Psychiatric/Mental Health Nursing

Cluster A

includes paranoid, schizoid, and schizotypal personality disorders. These clients are odd and eccentric and use strange speech, are angry, and have impaired relationship

schizotypal personality disorder

interpersonal problems, inappropriate affect, paranoid/magical thinking, odd beliefs demonstrate superstitious and socially anxious behavior

Tardive dyskinesia

involuntary repetitious tonic muscular spasms that involve the face, tongue, lips, limbs, and trunk; takes several months to years to develop after the start of therapy with a conventional antipsychotic d/c if observed, may be reversible

early signs (alcohol withdrawal)

irritability, increasing anxiety, Tachycardia

schizoid personality disorder

neither desire nor enjoy close relationships; prefer solitary activities; and demonstrate emotional coldness, detachment, and a flattened affect

tangential thinking

person never answers the question or returns to the central point of the conversation. It often is seen in people with dementia.

serotonin syndrome

potentially hazardous adverse effect of second-generation antidepressants that are used to treat depression hyperthermia and rhabdomyolysis

Neuroleptic malignant syndrome

severe, potentially fatal response to conventional antipsychotics caused by acute reduction in dopamine activity, precipitating hyperthermia/pyrexia, tachycardia, tachypnea, unstable blood pressure, dyskinesia, incontinence, decreased level of consciousness

thought blocking

sudden stoppage of the spontaneous flow of speaking for no apparent reason; it is seen most often in clients who are experiencing auditory hallucinations

borderline personality disorder

tend to be engaging and to establish intense relationships. They may be manipulative because they are opinionated and want people to conform to their agendas. These clients are often decisive and opinionated, have a pronounced intolerance for being alone, and are usually quite social. These clients are not perfectionists. irresponsible, amoral, and dishonest and do not learn from negative experiences. are often charming and calculating when exploiting others; they show no remorse for hurting others and do not develop insight into predictable consequence Impulsive, potentially self-damaging behaviors initial intervention after forming therapeutic relationship is to establish clear boundaries

Apraxia

the loss of purposeful movement in the absence of motor or sensory impairment. The individual is unable to perform purposeful tasks such as walking or putting on clothing properly

Agnosia

the loss of sensory ability to recognize familiar sounds and objects, as well as loved ones or even parts of the affected individual's body.

empathy

the projection of self into another's emotions to share the emotions and the other's state of mind; this technique helps the nurse understand the meaning and significance of the experience to the client

Introjection

treating something outside the self as if it is actually inside the self; it is unconsciously incorporating the wishes, values, and attitudes of another as if they were one's own

Mirtzapine

treatment of depression and also helpful in reducing the adverse sexual side effects in the male client receiving selective serotonin reuptake inhibitors therapy drowsiness and abnormal dreams are the adverse effects

imipramine

tricyclic antidepressant Urinary hesitancy and retention are adverse effects

fluphenazine

typical antipsychotic Acute dystonic reactions such as tremors, dyskinesia, and akathisia are observable side effects decreased salivating

Conversion

unconscious defense mechanism in which a person develops physical symptoms that have no organic cause serves the purpose of reducing anxiety

Duloxetine

used to treat both generalized anxiety disorder and depression can worsen uncontrolled angle-closure glaucoma

Bupropion

used to treat depression and also aid in smoking cessation contraindicated in clients with eating and seizure disorders can cause high blood pressure

Lithium

used to treat manic episodes but is contraindicated in clients with renal or cardiovascular disease therapeutic range of serum levels is 0.5 to 1.5

Clozapine

2nd gen atypical antipsychotic drug that is more effective than other second-generation antipsychotics Seizures, sedation, and akathisia are common side effects contraindicated in clients with bone marrow depression may cause agranulocytosis, the client's white blood cell (WBC) count should be monitored weekly. The drug should be discontinued if the count falls below 3,000/mm 3 use with caution in clients with seizures

They combat the extrapyramidal side effects of the neuroleptic drug.

