Mental Health 3 Jep.

Admission

100

Mental Health Admissions: Reason

when in danger to self or others, or cannot care for self-due to a mental health disorder

200

Voluntary vs involuntary (commitment, emergency)

Commitment- patients are more unwilling to receive treatment, explain process to patient, medications and treatment

Voluntary- more willing to receive treatment and to take medications.

300

Mental health admission process?

Nursing assessment

SA

AV

Falls

Pain 

Nutrition

Nursing objective and intervention

400

EPS

reversible if addressed early – symptoms of uncontrolled movement of lips, mouth, arms….

500

TD

sticking out tongue, smacking lips, jerky movements), or neuroleptic malignant syndrome (muscle rigidity, autonomic dysfunction

Medications

100

Name the different types of SSRI

also effective treatment for anxiety disorders; escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft

200

MAOI's and common side effects?

MAOIs – More side effects than newer drugs; avoid tyramine foods, isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), tranylcypromine (Parnate)

300

Name Tricyclics Medications?

clomipramine (Anafranil), imipramine (Tofranil);  amitriptyline (Elavil)

400

• Do not take which antidepressants together and what specific medication?

 MAOIs with SSRI or thyroid medications.

500

isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), tranylcypromine (Parnate)

Avoid what foods?

MAOI-

More side effects than newer drugs; avoid tyramine foods

Meds

100

Monitoring with hypnotics? 

• Needs close monitoring with HCP, cause sleepiness. Work more effectively than some over the counter herbs like melatonin.

200

benzodiazepines?

alprazolam (Xanax); buspirone (Buspar); diazepam (Valium) – also used to treat status epilepticus; lorazepam (Ativan) – also used to treat an active seizures

300

Lithium

mood stabilizer, monitor fluid and electrolyte balance, it is a sodium based drug. Understand clients start with higher dosages and move to lower maintenance dosages once stabilized. Watch renal and thyroid function

400

Risperdol side effects?

• commonly used with schizophrenia, bipolar disorder, and autism

500

fluphenazine (Prolixin)- side effects?

should not be given with clients diagnosed with dementia – could lead to death, do not take with carbonated beverages

Abuse/delirium/aging

100

Who is a mandatory reporter?

Everyone

200

usually dependent for care, may negate the abuse or injury, may ignore medical care of injury, continue to support their abuser – esp if family member

Elder

300

may not tell truth about injury, rationalize injury, show fear of abuser, frequent UTIs in female children can mean sexual abuse, abnormal interest

Child

400

Nursing interventions for delirum?

• nursing, symptoms, treatments (keep orientation strategies – clock, calendar), protect self in case client becomes hostile or aggressive, keep interactions to short periods of time, safety – safety – safety, do not over stimulate – limit visitors and excess stimulation / noise.

500

Aging stereotypes?

Elderly are not routinely debilitated, lack interest in life events, depressed, or demented and confused.

Crisis/violence/dementia

100

What should a nurse do in crisis intervention? Is it time limited?

crisis is an acute problem that is usually time-limited, can develop a feeling of being overwhelmed. Keep safe

200

Nursing assessment for patient that is violent?

- seclusion and restraint?

-number one priority?

• watch for change in behavior, muscle tension, change in tone of voice) & interventions & outcomes, communication, seclusion, restraints (need order, not ordered as PRN, try all other strategies before restraining). Safety! We first try to deescalate before calling security.

300

Nursing interventions for dementia?

Risk factors for disease?

Interventions?

• avoid isolation, assessments, symptoms, treatments, home care. Risks include family history, head injury, sedentary life style, contact sports like football, boxing.