MIDTERM IISTUDY IIGUIDE
NURS II6550 IIAcute IICare IIStudy IIGuide IIfor IImidterm
Psychosocial
* IIGeneralized IIanxiety IIdisorder IIdiagnosis IIcriteria
➢ Excessive IIanxiety IIand IIworry IIoccurring IImore IIdays IIthan IInot IIfor II6 IImonths
➢ Difficulty IIcontrolling IIworry
➢ 3 IIor IImore IIof IIthe IIfollowing: IIrestlessness, IIfeeling IIkeyed IIup IIor IIon IIedge; IIeasily IIfatigued;
IIdifficulty IIconcentrating IIor IImind IIgoing IIblank; IIirritability; IImuscle IItension; IIsleep
IIdisturbances
➢ significant IIdistress IIor IIimpairment IIon IIsocial, IIoccupational, IIor IIother IIimportant IIareas
➢ symptoms IInot IIattributed IIto IIanother IImedical IIcondition IIor IIsubstance IIabuse
➢ symptoms IInot IIexplained IIby IIanother IImedical IIdisorder
* IITreatment IIof IIacute IIpanic IIattacks
• physical IIactivity
• selective IIserotonin IIreuptake IIinhibitors IIare IIfirst IIline IItherapy
• continue IImedication IIfor II12 IImonths IIafter IIsymptoms IIimprove IIprior IIto IItapering
• antidepressants IIand IIbenzodiazepines IImay IIspeed IIrecovery IIfrom IIanxiety-related
IIsymptoms IIbut IIdo IInot IIimprove IIlong IIterm IIoutcomes. IIBenzodiazepines IIare IIassociated
IIwith IItolerance IIand IIshould IIonly IIbe IIused IIshort IIterm
• psychotherapy IIcan IIbe IIas IIeffective IIfor IIGAD IIand IIPD; IIcognitive IIbehavior IItherapy IIhas
IIthe IIbest IIlevel IIof IIevidence
• tailored IIoptions IIto IIindividuals IIhave IIthe IIbest IIoutcomes IIand IImay IIinclude IIa IIcombination
IIof IItherapies
* IIInpatient IItreatment IIof IIdepression
➢ reasons IIfor IIinpatient: IIsuicidal IIbehavior; IIrefusal IIto IIeat; IIsevere IImalnutrition; IIcatatonia;
IIpresence IIof IIgeneral IImedical IIor IIcomorbid IIpsychiatric IIconditions IIthat IImake IIoutpatient
IItreatment IIunsafe IIor IIineffective II(Depression IIMgnt IIGuidelines IIAC IIfolder)
* IIWhen IIis IIserotonin IInorepinephrine IIreuptake IIinhibitor IIindicated
➢ most IIoften IIprescribed IIfor IIanxiety/sleep IIdisorders
➢ influence IIon IIthalamus IIand IIprefrontal IIareas IIof IIthe IIcortex
➢ fibromyalgia
➢ when IISSRIs IIdon’t IIwork
➢ side IIeffects IIare IIworse
NURS II6550 IIMidterm IIStudy IIGuide II 1
,* IIVenlafaxine IIdosing
➢ generalized IIanxiety IIdisorder/major IIdepressive IIdisorder: II75-225mg IIqd
➢ social IIanxiety IIdisorder: II75mg IIqd
* IIEndogenous IIdepression IIpathophysiology
➢ type IIof IIMDD
➢ biological IIor IIgenetic IIpredisposition
* IIDifferences IIbetween IIpanic IIattacks IIand IIpanic IIdisorder
➢ panic IIattack: IIsudden, IIintense IIfear IIor IIanxiety IImay IIfeel IIshortness IIof IIbreath IIor IIdizzy IIor
IImay IImake IIyour IIheart IIpound. IIFeeling IIthey IIare IIhaving IIa IIheart IIattack. IILasts II5-20
IIminutes. II
➢ panic IIdisorder: IIwhen IIthe IIpanic IIattacks IIoccur IIoften
* IIDepressive IIdisorder IIsymptoms
➢ persistent IIsad, IIanxious, IIor IIempty IImood
➢ feelings IIof IIhopelessness, IIor IIpessimism
➢ irritability
➢ feelings IIof IIguilt, IIworthlessness, IIor IIhelplessness
➢ loss IIof IIinterest IIor IIpleasure IIin IIhobbies IIand IIactivities
➢ decreased IIenergy IIor IIfatigue
