Stress
Social interventions for someone in a stress response
facilitation of family functioning, assitance in expanding social networks, support of family unit functioning, parent education, family therapy
This type of crisis is when you are leaving home for the first time.
What is a developmental crisis? (due to a big developmental change)
What education is needed to be given to patients taking antipsychotics?
Don't stop taking abruptly, wear sunblock, no alcohol, no OTC drugs without talking to practioners, side effects of meds: normal and NMS.
Which of these would not be a nursing intervention for a client with mania?
A. Decrease environmental stimuli whenever possible
B. Use firm yet calm, relaxed approach
C. Create highly competitive activities for the client to compete in.
D. Make only promisied you can realistically keep.
What is C. Create highly competitive activities for the client to compete in.
Rationale:
A - the client's ability to deal with stimuli is impaired
B- Your presence and manner will help comminicate your interest, expectations, and limits, as well as your self-control.
C- Creative situations can exacerbte the client's hostile feelings or reinforce low self-esteem.
D- Breaking a promise will result in the client's mistrust and is detrimental to a therapeutic relationship.
Karen is in the BHU after being arrested in the grocery store. She was placed here involuntary due to her yelling at the deli worker that they placed a microchip in her deli meat so that they could track her. After she was yelling about this she proceeded to jump the counter and start hitting the deli worker. Did this patient exhibit just aggression or were they being violent as well?
Violence - She jumped the counter and starting hitting the deli worker.
Traits of type C and D personality types?
Type C: introverted, compliant, eager to please, responds to stress with depression and hopelessness
Type D: high levels of negative emotions when stressed, pesimissim, doesn't share emotions, stress related to not having outlet to discuss it
What nursing interventions do you see yourself using for a patient with ditorted (exaggerated) grief?
Assess for suicidal or homicidal risk (SAFETY!), assess their strengths, anticipate pharmacologic interventions to help reduce emotional intensity (Benzodiazipines), and help develop a social network
How would you explain schizophrenia, including its etiology and characteristics, to a patient and their family in simple terms? What are the positive and the negative symptoms?
Schizophrenia is a syndrome in which everyone has different symptoms. It is usually diagnosed when the patient has psychosis (positive symptoms). Children of people with schizophrenia are 10x more likely, identical twins are 40x (if their twin has it); exposure to viruses in infancy can affect if someone will get it. Positive symptoms is that is added to what is considered normal (dellusions, hallucinations). Negative symptoms are things that are taken away (lack of motivation and decreased interest in relationships).
This disorder switches between recurrent phases of depression and at least one phase of hypomania.
What is Bipolar type 2 disorder?
Anger management, CBT, benzodiazipines (Lorazepam), and antipsychotics (Ziprasidone)
What is the Transactional Theory of Stress/Components of the Model?
This theory states that stress comes from an individual interacting with their environment.
Primary appraisal is when the individaul evaluates the challenge and secondary appraisal is when they figure out if they have the coping skills to cope with the challenge.
What are the stages of grief according to Elisabeth Kubler-Ross?
Stage 1: Denial
Stage 2: Anger
Stage 3: Bargaining
Stage 4: Depression
Stage 5: Acceptance
Micheal has been talking about how an ape is in his house and has been throwing fecal matter at him everytime he tries to get him out. He calls the police at least 2x a week for a 2 weeks. Eventually the police come and see nothing. After this Micheal seems to realize the police were right and no longer believes an ape is in his house. What thought disorder is this?
Brief delusion disorder (only had the delusion for 2 weeks, can only be 1 month max for it to be brief)
Pharmacological treatments for Bipolar Disorder
Lithium and anticonvulsant (Valproate/Valproic Acid, Carbamazepine, Lamotrigine), Antianxiety (Clonazepam, Lorazepam), antipsychotics (Aripiprazole)
Describe psychiatric disorders that may be associated with an increased risk of hostility and physical aggression in clients.
The ones discussed in the video were schizophrenia, bipolar, alcohol withdrawl, ADHD, and traumatic brain condition
What stage of General Adaptation Syndrome is the patient in?
They have been experiencing weight gain, feeling of emptiness and irritability, impaired memory, and is often sick.
What is Stage 3, the exhaustion phase, and allostatic load? (These are all the names.)
acknowledges awareness of the loss, is able to express feelings about the loss, verbalizes stages of the grief process and behaviors associated with each one, expresses personal satisfaction and support from spiritial practices
Which generation is Haldol (Haloperidol)? What should I look out for?
Haldol (Haloperidol) is a first generation. It is rarely given anymore. It only treats positive symptoms. It blocks dopamine. Anticholinergics are often given with Haldol to counter the high risk of side effects (benzotropine = cogentin). TD, Akathisia, and NMS are some of the side effects.
Last week Rocko, went to the store and attempted to buy the whole thing. He just could not stop buying things. This week he has locked himself in his room and has not come out. He is lethargic and has a hopeless view on life. He has admitted self harm. What's the nurses first priorty?
#1 = SAFETY
Which of these would you not want to use for a patient experiencing stage 1, triggering, of the aggression cycle?
A. start giving the same energy back
B. using a calm voice
C. offer food or drink
D. use distaction
A. start giving the same energy back
What is Allostasis and Allostatic Load?
Allostasis is the adaption to stress.
Allostatic load is the failed allostasis or adaptation which results in chronic stress.
Johnny's mom was diagnosed with terminal cancer and has 3 months to live, what grieving process could Jonny experience? What is a pro and a con of this grieveing process?
Johnny will most likely experience anticipatory grieveing. A pro of this is you are able to say what you wanted to before they die, but the con is that you could detach from the person before they die.
Which antipsychotic can cause agranulocytosis? Which generation is it and what does that mean? What happens when a patient is perscribed it?
Clozapine (Clorazine), a 2nd generation, which treats both positive and negative symptoms. When a patient is perscribed Clozapine they are put on a blood database thats monitored because it has the potential to cause agranulocytosis. Can also cause TD and NMS. 2nd generation blocks dopamine and serotonin.
Which of these statements by the patient show that they did not fully understand the lithium medication education?
A. "I should drink around 2L of water a day"
B. "I should tell my provider if I start experiencing fluid retention."
C. "I should tell my provider if I start feeling anxious, having large changes in my emotions quickly, or sleeping difficulties."
D. I should increase my consumption of salt as that can help with lithium absorption."
D.
What is D. I should increase my consumption of salt as that can help with lithium absorption,"?
Rationale: Having too much salt in the diet because of unusually salty foods or the ingestion of salt-containing antacids can reduce receptor availability for lithium and increase lithium excretion, so the lithium level will be too low.
The nurse has proceeded to deny Samantha's request to leave as she is unable to yet. Samantha has started to throw objects at the nurse and spitting on her. What stage of the aggression cycle is Samantha experiencing?
Samantha is experiencing stage 3, crisis, of the aggression cycle.
Crisis: During an emotional and physical crisis, the client loses control. S/S: Loss of emotional and physical control, throwing objects, kicking, hitting, spitting, biting, scratching, shrieking, screaming, inability to communicate clearly