Legal & Ethical Issues
The quality of doing good; can be described as charity
Beneficence
What word is considered non therapeutic but I say it is okay to say in MI?
WHY- NOT THERAPEUTIC!
This classification of medications is your first line of treatment for depression, anxiety and obsessive-compulsive disorders.
SSRI's- Selective serotonin reuptake inhibitors
The patient has intrusive thoughts of unrealistic obsessions and tries to control these thoughts with compulsive behaviors, such as repetitive cleaning of particular objects or hand washing.
OCD- Obsessive Compulsive Disorder
The patient comes to your unit with Suicidal thoughts and states "if I was left alone, I would try to hurt myself" what is the priority for this patient?
The patients right to make their own decisions.
Autonomy
What is an example of an opened ended question? Why do we use this?
Facilitates spontaneous responses and interactive discussions. Tell me what brought you in?
A patient is taking Phenelzine. What do we need to educate this patient on to avoid HTN crisis?
Foods with tyramine- ripe avocados, figs, fermented or smoked meats, liver, dried or cured fish, most cheeses, some beer and wine and protein dietary supplements.
Exposure to traumatic events causes anxiety, detachment and other manifestations about the event for at least 3 days but NOT more than 1 month following the event is called what?
Acute Stress Disorder
Patient centered care for psychotic disorders includes..
Safe, structured environment, trust, promote self care, do not argue with the patient about their delusions, ask what are the voices saying?
Fair and equal treatment for all
Justice
What is the difference between Repression and Regression?
Repression-unconsciously putting unacceptable ideas out of awareness. Regression- Using childlike behaviors.
What are some complications of Lithium? What is the therapeutic Level?
Watch for lithium toxicity. GI distress, Fine hand tremors, Polyuria, Wt gain, renal toxicity, respiratory distress, seizures, coma, death. 0.5-1.2
Name the 3 personality disorders in Cluster A.
Paranoid, Schizoid, Schizotypal
A patient comes in stating "my last drink was 15 hours ago". What is the nursing priority?
Get the patient on a detox protocol, SZ prevention, education on DT's.
Confining a patient to a specific area physically, verbally or chemically when it is not part of the patients treatment is considered what?
False imprisonment
A patient believes that their thoughts are being heard by others. This is an example of what type of alteration of thought?
Thought broadcasting
First Generation Antipsychotics have what side effects associated with them?
EPS (Psudoparkinsonism, akathisia, TD) and NMS (Sudden high fever, BP flucutations, Tachy, muscle rigidity)
Name 3 types of CNS depressants that people abuse.
Alcohol- BAC is what? 0.08%
Benzo's, hypnotics, Sedatives,
Marijuana
A patient with somatic symptom disorder insists that they need to be seen again. They are upset and yelling because they think you are not taking their symptoms seriously. What should you do?
Assess them, accept that the symptoms are real to the patient, report new s/sx to HCP, limit the amount of time allowed to discuss somatic symptoms.
The nurse can obtain this without first obtaining a provider's written order if it is a emergency situation.
Seclusion or Restraint
Give an example of Transference vs. Countertransference.
Transference- pt transfers their feelings to nurse. Counter is opposite.
Abstinence Maintenance- Disulfiram (NO ETOH), Naltrexone (EE- ETOH)
A child is admitted for recurrent patterns of negativity, disobedience and hostility. You know that these are signs and symptoms for what disorder?
Oppositional Defiant Disorder
You have a child that has been prescribed dextroamphetamine. You know that it is important to monitor what?
CNS stimulation (insomnia, restlessness), wt. loss, growth suppression, cardiovascular effects, withdrawal reaction, toxicity.