NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022, Quizzes of Nursing

Download NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022 and more Quizzes Nursing in PDF only on Docsity! 1 NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022 NUR4005 Mental Health – Exam 2 Study Guide & Content Review – Summer 2021/2022 (Exam covers all assigned readings, assignments, PPTs, videos found in Modules 4 – 7) 1. Always promote SAFETY! 2. Admission of Mental Health Clients – only when in danger to self or others or unable to care for self-due to a mental health issue. Characteristics of a client who voluntarily is admitted & of a client who is admitted by commitment. 3. Evaluate client teaching for coping skills has been effective? 4. Therapeutic communication – apply to different situations. ie… suicide comments, nothing to live for, complaining of symptoms related to their disorder, unrealistic beliefs such as food being poisoned, mania, delusions, hallucinations, panic attacks, , anxiety, threatening / aggressive behavior (do not ever turn your back on a client who can potentially harm you; talk client down from aggression or threat of aggression – set limits). • Role of silence / reflection / listening skills/ setting limits with client behaviors / focusing / validating / open ended questions 5. Defense Mechanisms: denial / projection / regression / rationalization 6. Characteristics (symptoms / behaviors) of the identified psychopathologies (ie.. depression, schizophrenia, bipolar, personality disorder, ADHD, Autism, OCD……… • Major Depression – too much or too little sleep, poor appetite or increased appetite, loss of interest, anhedonia (inability to feel pleasure – even in events that previously brought pleasure) , disshuffled, poor hygiene, apathetic, lack of motivation, weight gain or loss, lack of emotion, flat affect, depressed mood, crying, withdrawn, poverty of ideas, can be suicidal, lack of interest in sexual activities, poor school performance….. • Schizophrenia – varies widely – psychotic behavior, delusions, hallucinations (5 senses), inability to care for self, bizarre behavior, disorganized thought, • avolition (decrease in the motivation to initiate & perform self-directed purposeful activities), • anergia (abnormal lack of energy), • delusions of grandeur (feeling famous or very important), • paranoia, • flight of ideas (thoughts & ideas leap from topic to topic), • echolalia (unsolicited repetition of vocalizations made by other persons) disconnected thought patterns, • loose associations, • can be suicidal or homicidal, • increased thirst (fluids), • catatonic (lack of movement)….. • BiPolar Disorder – depression / mania. Clients tend to experience more depression symptoms or more mania symptoms. • Mania – weight loss, impulsive, over spending on purchases, fast talk, fast movements, pacing, rapid thoughts, confabulation (make up words), disorganized thought, verbosity (speaking many words). Decompensation of cardiac system due to poor nutrition, fluid, & electrolyte balance. • Obsessive – Compulsive Disorder (OCD) – Commonly associated with feelings of guilt & inadequacies. Obsessions are repetitive thoughts, whereas compulsions are ritualistic behaviors. Compulsions like – washing hands excessively, aligning items in a certain way all the time to a point 2 NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022 of disturbance & stress if items are not in order. Can lead to panic attacks (SOB, tachycardia, chest 5 NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022 ➢ Stress-reduction therapy - teach patients coping strategies to manage symptoms & reduce stress. ➢ Cognitive-behavioral therapy - form of psychotherapy that treats problems & boosts happiness by modifying dysfunctional emotions, behaviors, & thoughts. ➢ Short-term classical analysis therapy (psychotherapy) - typically, within 6 to 8 sessions clients get help relinquishing unpleasant or negative emotions, which are sustained by certain unidentified thought patterns & core beliefs. ➢ Electroconvulsive therapy (ECT) – needs written signed consent, commonly used for client with what disorders (depression – most common, schizophrenia, bipolar). 