Test Bank For Varcarolis' Foundations Of Psychiatric-Mental Health Nursing.pdf, Exams of Nursing

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Test Bank For Varcarolis' Foundations Of

Psychiatric-Mental Health Nursing,

Definition of mental health according to World Health Organization - ANSWER state of well being in which each person is able to realize their own potential cope with normal life stressors work productively and make contribution to community you cannot have good mental health without - ANSWER good physical health definition of mental health according to society - ANSWER evolves over time shaped by culture and societies' values reflects changes in cultural norms and society expectations political climates and reimbursement by 3rd party payers When did the APA remove homosexuality from the DSM? - ANSWER 1973 rational thinking - ANSWER thinking logically mental health continuum - ANSWER A conceptual line used to represent levels of mental health and mental illness that vary from person to person and vary for a particular person over time.

self-awareness - ANSWER knowledge of oneself positive self-concept - ANSWER the mental picture you have of yourself as being equal with other people what are traits of mental health - ANSWER the mental health continium rational thinking effective coping resilency self control self awareness, etc. contributing factors to mental health and well-being - ANSWER attributes and behaviors social economic standards (can you pay your bills) environmental factors (war zones, toxins, etc.) resilence - ANSWER the personal strength that helps most people cope with stress and recover from adversity and even trauma (ie if they lose their job they will get a pt job until they find a job that suits them better) how are resilient people - ANSWER they are optimistic, have a sense of mastery and are competent resilience is essential to - ANSWER recovery mrs. m. comes to the clinic reporting a feeling of hopelessness. she works full time and is dealing with a troubled teen son and her elderly parents. she confides in you that she can't deal with

her life right now. discuss attributes you might screen for to quickly assess her over mental health - ANSWER any plans to hurt herself, what are her coping mechanisms self-control resilience what is mental health considered - ANSWER cultural because what one cultural might view as normal another cultural might view as mentally unstable what is the 10th leading cause of death - ANSWER suicide what is dsm-v - ANSWER Diagnostic and Statistical Manual of Mental Disorders what is mental ilness - ANSWER a disorder with a definable diagnosis why do nurses use the DSM- 5 - ANSWER it identify diagnoses and diagnostic criteria to guide assessment identify nursing diagnosis plan, implement and evaluation care cultural bound syndrome - ANSWER Specific behaviors related to a person's culture and not linked to a psychiatric disorder how does the mental health continuum work - ANSWER there are different levels can go from severely impaired and then back to normal it is not clear cut there is a wide variety

what psychiatric disorders are known throughout the world and not just in a certain culture - ANSWER schizo and bipolar As you work through Mrs. M's assessment you evaluate her possible level of resilience. Which other characteristic would you expect her to have? a. Optimism b. Patriotism c. Aggressiveness d. Depressed affect - ANSWER A. Optimism One cannot have good mental health without - ANSWER good physical health and vice versa a person who has a family history of schizo is more - ANSWER at risk for schizo this is nature genetic vulnerability nature v. nurture issue and mental health - ANSWER nurture is the environment in which you grow up in if you come from a loving family will probably not develop schizo if grew up in abusive family you are more at risk nature is the genetic vulnerability if there is a family history you are more at risk diathesis-stress model - ANSWER a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event it is the most accepted reason for mental illness

Which of these mental health problems has the highest annual prevalence in the United States? a. schizo b. panic disorder c. major depressive disorder d. generalized anxiety disorder - ANSWER c. major depressive disorder psychiatric mental health nursing - ANSWER promoting mental health through the assessment, diagnosis, and treatment of human responses to mental health problems and psychiatric disorders a psychiatric-mental health rn (PMH-RN) - ANSWER choses to work in a specialty at basic level can work pretty much anywhere after 2 years of ft working experience in psych, 2000 clinical hours and 30 hours of continuing education can get certified and become board certified (RN-BC) advanced practice psychiatric mental health rn - ANSWER master of science or doctor of nursing can prescribe meds, psychotherapy and one on one wellbutrin - ANSWER antidepressant bupropion

