the eating disorder clinical has lost 35 pounds during a summer spent by looking at colleges and cooking gourmet meals for friends and family. She was referred by her physician who was alarmed by the weight loss. To assess the client's eating patterns, the psych tech should ask?
What do you eat on a typical day?
Atomoxetine and bupropion must be administered
With food to minimize GI upset
How long does conversion disorder symptoms take to be resolved?
Within a few weeks (with 20% relapsing within 1 year)
For a client with anorexia nervosa, it is important to explain to the client the privileges and restrictions will be based on compliance with treatment and direcet weight gain. The rationale for this nursing intervention is?
Without adequate nutrition, a life threatening situation may occur
SSRIs
Zoloft (sertraline), Prozac (fluoxetine), Celexa (citalopram), and Lexapro (escitalopram)
Codependence
a cluster of behaviors that prevents one individual from taking care of his or her own needs due to a preoccupation with another who is addicted to a substance (makes excuses)
When crack is smoked, it produces a fleeting high 5-7 minutes followed by
a period of deep depression
Paranoia associated features may appear tense, has a difficult time relaxing, and lacks _____________________
a sense of humor
Dissociative Amnesia
a sudden loss of memory for important personal information that is too extensive to be due to normal forgetting, substance use, or neurological medical conditions
Substance abuse intervention
a useful tool in helping a resistant addict to agree to treatment
Schizoid Personality Disorder patients are seen as
absentminded, a loner, in a "fog", detached from others, or not connected
Improvement of symptoms in acute and chronic alcoholic myopathy occurs if the patient
abstains from ETOH and return to consuming adequate nutrition with vitamin supplements
Isoenzyme ________________________ is absent > needed to oxidize acetaldehyde > rapid accumulation of acetylhyde which produces the unpleasant effects
acetaldehyde dehydrogenase
Lysergic Acid Diethylamide (LSD)
acid it comes in a powder, liquid, tablets, or blotter squares.
an alcoholic individual is on the medical surgical floor with a diagnosis of alcoholic cardiomyopathy:congestive heart failure.what symptoms would the psychiatric technician expect to see in this client.
activity intolerance, dyspnea, edema, nonproductive cough, palpitation, EKG changes
Symptoms of alcoholic cardiomyopathy
activity intolerance, tachycardia, dyspnea, edema, palpitations, nonproductive cough
This condition is characterized by loss of control in substance consumption, use of a substance despite associated problems, and a tendency to relapse.
addiction
Communication Guidelines for counseling intervention concept
addiction is progressive and outside help is needed for addict to achieve recovery
Treatment for hepatic encephalopathy
administer neomycin or lactulose (reduces intestinal ammonia)
Job an OCPD patient would have
air traffic control
frequent absences and tardiness at work, driving under the influence, arrest, continued use despite recurrent social or interpersonal problems
alcohol abuse
recent ingestion of ETOH, sexually aggressive, irritability, incoordination
alcohol intoxication
cessation of heavy or prolonged ETOH use, experiencing visual & tactile hallucinations increased hand tremors.
alcohol withdrawal
Hepatic conditions due to
alcohol/ETOH use
withdrawal symptoms from sedative, hypnotic, or anxiolytic would include include all except which of the following
alertness
ETOH injestion
all organ systems affected
which principle of counseling intervention should not be observed by the psych tech for a chemically dependent client?
allow for minimum of one drink per day
Other associated features of Schizoid Personality Disorder include
aloofness, isolation, bland/apathetic manner, bizarre speech pattern, tangential, vague, digressive, and commonly anxious around people
Central nervous system depressants include all except ? ETOH amphetamines benzodiazepines barbiturates
amphetamines
Individuals who are obese are treated with these medications to suppress appetite and help lose weight
amphetamines
These class of medications used in patients with attention deficit hyperactivity disorder stimulates the central alpha adrenoceptors in the brain resulting in reduced sympathetic outflow from the nervous system?
amphetamines
pedophilia
an adult having sexual relations with a prepubescent child
Schizotypal Personality Disorder has social/interpersonal deficits, absence of close relationships, cognitive/perceptual distortions
and eccentricities of behaviors
which of the following are effects of cocaine on the body? anesthetic & stimulants depression & pain sensitivity hallucinogenic anhedonia & increase perception of pain
anesthetic & stimulants
schizotypal, antisocial and borderline personality disorders tend to be
annoying
Cluster B personality disorders
antisocial, borderline, histrionic, narcissistic
It accompanies every illness
anxiety
Associated features in general, __________ are common symptoms
anxiety and depression
People with DID go to the doctor not because they have split personalities but to find treatment for
anxiety or depression
Common symptoms associated with Illness Anxiety Disorder
anxiety, depression and OCD
Common characteristics of Cluster C
anxious, fearful, resents suggestions, fail to do their share of work, think they are doing better than they actually are
symptoms of high ammonia levels
apathy and confusion
Antidepressants, anti-anxiety, antipsychotics and mood stabilizers
are used to treat the symptoms of paranoia personality disorder but not cure
Schizoid Personality Disorder childhoods are bleak, cold, un-empathetic, lacking in nurturing;
as adults they see relationships that are not valuable or worth pursuing
a client with a long history of alcohol dependence comes to the emergency department with shortness of breath and an, enlarged abdomen.which complication of alcoholism is this client experiencing, and what is the probable cause?
ascites resulting from cirrhosis of the liver
a nurse holds the hand of a client who is withdrawing from alcohol. what is the nurse's rational for this intervention
assess for fine tremors
There is a relationship between stability of group membership and:
attendance of the group members
The parent of a 4 year old states "my child moves continually, as if driven by a motor. He is so distracted he ignored the toys I give him. He talks all the time and is awake every morning before 1 AM. I enrolled him in preschool but the teacher could not handle him. The child's problem meet the criteria for
attention deficit hyperactivity disorder
First generation antipsychotics
atypical psychotic: negative symptoms are treated better
Mr. Smith, group leader, starts the group by stating he wants to help in problem solving. When the group makes a decision, Mr. Smith criticizes it and tells them to work until they make the "right" decision. This type of leadership is
autocratic
Cluster C personality disorders
avoidant, dependent, obsessive-compulsive
Substance abuse disorder patients continue the use of substances despite the
awareness of physical or psychological problems
intravenous
bacterial endocarditis
IV drug users are more likely to get
bacterial endocarditis (infection in lining of the heart)
Nurising interventions for narcissistic personality disorder includes
being consistent and professional
alcohol potentials the effect of these drugs
benzodiazepine
The emergency medical service brings an intoxicated client to the emergency department after the client has been hit by a car while walking on the side of the road. The client states, "How did I get here? Who brought me to the hospital?" Which is the client most likely experiencing?
blackout
Cocaine/Crack anesthetic effect
blocks conduction pain impulses
Naltrexone such as Trexan and Revia has narcotic antagonist effects
blocks the euphoric effects of opioids for up to 72 hours
What behaviors would indicate that the treatment for a client in alcohol rehabilitation can be evaluated as effective?
