Pharm
Name 1 diagnosis that can be treated with a benzodiazepine.
Alcohol withdrawal
Anxiety (acute)
Seizures
Sedation (Anesthesia)
Muscle spasms
Catatonia
Name 1 sign or symptom associated with anorexia nervosa.
•Home environment can be overprotective with an emphasis on perfection.
•Weight loss is extreme, usually more than 15% of expected weight.
•Other symptoms include hypothermia, bradycardia, hypotension, edema, lanugo, and a variety of metabolic changes.
Describe 1 characteristic of intellectual developmental disorder.
◦Intellectual Developmental Disorder has its onset prior to age 18 years and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains.
◦General intellectual functioning is measured by both clinical assessment and a person’s performance on IQ tests.
◦Adaptive functioning refers to the person’s ability to adapt to requirements of activities of daily living and the expectations of their age and cultural group.
◦Motor development may be limited to gross motor activities.
Name 1 characteristic of abuse or neglect.
Signs:
Neglect and Abandonment
Neglect is a caregiver failing to meet an older person's basic needs for health and safety, while abandonment is the desertion of an older adult in need of help.
Signs: Dehydration, malnutrition, unexplained weight loss, poor hygiene, untreated medical issues, bedsores, hazardous living conditions, inadequate clothing for weather, or an older adult left alone by a caregiver.
Emotional/Psychological Abuse
This type of abuse involves inflicting mental pain, anguish, or distress through actions.
Signs: The older adult being emotionally upset, withdrawn, depressed, anxious, having personality changes like excessive apologizing, or a caregiver who is belittling, threatening, or controlling.
Financial Exploitation
Financial exploitation is the improper use of an older adult's funds, property, or assets for another person's benefit.
Signs: Sudden changes in bank accounts, wills, power of attorney, missing funds or possessions, or unpaid bills despite having resources.
What is the 6th stage of grief?
Kessler argues that it's finding meaning beyond the stages of grief.
This medication is an acetylcholinesterase inhibitor. It works by increasing the levels of the neurotransmitter acetylcholine in the brain, a chemical in the brain necessary for memory processes.
Most effective in the early stages, it serves to delay the progression of the disease.
Name the medical diagnosis associated with Russell's sign.
Russell's sign is scarring on the back of the client’s hand from self-inflicted purging. It is seen in those diagnosed with Bulimia Nervosa.
Define separation anxiety disorder.
•Maternal stress during pregnancy is associated with an increased incidence of this disorder.
The essential feature of separation anxiety disorder is excessive anxiety concerning separation from those to whom the individual is attached.
•The anxiety exceeds that which is expected for the person’s developmental level and interferes with social, academic, occupational, or other areas of functioning.
Define reminiscence therapy.
Encourages members to share positive and negative life events to promote resolution.
A therapeutic approach that uses prompts like photos, music, or objects to help people recall and discuss past experiences, memories, and feelings. It can improve mood, life satisfaction, and communication, particularly for older adults and individuals with dementia, by stimulating mental activity, reducing stress and agitation, and fostering a sense of self-worth and connection
Name 2 guidelines surrounding grief practices.
•Identify death rituals and expectations
•Encourage individual to describe mourning practices
Identify values and beliefs about death
Explore individual’s perceptions about death, dying, and the afterlife
Name 1 medication that can be given for binge eating disorder.
Lisdexamfetamine (the only medication with Food and Drug Administration approval for moderate-to-severe binge eating disorder in adults).
Selective serotonin reuptake inhibitors, such as fluoxetine can be helpful in bulimia nervosa and anorexia nervosa.
Name 2 symptoms of bulimia nervosa.
•Acidic emesis corrodes the tooth enamel.
Bulimia nervosa is an episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period (bingeing).
•The episode is followed by inappropriate compensatory behaviors to rid the body of the excess calories (self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
◦Fasting or excessive exercise may also occur.
◦Most patients with bulimia are within a normal weight range; some are slightly underweight, and some are slightly overweight.
◦Depression, anxiety, and substance abuse are common comorbidities.
◦Excessive vomiting and laxative or diuretic abuse may lead to problems with dehydration and electrolyte imbalances.
Describe 2 characteristics of autism spectrum disorders.
Research has shown that abnormalities in brain structure or function are to blame.
◦Autism spectrum disorder (ASD) is characterized by a wide range of social difficulties, communication impairments, and restricted and repetitive behaviors.
◦Prevalence is about 1 in 54 children.
◦ASD occurs more often in boys than in girls.
◦Onset occurs in early childhood.
◦ASD often runs a chronic course.
A heterogenous group of neurodevelopmental syndromes characterized by a wide range of social difficulties, communication impairments, and restricted and repetitive behaviors.
◦Neurological implications
◦Abnormalities in brain structure or function
◦Role of neurotransmitters under investigation
◦Genetics
◦Familial association
◦Chromosomal involvement
◦Prenatal and perinatal influences
◦Maternal asthma or allergies
Name 2 interventions when caring for aging clients.
•Nursing care of the aging individual is aimed at protection from injury caused by age-related physical changes or altered thought processes related to cerebral changes.
•The nurse is also concerned with preserving dignity and self-esteem in an individual who may have come to be dependent on others for their survival.
•Assistance is provided with self-care deficits while encouraging independence to the best of the client’s ability.
•Reminiscence therapy is encouraged.
List and describe 1 of the five stages of grief.
•Stage 1: Denial. In this stage, the individual has difficulty believing that the loss has occurred. This stage may protect the individual against the psychological pain of reality.
• Stage 2: Anger. This is the stage when reality sets in. Feelings associated with this stage include sadness, guilt, shame, helplessness, and hopelessness. Self-blame or blaming of others may lead to feelings of anger toward the self and others.
• Stage 3: Bargaining. At this stage in the grief response, the individual attempts to strike a bargain with God for a second chance, or for more time. The person acknowledges the loss, or impending loss, but holds out hope for additional alternatives.
• Stage 4: Depression. In this stage, the individual mourns for that which has been or will be lost. This is a very painful stage, during which the individual must confront feelings associated with having lost someone or something of value (called reactive depression). An example might be the individual who is mourning a change in body image. Feelings associated with an impending loss (called preparatory depression) are also confronted.
• Stage 5: Acceptance. At this time, the individual has worked through the behaviors associated with the other stages and accepts or is resigned to the loss. Anxiety decreases, and methods for coping with the loss have been established.
Name 1 medication that can be helpful in Tourette's syndrome.
Antipsychotics (like haloperidol, pimozide, risperidone, and aripiprazole) to reduce tics, as well as alpha-2 adrenergic agonists (such as clonidine and guanfacine).
List 3 types of eating disorders.
Anorexia Nervosa (AN)
Bulimia Nervosa (BN)
Binge-Eating Disorder (BED): This was a major addition as a formal diagnosis in the DSM-5, having previously been listed for further study in the DSM-IV.
Avoidant/Restrictive Food Intake Disorder (ARFID): This replaced the DSM-IV diagnosis of feeding disorder of infancy or early childhood and has broadened criteria that can apply across the lifespan.
Pica: Diagnosed when a person persistently eats nonfood items inappropriate for their developmental level.
Rumination Disorder: Characterized by the repeated regurgitation of food.
Other Specified Feeding or Eating Disorder (OSFED): This category is for conditions that cause significant distress or impairment but do not meet the full criteria for one of the other specific disorders (e.g., atypical anorexia nervosa, purging disorder).
Unspecified Feeding or Eating Disorder (UFED): A "catchall" diagnosis used when a clinician chooses not to specify the reason the criteria for a specific disorder are not met.
Describe 2 characteristics of oppositional defiant disorder.
A person must exhibit a persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness for at least six months.
