Exam 3 Review– Mental Health PDF

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Psychiatric disorders and medications as well as treatment plans ...

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Exam 3 Review Bitches – Mental Health Modules 7, 8, and 9 Chapter 12: Somatoform Disorder  Somatoform Disorders: we need to know highest priori-ty int. & secondary gains o Are characterized by the presence of one or more physical symptoms accompanied by: abnormal thoughts, feelings, and behavioral reactions in response to these symptoms.  Somatization may be used for secondary gains such as attention and decreased responsibilities. o These types of patients often undergo unnecessary surgeries such as invasive diagnostic procedures, and drug trials. WHICH IS LIFE THREATENING! o Table 12-3 – S/S with Nursing Diagnosis  s/s: Alterations in consciousness, memory, or identity  ND: Ineffective coping o Table 12-4 Interventions:  ENSURE PT SAFETY!  Rationale: Sense of bewilderment may lead to inattention to safety needs  Provide non-demanding simple routine  Reduces Anxiety  Confirm identity of patient and orientation to time and place  Supports reality and promotes ego integrity  Hypochondriasis- we need to know S/S o People with this disease are preoccupied with having or developing a serious illness  May or may not present with somatic symptoms, if they do typically they are mild.  Somatic symptom disorder- extreme anxiety about physical symptoms such as pain. THEY ARE NOT FAKING SYMPTOMS!  High level of anxiety and alarm about their health lasting at least 6 months

 May excessively check for problems or even avoid medical care o s/s: pain, gastric or intestinal distress, palpitations, dizziness, shortness of breath, sexual dysfunction, neurological symptoms, fatigue. o Nursing interventions:  Assess for any objective data  Show concern but avoid fostering dependency  Conversion Disorder: we need to define and know nursing int. o This disorder presents with one or more symptoms of impaired motor or sensory function. These findings don’t correlate with any neurological conditions and are not better explained by another mental or medical disorder.  Most common s/s: blindness, deafness, paralysis, inability to talk.  Symptoms are beyond conscious control and are related directly to conflict  Assessment for patients with conversion disorder:  Rule out physiological causes for symptoms or symptoms/ deficits o Physical limitations or disabilities, feelings of guilt, or frustration  SECONDARY GAIN IS ATTENTION, DECREASE IN WORK LOAD, DECREASED RESPONSIBILITIES.  Nursing interventions:  Encourage independence in ADL’s  Dissociative Disorders: o This is a disturbance in the wellbeing of your consciousness, memory, identity, and perception o It is a defense mechanism to protect the individual against:  Overwhelming anxiety r/t past trauma  Ranges from minor to severe presentation o These patients are not delusional or hallucinating; they have intact reality testing.  Dissociative Fugue:

 This patient relocates and assumes a new identity while not recalling the previous identity or places previously inhabited. o Commonly consist w/ PTSD, schizophrenia, anxiety disorder, bipolar disorder.  Body Dysmorphic Disorder: we need to know care plan and highest priority o This is an impairing disorder that causes distressing delusions. These patients have a preoccupation with an imagined defective body part  Patient with this typically have a normal appearance and the average age is typically 20 or younger. o Highest priority is pt safety because they are high risk of suicide o Care plan???

Chapter 13: Personality Disorders  Personality disorders- we need to be able to describe o Pt’s with this have personality traits that are exaggerated! They are difficult to be around. They don’t see their behavior as wrong. You are the issue, they are not. o Nursing Intervention: SET LIMITS! Never positive or negative, no leadership!!! Neutral colors to never over stimulate.  Borderline Personality- characteristic & Nursing Int. o They are unstable, they have mood changes, challenging everything, lots of self-mutilation, high suicidal ideation, but they don’t typically follow through with suicide. o Nursing Interventions: Set limits, be very consistent, and avoid staff splitting!  AVOID POWER STRUGGLE!

 Power struggle is when you are fighting for control of the situation  Dependent Personality- describe o They believe they incapable of surviving when left alone  Histrionic Personality- nursing interventions o These patients are VERY manipulative! They have dramatic and charming behavior, attention seeking. Relationships are superficial and shallow! o Nursing Interventions: Set clear limits! Avoid power struggle, avoid engaging in a discussion that may escalate.  Typically, Hispanic patients  Antisocial Personality- describe o Manipulative, dramatic, revenge, they harm others with no remorse for what they do.  SERIAL KILLERS Chapter 14: Eating Disorders  Anorexia- S/S, Assessment, and Milieu Management o S/S: See themselves as fat all the time but are skinny, Use laxatives or diuretics to lose weight, may purge food.  Anorexia a control issue  WORRY ABOUT REFEEDING SYNDROMEClinical manifestations o Refeeding syndrome is when you’re trying to replace depleted electrolytes and then system cannot compensate. o May cause cardiac muscle to have a hard time functioning. o Assessment...