Abstinent for 10 days
When conducting a history assessment, the PT notes the client's body language as inability to maintain eye contact, fidgeting during the interview, and hesitant when answering question. What would be the best interventions?
Address the noted discomfort to further assess the client's discomfort.
Groups work with family issues and codependency issues
Al-Anon Alateen Narc-Anon
This self help group offer support and guidance for teenagers in families with a chemically dependent member
Alateen
A client has recently been placed in a long-term-care facility because of marked confusion and inability to perform most activities of daily living, which nursing intervention is most appropriate to maintain the client's esteem?
Allow client to choose between two different outfits when dressing for the day
A symptom of anorexia, it is defined as the absence of menstruation that usually follow weight loss.
Amenorrhea
In clients taking CNS stimulants, atomoxetine and bupropion, it is important for the psych tech to be aware of the potential of which adverse effects?
Anorexia and weight loss
These individuals may be obsessed with food, they hoard/conceal food, talk about food in great length, and prepare elaborate meals for others only to restrict themselves to a limited amount of low-caloric food intake?
Anorexia nervosa
Psychopharmacological interventions known to be effective in treating bulimia nervosa include?
Antidepressants
About 25% of those diagnosed with attention deficit hyperactivity disorder will subsequently meet the criteria for
Antisocial personality disorder
A client diagnosed with an eating disorder experiences increased tension, helplessness, becomes overexcited with increased stimuli on the unit. What would be an appropriate nursing diagnosis for this client?
Anxiety (moderate to severe)
Which of the following is defined as unrealistic or inaccurate interpretation of physical symptoms or sensations leading to preoccupation and fear of having a serious disease?
Anxiety Illness Disorder
A client is frequently late to the group sessions. Leader should:
Ask the group how they feel about the client's lateness
Before administering clonidine and guanfacine what important nursing intervention must be implemented?
Assess BP & HR
What classification of medications has been approved by the US Food and Drug Administration to treat irritability in autism spectrum disorder?
Atypical antipsychotics
Symptoms of Sedative, Hypnotic or Anxiolytic Withdrawal
Autonomic Hyperactivity (sweating, pulse >100) Increased hand tremor Nausea and vomiting
Treatment for nicotine addiction includes application of nicotine patch and this medication.
bupropion (Wellbutrin)
The psych tech is reviewing an order of Ritalin 1-mg TID. The psych tech knows that the last dose should be administered
Before 4 pm
This therapeutic approach has the principle of positive reinforcements encourages repetition of desirable behaviors and aversive reinforcement discourages repetition of undesirable behaviors.
Behavior therapy
This type of intervention provides positive reinforcement for desired behavior and negative reinforcements for maladaptive behaviors.
Behavioral Modification
Which fact obtained during nursing assessment would cause the psych tech to consider a child to be at risk for the development of psychiatric disorder?
Being raised by a depressed mother
The overall goal for the severely and persistently mentally ill client would be:
Better adaptation to environment.
This eating disorder involves the patient engaged in binge eating behaviors without compensatory behaviors.
Binge eating disorder
The role of coordinator in a group would:
Bring together ideas and suggestions.
With this eating disorder, tension is relieved and pleasure is felt during the time of the binge, but is soon followed by feelings of guilt and depression?
Bulimia nervosa
This medication is contraindicated with individuals with known or suspected seizure disorder.
Bupropion
ETOH can affect all organ systems but specifically
CNS alteration (Wernicke's encephalopathy) GI System (gastritis)
Most likely to die during withdrawals
CNS depressants and alcohol
Preferred outcomes for Dissociative Disorders
Can demonstrate coping methods to avert dissociative behaviors of depersonalization and derealization Integration: verbalizes existence of multiple personalities
Somatic Symptom Disorder
Cannot be explained medically and are associated with psychosocial distress, chronic anxiety, depression, and suicidal ideation
Most obvious signs that one is portraying "classic" conversion disorder symptoms
Change in body function that cannot be explained by any known medical disorders such as Neurological Diseases include muscle weakness, numbness, and paralysis
Psychosocial Factors: Behavior Theory for Somatoform Symptoms
Change the conditioned ways of communicating helplessness that allow the individual to manipulate others, especially when reinforced symptoms become more intense
Any physical, sexual, emotional act by parent whether intentional or unintentional that is injurious to the child is
Child abuse
An appropriate outcome criteria for a nursing diagnosis of risk for injury is
Client with refrain from impulsive behaviors
Nursing Intervention: Health Teaching
Clients using somatization may need basic information about how the body functions as part of cognitive restructuring
The treatment modality used in managing eating disorders helps client confront irrational thinking and strive to modify distorted and maladaptive cognitions about body image and eating behaviors and serves to help normalize behaviors by reducing the number of binging episodes
Cognitive behavioral therapy
When members begin to feel a sense of belonging and feel that they are of value to each other, one could say that ________ is development.
Cohesiveness
Spice
Combination of herbal components including vanilla and baybean; when fused together it causes an effect similar to marijuana
A 15 year old is referred to the mental health by juvenile court after an arrest for vandalism and running away from home 6 times. The teen has been physically abusive to his mother and defiant to his father. The teen's problem is most consistent with?
Conduct disorder
Seen in children 8 years and older, projection is the most common defense mechanism used, The child behaves in a manner that deliberately annoys others
Conduct disorder
This disorder is characterized by a persistent pattern of behavior in which the right of others are violated and age appropriate norms are violated?
Conduct disorder
Malingering
Consciously motivated act to deceive based on the desire for material gain
Social and environmental factors that may contribute to the development of childhood mental disorders include all except?
Constant and stable environment
What are the issues in anorexia nervosa that psychological theories are based on?
Control
There medications have been approved by the FDA for control of motor and vocal tics associated with Tourette's disorder.
Conventional antipsychotics
A client experiencing lower extremity paralysis, is admitted to a medical unit. Extensive tests confirm disability but rule out any underlying organic pathology. The psych tech concludes that this is most suggestive of which disorder?
Conversion Disorder
A client, experiencing lower extremity paralysis, is admitted to a medical unit. Extensive tests confirm disability but rule out any underlying organic pathology. The nurse concludes that this is most suggestive of which disorder?
Conversion Disorder
Excessive vomiting and laxative/diuretic abuse may lead to what medical symptoms?
