mental health nursing ATI study #LEVEL 3!!!!!!!!!

guanfacine

(Intuniv) or clonidine (Kapvay), the action of alpha2 adrenergic agonists is not completely understood. However, they are known to activate presynaptic alpha 2 adrenergic receptors within the brain. Therapeutic use is for ADHD. Adverse effects, CNS effects (sedation, drowsiness, fatigue), cardiovascular effects, and weight gain. Extended release clonidine is contraindicated for children less than 6, use cautiously in pts with cardiac disease. Do not mix with CNS depressants, antihypertensives, foods with high fat content

aripiprazole

(abilify), forumal, tablets, orally disintegrating tablets, oral solution, short acting injectable, low or no risk for EPS. Low risk for diabetis, weight gain, dyslipidemia, orthostatic hypotension, and anticholinergic effects, adverse effects include sedation, headache, anxiety, insomnia, gi upset.

clozapine

(clozaril), tablets, orally disintegrating tablets, low risk of eps, high risk of weight gain, diabetes, and dyslipidemia, risk for fatal agranulocytosis, baseline and weekly monitoring of WBC recommended, notify the provider of indications of infection (fever, sore throat, mouth lesions), sedation, orthostatic hypotension, anticholinergic effects.

iloperidone

(fanapt), tablets, significant risk for weight gain, prolonged QT interval, and orthostatic hypotension, advise clients to follow titration schedule during initial therapy to minimize hypotension. Low risk for diabetes, dyslipidemia, and EPS. Dry mouth, sedation fatigue, nasal congestion.

desipramine

(norpramin), these meds (imipramine, and clomipramine) along with __ block reuptake of the monoamine neurotransmitters norepinephrine and serotonin in the synaptic space, therby intensifying their effects. Used for depression, Autism, ADHD, Panic, OCD, complications, Orthostatic hypotension, Anticholinergic effects, weight gain. Sedation, Toxicity resulting in cholinergic blockage, decreased seizure threshold, excessive sweating, do not mix with MAOIs, antihistamines, epinephrine, and alcohol or benzoes, opioids,

asenapine

(saphris), sublingual tablets, low risk of diabetes, weight gain, dyslipidemia, and anticholinergic effects, drowsiness, prolonged QT interval EPS, temporary numbing of the mouth.

atomoxetine

(strattera), this blocks reuptake of norepinephrine at synapses in the CNS. This is not a stimulant medications, this is used for ADHD in children and adults. Adverse affects appetite suppression, weight loss, growth suppression, GI effects, suicidal ideation, hepatotoxicity. Use cautiously in patients who have cardiovascular disorders. Do not mix with MAOIs, of SSRIs. Give med in the morning.

Triangulation

A third party is drawn into the relationship with two members whose relationship is unstable. For example, one parent can develop an alliance with a child, leaving the other parent relatively uninvolved with both.

coma

LOC is no response, can be achieved from repeated painful stimuli.

postpartum onset

MDD can be set by _____a depressive episode that begins within 4 weeks of childbirth known as postpartum depression, and can include delusions, which can put the newborn infant at high risk of bieng harmed by the mother.

psychotic features

MDD can have _______the presence of auditory hallucinations or the presence of delusions

Individual roles

These roles tend to prevent teamwork, because individuals take on roles to promote their own agenda. Examples include the dominator, who tries to control other members and the recognition seeker, who boasts about personal achievements.

Justice

This is fair and equal treatment for all.

Veracity

This refers to being honest when dealing with a client

benzodiazepine

_____________can help with seizure disorder, insomnia, muscle spasm, alcohol withdrawal( for preventnion and treatment of acute effects), induction of anesthesia, amnesic prior to surgery or procedures.

tyramine

_________rich foods include aged meats and chesses, smoked or pickled meats, meat extracts, avacoda, smoked fish, some dietary supplements, some beers, and red wine.

short term memory loss

a client had an ECT, the anesthesia provider gave a short acting anesthetic methohexital (Brevital) and then a muscle relaxant succinylcholine (anectine), the electrical stimules went for around 25 to 60 seconds, the seizure stopped, and now, the patient wakes up and has this common side effect, the nurse needs to provide frequent orientation.

durable power of attorney

a document that appoints an individual to make medical decisions when a client is no longer able to do so on his own behalf.

gustatory

a hallucination of experiencing tastes

tactile

a hallucination of feeling bodily sensations

hypomania

a less severe episode of mania that lasts at least 4 days accompanied by three to four findings of mania. Hospitalization is not required, and the client is less impaired.

Mixed episode

a manic episode and an episode of major depression experienced simultaneously. The client has marked impairment in functioning and can require admission to an acute care mental health facility to prevent self harm or other directed violence.

scapegoating

a member of the family who has little power is blamed for problems within the family. For example, one childwho has not completed his chores might be blamed for the entire family not being able to go on an outing.

emergency involuntary commitment

a type of involuntary commitment in which the client is hospitalized to prevent harm to self or others. This is usually temporary. It is usually imposed by primary care providers, mental health providers, or police officers.

tobacco withdrawal

abstinence syndrome is evidenced by irritability, nervousness, restlessness, insomnia, and difficulty concentrating (tip, stopping this addiction)

wellbutrin

adverse affects of this medication include, headache, dry mouth, gi distress, constipation, increased heart rate, nausea, reslessness, insomnia, suppression of appetite resulting in weight loss, seizures especially at higher dose ranges.

SSRIs

adverse effects can include nausea, headache, and CNS stimulation (agitation, insomnia, anxiety) Sexual dysfunction, Avoid concurrent use w st johns wort, weight gain in long term use

lithium

adverse effects of this include gi distress, fine hand tremors (exacerbated by stress or caffeine), polyuria, weight gain, kidney toxicity, goiter and hypothyroidism with long term treatment, bradydysrhythmias, hypotension, electrolyte imbalances. Toxic levels include early indications at 1.5 meq/l, advanced indications at 1.5 to 2 meq/l, severe toxicity greater than 2 to 2.5 meq/l, greater than 2.5 meq/l coma and death.

antipsychotic second generation medications

adverse effects of this include new onset of diabetes or loss of glucose control in diabetic clients, weight gain, hypercholesterolemia, risk for hypertension, orthostatic hypotension, anticholinergic effects such as urinary hesitancy or retention, dry mouth, agitation, dizziness, sedation, and sleep disruption, Mild EPS such as tremor.

valproic acid

adverse effects of this medication for bipolar include gi effects, hepatotoxicity (nausea, vomiting, fatigue, abdominal pain, jaundice) pancreatitis, thrombocytopenia, tertogenesis.

tricyclic antidepressants

adverse effects of this will include orthostatic hypotension, anticholinergic effects, sedation, toxicity resulting in cholinergic blockade and cardiac toxicity, decreased seizure threshold, excessive sweating.

tricyclic antidepressants

adverse effects, change positions slowly to minimize dizziness from orthostatic hypotension. To minimize anticholinergic effects, chew sugarless gum, eat foods high in fiber, and increase fluid intake to 2 to 3 l per day from food and beverage sources

bupropion, wellbutrin

adverse effects, observe for headache, dry mouth, gi distress, constipation, increased heart rate, nausea, restlessness, or insomnia. Nofity the provider if they become intolerable. Monitor food intake and weight due to appetite suppression. Avoid administering to clients at risk for seizures.

alpha 2 adrenergic agonists

advise clients to avoid abrupt discontinuation of medication, which can result in rebound hypertension. Medication should be tapered according to a prescribed dosage schedule when discontinuing treatment for ADHD. These drugs are guanfacine, (Intuniv), and clonidine (Kapvay)

d

alprazolam is preg category

tricyclic antidepressant

amitriptyline and clomipramine are ______________

mania

an abnormally elevated mood, which can be described as expansive or ittitable, that usually requires hospitalization.

flight of ideas

associative looseness, the client might say sentence after sentence, but each sentence relates to another topic, and the listener is unable to follow the clients thoughts.

psychoeducational groups

based on a client's level of functioning and personal needs such as adverse effects of medication

dependence

benzodiazepines are generally used short term due to the risk for

lithium carbonate

bipolar disorder is primarily managed with mood stabilizing medications such as

projection

blaming others for unacceptable thoughts and feelings

antiepileptic drugs

carbamazepine, valproic acid, lamotrigine these drugs are considered ____________and help bipolar by slowing the entrance of sodium and calcium back into the neuron, thus extending the time it takes for the nerve to return to its active state, potentiating the inhibitory effects of gamma butyric acid, and by inhibitin glutamic acid which in turn suppresses cns excitation.

cognitive reframing

changing cognitve distortions can decrease anxiety. This assists clients to identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self talk.

narcissistic

characterized by arrogance, grandiose views of self importance, the need for consistent admiration, and a lack of empathy for others that strains most relationships often sensitive to criticism.