➢ moving IIor IItalking IImore IIslowly
➢ feeling IIrestless IIor IIhaving IItrouble IIsitting IIstill
➢ difficulty IIconcentrating, IIremembering, IIor IImaking IIdecisions
➢ difficulty IIsleeping, IIearly-morning IIawakening, IIor IIoversleeping
➢ appetite IIand IIor IIweight IIchanges
➢ thoughts IIof IIdeath IIor IIsuicide, IIor IIsuicide IIattempts
➢ aches IIor IIpains, IIheadaches, IIcramps, IIor IIdigestive IIproblems IIwithout IIa IIclear IIphysical
IIcause IIand/or IIthat IIdo IInot IIease IIeven IIwith IItreatment
* IIPrimary IIneurotransmitter IIin IIPTSD
➢ catecholamines
➢ serotonin
* IIPTSD IIdiagnosis IIand IItreatment
➢ history IIof IIexposure IIto IIperceived IIor IIactual IIlife-threatening IIevent, IIserious IIinjury, IIor
IIsexual IIviolence
➢ comorbidity IIdepression IIor IIpanic IIdisorder
➢ comorbidity IIalcohol IIand IIsubstance IIabuse
➢ treatment: IIpsychotherapy IIand IISSRIs
NURS II6550 IIMidterm IIStudy IIGuide II 2
, * IILithium IIside IIeffects
➢ coma, IIseizures, IIventricular IIarrhythmias, IIsevere IIbradycardia, IIsyncope, IIBrugada
IIsyndrome, IIgoiter, IIhypothyroidism, IIhyperparathyroidism, IIpseudotumor IIcerebri,
IIRaynaud IIphenomenon. IIDiabetes IIinsipidus, IItremor, IIpolyuria, IIpolydipsia, IIweight IIgain,
IIdiarrhea, IIvomiting, IIdrowsiness, IIcognitive IIimpairment, IIimpaired IIcoordination, IImuscle
IIweakness, IIanorexia, IInausea, IIblurred IIvision, IIxerostomia II(dry IImouth), IIfatigue,
IIreversible IIleukocytosis, IIacne, IIedema
* IICommon IIadverse IIeffects IIof IIatypical IIantipsychotics
➢ dry IImouth, IIdizziness, IIlightheadedness, IIweight IIgain, IIsleep IIproblems, IIextreme IItiredness
IIand IIweakness
* IIMental IIstatus IIchanges IIrelated IIto IIUTI IIin IIelderly
➢ confusion
* IIDelirium IIin IIgeriatric IIpatients
➢ rapid IIonset IIand IIfluctuating IIcourse
➢ coexists IIwith IIdementia IIfrequently
➢ primary IIdeficit IIis IIin IIattention
➢ may IIbe IIhypoactive IIor IIhyperactive
➢ review IIof IImedications II
➢ meds IIthat IIincrease IIdelirium: IIsedatives/hypnotics, IIanticholinergics, IIopioids,
IIbenzodiazepines, IIand IIH1 and IIH2 antihistamines II
II II
* IIShort IIConfusion IIAssessment IIMethod II(Short IICAM)
➢ algorithm IIfor IIdelirium IIassessment
* IITypes IIof IIdementia II(Lewy IIbody, IIvascular, IIAlzheimer’s, IIParkinson’s)
➢ Lewy IIbody: IIhistologically IIindistinguishable IIfrom IIParkinson’s, IIalpha-synuclein-
containing IILewy IIbodies IIoccur IIin IIthe IIbrainstem, IImidbrain, IIolfactory IIbulb, IIand
IIneocortex. IIAlzheimer IIpathology IImay IIcoexist
o Cognitive IIdysfunction IIwith IIprominent IIvisuospatial IIand IIexecutive IIdeficits II
o Psychiatric IIdisturbances, IIwith IIanxiety, IIvisual IIhallucinations IIand IIfluctuating
IIdelirium
o Parkinsonian IImotor IIdeficits IIwith IIor IIafter IIother IIfeatures
o Cholinesterase IIinhibitors IIlessen IIdelirium; IIpoor IItolerance IIof IIneuroleptics IIand
IIdopaminergics
➢ Vascular: IImultifocal IIischemic IIchange
o Stepwise IIor IIprogressive IIaccumulation IIof IIcognitive IIdeficits IIin IIassociation IIwith
IIrepeated IIstrokes
NURS II6550 IIMidterm IIStudy IIGuide II 3
