MH 1
help to build trust between the clinician and the client
most often used when their is a risk of suicide or self harm
What is a 72 hour hold used for?
Provide immediate support/evaluation for individuals in mental health crisis
danger to themselves or others, gravely disabled
A client is recently prescribed an SSRI for the treatment of depression, what teaching would you provide for the client?
Blocks the reuptake of serotonin into the nerve cell which allows for an increase in the amount of serotonin. take 4-6 weeks to work, take as prescribed, don't stop abruptly
Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline
Your caring for a client being discharged from a treatment center for substance abuse. What strategies will be most helpful in preventing a relapse?
Teaching client coping strategies, educating client on expected changes or signs and symptoms they may experience as their body withdraws from the substance, discussing or rehearsing different situations the client might encounter, identifying support system or group
An accelerated speech with abrupt changes of topics
flight of ideas
What is triangulation?
dysfunctional communication patter where two people are experiencing a conflict and a third is pulled into the conflict
A client is scheduled to under go ECT treatment for MDD. What client education would you provide?
electrical stimulation induces seizures, treatment last for several weeks, s/s following procedure confusion, drowsiness, headache, memory loss is common,
What are some ways a nurse can demonstrate therapeutic communication?
empathy, active listening, open-ended questions, re-stating/rephrasing, seek clarification
Provide an example of a somatic delusion.
fixed belief about one's body or bodily function (foreign body inside, belief they are infected with worms)
How might a client with a narcissistic personality disorder present?
grandiosity, lack of empathy, entitlement
What interventions should you provide for a client experiencing an episode of mania?
maintain safety, decrease stimulation, assess for suicidal thought, medication management
What is a therapeutic milieu and how does it benefit a client?
Structured environment used to support mental health and recovery. Holistic approach that addresses all aspects related to the client's experience.
Identify 5 positive and 5 negative symptoms of Schizophrenia
Positive-hallucination, delusion, disorganized thinking and speech, abnormal motor behavior
Negative- Anhedonia (inability to experience pleasure), alogia (poverty of speech), blunt affect, avolition (lack of motivation), asociality
What are some teaching points for a client being discharged following hospitalization for anorexia?
continue prescribed medication or supplements, small frequent meals, avoid frequently weighting, avoid stress, follow prescribed exercise regimen, keep food diary, sit down for meals
What treatments should you anticipate being ordered for a client diagnosed with a Somatic Symptom Disorder?
CBT, psychotherapy, antidepressants
How might a client who is demonstrating behaviors of grandiosity present?
exaggerated belief in own ability
A client is newly prescribed Lithium to treat his Bipolar disorder? What education should you provide the client?
Side effects (nausea, diarrhea, increased thirst, weight gain, brain fog), therapeutic levels need to be monitored, don't stop abruptly
In what instances would seclusion be indicated for a client?
client is demonstrating violent or self-destructive behavior that jeopardized the safety of others or themselves
A client tragically lost his wife 2 days ago has developed a sudden inability to walk. You suspect what type of disorder?
Conversion Disorder
What laboratory value should you monitor for a client taking clozapine?
CBC and WBC can cause neutropenia and agranulocytosis, blood levels
You are caring for a client who is victim of domestic abuse who is preparing to leave their significant other. What items might you instruct a client to attempt gather?
important documents such as birth certificates, social security cards, identification
Hallucination sensory perception (hearing, seeing, tasting) delusion - false belief that something is true
SIGECAPS is a mnemonic used to identify commonly seen signs for what illness?
Major depressive disorder
(sleep, interests, guilt, changes energy, changes concentration, changes appetite, psychomotor disturbances, suicidal ideation)
You are caring for a client with borderline personality disorder what safety considerations should you prioritize?
high risk for suicide, self-injury
What factors increase the likelihood of an individual developing an addiction?
Family hx substance abuse, use of substance to cope with stress, positive attitude toward alcohol or drug use, socioeconomic factors, chronic pain
What are the 5 constructs that can help ensure that culturally competent can is provided for a client?
Cultural awareness, cultural knowledge, cultural encounters, cultural skill, cultural desire
What are risk factors for intimate partner violence (IPV)? What are the types of IPV?
age, substance abuse, depression, low education, isolation
Physical, sexual, emotional
What is the purpose of support groups such as AA?
provide community of individuals with shared experiences, mutual understanding, safe non-judgmental environment
Why are anticonvulsants used in the treatment of bipolar disorder? What are some examples that you may see?
help stabilize mood swings-make nerve cells in brain less excitable
Valproate (Depakote), Carbamazepine (Tegretol), Lamotrigine (Lamictal)
What physical signs might you expect to find in a client recently diagnosed with Bulimia nervosa?
dental decay, loss of tooth enamel, electrolyte imbalance, sore throat, weight loss, fixation on weight, amenorrhea, fainting, low self esteem, specific eating habits or rituals
What interventions should a nurse consider when planning care for a child with autism?
create supportive environment, environment of acceptance, diversionary activities, clear communication, flexibility and patience, structured enviornment
Loss or change of job, divorce, physical illness, change in financial status are all examples of what type of crisis.
Situational
Haloperidol is commonly used to treat what condition___________? What side effects would a nurse monitor for?
Schizophrenia
Dizziness, orthostatic hypotension, sleepiness, dry mouth, tremors
What is neuroleptic malignant syndrome? Why does it occur? Signs and symptoms
life-threatening reaction that occurs in response to antipsychotic or medication that decrease dopamine
symptoms-fever, confusion, rigid muscles, BP changes, hyperpyrexia, tachycardia, sweating
1st and 2nd generation antipsychotics haloperidol, chlorpromazine, risperidone, olanzapine, aripiprazole, ziprasidone, and quetiapine.
A client is visiting a crisis clinic following the death of his son, the client is distraught and is having difficulty coping. What is the purpose of crisis intervention and how long does it typically last?