Schziophrenia
What is positive symptoms?
This type of bipolar is one or more depressive episodes usually accompanied by hypomanic episodes
What is bipolar 2?
BPD is more common in this gender
What is female?
In 2020, the American Psychiatric association reported over 12 million Americans had these type of thoughts
What are suicidal thoughts?
What the acronym from this category stands for
What is extrapyramidal symptoms
Typically involves 2 or more weeks of this type of mood or a lack of interest in life activities with at least 4 other symptoms of depression
What is sad?
These include: Feelings of apprehension or dread•Feeling tense or jumpy•Restlessness or irritability•Hypervigilance•Pounding, racing heart•Shortness of breath •Sweating•Tremors•Upset stomach•Frequent urination and/or diarrhea
What are symptoms of anxiety?
•Natural disasters, Combat, Assault
It may not affect everyone the same way – each person gets to define what it means to them
It can occur at any age
What is Trauma or Traumatic event
•Characterized by persistent behavior that violates societal norms, rules, laws, and the rights of others
•Significantly impaired ability to function in social, academic, or occupational areas
•Exhibit callous and unemotional behavior
•Little empathy for others
•Onset before 10 years old is usually males, after 10 years old is both males and females
•May go on to have antisocial personality disorder as an adult
What is conduct disorder?
It's a type of symptom category that includes poor hygiene
What is negative?
This type of bipolar is one or more manic episodes usually accompanied by depressive episodes
What is bipolar 1?
People with BPD have a diffcult time regulating this
What is emotion?
1 in 5 Americans reported this outbreak of infectious disease had a significant impact on their mental health
What is the COVID pandemic?
These symptoms include: muscle rigidity and cramping, muscle spasms, difficulty swallowing, laryngospasm
what is acute dystonia?
Twice as common in this gender
What is female?
Anxiety is consider this when it when it’s appropriate to the situation and dissipates once the situation is resolved
What is normal?
•Avoidance
•Hyperarousal
•Reexperiencing the trauma through dreams, flashbacks, memories, or reactions to external cues
•Insomnia
•Irritability
•Angry outburst
•Sense of loss of control over life
•Emotional numbing – feels detached from others
What are the symptoms of PTSD?
•Characterized by inattention, hyperactivity, and impulsivity
•Usually diagnosed in childhood
•Can persist into adulthood
What is ADHD
Attention Deficit Hyperactivity Disroder
Hearing voices, seeing things
What is hallucinations?
Inflated self-esteem, Grandiosity, Decreased sleep, Elevated mood, Excessive and pressured speech,Flight of ideas Psychomotor agitation Engaging in risk taking or pleasure seeking activities and Easily distracted are the symptoms
What is mania?
Feels this intensely and for extended periods of time
What is emotions?
They aren't little kids anymore, but they aren't quite adults either, 1 in 6 of have reported experiencing a major depressive episode
What are adolescents?
These symptoms include feeling restless, tense, inability to hold still
What is akathsia?
•Anhedonia•Changes in weight•Changes in appetite•Changes in sleep•Lack of concentration•Loss of energy•Lack of interest in activities•Hopelessness•Guilty thoughts•Physical aches and pains•Suicidal thoughts
What are symptoms of depression?
In this country, anxiety is the most common mental health disorder
What is the United States?
•SSRIs
•Used to treat symptoms (insomnia, anxiety, etc)
What are medications used to treat PTSD?
•Amphetamines
•Ritalin (methylphenidate)
•Adderall (amphetamine)
•Strattera (atomoxetine)
Fixed false beliefs
What is delusions?
We typically see what class of medications being used
What are mood stabilizers
Difficult to return to baseline after this happens
What is an emotionally triggering event?
This percentage, or 1 in 5, Americans have experienced a mental illness
What is 20%
This resembles Parkinson’s – muscle rigidity, tremor, gait changes (shuffling gait), slowed movements, increased salivation, cogwheeling
What is pseudoparkinsonism?
medication used to treat
What is antidepressants?