antisocial

characterized by disregard for others with exploitation, repeated unlawful actions, deceit, and failure to accept personal responsibility

paranoid

characterized by distrust and suspiciousness toward others based on unfounded beliefs that others want to harm, exploit, or deceive the person

histrionic

characterized by emotional attention seeking behavior, in which the person needs to be the center of attention, often seductive and flirtatious

dependent

characterized by extreme dependency in a close relationship with an urgent search to find a replacement when one relationship ends

borderline

characterized by instability of affect, identity, and relationships, as well as splitting behaviors, manipulation, impulsiveness, and fear of abandonment often tries self injury and can be suicidal

schizotypal

characterized by odd beliefs leading to interpersonal difficulties, and eccentric appearance, and magical thinking or perceptual distortions that are not clear delusions or hallucinations

obsessive compulsive

characterized by perfectionism with a focus on orderliness and control to the extent that the indiviual might not be able to accomplish a given task.

schizoid

charcteized by emotional detachment, disinterest in close relationships, and indifference to praise or criticism, often uncooperative

nicotine replacement therapy

chew guum slowly and intermittently over 30 mins, avoid drinking 15 mins prior to and while chewing gum. If using a patch, dont wear during MRI.

antipsychotic first generation medications

chlorpromazine, haloperidol, fluphenazine, loxapine, thioridazine, thiothixene, perphenazine, trifluoperazine are all

specific learning disorder

client demonstrates persistent difficulty in acquiring reading, writing, or mathematical skills. Performance in one or more of the academci areas is significantly lower than the average range for the clients age, level of intelligence, or educational level. These benefit fron an individualized education program.

conduct disorder

clients who have this demonstrate a persistent pattern of behavior that violates the rights of others or rules and norms of society. Categories of conduct disorder include the following, aggression to people and animals, destruction of property, deceitfulness or theft, serious violations of rules.

disruptive mood dysregulation disorder

clients who have this disorder exhibit recurrent temper outbursts that are severe and do not correlate with situation. Temper outbursts are presnet three or more times per week and are observable by others, such as parents, peers, and teachers, in at least two settings, such as home and school, onset is from 6 to 10. Clinical manifestations are not due to another mental health disorder such as bipolar.

Intellectual developmental disorder

clients who have this disorder have an onset of deficits and impairments during the developmental period of infancy or childhood. The client has intellectual deficits such as reasoning, abstract thinking, academic learning, and learning from prior experiences. inability to maintain personal independence and social responsibility, need support through school.

25

collect data about the clients risk for suicide when taking atypical antidepressants. antidepressant induced suicide is mainly associated with clients under the age of

VNS

complications of this include voice changes due to the proximity of the implanted lead on the vagus nerve to the larynx and pharynx. Hoarseness, throat or neck pain, dysphagia. These improve with time. Dyspnea, especially with physical exertion, is possible. Therefore, the client might want to turn off the device during exercise.

TMS

complications of this include, mild discomfort or a tingling sensation at the site of the electromagnet. Monitor the client for lightheadedness after the procedure. Seizures are a rare but potential complication. It is not associated with systemic adverse effects or neurologic deficits.

chlorpromazine

complications of this medication include, agranulocytosis, anticholinergic effects, EPS, Parkinsonism, Akathis, tardive dyskinesia, neuroendocrine effects, neuroleptic malignant syndrome, orthostatic hypotension, sedation, seizures, severe dysrhythmias, sexual dysfunction, skin effects. This medication is used for schizophrenia.

neuroimaging

computer tomography and position emission tomography of the brain

donepezil

concurrent use of NSAIDS such as aspirin can cause gi bleeding, antihistamines, tricyclic antidepressants, and conventional antipsychotics, medications that block cholinergic receptors, can reduce the therapeutic effects of _______________

false imprisonment

confining a client to a specific area, such as a seclusion room, is __________________ if the reason for such confinement is for the convenience of the staff.

sundowning

confusion that occurs at night

chlorpromazine

conventional antipsychotic medication that blocks dopamine D2 acetylcholine, hitamine, and norepinephrine receptors in the brain and periphery, therapeutic for pyschotic disorders, schizophrenia spectrum disorders, bipolar, tourettes, prevention of nausea/vomiting.

rationalization

creating reasonable and acceptable explanations for unacceptable behavior

splitting

demonstrating an inability to reconcile negative and positive attributes of self or others

regression

demonstrating behavior from an earlier developmental level. Often exhibited as childlike or immature behavior.

living wills

directive documents that give speccific instructions for medical treatment per a clients wishes.

personal boundary difficulties

disenfranchisement with one's own body, identity, and perceptions, includes depersonalization, derealization

buspirone

do not use this medication with erythromycin, ketoconazole, st. Johns, graprefruit juice, these can increase effects.

alzheimers

donepezil, rivastigmine, and galantamine are used for ______in the mild to moderate stages.

opioids

effects of intoxication include slurred speech, impaired memory, pupilary changes, and decreased respirations and lOC, which can cause death. Maladaptive behavioral or psychological changes, including impaired judgment or social funcitoning,

alcohol withdrawel

effects usually start within 4 to 12 hours of the last intake of alcohol, peak after 24 to 48 hours and then suddenly disappear.

anorexia

enlargement of the parotid glands and dental erosion and caries if the client if purging, irregular heart rate, peripheral edema, muscle weakness, constipation

alzheimers

estrogen therapy for women can prevent ____but it is not useful in decreasing the effects of preexisting cognitive deficits

flooding

exposing a client while in the company of a therapist, to a great deal of an undesirable stimulus in an attempt to turn off the anxiety response

posttraumatic stress disorder

exposure to a traumatic event causes intense fear, horror, flashbacks, feelings of detachment and foreboding, restricted affect, and impairment for longer than 1 month after the event. Manifestations can last for years.

acute stress disorder

exposure to a traumatic event causes numbing, detachment, and amnesia about the event for at least 3 days but for not more than 1 month following the event.

maltreatment

family violence occurs across all economic and educational backgrounds and racial and ethnic groups in the United States. It is often termed

task 4

finding a meaningful connection with the lost entity while learing to live again.

light therapy

first line treatment for seasonal affective disorder; inhibits nocturnal secretion of melatonin.

decorticate rigidity

flexion and internal rotation of upper extremity joints and legs

detoxification

for __________chlordiazepoxide, diazepam, lorazepam, oxazepam, for the maintenance of vital signs within the expected reference range, decrease in the risk of seizures, decrease in the intensity of withdrawal manifestations, administer around the clock or PRN, obtain baseline vitals, monitor vitals and neruo status regularly, provide seizure precautions,

psychoanalys

for this therapy, the tools used are free association, drema nalysis and interpretation, transference, and use of defense mechanisms.

rapid cycling

four or more episodes of acute mania within 1 year.

antihistamine

hydroxyzine pamoate, and hydrochloride are both ________

rigid boundaries

in a dysfunctional family, rules and roles are completely inflexible. These families tend to have members that isolate themselves.

enmeshed boundaries

in a dysfunctional family, the thoughts, roles, and feelings blend so much that individual roles are unclear.

placating

in a dysfunctional family, this is when one member takes responsibility for problems to keep peace at all costs.

tension building phase

in this phase of the family cycle of violence, the abuser has minor episodes of anger and can be verbally abusive and responsible for some minor physical violence. The victim is tense during this stage and tends to accept the blame for what is happening.

honeymoon phase

in this phase of the family cycle of violence, the situation is defused for awhile after the violent episode. The abuser becomes loving, promises to change, and is sorry for the behavior. The victim wants to believe this and hopes for a change. Eventually, the cycle begins again.

acute battering phase

in this phase of the family cycle of violence, the tension becomes too much to bear and serious abuse takes place. The victim can try to cover up the injury or can get help.

Maintenance roles

in this, the members who take on these roles tend to help maintain the purpose and process of teh group For example, the harmonizer attempts to prevent conflict in the group.

benzodiazepine intoxication

increased drowsiness and sedation, agitation, slurred speech, uncoordinated motor activity, nystagmus, disorientation, nausea, vomiting, resp depression, decreased LOC, can be fatal,

Thought stopping

instructing a client, when negative thoughts or compulsive behaviors arise, to say or shout, "stop" and substitute a positive thought. The goal over time is for the client to use the command silently.

anergia

lack of energy

avolition

lack of motivation in activities and hygiene; for example, the client completes an assigned task, such as making his bed, but is unable to start the next common chore without prompting.

anhedonia

lack of pleasure or joy; the client is indifferent to things that often make others happy, such as looking at beautiful scenery.

neologisms

made up words that have meaning only the the client, such as, "I tranged and flittled"

assault

making a threat to a client's person, such as approaching the client in a threatening manner with a syringe in hand, is considered

alcohol withdrawel

manifestations include abdominal cramping; vomiting; tremors; restlessness and inability to sleep; increased heart rate; transietn hallucinations or illusions; anxiety; increased blood pressure, respiratory rate, and temperature; and tonic clonic seizures.

affective manifestations

manifestations involving emotions, hopelessness, suicidal ideation.

parkinsonism

manifestations of this include bradykinesia, rigidity, shuffling gait, drooling, tremors

neuroendocrine effects

manifestations of this include gynecomastia, galactorrhea, menstrual irregularities.