Dehydration and electrolyte imbalance
Effects of opiates intoxication include all except ? constricted pupils dilated pupils psychomotor retardation drowsiness
Dilated pupils
parasomnia
Displacement of sleep from its desired circadian period
A psych tech is working with a client diagnosed with somatic symptom disorder. What predominant symptoms should a psych tech expect to assess?
Disproportionate and persistent thoughts about the seriousness
Transitioning from one personality to another usually sudden/dramatic and precipitated by stressed
Dissociative Identity Disorder
Mr. L is suddenly traveling out of town. Upon return, he could not recall some or all of his travels and he had no recollection of his former identity. Which symptoms of dissociative amnesia would this be?
Dissociative fugue
Cognitive Assessments for patients with dissociative identity disorder
Distinguish symptoms of Illness Anxiety Disorder and Somatic Disorder
Depersonalization
Disturbance in the perception of oneself
Which nursing diagnosis is most appropriate for a client with anorexia nervosa who restricts and is at 20% below normal body weight?
Disturbed body image
Nursing Process: Interventions - Basic Level
Do not flood the client with data regarding past events for initial intervention (abreaction)
According to the DSM-5, an individual with anorexia nervosa meets the specified restricting type if these behaviors are present?
During last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behaviors
Which category of abused substances requires that the nurse understand the severity of morbidity and mortality associated with the withdrawal from these substances
ETOH & CNS depressants
Alcoholic myopathy lab studies
Elevated levels of creatine phosphokinase (CPK), lactate dehydrogenase (LDH), aldolase, and aspartate aminotransferase (AST)
Clients with somatoform disorders have poor communication of feelings and emotional needs
Encourage client to express feelings rather somatic complaints (for example, "I'm sicks" vs "I'd like to talk to you")
Physical assessment of a client with bulimia nervosa often reveals?
Enlarged parotid glands
What does assessment of bulimic client often reveal?
Enlarged parotid glands
What is the most accurate way to determine sleep requirement?
Establish a routine bedtime and allow oneself to sleep undisturbed without an alarm for several days
hypersomnia
Excessive sleep, excessive daytime sleepiness and/or feeling of sleepiness, then suddenly falling asleep while awake
Doctor Shopping
Experience significant distress and seek out multiple providers of medical care
Psychological Trauma
Experiences that take form from severe physical, sexual, or psychological abuse by a significant other in the child's life
A client diagnosed with somatic symptom disorder is most likely to exhibit which personality disorder characteristics?
Expresses heightened emotionality, seductiveness, and dependency
brief intervention strategies
FRAMES Feedback Responsibility Advice Menu (options) Empathy Self-efficacy/optimism of client
Which disorder refers to the deliberate fabrication of symptoms with the goal of assuming a sick role?
Factitious Disorder
When assessing a child suspected with autism spectrum disorder, the psych tech should be particularly alert for
Failure to develop interpersonal relationship
True or False; Studies strongly suggest that there is a strong suggestion that sugar plays a role in hyperactivity.
False
Derealization
Feelings of detachment from the external environment and alteration of the perception of reality
Dissociative Amnesia onset
Follows after severe psychosocial stress such as physical, sexual, emotional abuse, and other traumatic life events
Systematic desensitization involved having a client:
Gradually approach the feared object or situation while he/she is in a state of relaxation.
When working with a client diagnosed with a somatic symptom disorder, which is the most appropriate nursing action?
Gradually minimize time focusing on physical symptoms
Which of the following medications used to treat Tourette's disorder?
Haloperidol (haldol)
Groups that have a mixture of personalities, coping styles, and psychodynamics are sometimes termed ________ groups.
Heterogenous
schedule 2 drugs
High potential for abuse and have medical use with severe restrictions (Ativan, valium, cocaine)
Psychological Factors: Evidence a child is experiencing abuse and neglect for factitious behaviors
History of frequent hospitalizations; can even be a refuge from chaos at home Masochistic: Feels the need to be punished through painful procedures
During group therapy, Mr. Tibbs states, "When I first started in this group, Anne wasn't able to make a decision. Now she can; she's made a lot of progress. I'm beginning to think that maybe I can conquer my fears to." According to Yalom, this statement reflects:
Hope
The psych tech has given the client information on alcoholism recovery. Which client statement indicates that learning has occurred ?
I realize that recovery is a process that comes about in steps
A nursing diagnosis formulated for the client with bulimia nervosa was "ineffective coping related to feelings of loneliness and isolated as evidenced by use of overeating as a comfort measure followed by self-induced vomiting". The outcome related to this nursing diagnosis is that within 2 weeks the client will
Identify two alternative methods of coping with loneliness and isolation
A 14 year old female was admitted to the eating disorder unit for anorexia nervosa. She emaciated and refuses to eat. What would be the primary nursing diagnosis for this patient?
Imbalanced nutrition: less than body requirements
Hepatic Encepalopathy
Inability of liver to convert ammonia into urea for excretion; a rise in ammonia results apathy and confusion
Localized Amnesia
Inability to recall ALL incidents associated with the traumatic event for a specific period following the event
Selective Amnesia
Inability to recall ONLY CERTAIN incidents associated with a traumatic event for a specific period following the event
Generalized Amnesia
Inability to recall anything that has happened during the individual's entire lifetime, including personal identity
The psych tech is processing a new admission with anorexia nervosa. What should the initial nursing intervention be upon admission to the unit?
Increase the patient's caloric intake
Medical Treatments for Dissociative Disorders
Individual Psychotherapy (abreaction) & Cognitive Therapy
A 15 year old was referred to the mental health clinic by the juvenile court after an arrest for vandalism and assault on a teacher. The teen tells the psychiatric technician, "I hate my parents; they focus all their attention on my brother. He is perfect in their eyes." Which nursing diagnosis is most appropriate?
Ineffective coping
A child with oppositional defiant disorder demonstrates negative temperament, manipulation of others, and underlying hostility. What nursing diagnosis will be appropriate for the child?
Ineffective coping
The developmental disorder onset is prior to 18 years and is characterized by impairments in measure intellectual performance and adaptive skills across multiple domains?
Intellectual disability
Withdrawal
Involves physiological and psychological signs and symptoms associated with stopping or reducing use of substances
A disadvantage of an open group is:
It is difficult to have trust and stability.
A group that focuses on osteoporosis would be what type of group?
Know-your-body
Examples of opiate include all except which? Heroin Methadone LSD Fentanyl
LSD
A 24 yr old woman comes to the emergency department stating, "I feel restless, everything I look at wavers, sometimes I am outside my body looking at myself. I hear colors. I think I am losing my mind. "Vital signs are slightly elevated. The psych tech assumes the client most likely ingested which of the following
LSD injegestion
What is the most common finding among abusive parents?