Some of these include: •Psychotherapy – CBT
•Stress and relaxation techniques•Deep breathing
•Guided imagery•Journaling•Promote safety and comfort•Don’t leave the patient alone•Use a calm, soothing voice•Move to a less stimulating place
What are treatments for anxiety?
•Characterized by repetitive, unwanted, intrusive thoughts (obsessions) and ritualistic or repetitive behaviors (compulsions)
•Feel unable to stop obsessions and compulsions
What is Obsessive Compulsive Disorder?
•Disease process marked by progressive cognitive impairment
•No change in level of consciousness
•Multiple cognitive deficits:
•Memory impairment
•Aphasia (language function)
•Apraxia (motor function)
•Agnosia (recognize and name objects)
What is dementia?
This organization provided the following video
What is NAMI? (National Alliance for Mental Health)
80 to 90% of people with bipolar have a relative with either bipolar or this diagnosis.
What is depression?
This includes: Impulsivity, Poor self-image, Stormy relationships, Intense emotional responses to stressors, Suicidal threats, gestures, and attempts, Splitting – adore and idealize, then devalue, Attempts to avoid real or imagined abandonmen, Feeling bored or empty
What are symptoms of BPD
Symptoms of schizophrenia and a mood disorder
What is schizoaffective?
This includes: lower dosage of medication, change to a different antipsychotic, medications given Cogentin (benztropine), Benadryl (diphenhydramine), Inderal (propranolol)
What is treatment of EPS?
A procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure.
What is ECT?
This class of medications that treat anxiety include:
•Lorazepam (Ativan•Diazepam (Valium•Alprazolam (Xanax•Klonapin (clonazepam•Librium (clordiazepoxide)
What are benzodiazepines?
•Thoughts about harming or having harmed someone
•Doubts about having done something right (locking the door)
•Unpleasant sexual images
•Fears of saying something inappropriate in public
•Checking rituals – door is locked, oven is off, etc.
•Counting rituals – steps, ceiling tiles, cracks in the sidewalk
•Washing and scrubbing
•Touching, tapping
•Ordering – arranging things in a particular order
•Aggressive urges
What are symptoms of OCD
The unit at North we see dementia the most
What is Seasons?
Showing little interest in life
What is anhedonia?
Common mood stablizer to treat bipolar
What is lithium?
Medications just treat this, but not the diagnosis
What are symptoms?
It is the second leading cause of death in youth age 10-14
What is suicide?
Medication that is at highest risk for EPS
What is Haldol?
Common form of treatment that uses bright, ultraviolet (UV) lights on your exposed skin.
What is light therapy?
•Psychotherapy (CBT, exposure therapy, adaptive disclose, group therapies, and also self-management strategies like grounding techniques and coping skills
Nonpharmalogical treatment of PTSD
•Medication
•SSRIs
•Psychotherapy
•CBT
•Exposure and response therapy
for the one the one that starts with Winfrey's first name initial
What are treatments for OCD?
•Disturbance of consciousness
•Change in cognition
•Develops over a short period (hours)
•Fluctuates throughout the day
•Sensory disturbances (illusions, misinterpretations, hallucinations)
•Almost always has a cause and can be treated
What is delirium?
Lack of emotion to incidents or events which normally elicit emotion
Flat affect
We nurses watch for signs of this which include: vomiting, severe diarrhea, drowsiness, lack of coordination •Nausea, anorexia, fine hand tremor, polydipsia, polyuria
What is lithium toxicity?
These include: CBT,DBT, Promote safety, Self-harm, Teach coping skills, Journaling, Thought stopping, Deep breathing
What are treatments for BPD?
Percertange of US adults with 1 ACE
62%
This is characterized by movements of the mouth, tongue, face, extremities, and trunk •Irreversible •May see lip smacking, tongue thrusting, jaw movements, jaw grimacing, and trunk or extremity writhing
What is tardive dyskinesia?
