Mental Health
How should nurses approach assessing suicide risk?
Be caring yet direct in assessing suicide risk. Determine if they have suicidal thoughts, a plan, intent, and means to carry it out. Asking about suicide will not cause someone to attempt it. Patients often feel relieved to discuss it openly.
What are some common signs of addiction?
Signs include increased tolerance requiring more of the substance, withdrawal symptoms when stopping use, neglecting responsibilities, relationship problems, using in dangerous situations, failed attempts to quit, and spending excessive time/money obtaining and using the substance.
What is the CIWA scale used for?
The CIWA (Clinical Institute Withdrawal Assessment) scale, specifically the CIWA-Ar (Revised for Alcohol), is used to assess the severity of alcohol withdrawal symptoms and guide treatment decisions. It indicates whether inpatient or outpatient treatment is warranted based on the withdrawal symptom score.
Side effects of antipsychotics
- Extrapyramidal symptoms (EPS) like tremors, muscle stiffness, restlessness (akathisia), and involuntary movements (tardive dyskinesia) - Metabolic effects like weight gain, high blood sugar, high cholesterol - Sedation and dizziness - Dry mouth, constipation, blurred vision (anticholinergic effects) - Low blood pressure and dizziness when standing - Neuroleptic malignant syndrome (fever, muscle rigidity) - rare but potentially fatal
Safety
True or False: Patients with severe mental illness like schizophrenia are now routinely hospitalized long-term in psychiatric institutions.
False. The trend has shifted towards community-based treatment and support services, with inpatient hospitalization reserved for acute crisis stabilization when necessary.
Cocaine, Methamphetamine, and amphetamines are examples of what?
Stimulants
Alcohol Withdrawal Symptoms
Symptoms of alcohol withdrawal can include anxiety, insomnia, nausea, vomiting, tremors, sweating, elevated heart rate and blood pressure, seizures, hallucinations, and in severe cases, delirium tremens. Symptoms typically begin within 6-24 hours after the last drink and can peak around 48-72 hours. The severity depends on factors like the amount and duration of alcohol use.
What is disulfiram?
Disulfiram (Antabuse) is a medication used in alcohol rehabilitation programs to help chronic alcoholic patients maintain sobriety. It works by blocking the metabolism of acetaldehyde, a metabolite of alcohol.
When interviewing a patient with anxiety, what important details should be gathered about potential triggers, symptoms, and medical history?
Gather details on the specific anxiety symptoms, their severity, duration, and potential triggers like stressful life events. Ask about any medical conditions, medications, substance use, and family history that could contribute to or mimic anxiety. Assess the impact on daily functioning.
Hallucinations, Delusions and Disorganzied Speech are examples of what?
Positive symptoms of schizophrenia
Heroin, Oxycodone, Hydrocodone, Codeine, and Morphine are examples of what?
Opiods
What does the timeline look like for alcohol withdrawal?
6-12 hours after last drink: Mild symptoms like anxiety, insomnia, nausea, and abdominal pain.
12-24 hours: Symptoms worsen with shaking, sweating, rapid heart rate, and raised blood pressure.
24-48 hours: Peak of withdrawal with risk of hallucinations, seizures, and delirium tremens (DTs).
48-72 hours: Some improvement, but DTs and seizures still possible. 4-7 days: Most physical symptoms subside, but psychological distress like anxiety and depression may persist.
1-4 weeks: Lingering insomnia, fatigue, and mood disturbances can last for weeks after acute withdrawal.
crucial to manage alcohol withdrawal safely and prevent life-threatening complications
benzodiazepines
What are some potential challenges faced by patients with severe mental illness in accessing community-based care and resources?
Potential challenges include lack of insight into their illness, medication non-adherence, homelessness or unstable housing, lack of social support, stigma, financial barriers to treatment, and limited availability of community mental health services.
What are some common symptoms seen during a manic episode?
Elevated or euphoric mood, increased energy and activity levels, racing thoughts, pressured speech, inflated self-esteem or grandiosity, decreased need for sleep, distractibility, and excessive involvement in risky behaviors.
Benzodiazepines
Life-threatening complication of alcohol withdrawal.
When alcohol is then abruptly removed, it can trigger seizures due to this neuronal hyperexcitability.
How does the treatment approach differ for bipolar mania versus bipolar depression?
For acute manic episodes, mood stabilizers like lithium or antipsychotics are typically used to control symptoms. For bipolar depression, mood stabilizers combined with antidepressants may be utilized, though antidepressants carry a risk of inducing mania.
How can nurses help patients struggling with addiction?
Nurses can provide education on addiction as a disease, screen for substance use issues, make referrals for treatment, offer non-judgmental support, teach coping strategies, encourage participation in support groups, and monitor for health complications related to substance use.
What are the key symptoms of obsessive-compulsive disorder (OCD)?
Obsessions are recurrent, intrusive thoughts, images or urges that cause significant anxiety. Compulsions are repetitive behaviors or mental acts that the person feels driven to perform to reduce the anxiety caused by the obsessions. Common obsessions involve contamination, losing control, or causing harm. Compulsions may involve cleaning, checking, counting, or repeating actions.
What can cause slurred speech, impaired coordination, drowsiness, and respiratory depression. Long-term use can lead to physical dependence and addiction
Depressants
With a classic triad of symptoms which includes confusion/disorientation, abnormal eye movements (nystagmus, lateral rectus palsy), and ataxia (uncoordinated gait). Other symptoms may include vision changes, memory issues, and coma in severe cases. What disease is this?
classic symptoms of Wernicke's encephalopathy
How is Wernicke's encephalopathy treated
Prompt treatment with intravenous thiamine is crucial to prevent permanent brain damage or death. High doses of thiamine are given, often before the diagnosis is confirmed if suspected. Other treatments include correcting nutritional deficiencies and managing any underlying conditions.
How to communicate with a patient actively hallucinating.
Communicate in a calm, reassuring manner. Avoid arguing about the reality of the hallucinations. Gently orient the patient to the present reality. Use simple, clear statements like "I don't see or hear what you're experiencing, but I know it seems very real to you." Decrease stimuli that may worsen hallucinations. Ensure safety by removing potential weapons or objects that could cause self-harm.