akathisia

manifestations of this include inability to sit or stand still, continual pacing and agitation, manage this with beta blockers, benzodiazepines, or anticholinergic medications

alcohol withdrawal

manifestations of this include nausea; vomiting; tremors; restlessness and inability to sleep; depressed mood or irritability; increased heart rate, blood pressure, respiratory rate, and temperature; and tonic clonic seizures. Illusions are also common. (tip, stop taking this)

neuroleptic malignant syndrome

manifestations of this include sudden high fever, blood pressure fluctuations, dysrhythmias, changes in level of consciousness, muscle rigidity, coma, if this occurs stop antipsychotic medication, apply cooling blankets, increase fluid intake, wait 2 weeks before resuming therapy.

opioid withdrawal

manifestations of this occur within hours to several days after cessation of opioid use. Common findings include agitation, insomnia, flulike manifestations, rhinorrhea, yawning, sweating, and diarrhea. Withdrawal manifestations are not life threatening, although suicidal ideation can occur.

alcohol withdrawal

manifestations of this usually start within 4 to 12 hours of the last intake of alcohol, peak after 24 to 48 hr, and then suddenly disappear, unless alcohol withdrawal delirium occurs.

clang association

meaningless rhyming of words, often forceful, such as "Oh fox, box and lox"

acetylcholinesterase

medications such as donepezil (Aricept) rivastigmine (exelon), and galantamine (razadyne) increase acetylcholine at cholinergic synapses by inhibiting its breakdown by _______________________which increases the availability of acetylcholine at neurotransmitter receptor sites in the CNS

Task roles

members take on various tasks within the group process. An example of a task role is the recorder, who takes notes and records what occurs during each session.

0.8 to 1.4

monitor plasma lithium levels during treatment of lithium. During initial treatment of a manic episode, levels should be between

stereotyped behaviors

motor patterns that had meaning to client (sweeping the floor) but now are mechanical and lack purpose

decerbrate rigidity

neck and elbow extension, wrist and finger flexion

schizophrenia

negative symptoms of this disorder include social withdrawal, lack of emotion, lack of energy, flattened affect decreased motivation, decreased pleasure in activities.

depersonalization

nonspecific feeling that a person has lost her identity; self is different or unreal

reaction formation

overcompensating or demonstrating the opposite behavior of what is felt

morning

paroxetine should be taken in the ________and be taken with food. May take up to four weeks for this med to be therapeutic.

derealization

perception that environment has changed

undoing

performing an act to make up for prior behavior

MAOIs

phenelzine, isocarboxazid, tranylcypromine, selegiline, are all examples of

schizophrenia

positive symptoms of this disorder are related to behavior, thought, and speech (agitation, delusions, hallucinations, tangential speech patterns)

alogia

poverty of thought or speech; the client might sit with a visitor but only mumble or respond vaguely to questions

denial

pretending the truth is not reality to manage the anxiety of acknowledging what is real

response prevention

preventing a client from performing a compulsive behavior with the intent that anxiety will diminish

therapeutic relationship

primary purpose is to identify the client's problems or needs and then focus on assisting the client in meeting or resolving those issues.

cognitive manifestations

problems with thinking make it very difficult for the client to live independently. Disordered thinking, inability to make decisions, poor problem solving ability, difficulty concentrating to perform tasks, memory deficits, long term memory, working memory, such as inability to follow directions to find an address.

repression

putting anacceptable ideas, thoughts, and emotions out of conscious awareness

antipsychotic second generation medications

resperidone, aripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, ziprasidone are all considered

MAOIs

risk for hypertensive crisis, avoid avacoados figs, fermented or smoked meats, liver, dried or cured fish, most cheeses, some beer and wine, and protein supplements,

group therapy

scheduled sessions for a group of clients to address common mental health issues, such as substance use disorder

individual therapy

scheduled sessions with a mental health provider to address specific mental health concerns such as depression

hypertensive crisis

severe hypertension as a result of intensive vasoconstriction and stimulation of the heart, can result from intake of dietary tyramine, manifestations include headache, nausea, increased heart rate, increased blood pressure

maois

severe hypertension can happen to a patient going through ect therapy, so lithium and __________should not be taken for at least 2 weeks prior to surgery.

shaken baby syndrome

shaking can cause intracranial hemorrhage, monitor for respiratory distress, bulging fontanelles, and an increase in head circumference. Retinal hemorrhage can be present. Any bruising on an infant before age 6 months is suspicious.

displacement

shifting feelings related to an object, person, or situation to another less threatening object, person, or situation

hidden agenda

some group members (or the leader) might have goals different from tthe stated group goals that can disrupt group processes. For example, three members might try to embarrass another member whom they dislike.

dissociation

temporarily blocking memories and perceptions from consciousness

defense mechanism

the ____of denial is commonly used by clients who have problems with substance use or an addictive disorder. For example, a person who has long term tobacco use might say, "I can quit whenever I want to, but smoking really doesn't cause me any problems." Denial often prevents a client from abtaining help with substance use or an adictive behavior.

negative symptoms

the absence of things that are normally present. These symptoms are more difficult to treat successfully than positive symptoms. Blunted affect, alogia anergia, anhedonia avolition

pereveration

the client avoids answering questions by repeating phrases or behavior. This is another unconscious attempt to maintain self esteem when memory has failed.

agoraphobia

the client avoids being outside and has an impaired ability to work or perform duties

general anxiety disorder

the client exhibits uncontrollable, excessive worry for more than three months.

delusional disorder

the client experiences delusional thinking for at least 1 month. Self or interpersonal function is not markedly impaired.

separation anxiety disorder

the client experiences excessive fear or anxiety when separated from an individual to which the client is emotionally attached.

substance induced psychotic disorder

the client experiences psychosis within 1 month of substance intoxication or withdrawal. Can be caused by medications intended for therapeutic use.

Panic disorder

the client experiences recurrent panic attacks

phobias

the client fears a specific object or situation to an unreasonable level.

social phobia

the client has a fear of embarrassment, is unable to perform in front of others, has a dread of social situations, believes that others are judging him negatively, and has impaired relationships

cyclothymia

the client has at least 2 years of repeated hypomanic manifestations that do not meet the criteria for hypomanic episodes alternating with minor depressive episodes.

bipolor 1 disorder

the client has at least one episode of mania alternating with major depression.

hoarding disorder

the client has difficulty parting with possissions, resulting in extreme stress and functional impairments

Schizotypal personality disorder

the client has impairments of personality (self and interpersonal) functioning. However, impairment is not as severe as with schizophrenia.

obsessive compulsive disorder

the client has intrusive thoughts of unrealistic obsession and tries to control these thoughts with compulsive behaviors (for example, repetitive cleaning of a particular object or washing of hands)

Schizophreniform disorder

the client has manifestations similar to those of schizophrenia, but the duration is from 1 to 6 months, and social/occupational dysfunction may or may not be present.

bipolor 2 disorder

the client has one or more hypomanic episodes alternating with major depressive episodes.

brief psychotic disorder

the client has psychotic manifestations that last between 1 day to 1 month in duration.

schizophrenia

the client has psychotic thinking or behavior present for at least 6 months. Areas of functioning, including school or work, self care, and interpersonal relationships, are significantly impaired.

lethargy

the client is able to open her eyes and respond but is drowsy and falls asleep readily.

mindfulness

the client is encouraged to be mindul of his surrroundings using all of his senses such as the relaxing warmth of sunlight or the sound of a breeze blowing through the trees. The client will restructure thoughts, such as when the elevator is broken realize it is a good opportunity to use the stairs and burn calories.

guided imagery

the client is guided through a series of images to promote relaxation. Images vary depending on the individual. For example, one client might imagine walking on a beach, while another client might imagine himself in a position of success.

voluntary commitment

the client or client's guardian chooses commitment to a mental health facility in order to obtain treatment. A voluntarily committed client has the right to refuse medication and treatment

operant conditioning

the client receives positive rewards for positive behavior (positive reinforcement)

echolalia

the client repeats the words spoken to him.

stupor

the client requires vigorous or painful stimuli (pinching a tendon or rubbing the sternum) to elicit a brief response. She may not be able to respond verbally.

schizoaffective disorder

the client's disorder meets both the criteria for schizophrenia and depressive or bipolar disorder

denial anger bargaining depression acceptance

the kubler ross five stages of grief are ______stages might not be experienced in order, and the length of each stage will vary from person to person.

positive symptoms

the manifestation of things that are not normally present. These are the most easily identified symptoms of psychotic disorders, hallucinations, delusions, alterations in speech, bizarre behavior,

confabulation

the n nn mn client can make up stories when questioned about events or activities that she does not remember. This can seem like lying, but it is actually an unconscious attempt to save self esteem and prevent admitting that she does not remember the occasion

VNS

the nursing actions for this include, reinforce teaching to the client. The device delivers around the clock programmed pulsations. The client can turn off the device at any time by placing a special external magnet over the site of the implant. Assist the provider in obtaining informed consent.

refeeding syndrome

the potentially fatal complication that can occur when fluids, electrolytes, and carbohydrates are introduced to a severely malnourished client

ect

the typical course for this is three times a week for a total of six to twelve treatments.

anorexia

the vitals of this patient will have low blood pressure with possible orthostatic hypotension, decreased pulse and body temperature, hypertension can be present in clients who have binge eating disorder

command hallucinations

the voice instructs the client to perform an action, such as to hurt self or others.