Lack of support system
A female client on an inpatient unit enters the day area visiting hours dressed in a see-through blouse and wearing no undergarments. Which intervention should be a nurse's first priority?
Lead the client back to her room and assist her to choose appropriate clothing
A low level of estrogen in women can lead to:
Less vaginal
Medical Treatment for Antisocial Personality Disorder
Lithium, depakene, depakote, tegretal
avoidant personality disorder treatment includes
MAOI's for social phobias
Over half of diagnosed Schizoid Personality Disorder patient history may have at least one
Major Depressive Episode
Which of the following involves conscious motived acts, lies, or deception such as intentionally producing symptoms for an obvious material gain?
Malingering
This prenatal factor has been linked to hyperkinetic impulsive behavior in their offspring
Maternal smoking
Schizoid Personality Disorder Medical Treatment
Medication may not help since the patient will be suspicious of them; benzodiazepines (klonopine, xanax, ativan) may be helpful for brief crisis management Antipsychotics may help psychosis and severe agitation
Nursing Intervention: Promotion of Care
Method of using a matter-of-fact approach to support the highest level of self-care of which client is capable of completing
Psychosocial Factors: Cognitive Theory for Illness Anxiety Disorder
Misinterpretation of client's body sensations then excessively becomes alarm by them
Psychobiological Interventions for Dissociative Disorders
Monitor closely for dependence of benzodiazepines and antidepressants, especially SSRIs
Mary has been diagnosed with Dissociative Identity Disorder (DID). What type of behavior should the psych tech look out for?
Mood swings (behavior such as depression)
The person who developed the specialized the therapeutic group called psychodrama was:
Moreno
Schizoid Personality Disorder psychosocial treatment:
Most will not seek professional help for their diagnosis but for comorbid symptoms such as depression substance abuse and other issues Long-term psychotherapy has been useful in some cases (if patient is motivated and has exposure of social tasks) Group therapy can help overcome fears of isolation
Which of the following clients should not be asked to join a therapy group?
Mrs. Grimes, a 30 year old acute paranoid schizophrenic who is actively hallucinating
Which behavior would alert the PT to a circadian sleep disorder?
Multiple episodes of brief daytime sleeping followed by disturbed night time sleep
Factitious Disorder is also formally known as
Munchausen Syndrome (factitious disorder by proxy)
Which of the following is a form of factious disorder where the caregiver intentionally causes injury to victim to get sympathy for self?
Munchausen's Syndrome
This state involves a high level of brain and physical activity similar to the waking state
NREM
Treatment of opiate overdose
Naloxone (narcan) works to block opiate receptors and reverse effects of an overdose
Clonidine (Catapres)
Non-opioid suppressor of opioid withdrawal symptoms Effective somatic treatment when combined with naltrexone for opioid addiction
When a child is demonstrating suicidal ideations, it is important for the psych tech to establish a trusting relationship with the client. A priority nursing intervention for a suicidal child is?
Notify the child's psychiatrist and obtain an order for a 1-to-1 observation
Assessment Interveiew Guidelines
Observe client
Predisposing Factors of Paranoia Disorder
Occurs amongst relatives of clients with schizophrenia more than the general population
This is the repetition of one's own words/sounds.
Palilalia
People likely to get stigmatized
Patients with HIV, LGBTQ, substance abusers and the mentally ill
Somatic Symptoms Disorder characteristics
Personality is heightened emotionality, seductiveness, and strong dependency needs
One example of dysfunctional communication within a family is:
Placating
Members bringing hidden agenda to group can best be handled by
Pointing out the behaviors and allowing the group to discuss it
The unpleasant effects of disulfiram (Antabuse) when taken with alcohol
Prevents recovery
Example of passive aggressive behaviors include
Procrastination, negativism, resistance
A client diagnosed with substance dependence states to the psych tech. My wife causes me to abuse methamphetamines. She uses and expects me to. This client is using which defense mechanism?
Projection
Conversion Disorder
Psychological stress manifesting/converting into physical symptoms
A child was recently diagnosed with ADHD. He will be beginning medications therapy. The psychiatric technician should prepare a plan to teach the family about which classification of medication?
Psychostimulant medications
Advance Practice Interventions for Dissociative Disorders
Psychotherapy and consultations with PHCP
A 32 year old man tells the PT at the sleep disorder clinic that he awakens on some nights in the midst of acting out a violent dream on which he is defending himself against multiple attackers. When he awakens, he finds he had been kicking and hitting his wife to the point of causing bruising. His wife insists that he must get help. The PT assess this disorder as being most consistent with criteria of the following?
REM sleep behavior disorder
In which stage of a group's development would this interaction be most likely to occur? Leader: "Shall we begin?" Client 1: "Why do you ask us if we want to begin?" Client 2: "You ought to just tell us what you want us to do." Leader: "You seem irritated." Client 3: "We thought someone in this group would give us help with out problems, but you don't give us any answers."
Storming
Substance Abuse
can lead to medical complications
Alcohol (ETOH) depresses the
central nervous system
What does genetic theory suggest in regards to alcohol and drugs abuse
children of alcoholic parent are 4x more likely to develop
a client in an alcohol rehabilitation program tells the psych tech, "i have been such a loser all my life. i feel so ashamed of what i put my family through. Now, here I am in a program and i am not even sure i can succeed at staying sober." the psych tech should consider a nursing diagnosis of ?
chronic low self esteem
Of the following which best describes the 24 hours of behavior and physiology generated and influenced by internal and environmental factors?
circadian drives
ETOH withdrawal patients will need
clarification of illusions
Dual diagnosis
clients with substance abuse disorder and mental illness
A teenager has recently lost a parent. Which grieving behavior should a school nurse except when accessing this client?
clinging behaviors and personal insecurity
Schizoid Personality Disorder people lack
close friends/confidants other than first degree relatives due to excessive social anxiety
cocaine
coca bush
An example of a central nervous stimulant is which of the following? chloral hydrate cocaine marijuana opium
cocaine
Narcissistic Personality Disorder may be associated with anorexia nervosa and substance abuse related disorder especially
cocaine
Cardiac toxicity from
cocaine use
Schizotypal and Schizoid Personality Disorders are both detached and aloof but the Schizotypal Personality Disorder has more
cognitive impairment
A client is diagnosed with hypoactive sexual desire disorder. Which of the following is recognized as treatment options?
cognitive therapy
acute alcoholic myopathy
Sudden onset of muscle pain, swelling, and weakness; reddish tinge to the urine
Psychodynamic Theory
Suggests Somatic Symptoms, in general, is an ego defense mechanism; physical symptoms imply an expression of low self-esteem/worthlessness which relieves anxiety
Schizoid Personality Disorder Psychosocial Treatment
Supportive Psychotherapy is the choice of treatment although it takes time to build trust and intimacy; DOES NOT do well in group therapy
Psych techs should know the assessment of usual coping strategies regarding distressing side effects/change in body image due to illnesses such as
colostomies and breast cancer
The key notablility of this disorder is a pattern of decficits involving
communication, appearance, and behavior
Nutritional deficiencies in ETOH abuse may be reversed upon
complete cessation in ETOH use
Alcoholic cardiomyopathy
congestive heart failure (CHF) or arrhythmias
Wernicke & Korsakoff are
considered together
opiates will _______ the pupils
constrict
Paranoia Disorder causes the need to
control others around them
Substance-Induced Delirium
Symptoms developed during withdrawal; Impaired consciousness, visual/tactile hallucinations, and disorientation
A PT is assessing a client diagnosed with pedophilic disorder. What would differentiate this sexual disorder from a sexual dysfunction?
