Mental Health Exam 3 Study Guide: Substance Abuse and Personality Disorders, Exams of Nursing

Download Mental Health Exam 3 Study Guide: Substance Abuse and Personality Disorders and more Exams Nursing in PDF only on Docsity! MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ Patients on a memory care unit - CORRECT ANSWERS -Reminiscing about happy times may help one feel less isolated. -Always identify yourself. -Speak slowly. -Use short, simple words and phrases. -Maintain face-to-face contact. Continued...patients on a memory care unit - CORRECT ANSWERS -Be near the patient when talking, one or two arm lengths' away. -Focus on one piece of information at a time. -Have the patient wear eyeglasses or a hearing aid. -Keep the patient's room well lit. Nursing intervention with a patient with agnosia - CORRECT ANSWERS - It is best to demonstrate and talk the client through the correct process. -Have clocks, calendars, and personal items (e.g., family pictures, Bible) in clear view. Reinforce the patient's pictures, nonverbal gestures, X's on calendars, and other methods to present reality. Nursing intervention with a person with delirium and is disoriented - CORRECT ANSWERS Orient the patient. Don't offer false statements or argue with the patient. When the patient is delusional, acknowledge the patient's feelings and reinforce reality. Characteristics of a patient with borderline personality disorder. Be able to provide a concise description of one suffering from this disorder. - CORRECT ANSWERS Unstable, frequent mood changes; feelings of MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ anxiety, dysphonia, irritability can be intense (short-lived) [emotional liability], chronic depression, patterns of high emotional sensitivity, acute responsiveness, slow return to normal aka "emotional dysregulation", feelings of deadness, panic, and fury, and self-mutilation and suicide prone behaviors. Boarderline Personality - CORRECT ANSWERS - One must be consistent when managing a patient with borderline personality disorder with excessive demands Interventions such as what would be administered for a patient who overdosed on pcp (PCP) - CORRECT ANSWERS If alert: Caution: Gastric lavage can lead to laryngeal spasms or aspiration. Acidify urine (cranberry juice, ascorbic acid); in acute stage, ammonium chloride acidifies urine to help excrete drug from body— may continue for 10- 14 days. Nursing interventions PCP - CORRECT ANSWERS - Suicidal risk is always assessed, especially in cases of toxicity or coma. - Put in room with minimal stimuli. Do not attempt to talk down patient! Speak slowly, clearly, and in a low voice. - Administer diazepam. Haloperidol may be used for severe behavioral disturbance (not a phenothiazine). PCP S/S - CORRECT ANSWERS PCP, or 1-( phenylcyclohexyl) piperidine, is also known as angel dust, horse tranquilizer, and peace pill. -Signs and symptoms of PCP intoxication range from acute anxiety to acute psychosis as well as aggression, violence, and loss of coordination. Effects of PCP - CORRECT ANSWERS The drug produces a generalized anesthesia that lessens the sensations of touch and pain and makes staff interventions difficult. Chronic use of PCP can result in long- term effects MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ Possible Alcohol OD Treatment - CORRECT ANSWERS If awake: Keep awake. Induce vomiting. Give activated charcoal to aid absorption of drug. Check vital signs (VS) every 15 min. Coma: Clear airway; insert endotracheal tube. Give intravenous (IV) fluids. Perform gastric lavage with activated charcoal. Check VS frequently for shock and cardiac arrest after patient is stable. Initiate seizure precautions. Possibly perform hemodialysis or peritoneal dialysis. Administer flumazenil (Romazicon) IV. Marijuana - CORRECT ANSWERS -Overdose and withdrawal (other than craving) rarely occur. -Long-term effects are lethargy, anhedonia, difficulty concentrating, and loss of memory. Amphetamine Overdose: - CORRECT ANSWERS Respiratory distress, Ataxia, Hyperpyrexia, Convulsions, Coma, Stroke, Myocardial, infarction, Death Amphetamine Possible OD treatment: - CORRECT ANSWERS Possible OD TX: Anti-psychotic, Medical and nursing management for: Hyperpyrexia (ambient cooling), Convulsions (diazepam), Respiratory distress, Cardiovascular, shock, Acidification of urine (ammonium chloride for amphetamine) Acute alcohol withdrawal. What are indications/manifestations that one would need treatment? - CORRECT ANSWERS Cessation of prolonged heavy use: Nausea and vomiting, Tachycardia, Diaphoresis, Anxiety or irritability, Tremors in hands, fingers, eyelids, Marked insomnia, Grand mal seizures After 5 to 15 years of heavy use: Delirium [Immediate medical attention is warranted in alcohol withdrawal delirium]. - Is similar to all central nervous system (CNS) depressant drugs. - Early signs develop within a few hours. Signs peak in 24 to 48 hours. -Grand mal seizures occur in 7 to 48 hours after cessation. MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ - Illusions are experienced.Irritability and "shaking inside" are common. Alcohol dependence: when do withdrawal symptoms peak? - CORRECT ANSWERS - Early signs within a few hours. - Peaks within 24 to 48 hours. - Rapidly and dramatically disappears unless it progresses to delirium Alcohol withdrawal and confusion: what may be prescribed to allow for safe withdrawal? - CORRECT ANSWERS Safely and comfortably help achieve detoxification. Enhance motivation for abstinence and recovery. Alcohol WITHDRAWAL Medications include: - CORRECT ANSWERS benzodiazepines, anticonvulsants, beta-blockers, magnesium sulfate, thiamine (vitamin B1), folic acid, and multivitamins Narcan administration: nursing interventions after administration - CORRECT ANSWERS Naloxone (Narcan), an opiate antagonist, is often given to people who have overdosed on an opiate (usually heroin) to reverse respiratory and CNS depression. -The duration of action of naloxone may be less than that of the narcotic that was taken, further monitoring and possible additional doses of naloxone may be needed. Heroin overdose: symptoms post narcan administration - CORRECT ANSWERS -Withdrawal Effects: Yawning, Insomnia, Irritability, Runny nose(rhinorrhea, Panic Diaphoresis, Cramps Nausea and vomiting Muscle aches ("bone pain"), Chills, Fever, Lacrimation, Diarrhea -Used in withdrawal TX: Methadone tapering, Clonidine-naltrexone Vivitrol: ( naltrexone for extended release injectable suspension over 1- month period) Buprenorphine: for treatment acts as substitute MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ A drug that a cocaine abuser may use to counteract the effects of cocaine - CORRECT ANSWERS Combine drugs to weaken or inhibit the effect of one of the drugs (i. e., for the antagonistic effect). -EX/cocaine is often mixed with heroin (speedball). The heroin (CNS depressant) is meant to soften the intense let-down of withdrawal from cocaine (CNS stimulant). Nursing interventions with one withdrawing from a CNS stimulant - CORRECT ANSWERS Watch for suicide and depression. Keep patient safe, safe environment Histrionic Personality Disorder: Nursing interventions for inpatient stay. - CORRECT ANSWERS Boundary issues in relationships and a clear delineation of the therapeutic framework are relevant and important aspects of therapy. Monitor for suicide [suicide contract] Hypochondriasis: A disorder in which people have a constant fear of illness and a preoccupation with their health. - CORRECT ANSWERS Misinterpret innocent physical sensations as evidence of a serious illness. -cannot be reassured by negative diagnostic test findings, and they seek extensive medical care with frustrating results. -Most patients refuse referral to a psychiatrist because they believe their symptoms are physical. -Obsessive belief that one has a serious disease Family Planning Clinic: Why would a nurse ask the woman about domestic violence? - CORRECT ANSWERS If the woman has a history of falls, bruises and wounds at different healing stages. MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ Anxiety, Possible chemical dependency and shoplifting, Undoes weight after binging, Prominent parotid glands, if purging Binge eating- Is a variant of compulsive overeating. - CORRECT ANSWERS An eating pattern that resembles that of obesity. Recurrent episodes of thinking about and eating large amount of food occur in a short period. -Feelings of disgust, depression, and guilt are expressed after bingeing. Bulimia Nervosa: Nursing