ect

there are no absolute contraindications for this, but some medical conditions may cause a higher risk if the pt has had a recent MI, cerebrovascular accident, cerbrovascular malformation, intracranial mass, increased ICP. This is not useful for substance use disorders, personality disorders, dysthymic disorder.

bulimia

there is a direct loss of potassium due to purging, dehydration stimulates increased aldosterone production, which leads to sodium and water retention and potassium excretion, hypokalemia, espicially for those who have

MAOIs

thes can cause CNS stimulation (anxiety, agitation, hypomania, mania), orthostatic hypotension, hypertensive crisis, (manifested by headache, nausea, increased heart rate, increased blood pressure), local rash associated with transdermal preparation.

carbamazepine, valproic acid, lamotrigine

thes medications are used to treat manid and dpressive episodes of bipolar, as well as to prevent relapse of mania and depressive episodes. They are particularly useful for clients who have mixed mania and rapid cycling bipolar disorders. They are considered AEDs

venlafaxine, duloxetine, desvenlafaxine

these agents inhibit serotonin and norepinephrine reuptake, therby increasing the amount of these neurotransmitters available in the brain for impulse transmission. There is also a minmal amount of dopamine blockade.

antipsychotic second generation medications

these antipsychotic agents work mainly by blocking serotonin, and to a lesser degree, dopamine receptors. These medications also block receptors for norepinephrine, histamine, and acetylcholine. Therapeutic for schizophrenia, psychosis induced by levodopa therapy, relief of psychotic manifestations, bipolar.

atypical antipsychotics

these are _______Risperidone (risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Ziprasidone (geodon) Aripiprazole (abilify) clozapine (clozaril) have pt on low cal diet , watch for agitation, dizziness, sedation, sleep disruption.

suicide

these are at the highest risk for ____adolescent, young adult, older adult males, persons who have comorbid mental illness,

benzodiazepines

these are classified under schedule IV of the controlled substances act

MAOIs

these are contraindicated in clients taking SSRIs or clients who have pheochromocytoma, heart failure, cardiovascular and cerebral vascular disease, or severe impariment of kidney function. Use cautiously in clients who have diabetes or seizures, or taking TCAs.

Multigenerational issues

these are emotional issues or themes within a family that continue for at least three generations, such as a pattern of substance use or addictive behavior when the family is under stress, dysfunctional grief patterns, triangulation patterns, and divorce.

advance directives

these are legal documents that direct end of life issues.

ethical issues

these are philosophical ideas regarding right and wrong

clarifying techniques

these are restating, reflecting, paraphrasing, exploring

hallucinations

these are sensory perceptions that do not have any apparent external stimulus, including auditory, command, visual olfactory gustatory, tactile

vocabulary

these are the words that are used to communicate either a written or a spoken message

conventional antipsychotics

these are used to treat mainly positive psychotic symptoms. Haloperidol (Haldol), Loxapine, chlorpromazine, fluphenazine, watch for anticholinergic effects, chew gum, eat fiber, 2 to 3 l of fluid, lighteheadedness, dizziness, postural hypotension

anxiolytics

these are used to treat the anxiety often found in clients who have psychotic disorders, as well as some of the positive and negative symptoms, Lorazepam (ativan), Clonazepam (Klonopin) monitor for agranulocytosis, used with caution in older adults

antidepressants

these are used to treat the depression seen in many clients who have a psychotic disorder, Paroxetine (paxil) used temporaily to treat depression associated with psychotic disorders, monitor si, watch for deepened depression, avoid abrupt cessation

atypical antipsychotics

these can be useful in early treatment of bi polar to promote sleep and to decrease anxiety and agitation. These medications also demonstrate mood stabilizing properties

SSRI

these can cause gi bleeding so be careful with patients who have had ulcers, also, no concurrent use with MAOIs or coumadin, or TCAs or NSAIDs.

Antipsychotic first generation medications

these medication are contraindicated in clients who are in a coma, or who have severe depression, parkinsons, prlactin dependent cancer of the breast, or severe hypotension. Contraindicated in adult clients who have dementia.

SSRI

these medications are _______citalopram, escitalopram, vilazodone

SSRI

these medications are all _______Sertraline, escitalopram, fluoxetine, fluvaxamine.

antipsychotic first generation medications

these medications are all contraindicated with anticholinergic agents, cns depressants, or alcohol, opioids, antihistamines, levodopa, by activating dopamine receptors, levodopa counteracts effects of these drugs

AEDs

these medications are preg cat D. carbamazepine is containdicated in clients with bone marrow suppression or bleeding disorders. Valproic acid is containdicated in clients who have liver disorders.

MAOIs

these medications block MAO in the brain, thereby increasing the amount of norepinephrine, dopamine, and serotonin available for transmission of impulses. An increased amount of those neurotransmitters at nerve endings intensifies responses and relieves depression. Therapeutic for depresion, and bulimia nervosa

tricyclic antidepressants

these medications block reuptake of norepinephrine and serotonin in the synaptic space, therby intensifying the effects of these neurotransmitters. Terapeutic for depressive disorders, other uses are neuropathic pain, fibromyalgia, anxiety disorders, insomnia.

antidepressants

these medications such as bupriopion (wellbutrin) and sertraline (zoloft) are useful during the depressive phase of bi polar. these are typicall prescribed in combinaton with a mood stabilizer to prevent rebound mania.

blurred boundaries

these occur if the relationship begins to meet the needs of the nurse rather than those of the client, or if the relationship becomes social rather than therapeutic.

psychosocial rehabilitation programs

these programs provide a structured range of programs for clients in a mental health setting. ex. Residential services, day programs for older adults.

partial hospitalization programs

these programs provide intense short term treatment for clients who are well enough to go home every night and who have a responsible person at home to provide support and a safe environment. May include detoxification programs.

ssri

these selectively block reuptake of the monamine neurotransmitter serotonin the the synaptic space, thereby intensifying the effects of serotonin. Uses are major depressive disorder, ocd, bulimia, premenstual dysphoric disorder, panic disorder, PTSD.

behavioral therapies

these show clients ways to decrease anxiety or avoidant behavior and give clients an opportunity to practice techniques, it has been used successfully to treat clients who ahve phobias, substance use, or addictive disorders, and other issues.

anxiolytics

these such as clonazepam (klonopin) and lorazepam (ativan) can be useful in treating acute mania and managing the psychomotor agitation often seen in mania

olanzapine ziprasidone

these two medications are atypical antipsychotics used to control aggressive and impulsive behaviors. These are used more commonly than haloperidol because of the severity of adverse effects of haloperidol.

atropine sulfate

thirty minutes prior to beginning of a ECT procedure, an IM injection of ________or glycopyrrolate (Robinul)is given to decrease secretions and counteract any vagal stimulation.

alert

this LOC is responsive and able to fully respond by opening her eyes and attending to a normal tone of voice and speech. The client answers questions spontaneously and appropriately.

Transpersonal communication

this addresses an individual's spiritual needs and provides interventions to meet those needs.

binge eating disorder

this affects men and women of all ages, but is most common in adults 46 to 55, the weight gain associated with this increases the client's risk for other disorders, including type 2 diabetis, hypertension and cancer.

trazodone

this agent has moderate selective blockade of serotonin receptors, thereby increasing the amount of that neurotransmitter available for impulse transmission. Priapism can be a serious adverse effect, and clients should be instructed to seek medical attention if it occurs.

mirtazapine

this agent increases the release of serotonin and norepinephrine, thereby increasing the amount of these neurotransmitters available for impulse transmission.

exploring

this allows the nurse to gather more information regarding important topics mentioned by the client.

interpersonal psychotherapy

this assists clients in addressing specific problems. It can improve interpersonal relationships, communication, role relationship, and bereavement.

relapse prevention therapy

this assists clients in identifying the potential for relapse and promotes behavioral self control.

priority restructuring

this assists clients to identify what requires priority, such as devoting energy to pleasurable activities

clonidine

this assists with withdrawal effects related to autonomic hyperactivity (diarrhea, nausea, vomiting). This therapy does not reduce the craving for opioids.

cocaine

this can be injected, smoked, or inhaled, effects are rush of euphoria and pleasure, increased energy, effects of intoxication include mild toxicity, dizziness, irritability, tremor, blurred vision. Severe effects, hallucinations, seizures, extreme fever, tachycardia, hypertension, chest pain, cardiovascular collapse, death.

amphetamines

this can be taken orally, injected iv, or smoke, intended effects are increased energy, euphoria similar to cocaine, this will cause impaired judgment, psychomotor agitation, hypervigilance, extreme irritability, acute cardiovascular effects (tachycardia, elevated blood pressure), which can cause death.

