You're Young...Then You're Geri + Meds
1) Medications used to treat Alzheimer's disease
2) Signs and symptoms of dementia
1) What is cholinesterase inhibitors (donepezil, galantamine) and NMDA antagonist (memantine)
2) What is aphasia, apraxia, agnosia, confabulation, perseveration, agraphia, hyperorality, and sundowning
1) Interview guidelines for the assessment of a client who is experiencing abuse
2) Levels of prevention of abuse
1) What is ensuring safety, indicators of violence such as history of abuse, level of anxiety, suicide/homicide potential, support system
2) What is Primary prevention= Measures taken to prevent the occurrence of abuse, identification of high risk individuals and families, health teaching
Secondary prevention= Early intervention in abusive situations, screening, treatment of injuries resulting from violent episodes, ensuring physical and psychological safety
Tertiary prevention= Counseling, support groups
Therapeutic communication techniques nurses may use to deliver compassionate and empathetic care
What is patient-centered, goal directed, active listening, clarifying techniques (restating, reflecting, exploring), offering self, offering general leads, making observations, validating feelings
1) Cognitive distortions that may be observed in the context of schizophrenia
2)Nursing interventions for a patient experiencing severe anxiety
1) What is thought blocking, thought deletion, magical thinking, paranoia...
2) What is not leaving the client alone, administer a benzodiazepine, remain calm, give clear short directions
1) Interventions for each level of crisis care/intervention
2) Most restrictive interventions to manage aggressive behavior
1) What is Primary care (education, lifestyle changes, identify coping mechanisms)
Secondary care (intervention during acute crisis, crisis hotlines, warm lines)
Tertiary care (Long term support, therapy, outpatient clinics...)
2) What is chemical restraints, physical restraints, and seclusion
Signs and symptoms specific to autism spectrum disorder
What is deficits in social relatedness including communication, nonverbal behavior, and interactions---
Regression in milestones
Difficulty or differences in developing and maintaining relationships---awkwardness, lack of eye contact, does not reciprocate or initiate socially or emotionally
Repetitive speech
Repetitive motor activity- ex: lining up toys
Fixed interest or focus on specific objects
Sensitivity or hyporeactivity to sensory input
Resistant to change
Role of the nurse caring for sexual assault survivors
What is providing for client safety, obtaining informed consent, treat injuries, therapeutic communication, assess for suicidal ideation, anticipate prophylactic treatment of STI/pregnancy, facilitate the presence of support system, initiate referrals.
Remain empathetic, objective, and nonjudgemental.
Transference vs Countertransference
What is the patient unconsciously and inappropriately displacing onto the nurse feelings and behaviors related to significant figures in the patient’s past
vs
the nurse unconsciously displacing feelings related to significant figures in the nurse’s past onto the patient
1) Major side effects associated with antipsychotic medications
2) Treatment for Depressive Disorders
1) What is Neuroleptic malignant syndrome, Anticholinergic toxicity, EPS (Pseudo-parkinsonism, acute dystonia, akathisia, tardive dyskinesia), Metabolic syndrome, agranulocytosis, dysrhythmias, liver impairment
2) What is Antidperessants (SSRI, SNRI, MAOI, TCA, atypical), Therapy, Electroconvulsive therapy, Deep brain stimulation, Repetitive transcranial magnetic stimulation, Vagus nerve stimulation
1) Anger vs Aggression vs Violence
2) Interventions to manage aggressive and/or violent behaviors
1) What is a normal emotional response vs an action/behavior that results in an attack vs goal directed intentional harming of a person or object
2) What is respectful, calm, firm tone, respond quickly, address client concerns, provide space, nonaggressive stance, describe options and offer choices, trauma informed care
Stages and types of grief
What is DABDA (Denial, Anger, Bargaining, Depression, Acceptance) ***Be able to describe client presentation in each stage
Types of grief include normal grief where client achieves some acceptance by 6 months,
anticipatory grief is letting go of a person or object before the actual loss happens,
disenfranchised grief is experienced loss that cannot be publicly shared or is not socially accepted,
prolonged grief is being stuck in denial phase and unable to accept the reality of loss;Unable to perform ADL’s
1) Types of Violence
2) The cycle of violence phases
1) What is physical violence, sexual violence, emotional violence, neglect, and economic abuse
2) What is Tension building phase= Anger builds, verbal abuse and mild physical violence
Acute battering phase= Serious abuse occurs, the most violent stage
Honeymoon phase= Situation diffuses, abuser becomes "loving," apologetic, and promises to change
Characteristics of a therapeutic nurse-client relationship
What is patient-centered, establishing and maintaining clear boundaries, the needs of the patient and not the nurse being met, 4 phases (pre-orientation, orientation, working, and termination)
1) Applicable interventions for a patient experiencing alcohol withdrawal symptoms
2) Interventions for a client with an eating disorder
1) What is ensuring hemodynamic stability, seizure precautions, monitor for DT's, CIWA tool, Medications (diazepam, chlordiazepoxide, clonidine)
2) What is a structured eating schedule, lock out post meals, established meal plan by a dietitian, building rapport, positive approach, reward system
1) Signs and symptoms of PTSD
2) ODD vs Conduct Disorder vs Intermittent Explosive Disorder
1) What is sleep disturbances, hyperarousal, hypervigilance, HI, SI, aggression, mental fatigue
2) What is continuing pattern of defiance against authority, disobedience, and hostility vs behavior that violates the rights of other and rules or norms of society vs pattern of aggressive overreaction to normal events followed by feelings of shame and regret
Delirium vs Dementia
What is..
