Ch. 94: Psychiatric Nursing
Client taking MAIOs (antidepressant) should avoid
-OTC meds & - cheese, avocados, bananas, beer, bologna, caffeine, chocolate, liver, pepperoni, pickle food, red wine, fruit, Salami, smoked food, yeast, meat cooked w/ tenderizer, raisins, herrinf and yogurt
Principles of rational emotive behavior therapy (REBT): treatment for substance abuse disorders and Rehab
-People are accepted unconditionally -nothing is awful or terrible, even though it may be frustrating and difficult -support is helpful in learning and practicing new ways to react to stress
Signs and symptoms of PTSD
-Recurrent and intrusive flashbacks to or dreams of the event -insomnia, inability to concentrate -persistent avoidance of stimuli associated with the event -inability to recall all or part of it - person exhibits hypervigilence, exaggerated startled response
Signs and symptoms of depressive disorders
-Sleep disturbances: hyper/ insomnia -psychomotor retardation: slow movement -fatigue, diminished ability to concentrate -recurring thoughts of death or suicidal ideation
Sore throat
After client receives ECT treatment they may complain of
Disadvantages of ECT
Anxiety before treatment and short term memory loss
Extra pyramidal side effects (EPSE)
Causes adverse neurologic side effects (tardive dyskinesia, cognitive impairment, and other unwanted symptoms)
Neuroleptic malignant syndrome (NMS), a rare, life-threatening complication of certain neuroleptic meds
Causes muscle rigidity, hyperthermia, diaphoresis, tachypnea, tachycardia
Vulnerable adults
Clients with mental illnesses or intellectual impairment. Physical, sexual or verbal abuse or neglect of any client is illegal
Suppression
Consciously inhibiting an impulse or emotion that is unacceptable to the person
The nurse is caring for a client with schizophrenia who is experiencing positive symptoms. Which symptoms observed by the nurse will be documented as positive? Select all that apply
Delusions, hallucinations, disorganized speech
Reaction formation
Displaying a behavior, attitude are feeling opposite to that which one would normally exhibit in the same situation
Grandiosity
Excessive attention to clothing and makeup "entitlement" the world owes me everything
The nurse is caring for a client who is on the behavioral health unit. What cluster of symptoms reported by the client should the nurse recognize indicate suicidal ideation
Flat affect, Catatonia, hallucinations
A client treated for substance abuse disorder is being discharged from an inpatient facility to a facility that will make the transition into the community less traumatic. When should the nurses sure the client has a room?
Halfway house
side effects of buspirone (Buspar)
Hypotension, Headache, nausea, dry mouth
Organic disorder
Identifies a physical cause for the mental disorder
Acute psychotic episodes (APE)
Include visual hallucinations: things that others don't see; images, Shadows, visions
Agoraphobia
Irrational fear of crowds, public places and places from which Escape would be difficult (this client may be unable to leave home)
a mentally healthy person
Is able to adjust to new situations and handle stress without severe discomfort
Reality therapy
It's important for the client to learn that what happened in the past cannot be changed. Clients are encouraged to look forward to the future and live accordingly
the client being treated for bipolar Mania with lithium must
Maintain daily fluid intake (8 glasses) and should not use NSAIDs
OCD (Obsessive Compulsive Disorder)
Marked By obsessions - recurrent, persistent, intrusive thoughts or beliefs that they cannot ignore
A parent brings her 2 year old child to the emergency department frequently, reporting seizure activity that has not been Witnessed by anyone other than the parent. Diagnostic test reveal no organic cause. What should the nurse monitor the parent for?
Münchhausen syndrome by proxy
Dual diagnosis
Person has two separate chronic conditions
Goal of psychiatric care
Safety of the client, his or her family and others in the community
milieu
Therapeutic environment where the nurses try to assist people to return to as near normal functioning as possible
Electroconvulsive therapy (ECT)
Used to treat chronic depression and clients who don't respond to antidepressant meds (shocks the brain into a seizure)
The nurse says to a client, how are you today? The client repeats, today, today, today, today. How will the nurse document this Behavior?
echolalia
Malingering
feigning or faking symptoms so that he or she can stay in the hospital, receive medication, avoid arrest or get attention
Buspirone (Buspar)
given for anxiety (OCD, PTSD)
Transportation hold ("T" Hold)
placed by the police, to bring the unstable person to the hospital or mental health facility in an emergency
Halfway house
provides a buffer between the inpatient facility and the community. The client is there for a short time after discharge, making Readjustment into the community less traumatic
MMSE (mini mental state examination)
stated as (AMSIT): Appearance Mood Senserium Intelligence Thought process