how does wellbutrin work - ANSWER By inhibiting dopamine uptake as well as norepinephrine and serotonin complications of wellbutrin - ANSWER agitation, headaches dizziness, confusion seizures suicidal ideation flushing dysrhythmia n/v contraindications wellbutrin - ANSWER hypersensitivity head trauma eating disorder seizures renal and liver disease do not abruptly discontinue interactions wellbutrin - ANSWER do not taken within 14 days of MAOI's nursing interventions wellbutrin and client education - ANSWER monitor weight thoughts of suicide call dr. do not take with alcohol or cns depressants caution when driving need to taper neurons - ANSWER nerve cells that conduct electrical impulses Chemical Imbalance - ANSWER not enough neurotransmitters in the synaptic cleft Neurotransmitters - ANSWER Chemicals that transmit information from one neuron to another

synaptic cleft - ANSWER a gap into which neurotransmitters are released from the axon terminal some psychiatric drugs work by - ANSWER stopping cell from reabsorbing stopping enzyme that destroys the excess neruotransmitor some will stimulate receiptor what is the target of drugs used to treat psychiatric disorders - ANSWER the interaction between neurotransmitters and receptors a pet and spect scan looks at - ANSWER how the brain functions a ct or mri looks at - ANSWER the structure of the brain Which neuroimaging technique would reveal problems in the anatomical structure of the brain but not problems in function? a. ct b. pet c. spect d. none of the above - ANSWER a. ct which chemicals are involved in mental illness - ANSWER norepinephrine, dopamine, glutamate, gaba neuropeptides and acetylcholine

dopamine - ANSWER feel good norepinephrine - ANSWER energy gaba - ANSWER calming serotonin - ANSWER reward Pharmodynamics - ANSWER what the drug does to the body pharmacokinetics ADME - ANSWER absorption, distribution, metabolism, excretion antianxiety drugs - ANSWER drugs used to control anxiety and agitation hypnotic drugs used - ANSWER for sleep antianxiety and hypnotic drugs all have in common - ANSWER induce various degrees of behavioral depression benzodiazepines - ANSWER drugs that lower anxiety and reduce stress diazepam lorazepam chlordiazepoxide chlorazepate oxazepam clonazepam alprazolam

benzos are a what schedule - ANSWER iv and controlled substance can only have 3 month supply have to go back every 3 months lunesta - ANSWER hypnotic helps sleep versed - ANSWER preoperatively for moderate sedation short acting hypnotics - ANSWER useful in achieving sleep zolpiden (ambien) zaleplon (sonata) eszopiclone (Lunesta) these are z hypnotics z hypnotics - ANSWER Zolpidem (Ambien) Zaleplon (Sonata) Eszopiclone (Lunesta) short acting fast acting used for sleep adverse effects sleepwalking eating and driving short acting benzo - ANSWER klonopin valium flurazepan good for sleep intermediate acting benzo - ANSWER alprazolam (Xanax), lorazepam (Ativan), temazepam (Restoril) good for calming and sleep how do antianxiety and hypnotic drugs work - ANSWER potentiate the activity of GABA calming reducing cellular excitation

side effects of antianxiety and hypnotic drugs - ANSWER drowsiness confusion dizziness trembling vision problems impaired coordination grogginess depression headaches important safety information for antianxiety and hypnotics - ANSWER addictive do not give to someone who has substance abuse give temporarily or for a short time in small amounts need to taper cns depression with opioids alcohol don't give with sleep apnea Atypical antianxiety - ANSWER buspirone (BuSpar) no risk for dependency less sedation takes 2 to 6 weeks to kick in pregnancy risk b do not use if lactating is on a dosing schedule and is not prn hypnotics to treatment insomnia - ANSWER zolpidem - ambien eszpiclone-lunesta zaleplan-sonata work by slowing activities in the brain do not give with complex sleep disorders such as sleepwalking, etc. side effects: drowsy dizzy make sure to get full 8 hours of sleep first line treatment for depression - ANSWER SSRIs

SSRIs - ANSWER Fluoxetine, paroxetine, sertraline, citalopram. SSRIs used for - ANSWER Major:

• Depression
• Generalized anxiety disorder Other:
• OCD
• Eating disorders
• PTSD (Sertraline) side effects SSRIs - ANSWER Sexual dysfunction CNS stimulation Weight loss in early therapy, weight gain with long-term Serotonin Syndrome Withdrawal Syndrome Hyponatremia Rash Sleepiness, faintness, lightheadedness GI Bleeding Bruxism safety issue with SSRIs - ANSWER serotonin syndrome this is a medical emergency go to er mental confusion abdominal pain diarrhea agitation fever hallucinations diaphoresis tremors

norepinephrine dopamine reuptake inhibitors - ANSWER buspropion (wellbutrin) used to treat depression; inhibit the reuptake of both norepinephrine and dopamine no sexual side effects CONTRAINDICATED FOR SOMEONE WITH SEIZURES OR HEAD INJURY important to know about wellbutrin - ANSWER used for smoking cessation do not use if has risk of seizure or history of seizure or history of head injury or withdrawing from alcohol because of risk for seizure causes no sexual dysfunction can suppress appetite so don't give to anorexic or bulimia serotonine antagonists and reuptake inhibitor - ANSWER trazadone used for sleep and depression and anxiety se dry mouth sedation safety issue with trazadone - ANSWER suicide mania arrythmia and priapism (prolonged erection) norepinephrine and serotonin specific antidepressant - ANSWER mirtazapine (remeron) no sexual dysfunction and improves sleep se sedation appetite stimulation and weight gain

Tricyclic Antidepressants (TCAs) - ANSWER Nortriptyline (Pamelor) Amitriptyline (Elavil) Imipramine (Tofranil) not the first line any more because of side effects and take a long time for effects block reuptake of nonepephrine and serotonin Side effects of tricyclic antidepressants - ANSWER - Cause anticholingeric side effects: dry mouth, constipation, urinary retention, drying of the nasal passages, tachycardia and blurred vision. safety issues tricyclic antidepressants - ANSWER od can be fatal also can disrupt cardiac conduction MAOI's - ANSWER monoamine oxidase inhibitors antidepressant work by increasing norepinephrine serotonin and dopamine by blocking monoamine enzyme Isocarboxazid (Marplan) Selegiline (EMSAM) Tranylcypromine (Parnate) se MAOIs - ANSWER can't peep poop mouth dry htn etc. safety issue MAOIs - ANSWER htn crisis if taken w/tyramine (wine, cheese and aged meats) do not take with SSRIs cause Serotonin Syndrome

alternatives for depression - ANSWER St. John's Wart side effects st. john's wart - ANSWER photosensitivity, rash rapid heart rate gi distress safety issues with st. john's wart - ANSWER interact with a lot of meds do not take with any antidepressant as can cause serotonin syndrome do not take with tyramine lithium - ANSWER mood stabilizer for bipolar disorder reduces mania side effects lithium - ANSWER weight gain tremor, GI disturbance fatigue, arrythmias, seizures goiter/ HYPOTHYROIDISM leukocytosis coma polyuria/dipsia alopecia metallic taste safety issues lithium - ANSWER lithium toxicity (need to check levels) is teratogenic don't use if have liver, renal or cardiac disease don't fluctuate salt intake therapeutic level of lithium - ANSWER 0.6 to 1.

if toxic level of lithium - ANSWER will have diarrhea stop taking med draw for levels check sodium levels Early sign of Lithium Toxicity - ANSWER ********test ********diarrhea anticonvulsants - ANSWER suppress or reduce the number and/or intensity of seizures se: nystagmus double vision don't take if pregnant Steven Johnson Syndrome first generation antipsychotics - ANSWER reduce transmission of dopamine help with positive symptoms such as delusions and hallucinations haloperidol flupensazine thioridazine perhenozine usually cheaper than second generation but more problems cause of the extra pyramidal side effects weight gain and sedation second generation antipsychotics - ANSWER drugs that alleviate schizophrenia without producing movement problems target both negative and positive symptoms usually first line treatment risperidone (risperdal) Seroquel Zyprexa Abilify SE of first generation antipsychotics - ANSWER agranulocytosis, anticholinergic effects dystonia, pseudoparkinsonism akathsia tardive dyskineasia (weird face

and tongue movement)*******test neuroleptic malignant syndrome, metabolic syndrome (trigger blood super and hypertension)********test agranulocytosis - ANSWER A life-threatening drop in white blood cells. This condition is sometimes produced by the atypical antipsychotic drug clozapine. neuroleptic malignant syndrome - ANSWER very high fever muscle rigidity confusion, etc. treatment is dantrolene se of second generation antipsychotics - ANSWER metabolic syndrome (elevated triglycerides, bllod super and hypertension)******test anticholinergic agitation dizzy elevated prolactin gynomastia (breast in men) sexual dsyfunction