Delirium is medical emergency that requires immediate attention to prevent serious or irreversible damage.
It occurs suddenly and is characterized by reduced consciousness, impaired cognition, altered speech, visual or auditory hallucination and is accompanied by physical illness or drug toxicity. The patient’s hemodynamic stability fluctuates.
vs
Dementia is a progressive deterioration of cognitive functioning and global impairment of intellect with no change in consciousness.
It has an insidious onset during which the patient is conscious but is disoriented with impaired cognition. The patient is hemodynamically stable and is not affected by a physical illness or drug toxicity.
Assessment guidelines for sexual dysfunction, paraphilic, and gender dysphoria disorders
What is providing privacy, mitigate bias and judgment, relaxed posture, professional tone of voice, appropriate eye contact, consider cultural and religious factors, assess for suicidal ideations
Non-therapeutic communication techniques nurses should refrain from using
What is giving advice, minimizing feelings, giving false reassurance, asking why questions, making value judgments...
1) Nursing interventions to manage a client experiencing mania
2) Management of a suicidal patient
1) What is low stimulation environment, finger foods and hydration, firm calm voice, setting clear limits, redirection
2) What is 1:1 observation, check for cheeking, no suicide contract, remove and monitor harmful objects, establish therapeutic nurse client relationship, medications, therapy
1) Types of crisis
2) Phases of a crisis
1) What is situational (Loss or change experienced in everyday life events)
Maturational (Achieving a new developmental stage requiring the use of coping mechanisms)
Adventitious (Elevated above situational--Natural disasters, one on one violence such as murder, rape, war, terrorism
2) Phase 1=escalating anxiety
Phase 2=Coping mechanisms fail, anxiety continues to escalate, trial and error attempts to resolve anxiety
Phase 3= Trial and error attempts fail, severe or panic level anxiety, fight or flight and withdrawal behaviors
Phase 4= Client experiences overwhelming anxiety leading to feelings of powerlessness and anguish, disassociative symptoms present, suicidal and/or homicidal
Nursing interventions in the management of a client with a dementia disorder
What is maintaining client safety, medication reconciliation,
orient the person (who you are, what is happening, where they are. Note: Advanced stage of confusion unable to orient)
use distraction to manage aggressive or escalating behaviors, keep room well lit,
give one simple direction at a time, make eye contact, use a calm voice, maintain consistent routine
engage client in activities and encourage interaction with peers,
Support for clients family members/support system, remember dignity and respect
Nursing care of a client with a paraphilic disorder
What is maintaining safety of self and others, assess for suicidal ideations, health teaching and promotion, focus on improving interpersonal relationships, anticipate initiation of therapy and possibly medications
Prominent modalities of psychotherapy
What is cognitive behavioral therapy, dialectical behavioral therapy, interpersonal therapy, classical psychoanaysis, operant conditioning, exposure therapy, group therapy...
1) Characteristics of cluster A, B, and C personality disorders. Place all 10 personality disorders in the correct cluster.
2) Medications used to manage bipolar disorder
1) What is Odd, eccentric, bizarre (cluster A= paranoid, schizoid, schizotypal)
Dramatic, emotional, and erratic (cluster B= antisocial, borderline, histrionic, narcissistic)
Anxious, fearful, insecure, inadequate (cluster C= avoidant, dependent, obsessive-compulsive)
****Be familiar with the characteristics of the 10 personality disorders.
2) What is lithium, antipsychotics, and anticonvulsants
Legal rights of patients and the duty of providers
What is patients having the right to treatment, right to informed consent, right to refuse treatment, right to confidentiality.
Providers have the duty to warn and the duty to report.