Symptoms of sexual disorder include inappropriate sexual behaviors, whereas symptoms of sexual dysfunction include impairment in normal sexual responses.
Medical treatment for OCPD include
TCA's and MAOI's Anafranil (clomipramine) and SSRIs are for obsessional thinking and depression
1st step of 12 Step Program
Take responsibility
A 5 year old patient with ADHD bounces out of a chair in the waiting room then suddenly slaps another child. What would be the psych tech's best action?
Take the child (the aggressor) to another room with toys to act out feelings)
A client has spastic lower limbs and severe pain (somatic disorder). Which of the following intervention would the psych tech most likely perform?
Teach relaxation techniques (you don't want the client to resort to symptoms)
Active ingredient in marijuana
Tetrahydrocannabinol (THC)
Borderline Personality Disorder
The basic peculiarity of this disorder is a patter of mood swings, poor self image, and unstable interpersonal relationships
Nursing Intervention: Case Management
The case manager must help the client avoid behaviors of somatic symptom disorders such as "doctor shopping" by referring them to someone whom the client can relate (knowledge deficit)
A client is diagnosed with terminal cancer. Which situation would the nurse assess as reflecting Kubler-Ross's grief stage of "anger"?
The client is a devoted Catholic but refuses to attend church and states that his faith as failed him.
A client is experiencing pain that has no organic etiology. This pain allows the client to avoid going to work at a job he hates. What best describes what this client is experiencing?
The client is experiencing primary gain
A PT is working with a client diagnosed with pedophilic disorder. Which client outcome is appropriate for the PT to expect during the first week of hospitalization?
The client will identify triggers that lead to inappropriate behaviors.
The psych tech is caring for a patient with bulimia. Which nursing intervention is appropriate?
The client will not be allowed to use bathroom immediately after meals.
A client has been diagnosed as having blindness related to conversion disorder. She displays indifference regarding her conversion symptoms. The psych tech states, "I can't understand why the client doesn't seem more anxious about her symptom." What is the explanation for this?
The client's anxiety has been relieved through physical symptoms
Nonpharmacological interventions such as relaxation therapy (hypnosis, meditation) are helpful in establishing a good sleep hygiene. The success of such technique depends on mostly which of the following?
The client's denial that he or she needs to sleep in achieving a restful night of sleep
Factitious Disorder
The individual makes fictional conscious, intentional feigning of physical/psychological symptoms to receive emotional care and support; associated with the role of "patient receiving comfort"
blood alcohol concentration >.35
death
High doses of barbiturates can greatly
decrease body temperature
Progestin derivatives functions to ________________ and break the pattern of compulsive defiant behaviors.
decreased libido
Drug abusers commonly use
denial
ETOH abuse defensive styles
denial projection rationalization
stimulant users who crash will feel
depressed and suicidal
A common comorbid diagnosis of anorexia nervosa disorder is:
depression
A risk factor for medical noncompliance
depression
Schizoid Personality Disorder Nursing Interventions include assigning the same staff member to
develop trust/rapport; encourage group participation and treatment may be more palliative than curative (help manage but not cure) Open ended questions are best because of short answer responses
Benzodiazepines
diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin)
Insomnia
difficulty initiating/maintaining sleep
amphetamines will _______ the pupils
dilate
Symptoms of Alcohol Intoxication
disinhibition of sexual/aggressive impulses incoordination unsteady gait
Nursing care for the client with a _______________ is aimed at restoring normal thought processes
dissociative disorder
Freud's Psychodynamic Theory described dissociation as a repression of
distressing mental contents from conscious awareness (dissociative behaviors are a defense against unresolved painful issues)
Treatment of Alcoholism
disulfiram (Antabuse)
Schizoid Personality Disorder occupational functioning may be impaired but may
do well working in social isolation
Schizoid personality disorder relationships
doesn't want friends
Common characteristics of Cluster B
dramatic, emotional, erratic, impulsive, poor judgment
Chronic use of hallucinogens
dulled thinking, lethargy, loss of impulse control, poor memory and depression
Schizoid Personality Disorder patients don't exhibit
eccentricities of speech
this rave/techno drug produces euphoria, increased energy and sociability and has some psychedelic effect.
ecstacy
This drug is a methamphetamine substitute that produce euphoria, increased energy and self confidence and has some psychedelic effect
ecstasy
When the homosexual individual is emotionally comfortable with his or her sexuality, he or she is
ego syntonic
What nursing measures would the psychiatric technician initiate when caring for a client with acute exacerbation of congestive heart failure?
encourage the patient to rest, administer 02 as ordered, sodium restriction, administer digitalizing medication and diuretics as ordered
This factor regulates sleep and a host of other biological or physiological functions within the body, such as endocrine regulations, body temperature, sleep/wake cycle, metabolism, autonomic regulation, psychomotor and cognitive performance, attention, memory, and emotion.
endogenous
Paranoia Disorder causes patients to frequently become
engaged in legal disputes
avoidant personality disorder occurs
equally frequent in men and women
Nursing Process: Planning and implementation of interventions must focus initially on
establishing a helping relationship
Ecstacy affects
euphoria, increased energy, increased self-confidence, sociability, and some psychedelic effects
An example of compensatory behavior after a binge eating episode is?
excessive exercise
Often the individual desires to cut down but
fails and use of substance continues to increase
TRUE OR FALSE : primary dyssomnias disorders affect the normal sexual response cycle
false
TRUE OR FALSE : short acting drugs designed to promote sleep are given for patients who wake up in the middle of the night or has trouble staying asleep
false
TRUE OR FALSE :Melatonin levels are highest in the early morning
false
True or False; most individuals with bulimia nervosa are overweight due to fluid loss during self-induced vomiting?
