EXAM 2 MENTAL HEALTH REVIEW.
***50 questions, 1 med cal. Use PP, Tickets to Class, textbook, ATI resources, notes
FOCUS: Mental Health Disorders /Nursing Interventions/ Risk Factors/Signs
&Symptoms/Client Education
Medications for Disorders- Side Effects/Common uses/Client Education /Significant
Adverse effects (
e. G. MAOI/Contraindications and interactions, NMS, EPS)
PTSD-1
● S/S
○ Flashbacks, dreams about the traumatic event, memories of
the event recur involuntarily and are distressing to the client,
avoidance of people/places/events/situations that bring back
reminders of the event
○ Depressive or anxiety disorders, anger, irritability, decreased
interest in current activities, guilt, negative beliefs, detachment
from others, inability to experience positive emotional
experiences, hypervigilance, aggression, sleep disturbances
● Risk factors
○ Exposure to traumatic event or experience - ex. physical abuse
○ Exposure to trauma experienced during natural disasters - ex. Fire,
storm
○ Exposure or repeated re-exposure to trauma in occupational setting
○ Living through traumatic event experienced by family
member/close friend
● Client Education
○ Educate about relaxation techniques and other anxiety-reducing
strategies
○ Monitor for causes and manifestations of the disorder
○ Avoid caffeine and alcohol
○ Encourage to join group/family therapy, support groups
● Medications
○ ANTIDEPRESSANTS:
■ Side effects: headache, anxiety, drowsiness, insomnia,
nervousness, diarrhea, sexual dysfunction, increased
sweating, pruritus, tremor
■ Education:
● caution patient to avoid alcohol and other CNS
depressants
● Avoid driving and other activities that require alertness
● Change position slowly
● If dry mouth, urinary retention, or constipation
occurs - notify HCP
● Frequent rinses, good oral hygiene, sugarless
,EXAM 2 MENTAL HEALTH REVIEW.
candy/gum
● Notify HCP before starting herbal alternative therapies
● Inform importance of follow-ups
,EXAM 2 MENTAL HEALTH REVIEW.
○ SSRIs - Paroxetine, sertraline
■ Side effects: anxiety, dizziness, drowsiness, headache,
insomnia, weakness, sweating, constipation, diarrhea, dry
mouth, nause, ejaculatory disturbance. **SEVERE:
neuroleptic malignant syndrome, suicidal thoughts,
stevens-johnson syndrome, serotonin syndrome
■ Education:
● Assess for suicidal tendencies - esp. Early therapy
● Assess for serotonin syndrome
● Monitor for development of neuroleptic malignant
syndrome - discontinue
● Assess fro rash periodically during therapy
● Assess s/s of PTSD
○ SNRIs - Venlafaxine
■ Side effects: abnormal dreams, anxiety, dizziness, headache,
insomnia, nervousness, weakness, ecchymoses, rhinitis,
visual disturbances, anorexia, constipation, diarrhea, dry
mouth, dyspepsia, n/v, weight loss, sexual dysfunction,
paresthesia, chills
■ Education
● Advise to be aware of any suicidality during early
& dose changes
● Caution to avoid driving & other activities
● Notify HCP all OTC & Rx, vitamins, herbals currently
taking
● Notify HCP if rash occurs
○ Prazosin
■ Side effects: dizziness, headache, weakness, first-dose
orthostatic hypotension, palpitations
■ Education
● Take medication at same time each day; do not
double doses if missed dose
● Weight self 2x weekly & assess for fluid retention
● Avoid driving & other activities require alertness
● Change positions slowly
○ Propranolol - decreases elevated vitals & s/s of
anxiety, panic, hypervigilance, insomnia
■ Side effects: weakness, erectile dysfunction. *SEVERE:
arrhythmias, bradycardia, HF, pulmonary edema, stevens
johnson syndrome, toxic epidermal necrolysis,
anaphylaxis
● Nursing Care
○ Establish nurse-client therapeutic relationship to share feelings
, EXAM 2 MENTAL HEALTH REVIEW.
○ Provide safe, nonthreatening, routine environment
○ Assess for suicidal ideation, take precautions PRN
○ Use multiple strategies to decrease anxiety - massage, breathing
exercise
Major Depression-5
● S/S: lack of energy, no interest in normal activities, anxiety, reports
sluggishness, change in eating patterns & bowel patterns, sleep
disturbances, decreased
interest in sexual activity, fatigue, pain
○ Physical assessment: blunt affect, poor groom/hygiene, slow
physical
movement, slumped posture, restlessness, pacing, finger
tapping, socially isolated, slowed speech/less verbalization,
● Risk factors
○ Family Hx & previous personal Hx of depression
○ More common in FEMALES
○ Age over 65
○ Neurotransmitter deficiencies - affects mood, sexual
behavior, sleep cycles, hunger, & pain perception
○ Stressful life events
○ Presence of medical illness
○ Client’s postpartum period
○ Trauma occur in early life
● Client Education
○ Review s/s of depression w/ client & family member(s) to identify
stage
○ Reinforce intended effects & potential adverse effects of
medication(s)
○ Explain benefits of adherence to therapy
○ 30 mins of exercise daily for 3-5 days each week improves
clinical findings of depression & helps prevent relapse.