ECT

this can be used to subdue extreme manic behavior, especially when pharmacologic therapy, such as lithium, has not worke. IT also can be used for clients who are suicidal or who have rapid cycling.

serotonin syndrome

this can begin 2 to 72 hours after the start of treatment, and it can be lethal. Manifestations include, mental confusion, difficulty concentrating, abd pain, diarrhea, agitation, fevr, anxiety, hallucinations, hyperreflexia, incoordination, diaphoresis, tremors

alcohol withdrawal delerium

this can occur 2 to 3 days after cessation of alcohol and can last 2 to 3 days. This is considered a medical emergency. Clinical findings include severe disorientation, psychotic syptosm hallucinations, severe hyhpertension, cardiac dysrhythmias, and delirium. clinical findings can progress to death.

alcohol withdrawal delirium

this can occur 2 to 3 days after cessation of alcohol and can last 2 to 3 days. This is considered a medical emergency. Manifestations include severe disorientation, psychotic effects, severe hypertension, cardiac dysrhythmias, and delirium. This type of withdrawal can progress to death.

palliative

this care is an important aspect of nursing care that attempts to meet the clients physical and psychosocial needs.

gad

this causes significant impairment, manifestations include restlessness, muscle tension, avoidance of stressful activities or events, increased time and effort required to prepare for stressful activities or events, procrastination in decision making, seeks repeated reassurance

second generation

this class of medications for schizophrenia are atypical antipsychotic agents that are the current medications of choice for clients receiving initial treatment, and for treating breakthrough episodes in clients on conventional medication therapy, because they are more effective with fewer adverse effects, and they have fewer anticholinergic effects.

first generation

this class of medications for schizophrenia are conventional, antipsychotic medications are used mainly to control positive symptoms of psychotic disorders and are reserved for clients who are using them successfully and can tolerate the adverse effects, and who are violent or particularly aggressive

cluster b

this cluster of personality disorders consists of dramatic, emotional, or erratic traits such as antisocial, borderline, histrionic, narcissistic

cluster a

this cluster of personality disorders consists of odd or eccentric traits such as paranoid, schizoid, schizotypal

cluster c

this cluster or personality disorders consists of anxious or fearful traits; insecurity and inadequacy such as avoidant, dependent, obsessive compulsive

maturational crisis

this crisis is naturally occuring across the life span

bupropion

this decreases nicotine craving and manifestations of withdrawal. Treat anticholinergic effects with sugarless gum, hard candy, water, ice chips.

being controlled

this delusion believes that a force outside his body is controlling him.

thought broadcasting

this delusion believes that her thoughts are heard by others

thought withdrawel

this delusion believes that her thoughts have been removed from her mind by an outside agency.

somatic delusions

this delusion believes that his body is changing in an unusual way, such as growing a third arm.

thought insertion

this delusion believes that others thoughts are being inserted into his mind

grandeur

this delusion believes that she is all powerful and important, like a god

persecution

this delusion feels singled out for harm by others (eg, being hunted down by FBI)

ideas of reference

this delusion is misconstues trivial events and attaches personal significance to them, such as believing that others, who are discussing the next meal, are talking about him.

religiosity

this delusion is obsessed with religious beliefs

jealousy

this delusion may feel that her spouse is sexually involved with another individual

reflecting

this directs the focus back to the client in order for the client to examine his feelings.

oppositional defiant disorder

this disorder is characterized by a recurrent pattern of the following antisocial behaviors. Negativity, disobedience, hostility, defiant behaviors (especially toward authority figures), stubbornness, argumentativeness, limit testing, unwillingness to compromise, refusal to accept responsibility for misbehavior. The child does not see themselves as defiant. This can develop into conduct disorder.

assertiveness training

this educates clients to express feelings, and solve problems in a nonaggressive manner.

psychodynamic psychotherapy

this emplys the same tools as psychoanalysis. But it focuses more on the client's present state, rather than his early life.

diazepam

this enhances the inhibitory effects of gamma aminobutyric acid, in the cns, relief from anxiety occurs rapidly following administration. Therapeutic for generalized anxiety disorder and panic disorder.

mini mental state examination

this examination is used to objectively collect data about a client's cognitive status by evaluating the following, orientation to time and place, attention span and ability to calculate by counting backward by seven, registration and recalling of objects, language, including naming of objects, following of commands, and ability to write

glascow coma scale

this examination is used to obtain baseline data of a client's level of consciousness, and for ongoing monitoring. Eye, verbal, and motor response is evaluated, and a number value based on that response is assigned. The highest value possible is 15, which indicates that the client is awake and responding appropriately. A score of 7 or less indicates that the client is in a coma

secondary prevention

this focuses on early detection of mental illness. ex. a nurse provides assistance for screening of parents of children who have developmental disorders.

tertiary prevention

this focuses on rehabilitation and prevention of further problems in clients previously diagnosed. ex. a nurse participates in a support group for clients who have completed a substance use disorder program.

disenfranchised grief

this grief entails an experienced loss that cannot be publicly shared or is not socially acceptable, such as the loss of a loved one through suicide.

anticipatory grief

this grief implies the "letting go" of an object or person before the loss, as in the case of a terminal illness. Individuals have the opportunity to grieve before the actual loss.

dysfunctional grief

this grief involves difficult progression through the expected stages of the grieving process. Usually the work of grief is prolonged, the clinical manifestations are more severe, and they can result in depression or exacerbation of a preexisting disorder. The client can develop suicidal ideation, intense feelings of guilt, and lowered self esteem.

normal grief

this grief is considered uncomplicated, emotions can include anger, resentment, withdrawal, hopelessness, and guilt but should change to acceptance with time. Some acceptance should be evident by 6 months after the loss. Somatic complaints can include chest pain, palpitations, headaches, nausea, changes in sleep patterns, or fatigue.

delirium

this has a rapid onset, occurrence of impairments in memory, judgment, ability to focus, and ability to calculate. The impairments flucuate. LOC is altered and rapidly flucuates, restlessness, agitation, fluctuating mood are common. Sundowning cna occur, personality change is rapid. Outcome is reversible if diagnosis and treatment are prompt.

Monitoring thoughts

this helps clients to be aware of negative thinking.

journal keeping

this helps clients write down stressful thoughts and has a positive effect on well being

bereavement

this includes both grief and mourning (the outward display of loss) as a person deals with the death of a significant individual.

assertive community treatment

this includes nontraditional case management and treatment by an interprofessional team for clients who have severe mental illness and are noncompliant with traditional treatment. This helps reduce reoccurrences of hospitatlizations and provides crisis intervetnion, assistance with independent living, and information regarding resources for necessary support services.

substance use disorder

this involves a repeated use of chemical substances, leading to clinically significant impariment during a 12 month period, and at least two of the following critera.

psychotherapy

this involves more verbal therapist to client interaction than classic psychoanalysis. The client and the therapist develop a trusting relationship to explore the client's problems.

Dialectical behavior therapy

this is a cognitive behavioral therapy for clients who have a personality disorder and exhibit self injurious behavior. This therapy focuses on gradual behavior changes and provides acceptance and validation for these clients.

dialectical behavior therapy

this is a cognitive behavioral therapy used for clients who exhibit self injurious behavior. It focuses on gradual behavior changes and provides acceptance and validation for these clients.

forensic nursing

this is a combination of biophysical education and forensic science. The rn uses scientific investigatin, collection of evidence, analysis, prevention, and treatment of trauma and or death of perpetrators and victims of violence, abuse, and traumatic accidents/

autism spectrum disorder

this is a complex neurodevelopmental disorder thought to be of genetic origin with a wide spectrum of behaviors affecting an individuals ability to communicate and interact with others. Cognitive and language development typically are delayed. Characteristic behaviors include inability to maintain eye contact, repetitive actions, and strict observance of routines. More common in boys.

disulfiram

this is a daily oral medication that is a type of aversion (behavioral therapy. Used concurrently with alcohol will cause acetaldehyde syndrome to occur.

premenstrual dysphoric disorder

this is a depressive disorder associated with the luteal phase of the menstrual cycle. Primary manifestations include emotional lability, and persistent or severe anger and irritibility. Other manifestations include a lack of energy, overating, and difficulty concentrating.

trauma recovery and empowerment model

this is a gender specific model designed to assist survivors of trauma, specifically physical or sexual trauma.

critical incident stress debriefing

this is a group approach that can be used with a group of people who have been exposed to a crisis situation.

homogenous group

this is a group in which all members share a certain chosen characteristic, such as diagnosis or gender.

heterogeneous group

this is a group not based on a shared chosen personal charcteristic. An example of this is all clients on a unit, including a mix of males and females who have a wide range of diagnoses.

cognitive disorders

this is a group of conditions characterized by the disruption of thinking, memory, processing, and problem solving. Treatment of clients who have these require a compassionate understanding of both the client and the family. These include Delirium, Neurocognitive disorder, alzheimer's disease

normal anxiety

this is a healthy life force that is necessary for survival, it motivates people to take action. For example a potentially violent situation occurs on the mental health unit, and the nurse moves rapidly to defuse the situation.

lithium

this is a medication used for bipolar, do not mix with diuretics, decreased sodium leads to toxicity of this, NSAIDs will increase renal reabsorption of this leading to toxicity, and anticholinergics, abd discomfort from urinary retention

dysthymic disorder

this is a milder form of depression that usually has an early onset, such as in childhood or adolescence, and lasts at least 2 years in length for adults (1 year in length for children) This contains at least three clinical findings of depression, and can become a major depressive disorder later in life

depression

this is a mood (affective) disorder that is a widespread issue, ranking high among causes of disability, can be comorbid with anxiety disorders, psychotic disorders, substance use disorder, eating disorders, personality disorders

bipolar disorder

this is a mood disorder with recurrent episodes of depression and mania. Usually emerges in late adolescence or early adulthood. Similar to ADHD and is hard to diagnose in kids.

varenicline

this is a nicotininic receptor agonist that promotes the release of dopamine to simulate the pleasurable effects of nicotine. Reduces cravings for nicotine as well as the severity of withdrawal manifestations, reduces the incidence of relapse by blocking the desired effects of nicotine.