This type of treatment includes:
•CBT•Family•Interpersonal
What is psychotherapy?
One way to promote safety and security with your patient is to use this tone of voice
What is a calm, or soothing voice
•Repeated episodes of impulsive, aggressive, violent behavior and angry outbursts
•Usually lasts less than 30 minutes
•Most common in adolescence and young adulthood
•More common in males
What is intermittent explosive disorder
•Donepezil (Aricept)
•Memantine (Namenda)
•Namzaric – combination of Aricept and Namenda
What are medications for dementia?
Class of medications that treat
What is antipsychotics?
0.6 to 1.2
What is therapeutic range of lithium?
A word used in the diagnosis, but is usually used in a deragotory way and we should be careful using this word to describe patient's behavior (aka - try not to use this word please)
What is manipulative?
•Sometimes our patients behavior can be interpreted as manipulative. However, if you can work to understand what is driving the behavior you can help them heal.
•What is perceived as manipulative can be a far more complex phenomenon (and not one of malice), but an overwhelming distress filter through profoundly disordered coping skills.
Percentage of US adults with three or more ACEs
25%
With this syndrome you see: Fever, muscle rigidity, mental status changes, and autonomic instability and it is Rare but potentially fatal – It is a medical emergency
What is Neuroleptic Malignant Syndrome?
This class of medications can take 2-6 weeks for this to to reach their full effect
What are antidepressants?
The stress/relaxation technique Tracy is demonstrating now
This technique (phrase coined in ITAM) for patients with IED takes into consideration the patient's impuslivity and carefully choses words with the positive first
What is "get to the yes"
This method of intervention is more helpful than having a conversation about boundaries for our patient with dementia?
What is re-direction?
This type of treatment includes:
•Stress management •Avoid alcohol and drugs•Get adequate sleep•Maintain connections with family/friends •Improving social skills
What is supportive treatment?
Educating your patients on going to sleep at this time will help "rise above the lows" of bipolar depressive symptoms
What is the same time?
BPD is this many times more common in women than men
What is three times?
How many questions are on the ACE assessment
10
EPS is still possible, but less common with this type of medication
What is atypical antipsychotics?
This syndrome is a Serious drug reaction caused by medications that build up high levels of this chemical in the body •SSRIs•SNRIs•Tricyclics•MAOIs•Anti-migraine meds•Pain meds (opiates)•Can occur when starting a new med or increasing the dose
What is serotonin (syndrome)?
The brains ability to re-wire itself is called this
What is neuroplasticity?
Anger, many times, is a symptom of this
Not only seen in BH, about 60% of ICU patients experience this
What is delirium?
This cognitive distortion is false beliefs that random or irrelevant occurrences in the world directly relate to oneself. When someone believes their thoughts, actions, or presence caused an event to occur, they are experiencing this cognitive distortion.
What is ideas of reference?
Bipolar disorder was formerly called this
What is manic depression?
Wait until video stops to answer: What diagnosis does BPD mimic?
What is Bipolar disorder?
How many locked units do we have at North Hospital?
9
You may see: Weight gain (particularly with clozapine and olanzapine)•Hyperglycemia•Longer QT interval•Agranulocytosis (clozapine)•Weekly WBC’s for first 6 months•Characterized by fever, malaise, sore throat, leukopenia•Gynecomastia•Sexual dysfunction •Metabolic syndrome
What are common side effects of atypical antipsychotics?
Includes: Shivering Diarrhea Confusion Rapid heart rate/high BP, loss of muscle coordination Dilated pupils Muscle rigidity Sweating. Severe include: High fever Tremor Seizures Irregular heartbeat Unconsciousness
What are symptoms of Serotonin Syndrome?
typical length untreated
What is 6 months?
Seclusion and restraint should always be this
What is the last resort?
This is the most common form of dementia contributing 60-70%
What is Alzheimer disease?