PMHNP Study from Vital Boards

Outspoken opponent of NP role Martha Rogers Treatment for AUD Naltrexone 50mg daily to prevent relapse Acamprosate resembles GABA and NMDA antagonist. Anti-craving drug used for maintenance therapy of alcohol withdrawal. Dose 2000 mg/day. Combining acamprosate and naltrexone may be more beneficial together Disulfiram- 250mg day What drug is used to prevent alcohol consumption by blocking aldehyde dehydrogenase? Naloxone (Narcan) opiate antagonist, reverses opioid induced resiratory depression Buprenorphine Suboxone- used for detoxification and part of maintenance therapy in opioid withdrawal. temporal lobe key role in long-term memory, hearing, and interpretation of visual stimuli Salvador Minuchin Structural Family Therapy: uses joining, enactment, boundary making, and mimesis techniques Carol Anderson and William McFarlane psychoeducational family therapy Robert Liberman and Lawrence Weathers behavioral family therapy Michael White & David Epston Narrative Therapy Inhibitor substance that decreases the metabolism of drugs and leads to higher levels leading to toxicity Inducer a substance that increases the rate of a specific enzyme synthesis from a lower to a higher level Cyclothymic Disorder Criteria A) For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. B) During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time. C) Criteria for a major depressive, manic, or hypomanic episode have never been met. D) The symptoms in Criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. E) The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism). F) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. negative reinforcement the reinforcement of a response by the removal, escape from, or avoidance of an unpleasant stimulus positive reinforcement Increasing behaviors by presenting positive stimuli, such as food. A positive reinforcer is any stimulus that, when presented after a response, strengthens the response. negative punishment the removal of a stimulus to decrease the probability of a behavior's recurring positive punishment The application of an undesirable stimulus to reduce specific behavior Persistent Depressive Disorder (Dysthymia) Moderate depression that persists for two years or more Clozapine the drug of choice for treatment-resistnat shizophrenia. Can cause increased weight gain and agranulocytosis rarely so must monitor the absolute neutrophil count. Also good choice for drug-induced psychosis in patients with Parkinson's Disease. Glutamyltransferase (GGT) and carbohydrate deficient transferrin (CDT) provides up to 90% of sensitivity for heavy, chronic alcohol usage Gamma-hydroxybutyric acid (GHB) W/D similiar to ETOH w/d and benzo w/d and is rare due to rapid elimination of the drug. Sx's include anxiety, insomnia, tremor, confusion, nausea, and vomiting Medicare Part B The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies. Part of brain smaller in patients with dissociative identity disorder Hippocampus and Amygdala "claims-made policy" -a liability policy that pays claims only during the period that the policy is active. A "tail coverage" covers future claims should the NP change insurers or retire. cross-sectional study A study in which a representative cross section of the population is tested or surveyed at one specific time to assess disease incidence and prevalence. Case-control study One type of epidemiological study design used to identify factors that may contribute to a medical condition by comparing a group of patients who have that condition with a group of patients who do not. randomized controlled trial An experimental study in which researchers randomly assign individuals to either an experimental or a control group and expose the experimental group to the manipulated variable of interest. cohort study A type of epidemiologic study where a group of exposed individuals (individuals who have been exposed to the potential risk factor) and a group of non-exposed individuals are followed over time to determine the incidence of disease Alcohol inhibits CYP450 leads to increase in incidence of adverse profile of CYP450-dependent drugs Viewpoint of Schizophrenia by Benedict Augustin Morel premature dementia=early onset and progressive decline Viewpoint of Schizophrenia by Ernst Kretschmer A professor of psychiatry who claimed that body build could be related to personality type. Body habits lead to developing psychiatric illness Viewpoint of Schizophrenia by Galen mental disorders originated from the brain; "remedicalization" of the brain Viewpoint of Schizophrenia by Karl Ludwig Kahlbaum categorized sx's and derived subtypes of schizophrenia: catatonia and hebetic paraphrenia Kasanin schizoaffective Emil Kraepelin German psychiatrist responsible for creating the first truly comprehensive classification system of psychological disorders Gabriel Langfeldt schizophreniform Eugene Bleuler coined the term schizophrenia Cranial Nerve 1 Olfactory (smell) Cranial Nerve II sensory, vision Cranial Nerve III Oculomotor: eyelid elevation, pupil constriction and accommodation Cranial nerve five trigeminal nerve cranial nerve six Abducens Cranial nerve seven facial nerve Cranial nerve eight Vestibulocochlear antisocial personality disorder a personality disorder in which a person exhibits a lack of conscience for wrongdoing, even toward friends and family members; may be aggressive and ruthless or a clever con artist histrionic personality disorder a personality disorder characterized by excessive emotionality and preoccupation with being the center of attention; emotional shallowness; overly dramatic behavior Oppositional Defiant Disorder a childhood disorder in which children are repeatedly argumentative and defiant, angry and irritable, and in some cases, vindictive Intermittent Explosive Disorder An impulse-control disorder involving an inability to hold back urges to express strong angry feelings and associated violent behaviors. Medicare Part A (aka Hospital Insurance or HI) Provides hospital insurance automatically @ age 65 (if FICA qualified) @ no fee but may have deductible & co-pay. Medicare Part C (Medicare Advantage) optional, premium payment required participation in part A and B required provides coverage that a Medigap Plan would provide Medicare—Part D Prescription Drug Coverage a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. Protriptyline (Vivactil) tricyclic antidepressant- used for narcolepsy to achieve wakefulness promoting effect The calculation of risk ratio requires the __________________ in the exposed and unexposed. division Nonmaleficence avoidance of harm or hurt Beneficence to do good fidelity agreement to keep promises Justice fairness; rightfulness Loading dose of valproic acid 20-30 mg/kg NP's are regulated by: the Nurse Practice Act of the state they practice. NOT regulated by the Dept of Health and Human Services Shift to the right: tolerance increase in demand. As tolerance develops, higher doses are required to achieve same affect Eclectic brief therapy of Budman and Gurman Focuses on the reason the patient seeks therapy now. Losses, developmental dyssynchronies, interpersonal conflicts, symptomatic presentations, and personality disorders. NMDA receptor antagonist Memantine (Namenda) low risk of drug interactions for geriatric patients venlafaxine Jean Piaget Four stage theory of cognitive development: 1. sensorimotor, 2. preoperational, 3. concrete operational, and 4. formal operational. He said that the two basic processes work in tandem to achieve cognitive growth-assimilation and accomodation sensorimotor stage in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities