Anxiety, OCD and related
The patient with a history of acute anxiety has been prescribed alprazolam. This medical history would cause the nurse to question the order.
What is a history of alcohol use disorder?
The nurse should consider this intervention as a priority for a patient with AD with memory impairment and is unable to perform ADLS.
What is assistance with toileting and bathing?
(This ensures health and safety)
This protects patients with PTSD from emotional pain.
What is psychic numbing?
Learning theorists view negative reinforcement as behavior that leads to a reduction in an aversive experience, thereby reinforcing and resulting in repetition of the behavior. Psychic numbing decreases or protects an individual from emotional pain, and therefore, the learned response is the repetition of this behavior. Psychic numbing is a state of emotional detachment that can act as a coping mechanism to protect the patient from the overwhelming pain of traumatic memories.
Anxious and seeing multiple healthcare providers simultaneously for vague symptoms would indicate this dx.
What is somatic symptom disorder?
Patients often receive care from multiple providers for vague symptoms often concurrently.
A rape victim speaks in a monotone voice, using single words. Name this response pattern.
What is a controlled response pattern?
The patient's feelings are hidden or masked.
A young child loses her mother. At a follow-up doctor appt, it is stated the young child has started to pull her hair resulting in hair loss. Name an appropriate nursing diagnosis.
What is ineffective impulse control?
This client is coping with the anxiety generated by viewing her deceased family member by pulling out her hair.
A patient has two weeks of confusion and is diagnosed with Alzheimer's. What should the nurse consider or suspect?
AD does not develop suddenly. The signs are slow and insidious.
A patient is the sole survivor of a plane crash. A nursing diagnosis to address the patient's symptoms would be this.
What is complicated grieving?
The survivor guilt is disrupting the normal process of grieving, indicating complicated grieving as the nursing diagnosis.
Presenting with multiple personalities, depersonalization, derealization, and gaps in memory would indicate this dx.
What is dissociative disorder?
This criteria would need to be present for a patient to be diagnosed with dissociative fugue.
What is sudden unexpected travel or bewildered wandering?
True or False. A patient with generalized anxiety disorder (GAD) would experience paresthesia.
False. Paresthesia could occur in panic disorder, not GAD.
A patient with GAD may also experience muscle tension, restlessness, and procrastination.
Answer: None of the neuroendocrine hormones are linked to Alzheimer's disease. AD's pathology appears to involve plaques and changes in the hippocampus that lead to cell death, consistent with memory loss.
Which goal would be most appropriate upon discharge for a patient with PTSD:
The patient would have no flashbacks,
or
The patient will not require medication to obtain adequate sleep.
What is Obtaining adequate sleep without medication?
This would be a goal by time of discharge.
Aphonia, paralysis without medical cause, and possible hallucinations would indicate this.
What is conversion disorder?
Name a primary gain associated with SSD?
What is avoiding a stressful obligation?
Primary gains involve being excused from troublesome duties, such as court, or unwanted family functions.
This term is used for the administration of certain medications that are CNS depressants to patients with alcohol withdrawal.
What is medication-assisted treatment?
Various medications have been used to decrease the intensity of symptoms in an individual who is withdrawing from, or who is experiencing the effects of excessive use of, alcohol and other drugs.
This neurotransmitter is linked to dementia.
What is acetylcholine?
ACh is the main neurotransmitter of the central nervous system. The cholinergic deficit in NCDs is thought to be implicated in certain behavioral and psychological symptoms of dementia. These include irritability, depression, aberrant motor behavior, agitation, psychosis, and sleep disorders.
This amount of time is required before a diagnosis of PTSD can be made.
This distinguishing criterion is present in somatic symptom disorder but absent in illness anxiety disorder.
What is significant physical symptoms?
Individuals experiencing somatic symptoms without plausible pathology are considered to have SSD, and those with minimal or no somatic symptoms would have IAD.
A patient with schizophrenia is experiencing hallucinations. Name the neurotransmitter responsible.
What is dopamine?
A patient with GAD reports no relief after one week of taking buspirone. What is the nursing response?
An aggressive patient with dementia has refused verbal interventions and presents as an imminent danger. What is the priority response?
What is request assistance to restrain the patient?
Research shows that these two factors are the best predictors of PTSD in Vietnam veterans.
What is 1) the severity of the stressor; and
2) the degree of psychosocial isolation in the recovery environment.
In research with VV, it is show that the severity of the stressor and the degree of psychosocial isolation in the recovery environment is a strong predictor of PTSD.
This is a goal for patients with somatic symptom disorder in regards to stress.
What is identifying potential adaptive coping strategies to deal with stress?
This is the guiding principle for prioritizing care of patients with behavioral crisis.
What is resolving the crisis using the least restrictive intervention?