A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications?

acute dystonia

Acute, often painful, sustained contraction of muscles typically occurs 2 to 5 days after the introduction of antipsychotic medications can be treated with an antiparkinsonian or anticholinergic drug while the antipsychotic medication is continued

Neuroleptic Malignant Syndrome

Adverse reaction to antipsychotics with severe "lead pipe" rigidity, FEVER, and mental status changes adverse effect of chlorpromazin (antipsychotic)

antisocial personality disorder

Aggressive and manipulative behaviors

abandonment vs identity loss

Alternating clinginess and distance reflects a reenactment of the mother-child relationship and is based on a desire to avoid being rejected.

nms

Drugs used to treat _____ are dantrolene and bromocriptine

DELIRIUMS (causes mnemonic)

Drugs, Emotional factors, Low arterial oxygen level, Infections, Retention of urine or feces, Ictal or postictal state, Undernutrition, Metabolic conditions, and Subdural hematoma

first

During the ___________ stage of alcohol detoxification, nausea, anorexia, hypertension, tachycardia, and irritability are expected.

Foods high in tyramine

Fermented, smoked, aged foods, bologna, foods with yeast, beer, wine, chocolate, Ginseng, medications (cough meds)

cluster c

includes avoidant, dependent, and obsessive-compulsive personality disorders. These clients are anxious, fearful, tense, and rigid.

confabulation

Imagination is used to fill in memory gaps; defense mechanism used by people experiencing memory deficits

Isocarboxazid

MAOI Circulatory collapse is associated with toxicity

Selegiline

MAOI antidepressant used to treat Parkinson disease Oxcarbazepine significantly raises the level The most common adverse reaction is a localized rash. It is the only transdermal treatment for major depression.

Akathisia

Motor restlessness can be treated with an antiparkinsonian or anticholinergic drug while the antipsychotic medication is continued

side effects

On what basis would the primary healthcare provider choose a neuroleptic/First-generation antipsychotic drug (blocks access to dopamine receptors)?

oxazepam administration during detoxification

Reduces the anxiety-tremor state and prevents more serious withdrawal symptoms

contraindicated

Schizophrenia, bipolar depression, Alzheimer disease, and dementia are _____________________ for St. John's Wort herbal therapy.

Barbiturates

Seizures are a serious side effect that may occur with abrupt withdrawal from ___________________.

Displacement

a defense mechanism in which one's pent-up feelings toward a threatening person are discharged on those who are less threatening (common in physical abusers)

Torticollis

acute dystonia that involves muscle spasms of the neck; develops within 1 to 5 days after beginning therapy with a conventional antipsychotic

Regression

an unconscious defense mechanism that reduces anxiety by returning to behavior that was successful in earlier years commonly is used by clients with undifferentiated schizophrenia to reduce anxiety

haloperidol

antipsychotic drug used in the long-term treatment of psychosis Gynecomastia is one of the adverse effects of this drug Potential adverse effects: pseudoparkinsonism and urinary retention related to extrapyramidal syndrome

Projection

attributing of unacceptable feelings or thoughts to others organized defense used by clients with paranoid schizophrenia

Ziprasidone

atypical antipsychotic contraindicated in clients with a history of dysrhythmias

Disulfiram

aversion therapy for alcohol addiction/abuse cannot tolerate alcohol when on it consuming alcohol while taking it will cause a severe reaction: nausea, vomiting, hypotension, headache, tachycardia, tachypnea, and flushing

obsessive-compulsive disorder

controlling feelings of anxiety and guilt by maintaining an absolute set pattern of action Rigid, perfectionistic, controlling behaviors

repression vs suppression

coping with overwhelming emotions by blocking awareness or memory of the stressful event consciously keeping unacceptable feelings and thoughts out of awareness

interpersonal theory

development across lifespan highlights interpersonal behaviors and relationships as the central factors influencing child and adolescent development need to satisfy social attachments and a longing to meet biologic and psychological needs

histrionic personality disorder

draw attention to themselves, are vain, and demonstrate emotionality and attention-seeking behavior

Pseudoparkinsonism

extrapyramidal tract response that includes masklike facies, shuffling gait, pill-rolling tremors, stooped posture, and drooling; develops within several days to 1 month after the start of therapy with a conventional antipsychotic

undifferentiated schizophrenia

has psychotic manifestations that are extreme; may have ineffective thought processes are unable to repress disturbing thoughts/feelings out of the conscious mind and therefore have a need to escape from reality

cluster b

includes antisocial, borderline, histrionic, and narcissistic personality disorders. These clients are dramatic, erratic, labile, impulsive, hostile, and manipulative..