false
Assessment data of an adolescent with a conduct disorder might reveal all of the following behaviors except
feelings of guilt associated with exploitations of others
A client tells the psych tech that his sexual functioning is normal when his wife wears short red nightgowns. He states, "Without the red nighties , i am not interested in sex".The psych can assess this as consistent with
fetishism
the transitory recurrence of perpetual disturbance caused by a persons earlier hallucinogenic drug use when he or she is in drug-free state are known as
flashbacks
This SSRI has been used successfully to treat the client with exhibitionism, voyeurism, and pedophilia and persons who have committed rape
fluoxetine (Prozac)
Which medication has been used with some success in clients with anorexia nervosa?
fluoxetine (prozac)
A client with anorexia nervosa has lost 25% of her body weight and is being treated in an outpatient clinic. The psych tech developed a plan of care for the client with a priority nursing diagnosis of "imbalanced nutrition: less than body requirements". A desired outcome related to this nursing diagnosis would be that within 1 week the client will
gain 3 pounds
Non-substance addictive disorder that may coexist with OCD
gambling
Nursing interventions for OCPD is when the client gets involved with leisure/recreational activities
gardening (to show desires vs requires)
When biological sex differs from gender identity, the individual suffers from a feeling of unease about their maleness and femaleness. This disorder is known as?
gender identity disorder
three days after admission to a drug detoxification treatment program, a client is found crying, she describe seeing her arm floating as though if she moves she will be swallowed by the bed on which she is lying. these symptoms suggest that the client is experiencing
hallucination
Patients of Paranoia Personality Disorder see the world as
harsh and unkind; they anticipate humiliation/betrayal by others, learn to attack first
a client is admitted in a comatose state after ingesting 30capsule of phenobarbital sodium.her husband tells staff that the client often takes more of the drug than is ordered and frequently drinks alcohol concurrently. the psych tech assess that the use of alcohol with this drug
has a synergetic effect
Treatments with medications for antisocial personality disorders
haven't been proven to be effective
Substance abuse disorder patients participates in
hazardous activities when impaired
Relapse prevention goal
help person learn from relapse; periods of sobriety can be lengthened over time
An individual born with ovarian and testicle reproductive organ is refer to as which?
hermaphroditism
transvestic fetishism is characterized by achievement of sexual satisfaction by dressing in clothing of the opposite gender and involves mostly.
heterosexual male
The population that is attracted to the opposite sex are referred to as which of the following?
heterosexuals
orgasm phase
high levels of sexual tensions
Testosterone is normally present in both men and women but is:
higher in men
nurses maintain a ______ approach when caring for clients
holistic
The sleep process is dependent on the number of hours a person is awake, the longer the period of wakefulness, the stronger the sleep drive.
homeostatic
General Assessments for patients with dissociative identity disorders
identity/memory, client history, mood disturbances (depression/suicide risk), and substance abuse
a client report that he could see spiders crawling on the wall. when the psych tech caring for him checks, he discovers that the wallpaper has tiny butterfly patterns. the psych tech is aware that the client is experiencing.
illusions
The act of acting without reflecting and without thought to the consequences of the behavior is
impulsivity
Asian cultures: ETOH abuse is low due to
inability to breakdown acetaldehyde
Anterograde Amnesia
inability to form new memories, user does not remember what has just occurred
Schizoid Personality Disorder have flat or
inappropriate affect (laugh at sad situation)
zoophilia
incorporation of animals into sexual activity
Schizoid Personality Disorder patients are vague about goals and are
indecisive
marijuana
indian hemp plant
Substance abuse feel an
intense craving
exhibition
intentional display of genitals in a public place
Substance abuse is considered a disorder when the use of the substance
interferes with a persons ability to fulfill role obligations; work, school, or home
hypoxyphilia
involve the use of nitrous oxide or strangulation
early indicators of a chemically impaired nurse include
irritability blaming others
Alcoholic Hepatitis
is evidenced by ascites and weight loss in severe cases
Ego-syntonic-emotionally comfortable with the disorder or situation. This person __________________.
is less likely to seek help
Ego-dystonic-emotionally distressed with disorder or situation; this person ____________________.
is more likely to seek help
80% of ETOH is absorbed into the blood stream, only moments after consumption
it can be found in all tissues, organs, and secretions of the body
Intervention Strategies: Cognitive approaches
journal writing, assertiveness training and cognitive reframing
Narcissistic Personality Disorder
lack of empathy, grandiose sense of self-importance, takes advantage of others, envious of others/believes others are envious of them
Paranoid people excessively need to be self sufficient and have a strong sense of autonomy since they
lack trust in others
Environmental influences in the development of attention deficit hyperactivity disorder includes exposure to
lead
Cocaine naturally occurring extract from
leaves of coca bush
Which are the strongest external cue for wakefulness and sleep?
light and darkness
Histrionic Personality disorder
likes to be artsy
addiction is characterized by
loss of control of substance consumption, substance use despite associated problems, tendency to relapse
What psychiatric disorder would the nurse expects to see diagnosed in a client's later life?
major depressive disorder
OCPD is commonly seen in
males and the oldest sibling
ETOH addicts who are first admitted to the hospital are usually first treated for
malnutrition (always drinking, never eating) withdrawals vitamin supplements
Cocaine uses
medical use: numbs/deaden nerves street use: stimulant
All these interventions are appropriate for the treatment of paraphiliase except
medroxyprogesterone
This hormone is produced during night time and is virtually absent at day time.
melatonin
Paranoia Disorder is more commonly diagnosed in
men
Schizoid Personality Disorder is diagnosed slightly more in
men and may cause more impairment in them
Treatment of Opioid Addiction
methadone (dolophine) naltrexone clonidine narcan
Psilocybin
mushrooms
Medication to treat Alcohol Withdrawal
naltrexone (Trexan, Revia); helpful in recovering alcoholics to reduce cravings (very effective)
Antagonistic effective drug to treat opiate overdose
narcan
A client reports that every night she awakes to feeling frightened after a bad dream. The dream usually involves being hunted by individuals who wish to harm her. She tells the PT that the awakening constantly takes place between 3 and 4 AM. The PT assess this disorder as being most consistent with which of the following?