NURS II6550 IIAcute IICare IIStudy IIGuide IIfor IImidterm
Psychosocial
* IIGeneralized IIanxiety IIdisorder IIdiagnosis IIcriteria
➢ Excessive IIanxiety IIand IIworry IIoccurring IImore IIdays IIthan IInot IIfor II6 IImonths
➢ Difficulty IIcontrolling IIworry
➢ 3 IIor IImore IIof IIthe IIfollowing: IIrestlessness, IIfeeling IIkeyed IIup IIor IIon IIedge; IIeasily IIfatigued;
IIdifficulty IIconcentrating IIor IImind IIgoing IIblank; IIirritability; IImuscle IItension; IIsleep
IIdisturbances
➢ significant IIdistress IIor IIimpairment IIon IIsocial, IIoccupational, IIor IIother IIimportant IIareas
➢ symptoms IInot IIattributed IIto IIanother IImedical IIcondition IIor IIsubstance IIabuse
➢ symptoms IInot IIexplained IIby IIanother IImedical IIdisorder
* IITreatment IIof IIacute IIpanic IIattacks
• physical IIactivity
• selective IIserotonin IIreuptake IIinhibitors IIare IIfirst IIline IItherapy
• continue IImedication IIfor II12 IImonths IIafter IIsymptoms IIimprove IIprior IIto IItapering
• antidepressants IIand IIbenzodiazepines IImay IIspeed IIrecovery IIfrom IIanxiety-related
IIsymptoms IIbut IIdo IInot IIimprove IIlong IIterm IIoutcomes. IIBenzodiazepines IIare IIassociated
IIwith IItolerance IIand IIshould IIonly IIbe IIused IIshort IIterm
• psychotherapy IIcan IIbe IIas IIeffective IIfor IIGAD IIand IIPD; IIcognitive IIbehavior IItherapy IIhas
IIthe IIbest IIlevel IIof IIevidence
• tailored IIoptions IIto IIindividuals IIhave IIthe IIbest IIoutcomes IIand IImay IIinclude IIa IIcombination
IIof IItherapies
* IIInpatient IItreatment IIof IIdepression
➢ reasons IIfor IIinpatient: IIsuicidal IIbehavior; IIrefusal IIto IIeat; IIsevere IImalnutrition; IIcatatonia;
IIpresence IIof IIgeneral IImedical IIor IIcomorbid IIpsychiatric IIconditions IIthat IImake IIoutpatient
IItreatment IIunsafe IIor IIineffective II(Depression IIMgnt IIGuidelines IIAC IIfolder)
* IIWhen IIis IIserotonin IInorepinephrine IIreuptake IIinhibitor IIindicated
➢ most IIoften IIprescribed IIfor IIanxiety/sleep IIdisorders
➢ influence IIon IIthalamus IIand IIprefrontal IIareas IIof IIthe IIcortex
➢ fibromyalgia
➢ when IISSRIs IIdon’t IIwork
➢ side IIeffects IIare IIworse
NURS II6550 IIMidterm IIStudy IIGuide II 1
,* IIVenlafaxine IIdosing
➢ generalized IIanxiety IIdisorder/major IIdepressive IIdisorder: II75-225mg IIqd
➢ social IIanxiety IIdisorder: II75mg IIqd
* IIEndogenous IIdepression IIpathophysiology
➢ type IIof IIMDD
➢ biological IIor IIgenetic IIpredisposition
* IIDifferences IIbetween IIpanic IIattacks IIand IIpanic IIdisorder
➢ panic IIattack: IIsudden, IIintense IIfear IIor IIanxiety IImay IIfeel IIshortness IIof IIbreath IIor IIdizzy IIor
IImay IImake IIyour IIheart IIpound. IIFeeling IIthey IIare IIhaving IIa IIheart IIattack. IILasts II5-20
IIminutes. II
➢ panic IIdisorder: IIwhen IIthe IIpanic IIattacks IIoccur IIoften
* IIDepressive IIdisorder IIsymptoms
➢ persistent IIsad, IIanxious, IIor IIempty IImood
➢ feelings IIof IIhopelessness, IIor IIpessimism
➢ irritability
➢ feelings IIof IIguilt, IIworthlessness, IIor IIhelplessness
➢ loss IIof IIinterest IIor IIpleasure IIin IIhobbies IIand IIactivities
➢ decreased IIenergy IIor IIfatigue
