Addiction
Symptoms of alcohol withdrawal?
What are nausea, vomiting, tremors, restlessness, insomnia, depressed mood or irritability, tonic-clonic seizures, illusions.
You are the nurse caring for a schizophrenic patient. The patient is noted to be covering his ears during the assessment. You would expect the patient to receive a prescription for what type of medication?
What is an antipsychotic such as Haldol, Risperdal, and Seroquel?
Name some nursing interventions for a depressed patient?
-make time to be with client even if he doesn't speak
-communicate with observations rather than asking direct questions
-give directions in simple, concrete sentences
-allow the client sufficient time to verbally respond
-disordered thinking
-inability to make decisions
-poor problem solving ability
-difficult concentrating to perform tasks
-Memory deficits
What are cognitive symptoms of psychotic disorders?
1. Alert- client is responsive, eyes open, fully able to respond, answer questions normally, appropriately
2. Lethargy- can open eyes & respond but easily falls asleep
3. Obtundation- needs to be lightly shaken, may be confused and slow to respond
4. Stupor- requires painful stimuli to elicit brief response, may not be able to respond verbally
5. Coma- no response achieved via painful stimuli, abnormal posturing may be present
What are levels of consciousness?
Agitation, insomnia, flu-like symptoms, rhinorrhea, yawning, sweating, and diarrhea. The person may have suicidal ideations.
What are symptoms of opioid withdrawal?
benzodiazepines, sedative hypnotic, anxiolytics, atypical anxiolytic/nonbarbiturate anxiolytic, SSRIs, SNRIs, TCAs, MAOIs, antihistamines, beta blockers, centrally acting alpha blockers, anticonvulsants
What are medications to treat anxiety disorders?
A nurse in a mental health clinic is assessing a client who has a history of mania. Which findings indicate that the client is experiencing a relapse?
What are pressured speech, use of substances such as alcohol, illicit drugs, and caffeine, weight loss, and sleep disturbances?
Describe somatic delusions
A person believes their body is changing in an unusual way, such as growing a third arm
The subjective information supplied about one's emotions and the objective expression of their mood
What are mood and affect?
Chlordiazepoxide (Librium), Diazepam (Valium), Lorazepam (Ativan), Oxazepam (Serax)
What kind of medications would be expected to be prescribed for a patient who is detoxing from alcohol?
This class of antidepressants can cause cardiac dysrhythmia's which indicate toxicity. The nurse should instruct the client to take this medication at bedtime due to sedation and risk for orthostatic hypotension.
What are tricyclic antidepressants?
A less severe episode of mania that lasts at least 4 days accompanied by three or more manifestations of mania. Hospitalization is usually not required but it may progress to mania.
What is hypomania?
A delusional patient believes that her thoughts are heard by others
What is thought broadcasting?
-beneficence: the quality of doing good; can be described as a charity
-autonomy: the clients right to make her own decisions. The client must accept the consequences of those decisions. the client must also respect the decisions of others
-justice: Fair and equal treatment to all
-fidelity: loyalty and faithfulness to the client and to one's on duty
-veracity: honesty when dealing with clients
What are ethical principles?
Slurred speech, impaired memory, pupillary changes, decreased respirations, decreased level of consciousness which may lead to death. The antidote for this intoxication is naloxone.
What is opioid intoxication?
Mood stabilizer (Lithium) and mood stabilizing antiepileptic medications such as valporic acid, carbamazepine, and lamotrigine
depressed mood
insomnia
excessive sleeping
indecisiveness
decreased ability to focus
suicidal ideation
increase/decrease in motor activity
ahendonia
weight change
What are symptoms of Major Depressive Disorder?
*flight of ideas or loose associations ex. sentences do not relate
*Neologisms- made up words
*Echolalia- repeating words spoken to them
*clang association- meaningless rhyming of words (box,lox,and fox)
*word salad- words that make no sense together (the flip is cast,and wide-sprinting in the forest)
What are alterations of speech in psychotic disorders?
used to objectively assess the client's cognitive status
What is the Mini-Mental Status Examination?
A nurse in a substance use disorder treatment facility is reviewing the medication records for a group of clients. The nurse should expect to administer methadone for a client who has a substance use disorder for which of the following substances?
What are opioids?
CNS depression (such as sedation, lightheadedness, ataxia, and decreased cognitive function);
anterograde amnesia (difficulty recalling events that occur after dosing);
acute toxicity;
paradoxical response (insomnia, excitation, euphoria, anxiety, rage);
withdrawal effects
What are complications of benzodiazepines?
The nurse should identify that the priority goal for the stage of this disorder is to prevent physical exhaustion, maintain health, and meet nutritional and rest needs during the acute phase. Maslow's hierarchy of needs, which includes five levels of priority, is used when planning care for this client. The first level consists of physiological needs; the second level consists of safety and security needs; the third level consists of love and belonging needs; the fourth level consists of personal achievement and self-esteem needs; and the fifth level consists of achieving full potential and the ability to problem solve and cope with life situations. When applying Maslow's hierarchy of needs priority-setting framework, the nurse should review physiological needs first. The nurse should then address the client's needs by following the remaining four hierarchal levels.
What is bipolar disorder during acute mania?
A Patient is admitted to the emergency department with spasms of the face and back. He recently began taking Chlorpromazine to treat schizophrenia, Which of the following adverse reactions should the health care provider suspect?
What is acute dystonia?
A nurse is communicating with a client on the acute mental health facility. The client states, "I can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" What therapeutic communication technique is the nurse demonstrating?
What is restating?