Chapter 35: Care of the Patient with a Psychiatric Disorder
What is the typical schedule for electroconvulsive therapy (ECT)?
10 treatments over several weeks
Selective serotonin reuptake inhibitors
monoamine oxidase inhibitors
A patient who is taking a monoamine oxidase inhibitor (MAOI) asks the nurse about the addition of St. John's wort to help with his depression. What would be the best response of the nurse?
"Did you know that St. John's wort can raise your blood pressure dramatically?"
The patient is concerned about confidentiality and asks the nurse not to tell anyone what is said. What is the best response by the nurse?
"I am required to report any intent to hurt yourself or others."
The nurse asks a patient with schizophrenia if he had any visitors on Sunday. Which response indicates loose association?
"We visited Yellowstone Park last summer."
What are considered warning signs of suicide? (Select all that apply.)
-Talking about suicide -Drug or alcohol abuse -Difficulty concentrating on work or school -Personality changes
Adjunctive therapies are used for which reasons? (Select all that apply.)
-To increase self-esteem -To promote positive interaction -To enhance reality orientation
When all five axes of the Diagnostic and Statistical Manual of Psychiatric Disorders, V, are used, it provides what type of assessment approach to comprehensive care?
Holistic
A home health nurse has a patient who is taking lithium. What should be included in the teaching plan?
Have her drug blood level checked every month.
A profound, disabling mental illness is characterized by bizarre, nonreality thinking. What is the illness?
Schizophrenia
The home health nurse assesses a patient who creates elaborate excuses for not leaving home. Further questioning reveals the patient had not left home for 6 months. How should this be documented?
Agoraphobia
What disorder is a severe form of self-starvation that can lead to death?
Anorexia nervosa
Cluster B Dramatic Emotional or Erratic
Antisocial personality disorder Borderline personality disorder Narcissistic personality disorder
The nurse is assessing a female patient who has become rapidly and exceedingly anxious because her fingernail polish is chipped. What type of anxiety should the nurse conclude that the patient is exhibiting?
Anxiety traits
The patient talks with his dead brother and arranges furniture so that his brother will have a place to sit. How should the nurse document this behavior?
Hallucination
When a patient demonstrates accelerated heart rate, trembling, choking, and chest pain along with acute, intense, and overwhelming anxiety, the nurse should recognize that the patient is most likely experiencing what condition?
Panic
A patient believes himself to be the president of the United States and that terrorists are trying to kidnap him. The nurse records these observations as which type of behavior?
Positive behavior
If a patient believes he is the president of the US and that terrorists are trying to kidnap him. Which behavior is he exhibiting?
positive
he nurse recognizes that stress can cause an ulcer, which is classified as a _______________ symptom illness.
somatic
The nurse instructs a patient who has just been prescribed a protocol of fluoxetine HCl (Prozac) that the drug takes 2 to 4 ____ to take effect.
weeks
A 14-year-old survivor of a school shooting screams and dives under a table when firecrackers go off. What does this behavior represent?
Posttraumatic stress disorder
When the patient with a psychosis is thought to be a danger to self or others, by what method should the patient be admitted to the hospital?
Probating
What is the term used for the beginning stage of schizophrenia, characterized by a lack of energy and complaints of multiple physical problems?
Prodromal
What is the term for a long-term and intense form of psychotherapy developed by Sigmund Freud that allows a patient's unconscious thoughts to be brought to the surface?
Psychoanalysis
Cluster A Odd or Eccentric
Schizoid personality disorder Paranoid personality disorder Schizotypal personality disorder
28. The patient complains of recurrent, multiple physical ailments for which there is no organic cause. How should the nurse assess this?
Somatic symptom disorder
The nurse is caring for a patient with a diagnosis of catatonic schizophrenia. What behavior is consistent with this diagnosis?
Stands on one foot for 15 minutes.
A patient admitted for delirium demonstrates increased disorientation and agitation only during the evening and nighttime. What is the term applied to this type of delirium?
Sundowning syndrome
The nurse cautions a patient to watch his step. What response indicates concrete thinking?
The patient fixedly begins to watch his feet.
The nurse is discussing the differences between a patient with a neurosis and one with a psychosis. What is true of the patient experiencing a neurosis?
The patient has insight that there is an emotional problem.
The nurse is told that a patient believes he was born into the wrong body. What is the correct terminology for the desire to have the body of the opposite sex?
Transsexualism
The nurse explains that an alternative therapy that uses essential oils and scented candles to help a patient relax and focuses on the atmosphere of the moment is ______________.
aromatherapy
What is the prognosis for a schizophrenic patient who is exhibiting positive behaviors?
Good
The nurse recognizes that researchers have identified that hereditary factors account for what percentage of mood disorders?
60% to 80%
What should the nurse preparing a patient for a scheduled appointment for electroconvulsive therapy (ECT) remind the patient to do?
Arrange for transportation to and from the appointment.
Cluster C Anxious Fearful
Avoidant personality disorder Dependent personality disorder Obsessive Compulsive personality disorder
For the past 3 weeks, the nurse has observed a patient interacting with staff and other patients, helping decorate the dining room for a party, and leading the singing in the activity room. Today, the patient tearfully refuses to dress or get out of bed. The nurse recognizes these behaviors as evidence of which psychiatric disorder?
Bipolar disorder
The nurse alters the care plan for a patient with depression to include what type of activity?
Group outing to view wildflowers
Dementia is an organic mental disease secondary to what problem?
Cerebral disease
When a patient is experiencing a panic attack, how should the nurse best assist the patient?
Coach in deep breathing.
Why psychological technique focuses on breaking negative thought patterns and developing positive feelings about memories or thoughts?
Cognitive Therapy
A young man with malaria spikes a temperature of 105°F (40.5°C) and begins to hallucinate. How should the nurse assess this?
Delirium
The Diagnostic and Statistical Manual of Psychiatric Disorders, V (DSM-V), is used by most hospitals and is the current tool used to examine mental health and illness. What approach does the DSM-V use to classify mental disorders?
Multiaxial system
A patient is frequently late for appointments because he goes back to his room numerous times to assure himself that none of his belongings have been stolen. What does this behavior represent?
Obsessive-compulsive
