Disorders
What are symptoms of Chronic Stress?
Immune changes leading to increased infection and illness, aches & pains, insomnia, sleepiness, withdrawal from activities, low energy, trouble concentrating, changes in appetite, increased substance use
Risk factors for suicide include:
Biological: family history, comorbid physical conditions (chronic pain, disease)
Psychological: hopelessness, poor interpersonal relationships, developmental stressors, intense emotions: rage, anger, guilt, impulsivity
Environmental: access to lethal methods, lack of access to mental healthcare, unemployment
What are the four characteristics of therapeutic communication?
trust, authenticity, empathy and self-awareness
What are the signs of antidepressant discontinuation syndrome?
Hint: pneumonic FINISH
F: flu-like symptoms (fatigue, headache, sweating, body aches)
I: insomnia
N: nausea
I: imbalance (dizziness, vertigo, light-headedness)
S: sensory disturbances (burning, tingling, brain zaps, shocks)
H: hyperarousal (anxiety, irritability, agitation, aggression, mania)
What are unintentional torts?
negligence and malpractice
What are the stages of Alzheimer's Disease?
2 Basic Forgetfulness: memory lapses that become more frequent and most noticeable by others
3 Noticeable Memory Difficulties: organization is more difficult, struggling with retrieving a name or word, challenges in social or work settings, struggles with recent memory like in books or the news
4 More than Memory Loss: confusion about what day it is or where they are, increased risk of wandering, changes in sleep patterns, increased restlessness at night and sleeping during the day
5 Decreased Independence: require regular assistance with daily living tasks and emotional changes such as delusions, hallucinations, and paranoia are common
6 Severe Symptoms: loss of communication, personality changes, increased frustration and agitation may occur
7 Lack of Physical Control: requires round-the-clock care, reduced mobility, increased risk of infection, struggling with eating and swallowing
What types of milieu modifications are required for acutely manic patients?
Room away from nurses station to provide less stimulation, individual room, no electronic access such as TV or radio in room, dim lighting
What are the 5 C's of verbal communication?
Clear, cohesive, complete, concise, and concrete
What are the symptoms of amphetamine withdrawal?
excessive sleepiness, depressed mood and mood swings, overeating, and potential for lasting psychotic symptoms
What are intentional torts?
assault, battery, intentional infliction of emotional distress, false imprisonment
What are the primary symptoms of PTSD?
What is the first action the nurse should take when a suicidal client is unable to contract for safety?
Assign a 1:1 monitor
What are non-verbal messages that display therapeutic communication?
open, relaxed body posture, eye contact, uncross arms and legs, sit at an angle to the client (45 degrees), monitor facial expressions
What are the signs of lithium toxicity and the most common cause of lithium toxicity?
Signs: nausea, vomiting, lethargy, polydipsia, tachycardia, hand tremors, confusion, vision changes, increased urination
Cause: dehydration
What are the ethical principles of nursing?
Autonomy, beneficence, justice, and non-maleficence
What are the symptoms of Bipolar Disorder?
Depression: feeling sad, hopeless, irritable most of the time, lacking energy, difficulty concentrating, loss of interest in activities, feelings of guilt & despair, self-doubt, change in appetite, can include suicidal thoughts
Mania: feelings of elation and euphoria, overjoyed, rapid & pressured speech, grandiose delusions, psychomotor agitation, hallucinations, paranoia, illogical thinking, insomnia, increased risk-taking behaviors (increased spending, reckless driving, sexual encounters), apparent and perceptible change in personality
Hypomania: increased feelings of happiness, uncontrollably excited speaking quickly, racing thoughts, increased energy, trouble concentrating, increased confidence
What is the first priority for the nurse when a psychotic client begins yelling at another RN on the unit?
Assess for the potential for harm by using a soft, pleasant voice, providing at least an arm's length between nurse-patient, request support from team members and removing the client from a stimulating environment to a calmer space
What is the most powerful form of therapeutic communication in psychiatry?
using silence
What are the educational points for the patient when starting valproate therapy and why?
contact the physician if symptoms such as anorexia, fatigue, abdominal pain, blood in the stool, or jaundice occur
because valproate can cause pancreatitis, blood-dyscrasias, and is hepatotoxic
Your patient is ordered to receive a bolus of 1,000mL NS over 6 hours. What is the drip rate if the standard tubing has a drop rate of 10gtt/mL.
6 hours*60 minutes=360 minutes
1 liter*1,000mL/L=1,000mL
(1,000mL/360minutes)*(10gtt/1mL)=2.78x10gtt=
27.8drops/minute rounded to 28 drops/minute
What are the positive and negative symptoms of schizophrenia?
Positive: hallucinations, delusions, motor agitation, alteration in speech (echolalia, clang association, neologisms), thought pattern disruptions (loose associations, tangential, derailment)
Negative: blunted affect, anhedonia, alogia, apathy, abolition, asociality
What is the Dual Process Model of Grief?
What are five examples of effective therapeutic communication?
active listening, adapting communication style, receiving constructive feedback, utilizing teach-back methods, using open-ended questions
Your patient has an order for heparin infusion to start at 18units/kg/hour. Current weight is 165lbs. Heparin infusion comes in a 500mL bag with 25,000units. Calculate the starting rate of the infusion.
Find weight in kg (165/2.2=75kg) multiply by ordered units (75*18=1350units/hour) calculate the rate of infusion by solving for X. 25,000units/500mL=1350units per hour/X mL per hour
X mL per hour= 675,000/25,000
X=27mL/hour
What are Freud's 7 defense mechanisms?
Reaction formation
Projection
Displacement
Undoing
Isolation
Sublimation
Denial