➢ moving IIor IItalking IImore IIslowly
➢ feeling IIrestless IIor IIhaving IItrouble IIsitting IIstill
➢ difficulty IIconcentrating, IIremembering, IIor IImaking IIdecisions
➢ difficulty IIsleeping, IIearly-morning IIawakening, IIor IIoversleeping
➢ appetite IIand IIor IIweight IIchanges
➢ thoughts IIof IIdeath IIor IIsuicide, IIor IIsuicide IIattempts
➢ aches IIor IIpains, IIheadaches, IIcramps, IIor IIdigestive IIproblems IIwithout IIa IIclear IIphysical
IIcause IIand/or IIthat IIdo IInot IIease IIeven IIwith IItreatment
* IIPrimary IIneurotransmitter IIin IIPTSD
➢ catecholamines
➢ serotonin
* IIPTSD IIdiagnosis IIand IItreatment
➢ history IIof IIexposure IIto IIperceived IIor IIactual IIlife-threatening IIevent, IIserious IIinjury, IIor
IIsexual IIviolence
➢ comorbidity IIdepression IIor IIpanic IIdisorder
➢ comorbidity IIalcohol IIand IIsubstance IIabuse
➢ treatment: IIpsychotherapy IIand IISSRIs
NURS II6550 IIMidterm IIStudy IIGuide II 2
, * IILithium IIside IIeffects
➢ coma, IIseizures, IIventricular IIarrhythmias, IIsevere IIbradycardia, IIsyncope, IIBrugada
IIsyndrome, IIgoiter, IIhypothyroidism, IIhyperparathyroidism, IIpseudotumor IIcerebri,
IIRaynaud IIphenomenon. IIDiabetes IIinsipidus, IItremor, IIpolyuria, IIpolydipsia, IIweight IIgain,
IIdiarrhea, IIvomiting, IIdrowsiness, IIcognitive IIimpairment, IIimpaired IIcoordination, IImuscle
IIweakness, IIanorexia, IInausea, IIblurred IIvision, IIxerostomia II(dry IImouth), IIfatigue,
IIreversible IIleukocytosis, IIacne, IIedema
* IICommon IIadverse IIeffects IIof IIatypical IIantipsychotics
➢ dry IImouth, IIdizziness, IIlightheadedness, IIweight IIgain, IIsleep IIproblems, IIextreme IItiredness
IIand IIweakness
* IIMental IIstatus IIchanges IIrelated IIto IIUTI IIin IIelderly
➢ confusion
* IIDelirium IIin IIgeriatric IIpatients
➢ rapid IIonset IIand IIfluctuating IIcourse
➢ coexists IIwith IIdementia IIfrequently
➢ primary IIdeficit IIis IIin IIattention
➢ may IIbe IIhypoactive IIor IIhyperactive
➢ review IIof IImedications II
➢ meds IIthat IIincrease IIdelirium: IIsedatives/hypnotics, IIanticholinergics, IIopioids,
IIbenzodiazepines, IIand IIH1 and IIH2 antihistamines II
II II
* IIShort IIConfusion IIAssessment IIMethod II(Short IICAM)
➢ algorithm IIfor IIdelirium IIassessment
* IITypes IIof IIdementia II(Lewy IIbody, IIvascular, IIAlzheimer’s, IIParkinson’s)
➢ Lewy IIbody: IIhistologically IIindistinguishable IIfrom IIParkinson’s, IIalpha-synuclein-
containing IILewy IIbodies IIoccur IIin IIthe IIbrainstem, IImidbrain, IIolfactory IIbulb, IIand
IIneocortex. IIAlzheimer IIpathology IImay IIcoexist
o Cognitive IIdysfunction IIwith IIprominent IIvisuospatial IIand IIexecutive IIdeficits II
o Psychiatric IIdisturbances, IIwith IIanxiety, IIvisual IIhallucinations IIand IIfluctuating
IIdelirium
o Parkinsonian IImotor IIdeficits IIwith IIor IIafter IIother IIfeatures
o Cholinesterase IIinhibitors IIlessen IIdelirium; IIpoor IItolerance IIof IIneuroleptics IIand
IIdopaminergics
➢ Vascular: IImultifocal IIischemic IIchange
o Stepwise IIor IIprogressive IIaccumulation IIof IIcognitive IIdeficits IIin IIassociation IIwith
IIrepeated IIstrokes
NURS II6550 IIMidterm IIStudy IIGuide II 3