interventions in plan of care - CORRECT ANSWERS Interrupt the binge/purge cycle Binge-purge bulimia: patient teaching and what to prioritize when considering complications - CORRECT ANSWERS Interrupt binge/purge cycle, psychotherapy, self-care skills, treat underlying depression, substance abuse, and/or personality disorder. Anorexia nervosa: milieu management, psychotherapy, develop self-care skills, physiological interventions. - CORRECT ANSWERS In the effort to motivate the patient and take advantage of the decision to seek help and be healthier, the nurse must avoid authoritarianism and assumption of a parental role. What to ask a client when assessing for an eating disorder? - CORRECT ANSWERS "Have you ever had thoughts of suicide?" Refeeding Syndrome: complications and system dysfunction - CORRECT ANSWERS a potentially catastrophic treatment complication in which the demands of a replenished circulatory system overwhelm the capacity of a nutritionally depleted cardiac muscle, which results in cardiovascular collapse -Too much food, too fast MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ Nursing diagnosis for levels of consciousness, orientation, and hallucinations - CORRECT ANSWERS Risk for injury, Acute confusion, Deficient fluid volume, Insomnia and sleep deprivation, Impaired verbal communication, Fear, Self-care deficit, Disturbed thought process Visual and auditory illusions: interventions to manage illusions - CORRECT ANSWERS Illusions, unlike delusions or hallucinations, can be explained and clarified for the individual. What to prescribe a cognitively impaired and combative patient. - CORRECT ANSWERS Use structural education programs for staff to help manage disruptive behaviors through behavioral interventions and/ or cognitive techniques in order to reduce use of both medications and restraints -Atypical antipsychotic medications (particularly risperidone [ Risperdal], olanzapine [ Zyprexa], and quetiapine fumarate [Seroquel]) have been used extensively for treating behavioral symptoms of AD. Some of these troubling symptoms are ( 1) psychoses (hallucinations and delusions), ( 2) severe mood swings, ( 3) anxiety ( agitation), and ( 4) verbal or physical aggression (combativeness). Types of abuse: - CORRECT ANSWERS physical, sexual, emotional, economic Child abuse or neglect suspicion: nurse's legal responsibility - CORRECT ANSWERS Nurses are legally responsible for reporting child abuse to the appropriate child protective agency. Alzheimer's disease and patient/family coping: Nursing interventions - CORRECT ANSWERS When caring for a patient with AD or teaching family members: (a) communication; talk to pt. about familiar things, Do not argue or refute delusions (b) health maintenance; diet, wondering MENTAL HEALTH EXAM 3 STUDY GUIDE 73QUESTIONS AND ANSWERS LATEST UPDATE - 2023/2024 RATED A+ precautions (c) safe environment, group activity, no driving, remove throw rugs. Sexual Assault Victim: Nursing intervention at discharge - CORRECT ANSWERS Before leaving the ED, sexually assaulted individuals are told what kinds of reactions are commonly experienced by sexually traumatized victims following a crisis. -Follow- up counseling, support groups, and resources to effective legal attorneys who specialize in sexual assault should always be given before discharge from the ED. Physical aggression behavior examples - CORRECT ANSWERS Physical and emotional harm to others. Bullying Violent behavior: predictors of high risk - CORRECT ANSWERS Childhood aggression, Males aged 15-24, Setting fires, animal cruelty during childhood, diagnosis of conduct disorder, Childhood family history of violence, Abuse of alcohol and/or other substances, Low socioeconomic status/Poor population, Learned angry reactions [societal norms], Genetics, Neurobiological factors and brain structure. History of familial violence: characteristics - CORRECT ANSWERS Recurrent emergency department ( ED) visits for injuries attributed to being "accident prone" -Presenting problems reflecting signs of high anxiety and chronic stress: Hyperventilation, Panic attacks, Gastrointestinal disturbances, Hypertension, Physical injuries, Depression -Stress related conditions: Insomnia, Violent nightmares, Anxiety, Extreme fatigue, Eczema, Loss of hair