nightmare disorder
There is ______________ to treat paranoia disorders
no specific medications
In certain areas drug use is socially common
nurse may be accepting but leads to underestimation of client's needs for support and education
telephone scatologia
obscene phone calling
an important nursing intervention when giving care to a client withdrawing from CNS stimulant is to
observe for depression and suicidal ideation
necrophilia
obsession with having sexual encounter with a cadaver
Substance abuse disorder patients spend excessive amount of time trying to
obtain and use substances, just as much time spent on recovering from substance use
flashbacks
occur when the client is drug free
Alcohol Withdrawal
occurs within 4 to 12 hours of cessation of or reduction in heavy and prolonged alcohol use PEAK: after 24 to 48 hours symptoms include hallucinations
Common characteristics of Cluster A
odd, eccentric
Paranoid personality disorder patients perceives attacks
on their character that are not apparent to others; is quick to react angrily/counter attack
Types of Opiates
opium morphine (ms emma) heroin codeine fentanyl
Parents of narcissistic personality disorder may have parents who have ____________ them/no limits/inconsistent parenting
overindulged
OCPD patients are unable to discard items with no sentimental value
packrats
Cluster A personality disorders
paranoid, schizoid, schizotypal
Treatment for Korsakoff's Psychosis
parenteral/oral thiamine replacement
Munchausen Syndrome example
parents harm their kids and portray the abuse as illness to receive special care/treatment
Schizoid Personality Disorder males rarely date/marry while females may
passively accept courtship and marry
Patient with high blood alcohol concentration but actions don't match the amount that was drank
patient has high tolerance to ETOH
Sexual activity with a child 13 years or younger is known as?
pedophilia
Voyuerism
peeping tom
Obsessive compulsive personality disorder has a pattern of
perfectionism and inflecibility
Mescaline
peyote
lysergic acid diethylamide
peyote & psilocybin mushrooms
Symptoms of Somatic Disorders such as Anxiety and Depression are co-morbid conditions
physical symptoms may relieve the anxiety
Which of the following is a sleep test used to diagnose patients with breathing sleep disorders?
polysomnography
This sleepy test is used to document adequate alertness in individuals with careers for which sleepiness would pose a risk to public safety.
polysomnography (PSG)
This refers to the simultaneous use of many substance
polysubstance abuse
Complications of Cirrhosis include
portal hypertension and ascites
Cocaine/Crack stimulant effects
produces sexual arousal/violent behavior
Schizoid Personality Disorder features of aloofness may actually be
profound shyness
Paranoid Personality Disorder Defense Mechanism
projection
Paranoid patients use the defense mechanism:
projection
which nursing intervention is appropriate for a client who has a nursing diagnosis of risk for injury R/T alcohol withdrawal?
provide the client with a quiet room free from environmental stimuli
When sex reassignment is desired, the client must first undergo which step?
psychotherapy
excitement phase
public erection and vaginal lubrication
Signs/Symptoms of Opiate intoxication
pupil constriction drowsiness psychomotor retardation
CNS stimulant signs of abuse
pupil dilation excessive motor activity twitching paranoia hyperpyrexia
When interviewing a client suspected of having drug or alcohol problems, the psych tech must be aware of these red flags that indicate a need for further assessment
rationalization, automatic responses, slow prolong answer
antisocial personality disorder patients tend to use
rationalization, projection and denial ("I beat her because she nags")
Outcome criteria and goals must be
realistic and attainable
a 16 year old was brought to a 24-hour drug clinic, after taking her first dose of LSD and having had a "bad trip" the drug effect were off after 8 hours. what intervention /education should be performed before the client is released?
reassurance in a pleasant environment, educate them about flashbacks
synergistic effect
refers to the intensification/prolongation of the effect of two or more drugs occurring when they are taken together (ETOH & benzodiazepine)
antagonistic effects
refers to the weakening/inhibiting effect of one drug by using another (using cocaine and heroin)
Sexual dysfunction are identified as occurring in all these phases of sexual response cycle except:
resolution
Smoking substances increases incidences of
respiratory problems
smoking
respiratory problems
Paranoid personality disorder feelings are
restricted feelings; may take pride in being cold, emotional, doesn't show tender feelings
associated feature of an OCPD patient is
rigidity and stubbornness
frotteurism
rubbing/touching a nonconsenting person
The PT knows the priority nursing interventions for a patient with REM sleep behavior disorder is which of the following:
safety for the patient and their partner
Schizotypal Personality Disorder is more prevalent in first-degree biological relatives of individuals with
schizophrenia
Predisposing Factors of Schizoid Personality Disorder in relatives of
schizophrenia or schizotypal disorder
Personality disorders most commonly seen in a hospital setting:
schizotypal, antisocial and borderline
fetishism
sexual focus on objects intimately associated with the human body
Barbiturates can increase
sexual functioning; increase in libido but followed by decrease ability to maintain an erection
Desire Phase
sexual interest
internet sex
sexual messages transmitted via electronic mail
Which paraphilia involves the achievement of sexual satisfaction from physical or psychological suffering of the victim?
sexual sadism
resolution phase
sexual tension subsides to baseline level
A patient showing that the rehab has been affective will
show responsibility
Schizotypal Personality Disorder childhoods may have been
shunned, overlooked, rejected, withdrawn, and reduced contact with people
Substance Use disorder and Psychiatric disorder both
simultaneously need treatment
intranasal
sinusitis
Intranasal use may be predisposed to
sinusitis (perforated nasal septum)
Schizoid Personality Disorder is common on
skid row
Mrs H, an elderly client, tells the nurse, "The only medication i take is Ambien" based on this statement, the nurse should ask questions designed to assess for
sleep disorder
When an individual suffers from a sleeping disorder secondary to a medical condition, where is the treatment is directed?
sleep disorder, underlying condition & life stresses
The time it takes to go to sleep is referred to as:
sleep latency
This parasomnia is associated with extreme anxiety and even panic. Episodes are described as the patient being unable to move, but reports a complete awareness of their surroundings.
sleep paralysis
Barbiturates decrease amount of
sleep time spent in dreaming (REM sleep)
Psych diagnosis such as a major depression anxiety disorder and maniac episodes have ______________ as part of the diagnostic criteria
sleepy disturbance
Lung disease for
smoking
Nursing care of the individual with a ________________ is aimed at relief of discomfort from the physical symptom
somatic symptom disorder
Sleepwalking is also referred to as:
somnambulism
tolerance to ETOH, ingestion of substance in large amounts or longer periods than intended desire to cut down or control use.
substance dependence
impaired consciousness disorientation ,visual & tactile hallucination ,developing over time (hours to days), symptoms appear during withdrawal syndrome
substance induced delirium
Phase 1 of Cocaine withdrawal
symptoms of depression and suicidal ideation
methadone (dolophine)
synthetic opiate; blocks/reduces craving for heroin
Schizoid Personality Disorder Medical Treatment is not useful except for
temporary periods of excessive anxiety; antidepressants and antipsychotics help manage the disorder but not cure
The most effective treatment modality for all addictions has been which of the following?