TRanscranial magnetic stimulation

this is a noninvasive therapy that uses magnetic pulsations to stimulate specific areas of the brain. Indications are major depressive disorder, clients who are not responsive to pharmacologic treatment.

anger

this is a normal feeling, is an emotional response to frustration as perceived by the individual. It can be positive if there is truly an unfair or wrong situation that needs to be righted. It becomes negative when it is denied, suppressed, or expressed inappropriately, such as by using aggressive behavior.

bupropion

this is a preg cat B med, this is contraindicated in clients who have a seizure disorder, contraindicated with MAOIs, contraindicated in clients who have anorexia or bulimia.

Risperidone

this is a preg cat C med. This medications should not be used for clients who have dementia. Avoid alcohol. Use cautiously in clients who have cardiovascular or cerebrovascular disease, seizures, or diabetes mellitus, clients who have diabetes should have baseline sugar and glucose monitored carefully.

amitriptyline

this is a preg category C. Contraindicated in clients with seizures. This is a TCA. Use med cautiously in clients who have coronary arter disease; diabets; liver, kidney, and resp disorders; urinary retention and obstruction; angle closure glaucoma; benign prostatic hypertrophy and hyperthyroidism. Avoid MAOIs, avoid other TCAs, avoid other CNS depressants.

naltrexone

this is a pure opioid antagonist that suppressies the craving and pleasurable effects of alcohol (also used for opioid withdrawal. Concurrent use of this will increase the risk for overdose of opiates. Take this with meals. Suggest monthly IM injections.

venlafaxine

this is a serotonin norepinephrine reuptake inhibitor

sad persons scale

this is a simple and practical tool that assesses 10 major risk factors for suicide and assigns scores for each. It allows the triaging of suicidal clients to determine the necessity of hospitalization. Another important area to consider, not included in this tool, is the individual's intake of illicit or prescribed drugs.

major depressive disorder

this is a single episode or recurrent episodes of unipolar depression (not associated with mood swings from major depression to mania) resulting in a significant change in a client's normal functioning accompanied by a possible depressed mood, difficulty sleeping, or excessive sleeping, indecisiveness, decreased ability to concentrate, suicidal ideation, inability to feel pleasure, increase or decrease in weight of more than 5% of body weight

subgroup

this is a small number of people within a larger group who function separately from the group.

cage aid

this is a standardized screening tool that asks questions of clients to determine how clients perceive their current substance use.

mood disorders questionnaire

this is a standardized tool that places mood progression on a continuum for hypomania (euphoria) to acute mania (extreme irritability and hyperactivity) to delirium (completely out of touch with reality)

psychoanalysis

this is a therapeutic process of determining unconscious thoughts and feelings and resolving conflict by talking to a psychoanalyst. Clients attend many sessions over the course of months to years. Created sy Freud, Past relationships are a common focus for therapy

free association

this is a therapeutic tool, which is the spontaneous, uncensored verbalization of whatever comes to a client's mind

Modeling

this is a therapist or others serve as role models for a client, who imitates to improve behavior. The therapist demonstrates appropriate behavior in a stressful situation with the goal of having the client imitate the behavior.

tort

this is a wrongful act or injury committed by an entity or person against another person or another person's property. These can be used to decide liability issues, as well as intentional issues that can involve criminal penalties, such as abuse of a client.

involuntary commitment

this is also called civil commitment, where the client enters the mental health facility against her will for an indefinite period of time. the commitment is based on the clien'ts need for treatment, the risk of harm to self or others, or the inability to provide self care. The need for commitment could be determined by a judge of the court or by another agency. The number of physicians which is usually two, , required to certify that the client's condition requires commitment varies from state to state.

Long term involuntary commitment

this is also called formal commitment, a type of commitment that is similar to temporary commitment but must be imposed by the courts. Time of commitment varies, but is usually 60 to 180 days. Sometimes there is no set release date.

observational involuntary commitment

this is also called temporary commitment, a type of involuntary commitment in which the client is in need of observation, a diagnosis, and a treatment plan. The time for this type of commitment is controlled by state statute, and varies greatly between states. This can be imposed by a family member, legal guardian, primary care provider, or a mental health provider.

crisis

this is an acute, time limited (usually lasting 4 to 6 weeks) event during which a client experiences an emotional response that cannot be managed with the clients normal coping mechanisms. This is not pathological, but represents a struggle for equilibrium and adaptation.

buprenorphine

this is an agonist antagonist opioid used for both detoxification and maintenance. This medication decreases feelings of craving and can be effective in maintaining compliance. Administer this sublingually.

haloperidol

this is an antipsychotic agent used to control aggressive and impulsive behavior. Monitor for clinical findins of parkinsonism and anticholinergic adverse effects. Keep client hydrated, risk for neuroleptic malignant syndrome.

ginkgo biloba

this is an herbal product, is used by some clients to enhance memory, tell clients to inform the provider of this use, due to potential interactions, such as the risk for bleeding in clients taking antiplatelet medications, as well as the risk for seizures in clients taking medications that can lower seizure threshold.

risperidone

this is available as a depot injection administered IM once every 2 weeks. This method of administration is a good option for clients who have difficulty adhering to a medication schedule. Therapeutic effect occurs 4 to 6 weeks after first depot injection. Gradually increase medication dose.

Cognitive therapy

this is based on the cognitive model, which focuses on individual thoughts and behaviours to solve current problems. It treats depression, anxiety, eating disorders, and other issues that can improve by changing a clients attitude toward life experiences.

behavioral therapy

this is based on the theory that behavior is learned and has consequences. Abnormal behavior results from an attempt to avoid painful feelings. Changing abnormal or maladaptive behavior can occur without the need for insight into the underlying cause of the behavior.

acetaldehyde syndrome

this is caused by using disulfiram and alcohol together, effects include nausea, vomiting, weakness, sweating, palpitations, and hypotension. This can progress to respiratory depression, cardiovascular suppression, seizures, and death.

avoidant

this is characterized by social inhibition and avoidance of all situations that require interpersonal contact, despitewanting close relationships, due to extreme fear of rejection often very anxious in social situations.

TMS

this is commonly prescribed daily for a period of 4 to 6 weeks. It can be performed as an outpatient procedure. Procedure lasts 30 t 40 mins, A noninvasiv electromagnet is placed on the client's scalp, allowing the magnetic pulsations to pass through. The client is alert during procedure.

transdermal selegiline

this is contraindicated for clients taking carbamazepine or oxcarbazepine, concurrent use of these medications may increase blood levels of the MAOI.

alprazolam

this is contraindicated in clients who have pulmonary disease, myathenia gravis, or glaucoma, use cautiously in clients who have liver disease or a history of alcohol use disorder,

altruism

this is dealing with anxiety by reaching out to others

sublimation

this is dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression

level of consciousness

this is described using the folowing terms, and observed behavior included in documentation, alert, lethargy, stupor, coma, physical appearance, behavior,

anterograde amnesia

this is difficulty recalling events that occur after dosing benzodiazepines

negativism

this is doing the opposite of what is requested

wavy flexibility

this is excessive maintenance of position

worden four tasks of mourning

this is four tasks of loss, accepting reality, using coping mechanisms, chagning environment, finding a meaningful connection with the lost entity

paradoxical response

this is insomnia, excitation, euphoria, anxiety, rage, after giving benzodiazepines

timing, relevance

this is knowing when to communicate allows the receiver to be more attentive to the message

serotonin syndrome

this is manifested by agitation, confusion, disorientation, difficulty concentrating, anxiety, hallucinations, hyperreflexia, fever, diaphoresis, incoordination, tremors, usually begins 2 to 72 hours after initiation of treatement, resolves when the medication is discontinued.

tardive dyskinesia

this is manifested by late EPS, involuntary movements of the tongue and face, such as lip smacking and tongue fasciculations, involuntary movements of the arms, legs, and trunk, if this occurs, lower medications, or the client should be switched to an atypical schizophrenic medication

extrapyramidal symptoms

this is manifested by severe spasm of the tongue, neck, face, and back, crisis situation that requires rapid treatment. Treat this with anticholinergic agents, such as benztropine (cogentin) or diphenhydramine.

stupor

this is motionless for long periods of time, comalike

no suicide contract

this is not legally binding and should only be used according to facility policy, this may be beneficial, but it should not replace other suicide prevention strategies, this can be used as a tool to develop and maintain trust between the nurse and the client, this is discouraged for clients who are in crisis, under the influence of substances, psychotic, very impulsive, or very angry, this does not take the place of suicide precautions.

aversion therapy

this is pairing of a maladaptive behavior with a punishment or unpleasant stimuli to promote a change in the behavior.

diagnostic and statistical manual of mental disorders

this is published by the american psychiatric association, is used as a diagnostic tool to identify mental health diagnoses. It is used by mental health professionals for clients who have mental health disorders.

