Mh exam 2 - mh exam 2 PDF

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Mental Health 2459 Exam 2 –

Module 4 Topic: Cognitive Dysfunction & Substance Related Conditions Delirium, Dementia, Drug & Drug Related Disorders - Substances with intoxication & withdrawal symptoms. Module 5 Topic: Nursing Care of the Client who is Psychotic Schizophrenia, Positive & Negative Symptoms, Psychopharmacology Module 6 Topic: Healthcare Strategies for Clients with a Mood Disorder Depressive Disorders, Suicide, Pharmacology & Bipolar Disorder.

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Remember to ASSESS. You must do a physical assessment if physical complaints. Don’t forget to give them their Glasses, Hearing Aids, assistive devices before you call it a hallucination. Depression - causes, physical changes, assessment, interventions, tx, nursing diagnoses, therapeutic communication. MDD (Major depressive disorder) – FLAT affect, anergia, anhedonia, Hopeless

MDD – when a suicide risk (first few weeks of meds, give away personal objects, become energized or cheerful). Suicide assessment, tx, nursing diagnosis, treatments, levels of, most at risk, increased risk the first few weeks of medication. Keep 1:1 be vigilant on precautions. PRIORITY Nursing Interventions: 1:1, Removal harmful objects, suicide contract, decrease stimulation (agitated, not tolerating stimulation) Violence/safety - – Anger, Aggression (has intent) and Violence

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Physical Aggression – Signs/Symptoms Violent Behavior – Highest Risk Restraint & Seclusion Pg. 379- Nursing interventions for maintaining safety

Non-Pharmacologic Treatments – ECT, CBT, Milieu, Aversion Therapy, Systematic Desensitization Meds – SSRIs, TCAs, MAOIs - TCA’s – action, SE, contraindications, patient and family education, Serotonin Syndrome, Suicide Risk increases in the first few weeks. Anxiety – S/S, Assessment, Tx, interventions, planning, different levels Benzodiazepines Vs Buspirone-action, SE, pt. education Defense Mechanisms Healthy, intermediate & immature

Phobias – treatment, interventions Bipolar - assessment, interventions, treatments. Mania – assessment, tx, interventions, therapeutic communication. Treated with MOOD STABILIZERS + Lithium & Seizure Meds. High Calorie Finger Foods. Birth control with Psych Meds especially!! Some mood stabilizers null & void OCs. Need to ensure adequate BC

Lithium dose, action, SE, contraindications, patient and family education. Fluid Overload & levels go down (hemodiluted). Dehydration & levels go up (think Toxic – hemoconcentrated) Schizophrenia - Schizophrenia Disorders – assessment, interventions, nursing diagnoses, treatment. Hallucinations and delusions – types, treatment, interventions, therapeutic communication Delusions of persecution. Command hallucinations are the most dangerous. Determine the content of hallucinations. Positive & Negative symptoms Typical & Atypical Antipsychotics (Neuroleptic Medication) – 3 Reasons to STOP 1. NMS 2. Agranulocytosis (infection & WBC) 3. Dystonia (airway issue) Antipsychotics – action, contraindications, SE, Alternative for non-adherence to prescribed medication. Long Acting & IM (Atypical) Extrapyramidal Symptoms (EPS) = Give Cogentin (benztropine) Dystonia = Give Benadryl (Diphenhydramine) Substance Abuse: CAGE, Signs of Alcohol Withdrawal, Priority concerns for Alcohol Withdrawal?

Alcohol Dependence & Alcohol withdrawal (usually begins 4 to 12 hours after cessation or marked reduction of alcohol intake. It peaks between 24 and 48 hours, then resolves or progresses to delirium). Sedation allows for safe withdrawal from alcohol. Benzodiazepines are the drugs of choice in most regions because of their high therapeutic safety index and anticonvulsant properties. Need to know/ask when their last drink was.

PP Townsend 13 additionally Helpful. Withdrawal versus Overdose – Clinical Manifestations; Signs/Symptoms, treatments - Remember withdrawal versus intoxication = opposites

Dementia vs Delirium Dementia – Slow insidious onset, irreversible.

Delirium – Rapid Onset. Fix the underlying problem & it is revisable Delirium – Therapeutic Comm. Hallucinations – That must be frightening. I am here. I will stay with you 7 Stages of Dementia, Caregiver Fatigue, MMSE / Cognitive issue (Dementia fabrication to cover memory loss), Signs of, physiological changes, Medications, Memory Care – Reminiscing is good.

Vocab: Euphoria Anhedonia – Lack of Pleasure Ataxia = mimic those of being drunk, such as slurred speech, stumbling, falling, and incoordination. Dysthymia – Depression (milder form) for at least 2 years Anergia – Lack of Energy Alogia – without speech Affect or affective -any experience of feeling or emotion, ranging from suffering to elation.

Delusion Hallucination Agnosia = loss of the ability to recognize objects, faces, voices, or places Avolition – lack of motivation Akathisia – Movement Disorder with Antipsychotics. Remember video of man in constant motion. Dystonia – Arched Neck, eyes gazed upwards, difficultly speaking AIRWAY ISSUE – Remember Video EPS Extrapyramidal symptoms = Dyskinesia & Tardive Dyskinesia – Movement disorders like Akathisia, from Antipsychotics. Serotonin Syndrome – Deadly from SSRIs Parkinsonism/Pseudo- Parkinsonism Never give an Antipsychotic medication to a Parkinson’s patient. Neuroleptic Malignant Syndrome – Deadly from Antipsychotics Prodromal = EARLY or precursor Prodromal in MH is usually a decrease in function.

http://www.youtube.com/watch?v=ZwMlHkWKDwM http://www.youtube.com/watch?v=uxktavpRdzU Euphoria Anhedonia – Lack of Pleasure Ataxia = mimic those of being drunk, such as slurred speech, stumbling, falling, and incoordination. Dysthymia – Depression (milder form) for at least 2 years Anergia – Lack of Energy Alogia – without speech Affect or affective -any experience of feeling or emotion, ranging from suffering to elation. Delusion Hallucination Agnosia = loss of the ability to recognize objects, faces, voices, or places Avolition – lack of motivation Akathisia – Movement Disorder with Antipsychotics. Remember video of man in constant motion. Dystonia – Arched Neck, eyes gazed upwards, Difficultly speaking AIRWAY ISSUE – Remember Video EPS Extrapyramidal symptoms = Movement disorders caused from Antipsychotics (Tardive Dyskinesia, Akathesia, Dystonia & NMS). Neuroleptic Malignant Syndrome – Deadly from Antipsychotics Serotonin Syndrome – Deadly from SSRIs Parkinsonism/Pseudo- Parkinsonism Never give an Antipsychotic medication to a Parkinson’s patient....