the 12 Step Program
Ascites
the accumulation of fluid in the peritoneal cavity, causing abdominal swelling
Stigmatization
the action of describing or regarding someone or something as worthy of disgrace or great disapproval
Nursing process intervention for substance related disorders and addictive disorders
the goal is self responsibility, not compliance
Schizotypal personality disorder is probably
the hardest personality disorder to treat
Tolerance
the need for higher and higher doses of substances to achieve the desired effects
The need for higher and higher dosage of a substance to achieve the desired known as
tolerance
Clonidine & Naltrexone are used together for
treating opioid withdrawal
True or False :In advance age, sleep is more fragmented & lighter, there is a reduction in both slow-wave sleep& REM sleep
true
Phenothiazines
typical antipsychotics: look out for EPS & photosensitivity
Schizoid Personality Disorder patients may have had poor peer relationships and were
underachievers when young, may have been teased
In areas where drug use is common , the nurse/psych tech is more accepting of clients addiction which leads the psych tech/nurse to
underestimate the need for education and support
Paranoid behaviors regarding their intimate partner involves
unjustified recurrent suspicions of their infidelity
Schizoid Personality Disorder patients are usually
unkempt and does not maintain grooming
Schizoid Personality Disorder Patients display
unusual mannerisms and talk to themselves
a client in the emergency department has a history of heavy ETOH use. he presents with acute onset of muscle pain, swelling and weakness of his laboratory studies, the psychiatric technician would expect which laboratory abnormalities.
urine has red tinged appearance and CPK, LDH, AST, aldolase levels are elevated
Parents may have harassed patients of paranoia personality disorder:
used as scapegoats for parental aggression, no hope for affection/approval
disulfiram (Antabuse)
useful in preventing impulsive drinking
Dependent personality disorder is more common with the
youngest child in the family;more frequently diagnosed in females
A client tells the advanced practice nurse that she has trouble falling asleep at night and might lie awake until 3 or 4 am before falling asleep. The appropriate pharmacological treatment is:
zolpidem (Ambien)
A psych tech instructor is teaching about the psychological effects of the diagnosis of a sexual transmitted disease (STD). Which student statement indicates that further instruction is needed?
"Antibiotics administered in the early stages can cure all STD's"
What is the appropriate nursing diagnosis for "Amnesia of fugue related to a traumatic event"?
"Disturbed personal identity..."
Common nursing diagnosis for client with dissociative disorder
"Disturbed sensory perception..." (depersonalization-derealization disorder)
The client is sharing with the cognitive therapist that she is very depressed over the break up of a relationship. The therapist would respond by saying:
"Do you believe that his event shouldn't have happened to you?"
During the initial stage of group, the group leader asks each member to tell something about himself/herself. One woman states that she has had difficulties with sex in her marriage. The group leader's best response would be:
"I can see how much this bothers you. When the group is ready, we will discuss this further."
Michael tells the group leader, "You are stupid, you don't help me at all and this group garbage is worthless." The group leader's best response is:
"I can see you are upset with all of us Michael."
"Let's go to the movies" an avoidant personality disorder person would say;
"I can't, it's supposed to rain"
During group the psych tech observes that a particular client never participates although he seems interested in what is happening. The most effective way to draw this client out is to make which of the following statements?
"I notice you seem interested in Ms. Stafford's comments, would you like to say something?"
The nurse providing teaching for a patient who has been taking a hypnotic medication to sleep. What statement by the PT is appropriate?
"Make sure you follow up with your doctor regularly while you take this medication"
The psych tech is assessing a teenage patient for self-harm. Which statement would require further nursing assessment?
"My mom keeps a bunch of pills in her nightstand"
A son who recently brought his extremely confused parent to a nursing home for admissions reports feeling of guilt. Which is the appropriate nursing reply?
"People often have mixed emotions about decisions like this. Support groups are held here on Mondays for children of residents in similar situations."
A client tells the PT, "Everyone says we should sleep 8 hours a night, I can only sleep approximately 6 hours no matter how hard I try. Am I doing harm to my body?" The best response for the PT to make is:
"Tell me things you have done to try to increase your sleep hours"
Which remark would the psych tech expect to hear during the performing stage of group therapy?
"Telling you about that problem has made me feel better, I appreciate the support and suggestions."
iCarly has been diagnosed with somatic symptoms disorder. As the psych tech is talking with iCarly and her family, which of the following statements suggest primary/secondary gains that the physical symptoms are providing for the client?
"iCarly's mother reports that someone from the family stays with..."
This childhood disorder is characterized by excessive fear or anxiety concerning separation from those the individual is attached.
Separation anxiety disorder
This disorder may develop as a sign of significant stress such as the death of a relative or a pet
Separation anxiety disorder
A nurse is performing a nursing assessment on a 59 year old man who is hypertensive. What is the rationale for including questions about prescribed medications and their effects on sexual function in the assessment?
Several dysfunction may result from use of prescription and nonprescription drugs
Autism spectrum disorder affects the normal development of the brain that involves?
Social interactions and communication
Excessively concerned long-term seeking assistance from HCP and preoccupied/fearful of 1 or more chronic somatic symptoms
Somatic Symptom Disorder
Learning Theory
Somatic complaints are reinforced when they learn primary, secondary, or tertiary gains
Tertiary Gain
Somatic complaints may relieve conflict within the family as concern is shifted to the ill person and away from the real issue
Primary Gain
Somatization avoids stressful obligations/be excused from unwanted duties
Secondary Gain
Somatization includes seeking the attention/care to be received (be taken care of/pampered)
Which of the following sleep patterns observed in the elderly would be assessed by the psych tech as a sleep disorder?
Reduction in REM sleep
According to psychodynamic theory, which primary defense mechanism would the nurse expect to find in a client with dissociative amnesia?
Repression (involuntary blocking of unpleasant feelings)
According to cognitive theories the characteristics of a client with eating disorder is more likely noted
Rigidity
A child who is hyperactive, impulsive and accident-prone is unable to perceive danger. What would be an appropriate nursing diagnosis?
Risk for injury
treatment for gambling
SSRI's
Not many medications have been identified to treat gambling disorder however the obsessive-compulsive traits of this disorder have been known to respond to what classification of medications?
SSRIs
The core psychopathology of anorexia nervosa and bulimia nervosa include all except?
Satisfaction with weight and body image
What is the cause of muscle breakdown and wasting known as alcoholic myopathy ?
vitamin B
alcoholic myopathy treatment
vitamin B
inhalants
volatile solvent from spray paint
The manager of a health club has been discovered to have placed a hidden video camera in the women's locker room and as taped several women as they showered and dressed. The PT who reads this in the paper can assess that the club manager probably is a:
voyeur
Which of the following is an example of a Paraphilia?
voyuerism
Avoidant personality disorder relationships
wants friends
Bupropion medications to treat nicotine withdrawal/cessation
wellbutrin & zyban
A client diagnosed with depression and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribes a sedative. Which rationale explains
will not give sufficient sleep (won't enter REM cycle)