•Occurs more frequently than is usually observed in individuals of comparable age and developmental level
•Interferes with social, educational, or vocational activities
◦Stubbornness, procrastination
◦Disobedience, negativism
◦Carelessness, testing of limits
◦Resistance to directions
◦Unwillingness to cooperate
◦Running away
◦School avoidance and underachievement
◦Temper tantrums, fighting, and argumentativeness
◦Impaired interpersonal relationships
Name 2 ways to promote communicate with elderly patients.
Describe 2 characteristics of hospice care.
Focus is on quality of life.
Hospice is a program that provides palliative and supportive care to meet the special needs of people who are dying, as well as the needs of the patients’ families. Hospice care provides physical, psychological, spiritual, and social care for the person for whom aggressive treatment is no longer appropriate.
Hospice follows an interdisciplinary team approach to provide care for the terminally ill individual in the familiar surroundings of the home environment.
Name 2 concerns associated with antidepressants.
Antidepressants can trigger manic episodes for individuals who have bipolar 1 disorder.
Tricyclic antidepressants can take 4 weeks before they exhibit their full therapeutic effect.
Side effects include weight gain and sexual dysfunction, nausea, headaches, sleep disturbances, and dizziness.
A low-tyramine diet is required when taking classic MAOIs (Monoamine Oxidase Inhibitors) to prevent a dangerous spike in blood pressure. This is because the MAOI medication prevents the body from breaking down tyramine, an amino acid found in certain aged, fermented, cured, or spoiled foods, allowing it to build up in the body.
Serotonin syndrome is a serious, potentially life-threatening drug reaction caused by having too much serotonin in the body, which can occur with the use of Selective Serotonin Reuptake Inhibitors (SSRIs).
List 2 nursing diagnoses associated with eating disorders.
◦Anxiety (moderate to severe) related to feelings of helplessness and lack of control over life events
Imbalanced nutrition: Less than body requirements related to refusal to eat
◦Deficient fluid volume (risk for or actual) related to decreased fluid intake, self-induced vomiting, and laxative and/or diuretic abuse
◦Ineffective denial related to delayed ego development and fear of losing the only aspect of life over which they perceive some control (eating)
◦
•Imbalanced nutrition: More than body requirements related to compulsive overeating
•Disturbed body image/low self-esteem related to retarded ego development, dysfunctional family system, or feelings of dissatisfaction with body appearance
Name 2 considerations of methyphenidate (Ritalin).
The pharmacological action of Ritalin causes a decrease in appetite.
A tolerance can develop over time, requiring an increase in dosage.
Methylphenidate (brand name Ritalin, also Concerta, Daytrana, etc.) is a central nervous system (CNS) stimulant primarily used to treat Attention-Deficit Hyperactivity Disorder (ADHD) and narcolepsy.
It may lower the effectiveness of medicines used to treat hypertension.
Monitor for potential abuse.
Common side effects
Upset stomach, loss of appetite, insomnia, and mild anxiety
Rare side effects
Contact your health care provider if any of the following occur while taking methylphenidate or dexmethylphenidate:
Name 2 psychological aspects of normal aging.
•Short-term memory seems to deteriorate with age, but long-term memory does not show similar changes.
•Time required for memory scanning is longer for both recent and remote recall among older people.
•Mentally active people show less memory decline than those who are not mentally active.
•
•Intellectual functioning
•Crystalized abilities, or knowledge acquired over the course of the socialization process, tend to remain stable over the adult life span.
•Fluid abilities, or abilities involved in solving novel problems, tend to decline gradually from young to old adulthood.
•Learning ability
•The ability to learn continues throughout life, although it is strongly influenced by interests, activity, motivation, health, and experience.
•Adjustments do need to be made in teaching methodology and time allowed for learning.
List the 5 stages of grief according to Kubler-Ross.
Denial: A temporary refusal to believe or accept the reality of a situation.
Anger: Frustration and outrage may be directed at others or even oneself.
Bargaining: Attempting to negotiate with a higher power to postpone the inevitable or change the outcome.
Depression: A period of deep sadness and despair, often accompanied by a sense of hopelessness.
Acceptance: Coming to terms with the reality of the loss, which doesn't mean the pain is gone, but that it is manageable.