*Regarded as an adjunct to other therapies for major depressive
disorder
● Medications
○ Side effects
■ Antidepressants: headache, anxiety, drowsiness,
insomnia, nervousness, diarrhea, sexual dysfunction,
increased sweating, pruritus, tremor
■ SSRIs: nausea, headache, & CNS stimulation
○ Education
■ Antidepressants: do not abruptly discontinue meds,
therapeutic effects are not immediate (takes several
weeks), avoid hazardous activities due to potential side
effect of sedation, notify HCP of any thought of suicide,
***50 questions, 1 med cal. Use PP, Tickets to Class, textbook, ATI resources, notes
FOCUS: Mental Health Disorders /Nursing Interventions/ Risk Factors/Signs
&Symptoms/Client Education
Medications for Disorders- Side Effects/Common uses/Client Education /Significant
Adverse effects (
e. G. MAOI/Contraindications and interactions, NMS, EPS)
PTSD-1
● S/S
○ Flashbacks, dreams about the traumatic event, memories of
the event recur involuntarily and are distressing to the client,
avoidance of people/places/events/situations that bring back
reminders of the event
○ Depressive or anxiety disorders, anger, irritability, decreased
interest in current activities, guilt, negative beliefs, detachment
from others, inability to experience positive emotional
experiences, hypervigilance, aggression, sleep disturbances
● Risk factors
○ Exposure to traumatic event or experience - ex. physical abuse
○ Exposure to trauma experienced during natural disasters - ex. Fire,
storm
○ Exposure or repeated re-exposure to trauma in occupational setting
○ Living through traumatic event experienced by family
member/close friend
● Client Education
○ Educate about relaxation techniques and other anxiety-reducing
strategies
○ Monitor for causes and manifestations of the disorder
○ Avoid caffeine and alcohol
○ Encourage to join group/family therapy, support groups
● Medications
○ ANTIDEPRESSANTS:
■ Side effects: headache, anxiety, drowsiness, insomnia,
nervousness, diarrhea, sexual dysfunction, increased
sweating, pruritus, tremor
■ Education:
● caution patient to avoid alcohol and other CNS
depressants
● Avoid driving and other activities that require alertness
● Change position slowly
● If dry mouth, urinary retention, or constipation
occurs - notify HCP
● Frequent rinses, good oral hygiene, sugarless
,EXAM 2 MENTAL HEALTH REVIEW.
candy/gum
● Notify HCP before starting herbal alternative therapies
● Inform importance of follow-ups
,EXAM 2 MENTAL HEALTH REVIEW.
○ SSRIs - Paroxetine, sertraline
■ Side effects: anxiety, dizziness, drowsiness, headache,
insomnia, weakness, sweating, constipation, diarrhea, dry
mouth, nause, ejaculatory disturbance. **SEVERE:
neuroleptic malignant syndrome, suicidal thoughts,
stevens-johnson syndrome, serotonin syndrome
■ Education:
● Assess for suicidal tendencies - esp. Early therapy
● Assess for serotonin syndrome
● Monitor for development of neuroleptic malignant
syndrome - discontinue
● Assess fro rash periodically during therapy
● Assess s/s of PTSD
○ SNRIs - Venlafaxine
■ Side effects: abnormal dreams, anxiety, dizziness, headache,
insomnia, nervousness, weakness, ecchymoses, rhinitis,
visual disturbances, anorexia, constipation, diarrhea, dry
mouth, dyspepsia, n/v, weight loss, sexual dysfunction,
paresthesia, chills
■ Education
● Advise to be aware of any suicidality during early
& dose changes
● Caution to avoid driving & other activities
● Notify HCP all OTC & Rx, vitamins, herbals currently
taking
● Notify HCP if rash occurs
○ Prazosin
■ Side effects: dizziness, headache, weakness, first-dose
orthostatic hypotension, palpitations
■ Education
● Take medication at same time each day; do not
double doses if missed dose
● Weight self 2x weekly & assess for fluid retention
● Avoid driving & other activities require alertness
● Change positions slowly
○ Propranolol - decreases elevated vitals & s/s of
anxiety, panic, hypervigilance, insomnia
■ Side effects: weakness, erectile dysfunction. *SEVERE:
arrhythmias, bradycardia, HF, pulmonary edema, stevens
johnson syndrome, toxic epidermal necrolysis,
anaphylaxis
● Nursing Care
○ Establish nurse-client therapeutic relationship to share feelings
, EXAM 2 MENTAL HEALTH REVIEW.
○ Provide safe, nonthreatening, routine environment
○ Assess for suicidal ideation, take precautions PRN
○ Use multiple strategies to decrease anxiety - massage, breathing
exercise
Major Depression-5
● S/S: lack of energy, no interest in normal activities, anxiety, reports
sluggishness, change in eating patterns & bowel patterns, sleep
disturbances, decreased
interest in sexual activity, fatigue, pain
○ Physical assessment: blunt affect, poor groom/hygiene, slow
physical
movement, slumped posture, restlessness, pacing, finger
tapping, socially isolated, slowed speech/less verbalization,
● Risk factors
○ Family Hx & previous personal Hx of depression
○ More common in FEMALES
○ Age over 65
○ Neurotransmitter deficiencies - affects mood, sexual
behavior, sleep cycles, hunger, & pain perception
○ Stressful life events
○ Presence of medical illness
○ Client’s postpartum period
○ Trauma occur in early life
● Client Education
○ Review s/s of depression w/ client & family member(s) to identify
stage
○ Reinforce intended effects & potential adverse effects of
medication(s)
○ Explain benefits of adherence to therapy
○ 30 mins of exercise daily for 3-5 days each week improves
clinical findings of depression & helps prevent relapse.
*Regarded as an adjunct to other therapies for major depressive
disorder
● Medications
○ Side effects
■ Antidepressants: headache, anxiety, drowsiness,
insomnia, nervousness, diarrhea, sexual dysfunction,
increased sweating, pruritus, tremor
■ SSRIs: nausea, headache, & CNS stimulation
○ Education
■ Antidepressants: do not abruptly discontinue meds,
therapeutic effects are not immediate (takes several
weeks), avoid hazardous activities due to potential side
effect of sedation, notify HCP of any thought of suicide,
