NURS 335 Exam 3 PRACTICE FLASHCARDS

A complete set of vocabulary-style flashcards covering PTSD, OCD, Anxiety Levels, Mood Disorders, Grief, Hospice, and Medications as outlined in the NURS 335 Exam 3 transcript.

PTSD Hallmark Symptoms

Symptoms occurring 1 month after a traumatic event, including nightmares, flashbacks, and frequent re-experiencing of events.

PTSD Timing Requirement

Symptoms must occur at least 1 month after the traumatic event to be classified as PTSD.

OCD Ritual Management

Nursing considerations include allowing the client time to perform rituals and celebrating small victories.

Compulsions Underlying Mechanism

The performance of rituals or compulsions temporarily relieves the client's anxiety.

Cognitive Restructuring Example

The process of challenging unwanted or irrational thoughts, often used in OCD treatment.

Agoraphobia Definition

A fear of open spaces or enclosed spaces, such as a park, which causes the client significant distress.

Moderate Anxiety Nursing Interventions

Offer self, remain calm, engage in talking or active listening, and ask the client to verbalize their feelings.

Moderate Anxiety Environment

Redirect the client to a location where we can talk without interruption or reduce environmental stimuli.

Moderate Anxiety Physical Manifestations

Includes urinary frequency, GI butterflies, and racing thoughts.

Moderate Anxiety Cognitive Function

The client focuses on the task or problem at hand, though problem-solving may be suboptimal.

Severe Anxiety Physical Signs

Sweating without exertion, shortness of breath (SOB), and headache.

Severe Anxiety Behavioral Signs

Repeating the same word or thought and demonstrating fearful or threatening behavior.

Severe Anxiety Cognitive Impairment

A lack of ability to problem solve and a pervasive sense of doom.

Panic Level Nursing Considerations

The nurse must stay with the client and prioritize their safety.

Anxious Client Communication

Use therapeutic openers such as "Tell me…" to encourage the client to share.

Nervous Energy Interventions

Offer the client an activity, offer a walk, and model walking progressively slower.

OCD Treatment Efficacy Signs

A slow reduction in compulsive behaviors indicates that treatment is working.

OCD Nursing Action Plan

Set goals to reduce compulsions, identify triggers, and challenge obsessive thoughts.

Munchausen by Proxy Approach

Take a team approach, gather evidence, and ensure the safety of the cared-for person (child).

Benzodiazepines Indications

Used for the short-term treatment of anxiety on an as-needed basis.

Benzodiazepines Examples

Diazepam, alprazolam, and clonazepam.

Benzodiazepines Contraindications

Avoid use in elderly patients and pregnant patients.

Anxiolytic Effectiveness Signs

The client reports feeling less anxious and appears more relaxed.

Acute Anxiety Priority Intervention

Safety, specifically protecting the client from injury and assessing for safety concerns.

Crisis Intervention Initial Actions

Assess safety, establish rapport, validate feelings, and use active listening.

Crisis Intervention Assessment

Assess the cause or trigger of the anxiety to better understand the crisis.

Crisis Intervention Plan

The plan developed for the client must be concrete and specific.

Situational Crisis Priority

Priority assessment is required immediately after the situational crisis occurs.

MDD Therapeutic Communication Observation

Notice small changes and make observations to encourage engagement.

MDD Activity Refusal Strategy

For clients who do not want to engage in activities, use a gentle but firm approach.

MDD Sitting in Silence

A therapeutic intervention used for depressed clients who are not yet ready to engage verbally.

ECT Patient Education: Memory

Temporary memory loss is a common side effect of Electroconvulsive Therapy.

ECT Patient Education: Consent

Informed consent is required prior to the procedure.

ECT Medication Restrictions

Do not take anticonvulsants such as lamotrigine or valproic acid, and avoid benzodiazepines prior to the procedure.

ECT Pre-Procedure Fasting

The patient must remain NPO (nothing by mouth) prior to the treatment.

ECT Indicated Disorders

Used in the treatment of depression, bipolar disorder, and psychotic disorders.

MDD Task Guidance

For clients with difficulty concentrating or completing tasks, assign one-step-at-a-time tasks.

MDD Client Progress

Allow extra time for clients to communicate their needs and celebrate small victories.

Suicide Attempt Priority Intervention

Initiate suicide precautions and provide 1:1 observation.

Imminent Suicide Warning: Mood

An abrupt lift in mood can indicate that a suicide attempt may be imminent.

Imminent Suicide Warning: Preparations

Giving things away and getting financial affairs in order.

Passive SI Nursing Response

Respond by asking if they have a plan and saying "tell me more…"

Antidepressant Education: Onset

The medication takes several weeks to take effect; the client might feel worse before they feel better.

Antidepressant Side Effects: General

Weight gain is possible and the medication may affect sex drive.

Antidepressant Safety Teaching

Advise the client to never abruptly stop taking their medication.

Fluoxetine (Prozac) Administration

Should be taken in the morning because it can cause sleep disturbances at night.

Fluoxetine (Prozac) Skin Signs

The medication may cause a skin rash which should be reported.

Serotonin Syndrome Signs: Vitals

Includes increased BP, HR, and sweating (fever).

Serotonin Syndrome Signs: Physical

Anxiety, abdominal pain, and diarrhea.

Serotonin Syndrome Trigger

Usually occurs when a client has recently increased their dose of an SSRI or other serotonin medication.

Denial (Grief)

An example of the grief process in which a person does not believe a person has passed.

Maladaptive Grief Definition

Persistent grief occurring for more than a year after the loss.

Maladaptive Grief Manifestations

Engaging in risk behaviors and experiencing feelings of worthlessness, guilt, or low self-esteem.

Grief Therapeutic Communication: Negative

Avoid saying "you will be fine," "I know how you feel/I understand," or "this is for the best."

Grief Therapeutic Communication: Positive

Allow the client time to grieve in their own way, actively listen, and validate their feelings.

Hospice Goal

The emphasis is on quality of life, making the client as comfortable as possible, and pain management.

Maladaptive Hospice Responses

The client making plans for the future or making denial statements about their condition.

Mania Priority Nursing Intervention

Assess for safety because clients are impulsive and may act on fleeting thoughts of self-harm.

Mania Nutrition Intervention

Provide high-calorie finger foods since clients are often too active to sit for meals.

Mania Environmental Control

Reduce environmental stimuli and monitor/encourage sleep.

Mania Behavioral Boundaries

Set boundaries and limits, maintain consistent routines, and use a calm approach.

Mania Manifestations: Cognitive

Grandiosity and irritability.

Mania Manifestations: Energy

Risky behaviors, high energy, and an inability to complete tasks.

Mania Manifestations: Physical

Reduced need for sleep and a reduced interest in food.

Medication Non-Compliance (Mood)

If a client abruptly stops taking medication, the nurse should discuss the reasons why.

Lithium Daily Living Education

No alcohol, maintain hydration, and keep salt intake steady.

Lithium Safety Education

Do not take NSAIDs and always take the medication with food.

Lithium Lab Monitoring

Blood levels need to be checked regularly to ensure they are within the therapeutic range.

Lithium Therapeutic Level

The therapeutic range for lithium is $0.6-1.2$.

Common Mood Stabilizing Anticonvulsants

Names of the three most common are lamotrigine, carbamazepine, and valproic acid.