13. Acute Stress disorder (ASD) vs PTSD: General symptoms include – re-experiencing event symptoms: flashbacks, upsetting thoughts, nightmares; avoidance symptoms: feeling distant, staying away from things that remind them of event; hyperarousal symptoms: irritability, difficulty sleeping, jumpiness, bursts of anger • Acute Stress Disorder: responds to anti-anxiety medications. May first display denial symptoms (calm, cooperative). Display symptoms for at least 2 days but for less than 4 weeks • PTSD: Same symptoms as ASD but suffered the symptoms for a minimum of 30 days. 14. Grief: Can occur with any loss or perceived loss. Stages – Denial, Anger, Bargaining, Depression, Acceptance. Do not disrupt someone’s grieving process unless endanger to self or others. 15. Somatization disorder: A physical symptom is displayed as a coping mechanism to psychological stresses that are difficult to deal with. They are real physical symptoms. It is essential to identify effective coping mechanisms. Examples include things like inability to talk, inability to walk…… 16. Sleep – Need varies with individuals & may change over time. Insomnia- Inability to fall asleep or inability to stay asleep. Keeping a consistent pattern of sleep is essential. Circadian Rhythm is the body’s 24 hour regulation pattern. When traveling or changing environments or time zone the circadian rhythm can be altered. 17. Sexual disorders: ➢ Stress can decrease sexual desire & lead to sexual dysfunction ➢ Fetishistic disorder (persistent & repetitive use of or dependence on nonliving objects (undergarments or a high-heeled shoe) or a highly specific focus on a body part -typically nongenital- to reach sexual arousal.). ➢ Frotteuristic disorder (touching or rubbing one's genitals up against another person in a sexual manner without their consent, in order to derive sexual pleasure – lasting more than 6 months). ➢ Gender dysphoria. Transgender. Distress a person experiences as a result of the sex & gender they were assigned at birth. ➢ Transvestic disorder (cross-dressing to get sexually aroused). ➢ Pedophilia (ongoing sexual attraction to pre-pubertal children) – commonly exhibitionist. 18. Feeding disorders: usually reflect poor parenting. Behavior modification works well. 19. Autism: troubles with social interaction & communication, & by restricted & repetitive behavior. Genetic & environmental factors. Behavior modification works well 20. Erickson’s stages: Trust vs. mistrust (0-18 months), Industry vs inferiority (5-12 y.o.). Identity vs Role Confusion (13 – 19 y.o). Intimacy vs Isolation (20-39). Generativity vs stagnation (40-64 y.o.). Ego 6 NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022 integrity vs. despair (65 y.o. & up). 7 NUR4005 Mental Health Exam 2 Study Guide – Summer LATEST UPDATE 2021/2022 21. Abuse: • Characteristics for elder or child abuse: Blame injuries on accident. Dependent on others for care. Do not get timely treatment for injuries. Bruises without explanation. History of frequent “accidents”. • Domestic Violence: Safety is #1 concern. A safe shelter is basic need (Maslow). Never encourage victim to try & fight abuser. 22. Substance Abuse: “Ineffective coping” - Alcohol or drug abuse or both. - Essential that client can develop effective coping skills to replace the alcohol / drugs. Recovery from alcohol abuse requires complete abstinence from alcohol & alcohol containing products. • Alcohol withdrawal – anxiety, insomnia, fever, confusion, delirium tremens (DTs) symptoms – hypertension, tremors, shakiness, diaphoresis, tachycardia, seizures, hallucinations. Usually treated with lorazepam (Ativan), stay away from food with caffeine (stimulants). • Heroin withdrawal – frequent yawning, nausea, abdominal pain, nervousness, agitation. Usually treated with methadone. • Opioid withdrawal – abdominal cramping, excessive sweating, frequent yawning, runny nose, anxiety, restlessness. • Benzodiazepine withdrawal – Most commonly abused - alprazolam (Xanax) withdrawal – can be life threatening, pronounced restlessness, panic attacks, palpitations, anxiety, seizures, shaking, N/V 23. Dementia / Alzheimer’s – nursing interventions related to safety / response to wandering behavior / nutrition / physical needs / “sun-setting” is where clients get more confused in the evening Remember to always ask yourself – “How would I respond in this situation?” “What would I say to a client displaying this behavior?” “How do I keep the client safe?” “How do I stay safe?” “How do I keep other clients safe?”