N244 Mental Health Midterm Exam

Altruism - -Dealing with anxiety by reaching out to others. Sublimation - -Dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression. Suppression - -Voluntarily denying unpleasant thoughts and feelings Repression - -Unconsciously putting unacceptable ideas, thoughts, and emotions out of awareness Displacement - -Shifting feelings related to an object, person, or situation to another less threatening object, person, or situation Reaction Formation - -Overcompensating or demonstrating the opposite behavior of what is felt Undoing - -Performing an act to make up for prior behavior Rationalization - -Creating reasonable and acceptable explanations for unacceptable behavior Denial - -Pretending the truth is not reality to manage the anxiety of acknowledging what is real Intellectualization - -Separation of the emotions of a painful event or situation from the facts involved; acknowledging the facts but not the emotions Conversion - -Responding to stress through the unconscious development of physical manifestations not caused by a physical illness Splitting - -Inability to reconcile negative and positive attributes of self or others Projection - -Attributing one's unacceptable thoughts and feelings onto another who does not have them Always Send Mail Through the Post Office - -Appearance (unkept/disheveled) Speech (pressured) Memory/Mood (labile) Thoughts (tangential, flight of ideas, circumstantial, loose association) Thoughts of self harm Perception (delusions/hallucinations) Orientation NUR244 NUR244 Maximum legal limits for seclusion and restraints - -18+: 4 hours 9-17: 2 hours 8 and younger: 1 hour Maslow's Heirarchy - -Mental Health – N244Safety/security Love and belonging Esteem Self-actualization Cognitive Behavioral Therapy - -Focuses on thoughts and behaviors to solve current problems. How thoughts and behaviors are related to each other. Good for depression, anxiety, and eating disorders. Dialetical behavior therapy - -Focusing on gradual behavioral changes and proving acceptance and validation. Good for personality disorders. Therapy for phobias - -Systematic desensitization Therapy for PTSD - -Prolonged exposure Tangential thoughts - -Going on a tangent and cannot come off of the topic (autism/ADHD) Flight of Ideas - -Nothing connects (mania) Circumstantial thoughts - -Adding extra details that do not matter (OCD) Loose association - -One point to another with a common thread (schizophrenia) Orientation phase - -Introduce Contract Set goals Explore Working phase - -Assess Evaluate Coping skills Problem solve Termination phase - -Summarize Incorporate behaviors into life Termination 2 drugs administered prior to ECT - -Etomidate (anesthetic) NUR244 NUR244 Succinylcholine (muscle relaxer) To start, how many ECT treatments per week? - -3 4 reasons for ECT - -Medication resistant MDD Suicidal/homicidal with rapid need for treatment Bipolar with rapid cycling (4+ mania per year) Catatonia (slow or fast purposeless movements) 4 aspects of ECT workup - -2 psychiatrists must agree Stop benzos the night prior Chest xray, blood work, and ECG Depression scale How long should an ECT seizure last? - -20-80 seconds During ECT - -IV placement Frequent VS EEG/EMG machines hooked up to patient BP cuff around ankle After ECT - -Headache, muscle soreness, cardiac changes, short term memory loss, possible relapse of depression. Must have a driver ECT Restrictions - -Cardiovascular complications History of CVA SIGECAPS of depression - -Sleep Interest Guilt Energy Concentration Appetite Psychomotor retardation Suicidal thoughts Diagnosis for MDD - -5/9 symptoms for 2 weeks (2 blue weeks) Dysthymic/Persistent Depression Disorder diagnosis - -Adults: 3/9 symptoms, lasting 2 years, for more than 50% of the time Children: 3/9 symptoms, lasting 1 year, for more than 50% of the time Comorbidities of Depression - -Anxiety disorders Psychotic disorders Eating disorders NUR244 NUR244 Personality disorders Risk factors for depression - -Family history Female Over 65 Neurotransmitter deficiencies External factors Anhednoia - -Lack of joy/interest Anergia - -Lack of energy Depression screening tools - -Columbia Suicide Severity Rating Scale Hamilton/Beck inventory scale First generation antidepressants - -TCA and MAOIs Second generation antidepressants - -SSRIs Third generation antidepressants - -SSNRI and SSNDRI Serotonin Syndrome symptoms - -Shits & Shivers Diarrhea Shivering Hyperreflexia Increased temperature Vital sign instability Encephalopathy (abrupt AMS)