echopraxia

this is purposeful imitation of movements made by others

acamprosate

this is taken orally three times a day to reduce the craving for alcohol. Diarrhea can result. Avoid use with pregnancy.

resiliency

this is the ability to adapt to changes in the environment, form nurturing relationships, distance oneself from the emotional chaos of the parent or family, model effective coping strategies, and use problem solving skills can help an at risk child avoid the development of the mental health disorder.

flumazenil

this is the antidote for benzodiazepine toxicity, there is no antidote for barbiturate toxicity

general adaptation syndrome

this is the bodys response to an increased demand. The first stage is the initial adaptive response, also known as the "fight or flight" mechanism. If stress is prolonged, maladaptive responses can occur.

blaming

this is the dysfunctional behavior of blaming others to shift focus away from the individuals own inadquacies

distraction

this is the dysfunctional behavior of inserting irrelevant information during attempts at problem solving.

manipulation

this is the dysfunctional behavior of using dishonesty to support individual goals

Trauma affect regulation

this is the guide for education and therapy TARGET, provides trauma survivors with a therapeutic approach to healing while offering education about practical skills to manage emotions and the effect of memories on daily life.

splitting

this is the inability to incorporate positive and negative aspects of oneself or others into a whole image, is frequently seen in the acute mental health setting. Commonly seen in patients with borderline, the client tends to charcterize people or things as all good or all bad at any particular moment.

greif

this is the inner emotional response to loss and is exhibited in as many ways as there are individuals.

therapeutic communication

this is the purposeful use of communication to build and maintain helping relationships with clients, families, and significant others.

pacing

this is the rate of speech can communicate a meaning to the receiver.

automatic obedience

this is the responding in a robotlike manner

clarity, brevity

this is the shortest, simplest communication and is usually most effective.

bruxism

this is the term for grinding and clenching of teeth, usually during sleep.

polypharmacy

this is the term for multiple medications, the potential interaction between substances and medication, and age related physiological changes raise the likelihood of adverse effects, such as confusion and falls, in older adults

anorgasmia

this is the term for sexual dysfunction, impotence, and decreased libido.

intonation

this is the tone of voice can communicate a variety of feelings

group norm

this is the way the group behaves during sessions. Over time, it provides structure for the group.

lithium

this is used for bipolar, preg cat D. Considered teratogenic. No breastfeeding. Use this carefully if client has impaired kidney function, heart disease, sodium depletion, and dehydration.

milieu therapy

this is used for clients who have a psychotic disorder both in acute mental health facilities and in community facilities, such as residential crisis centers, halfway houses, and day treatment programs.

buspirone

this is used for panic disorder, ocd, social anxiety disorder, trauma, and stressor related disorders, such as PTSD. Can cause CNS effects, such as dizziness, nausea, headache, lightheadeness, agitation. Preg cat B. Not recomended for breast feeding. Use cautiously in liver and kidney disease. No concurrent use with MAOI.

suppression

this is voluntarily denying unpleasant thoughts and feelings

denotative, connotative meaning

this is when communicating, participants must share meanings

democratic

this leadership style supports group interaction and decision making to solve problems

laissez faire

this leadership, the group process progresses without any attempt by the leader to control the direction.

Autocratic

this leadership, the leader completely controls the direction and structure of the group without allowing group interaction or decision making to solve problems.

Chronic anxiety

this level of anxiety is one that usually develops over time, often starting in childhood. The adult who experiences chronic anxiety can display that anxiety in physical findings, such as fatigue and frequent headaches.

acute anxiety

this level of anxiety is precipitated by an imminent loss or change that threatens one's sense of security. For example, the sudden death of a loved one precipitates an acute state of anxiety.

hemodialysis

this may be indicated if a patient has lithium toxicity. Be careful with giving older adults lithium and monitor for levels greater than 1.5 meq/l Stress importance of adequate fluid and sodium intake when taking lithium.

buspirone

this medication does bind to serotonin and dopamine receptors. There is less potential for dependency than with other anxiolytics, and use of this does not result in sedation or potentiate the effects of other CNS depressants.

sertraline

this medication is indicated for panic disorder, OCD, social anxiety disorder, and PTSD

disulfiram

this medication will help with alcohol abstinence, along with naltrexone, acamprosate,

diazepam

this medication will help with alcohol withdrawal, along with carbamazepine, clondidine, and chlordiazeposide

methadone

this medication will help with opioid withdrawal, along with clonidine, and buprenorphine,

interpersonal communication

this occurs between two or more people in a small group. This is the most common form of communication in nursing and requires an exchange of information with an individual or small group.

abstinence syndrome

this occurs when a client abruptly withdraws from a drug on which he is physically dependant. Withdrawing from a substance that has the potential to cause this can cause distressing manifestations that also can be life threatening.

countertransference

this occurs when a health care team member displaces characteristics of people in her past onto a client, an example is a nurse can feel defensive and angry with a client for no apparent reason if the client reminds her of a friend who often elicited those feelings.

transference

this occurs when the client views a member of the health care team as having characteristics of another person who has been significant to the client's personal life.

intrapersonal communication

this occurs within an individual, also identified as "self talk" This is the internal discussion that takes place when an individual is thinking thoughts and not outwardly verbalizing them. In nursing, this communication allows the nurse to collect data from a client or situation and critically think about the client/situation before communicating verbally

public communication

this occurs within large groups of people. In nursing, this commonly occurs during educational endeavors where the nurse is educating a large group of individuals, such as in a community setting.

neurocognitive disorder

this onset is gradual deterioration of function over months or years. Impaired memory, judgment, speech, ability to recognize familiar objects, executive functioning, and movement, do not change throughout the day. LOC is usually unchanged, restlessness, agitation are common. Subtypes of this include alzheimer's disease. traumatic brain injury, parkinsons, the outcome is irreversible and progressive

phase 1

this phase of crisis is escalating anxiety from a threat activates increased defense responses.

phase 2

this phase of crisis, anxiety continues escalating as defense responses fail, functioning becomes disorganized, and the client resorts to trial and error attempts to resolve anxiety

phase 4

this phase of crisis, the client experiences overwhelming anxiety that can lead to anguish and apprehension, feelings of powerlessness and being overwhelmed, dissociative symptoms (depersonalization, detachment from reality) depression, confusion, and or violence against self or others.

phase 3

this phase of crisis, trial and error mehtods of resolution fail and the client's anxiety escalates to severe or panic levels, leading to flight or withdrawal behaviors.

social relationship

this primary purpose is for socialization or friendship with a focus on the mutual needs of the individuals involved in the relationship.

lithium

this produces neurochemical changes in the brain, including serotonin receptor blockade. There is evidence that this decreases neuronal atrophy and increases neuronal growth. This is used in the treatment of bipolar disorders. This controls episodes of acute mania, helps to prevent the return of mania or depression, and decreases the incidence of suicide.

acceptance and commitment therapy

this promotes acceptance of the client's experiences and promotes client commitment to positive behavior changes.

vagus nerve stimulation

this provides electrical stimulation through the vagus nerve to the brain through a device that is surgically implanted under the skin on the client's chest. It is believed to result in an increased level of neurotransmitters. Indications are depression that is resistant to pharmacological treatment and or ECT. And possible anxiety disorders.

autonomy

this refers to the client's right to make her own decisions. But the client must accept the consequences of those decisions. The client also must respect the decisions of others.

Fidelity

this relates to loyalty and faithfulness to the client and to one's duty.

beneficence

this relates to the quality of doing good and can be described as charity

paraphrasing

this restates the client's feelings and thoughts for the client to confirm what has been communicated.

global assessment of functioning

this scale helps to determine a client's ability to perform activities of daily living and to function independently. This is appropriate for use with all clients who have a mental health disorder.

paroxetine

this selectively inhibits serotonin reuptake, allowing more serotonin to stay at the junction of the neurons, it does not block uptake of dopamine or norepinephrine. It causes CNS stimulation, which can cause insomnia. Medication has a long effective half life. Up to 4 weeks are necessary to produce therapeutic medication levels. This is used for GAD, panic disorder, OCD, Social anxiety disorder, traume, depressive disorders.

stage 3

this stage of alzheimers indicates mild cognitive decline, including problems with memory or concentration that can be measurable in clinical testing or during a detailed medical interview, mild cognitive deficits, including losing or misplacing important objects, decreased ability to plan, short term memory loss noticeable to close relations, decreased attention span, difficulty remembering words or names. Difficulty in social or work situations

stage 1

this stage of alzheimers indicates no memory problems, no memory problems evident to provider

stage 2

this stage of alzheimers indicates very mild cognitive decline, which can be normal age related changes or very early signs, these will include, forgetfulness, especially of everyday objects like glassess, wallet.

stage 4

this stage of alzheimers is moderate cognitive decline (mild or early stage alzheimers disease)that is clearly detected during a medical interview, personality change; appearing withdrawn or subdued, especially in social or mentally challening situations, obvious memory loss, limited knowledge and memory of recent occasions, current events, or personal history, difficulty performing tasks that require planning and organizing (paying bills, managing money) difficulty with complex mental arithmetic

stage 5

this stage of alzheimers is moderately severe cognitive decline (moderate or mid stage alzheimers disease), increasing cognitive deficits, disorientation and confusion as to time and place, inability to recall important details, such as address and telephone number, but ability to remember information about self and family.

stage 6

this stage of alzheimers is severe cognitive decline (moderately severe or mid stage alzheimers disease). Continued worseing of memory difficulties, loss of awareness of recent events and surroundings, wandering behavior, assistance required for usual daily activities, such as dressing, toileting, and other grooming, disruption of normal sleep cycle, increased episodes of urinary and fecal incontinance, violent tendencies with potential danger to self or others.

stage 7

this stage of alzheimers is very severe cognitive decline (severe or late stage alzheimers disease), loss of ability to respond to environment, to speak, and to control movement unrecognizable speech, general urinary incontinence, inability to eat without assistance, and impaired swallowing, gradual loss of all ability to move stupor and coma, death frequently related to choking or infection

methadone

this substitution is an oral opioid agonist that replaces the opioid to which the client is addicted. This prevents abstinence syndrome from occurring and removes the need for the client to obtain illegal opioids. This is used for withdrawal and long term maintenance.

task 1

this task in the wordens tasks is accepting the reality of the loss

task 3

this task in the wordens tasks is changing the environment to accommodate the absence of the deceased.

task 2

this task in the wordens tasks is using coping mechanisms to experience the emotional pain of the loss.

family therapy

this therapy identifies codependency, which is a common behavior demonstrated by the significant other, family, and friends of an individual who has substance or process dependency, and assists the family to change that behavior.

systematic desensitization

this therapy is the planned progressive, or graduated exposure to anxiety provoking stimuli in real life situations, or by imagining events that cause anxiety. During exposure, the client uses relaxation techniques to suppress anxiety response.

blessed dementia scale

this tool provides the nurse with client behavioral information based on an interview with a secondary source such as a clients family member.

restricting type

this type of anorexia, the individual drastically restricts food intake and does not binge or purge.

binge,purge type

this type of anorexia, the individual engages in binge eating or purging behaviors.

nonpurging type

this type of bulima, the client can also compensate for binge eating through other means such as excessive exercise and the misuse of laxatives, diuretics, and enemas

purging type

this type of bulimia the client uses self induced vomiting, laxatives, diuretics, and enemas to lose or maintain weight

maturational internal

this type of crisis is achieving new developmental stages, which requires learning additional coping mechanisms.

situational external crisis

this type of crisis is often unanticipated loss or change experienced in everyday, often unanticipated, life events.

adventitious

this type of crisis the occurrence of natural disasters, crimes, or national disasters. People in communities with large scale psychological trauma caused by natural disasters.

separation anxiety disorder

this type of disorder is characterized by excessive anxiety when a child is separated from anticipating separation from home or parents. The anxiety can develop into a school phobia or phobia of being left alone. Depression is also common.

grief experienced by public tragedy

this type of grief is a loss shared by a community or group of individuals. It can inlclude terrorist attacks, assassinations, natural disasters, work or school shootings.

perceived loss

this type of loss is any loss defined by a client that is not obvious to others

actual loss

this type of loss is any loss of a valued person or item

maturational loss

this type of loss is losses normally expected due to the developmental processing of life

necessary loss

this type of loss is part of the cycle of life, anticipated but can still be intensely felt

situational loss

this type of loss is unanticipated loss caused by an external event.

aggression

this unlike anger, is typically goal directed with the intent of harming a specific person or object. This includes physical or verbal responses that indicate rage and potential harm to self, others and property, this person can have underlying feelings of inadequacy, insecurity, guilt, fear, and rejection.

cognitive behavioral therapy

this uses both cognitive and behavioral approach to assist a client with anxiety management.

ect

this uses electrical current to induce brief seizure activity while the client is anesthetized. It can enhance the effects of neurotransmitters (serotonin, dopamine, and norepinephrine) in the brain.

restating

this uses the client's exact words

LSD and PCP

this will cause a heightened sense of self and altered perceptions, effects of intoxication, anxiety, depression, paranoia, impaired judgment and social functioning, pupil dilation, tachycardia, diaphoresis, palpitations, blurred vision, tremors, incoordinations, and panic attacks

end of life issues

this will include decision making in a highly stressful time during which the nurse must consider the desires of the client and the family. And decisions must be shared with other health care personnel for a smooth transition during this time of stress, grief, and bereavement.

comorbidities

this will include depressive disorders, ptsd, alzheimers disease, and personality and psychotic disorder.

anticholinergic effects

this will include dry mouth, blurred vision, photophobia, urinary hesitancy or retention. Constipation, tachycardia.

therapy session

this will include use of open and clear communication, cohesiveness and guidelines for the therapy session. Direction toward a particular goal. Opporunities for the development of interpersonal skills, resolution of personal and family issues, and the development of appropriate, satisfying relationships.

primary prevention

thispromotes health and prevents mental health problems from occurring. ex. a nurse leads a group for parents of toddlers, discussing normal toddler behavior and ways to promote healthy development.

battery

touching a client in a harmful or offensive way. This would occur if the nurse threatening the client with a syringe acutally grabbed the client and gave an injection.

SSRI

use __________medications cautiously in clients who have bipolar disorder, due to the risk for mania.

functional dementia scale

use of this tool will give the nurse information regarding the clients ability to perform self care, the extent of the clients memory loss, mood changes, and the degree of danger to self and others

antiepileptic medications

valproic acid, carbamazepine,(tegretol) lamotrigine (lamictal) are all _______________and may be used for bipolar disorder

atypical antidepressants

venlafaxine, duloxetine, desvenlafaxine, mirtazapine, trazodone. With these, only provide one weeks supply for risk of SI in an acutely ill patient. only prescribing 1 months supply especially with TCAs which have a concurrent deadly mix.

atypical antidepressants

wellbutrin is a __________this inhibits dopamine uptake. Treats depression, alternative to SSRis for clients unable to tolerate the sexual dysfunction adverse effects, acts as an aid to quit smoking, prevention of seasonal affective disorder.

nausea, diarrhea, bradycardia

what are the side affects of donepezil, rivastigmine, and galantamine

home, education activities drugs sexuality suicide

what is the acronym HEADSS used for in the assessment in an adolescent stand for

ssri

when a pt is taking an _________hyponatremia which is more likely to occur in older adults taking diuretics, can occur

1.5

when monitoring lithium levels, a level greater than __________ can result in toxicity.

0.4 to 1.0

when monitoring lithium levels, maintenance level range is between _______________meq/l

atypical antidepressants

with these medications, advise clients who have seasonal affectvie disorder to begin taking bupropion in autumn each year, gradually taper dose, and iscontinue by spring. Avoid concurrent use with Maois.

MAOIs

with these medications, provide clients with a list of foods containing tyramine, to reduce the risk of hypertensive crisis. INstruct the client to avoid taking any other prescription or nonprescription medications unless approved by the provider.

SSRIs

with these, advise clients to take these medications in the morning to minimize sleep disturbances. Advise clients to take these medications with food to minimize gastrointestinal disturbances. Obtain baseline sodium levels for older adult clients taking diuretics. Monitor these clients periodically.

TCAs

with these, monitor for cardiac dysrhythmias, which are an indication of toxicity. Administer at bedtime due to sedation and risk for orthostatic hypotension

buspirone

with this medication, advise the client that effects do not occur immediately. It can take a week to notice first therapeutic effecgts, and 3 to 6 weeks to reach full therapeutic benefit. Medication should be taken on a regular basis, rather than an as need basis.

varenicline

with this medication, take after a meal, monitor blood pressure, monitor diabetes, this medication is a nicotine receptor agonist that promotes the release of dopamine to simulate the pleasurable effects of nicotine, this is contraindicated for clients who have chronic depression, serious mental illness, or suicidal ideation.

benzodiazepine intoxication

withdrawal manifestations include, anxiety, insomnia, diaphoresis, hypertension, possible psychotic reactions, hand tremors, nausea or vomiting, hallucinations or illusions, psychomotor agitation, and sometimes seizure activity

opioids

withdrawal manifestations of this are, abstinence syndrome begins with seating and rhinorrhea progressing to piloerection (gooseflesh), tremors, and irritability followed by severe weakness, diarrhea, fever, insomnia, pupil dilation, nausea and vomiting, pain in the muscles and bones, and muscle spasms. Withdrawal is very unpleasant but not life threatening, and it is self limiting to 7 to 10 Days.

cocain

withdrawal manifestations of this substance, characteristic withdrawal syndrome occurring within 1 hr to several days of cessation of drug use, depression, fatigue, craving, excess sleeping or insomnia, dramatic unpleasant dreams, psychomotor retardation or agitation, not life threatening, but possible occurrence of suicidal ideation

lsd and pcp

withdrawal manifestations, hallucinogen persisting perception disorder, visual disturbances or flashback hallucinations can occur intermittently for years.

amphetamines

withdrawal of this include, craving, depression, fatigue, sleeping (similar to those of cocaine) not life threatening

word salad

words jumbled together with little meaning or significance to the listener, such as "Hip hooray, the flip is cast and wide sprinting in the forest"