Psych exam 1

Mental Health

Ability to cope with stress, maintain relationships, and contribute to society.

Mental Illness

Disorders with significant disturbances in cognition, emotion, or behavior.

Cerebrum

Reasoning, emotions, and movement.

Diencephalon

Thalamus and hypothalamus regulate emotions and homeostasis.

Brainstem

Vital functions - breathing, heart rate.

Cerebellum

Coordination and balance.

Dopamine

Movement, pleasure, motivation.

Serotonin

Mood, sleep, appetite.

Norepinephrine

Alertness, stress response.

GABA

Inhibitory, reduces anxiety.

Glutamate

Excitatory, involved in learning and memory.

Confidentiality

HIPAA compliance.

Informed Consent

Right to accept or refuse treatment.

Least Restrictive Environment

Mandated by law.

Patient Rights

Protection against unjustified restraint or seclusion.

Community Mental Health

Focus on prevention, treatment, and rehabilitation.

Deinstitutionalization

Shift from long-term hospitalization to community care.

Active Listening

Full attention to the patient.

Empathy

Understanding patient feelings.

Clarification

Ensuring clear understanding.

Open-Ended Questions

Encouraging detailed responses.

Crisis Intervention

Short-term, focused therapy.

Goals of Crisis Intervention

Stabilize, reduce symptoms, and restore functioning.

Nursing Role during crisis intervention

Safety assessment, emotional support, facilitating coping strategies.

Med groups: Antidepressants

SSRIs, SNRIs.

Med groups: Antipsychotics

Typical and atypical.

Med groups: Mood Stabilizers

Lithium, anticonvulsants.

Med groups: Anxiolytics

Benzodiazepines, buspirone.

Cognitive Behavioral Therapy (CBT):

Restructuring thoughts.

Psychotherapy

individual or group therapy.

Electroconvulsive Therapy (ECT)

for severe depression.

Mindfulness and Relaxation Techniques

reducing stress.

SSRIs meds

Fluoxetine, Sertraline, Escitalopram.

SSRIs Clinical Purpose

Depression, Anxiety Disorders, PTSD, OCD.

SSRIs Precautions

- Risk of serotonin syndrome

- suicidal thoughts in young adults

SSRIs Contraindications

- concurrent use of MAOIs

- known hypersensitivity

SNRIs meds

- Venlafaxine

- Desvenlafaxine

- Duloxetine

SNRIs Clinical Purpose

- Depression

- Generalized Anxiety Disorder (GAD)

- Neuropathic pain

SNRIs Precautions

- risk of serotonin syndrome

- Monitor blood pressure

SNRIs Contraindications

- concurrent use of MAOIs

- Uncontrolled narrow-angle glaucoma

DSRIs meds

Bupropion.

DSRIs Clinical Purpose

- Major Depressive Disorder (MDD)

- Smoking cessation (Zyban)

DSRIs Precautions

- Risk of seizures (especially with high doses)

- insomnia

DSRIs Contraindications

- Seizure disorders

- eating disorders (anorexia/bulimia)

Mood Stabilizers meds

- Lithium

- Valproic acid

- Carbamazepine

- Lamotrigine

Mood Stabilizers Clinical Purpose

Bipolar Disorder (mania and depression prevention)

Mood Stabilizers Precautions

- Monitor renal and thyroid function (lithium)

- liver function (valproic acid)

Mood Stabilizers Contraindications

- Renal impairment (lithium)

- pregnancy (valproic acid)

TCAs meds

- Amitriptyline

- Nortriptyline

- Imipramine

TCAs Clinical Purpose

- Depression

- Chronic Pain

- Insomnia

TCAs Precautions

- High risk of overdose toxicity

- anticholinergic effects (dry mouth, urinary retention)

TCAs Contraindications

- seizure disorders

- Cardiac arrhythmias

- recent myocardial infarction

Antipsychotic Medications meds

- Risperidone

- Olanzapine

- Haloperidol

- Aripiprazole

Antipsychotic Medications Clinical Purpose

- Schizophrenia

- Bipolar Disorder (mania)

- Psychotic depression

Antipsychotic Medications Precautions

- Risk of extrapyramidal symptoms (EPS)

- weight gain

- diabetes risk (atypicals)

Antipsychotic Medications Contraindications

- Dementia-related psychosis (increased mortality)

- severe CNS depression

SSRIs are first-line due to

better safety profiles compared to older antidepressants

SNRIs add norepinephirne effects,

useful for pain syndromes but monitor BP

DSRIs are unique for

energizing effects but have seizure risks

mood stabilizers are critical in bipolar management but

require frequent labs

TCAs are effective but risky with overdose

mainly used when newer drugs fail

Typical Antipsychotics meds

- Haloperidol

- Chlorpromazine

- Fluphenazine

- Loxapine

Typical Antipsychotics Clinical Purpose

- schizophrenia (positive symptoms)

- acute psychosis

- mania

Typical Antipsychotics Key Characteristics

- Strong D2 receptor antagonists

- effective for hallucinations/delusions

- higher risk of EPS and tardive dyskinesia

Typical Antipsychotics Precautions

- Monitor for EPS

- neuroleptic malignant syndrome (NMS)

- orthostatic hypotension

Typical Antipsychotics Contraindications

- Parkinson's disease

- CNS depression

- severe cardiac disorders

Atypical Antipsychotics meds

- Risperidone

- Olanzapine

- Quetiapine

- Aripiprazole

- Clozapine

Atypical Antipsychotics Key Characteristics

- Weaker D2 antagonism + serotonin (5-HT2A) antagonism

- lower risk of EPS

- metabolic syndrome risks (weight gain, diabetes, hyperlipidemia)

Atypical Antipsychotics Precautions

Monitor weight, blood glucose, lipids, WBC (especially with clozapine)

Atypical Antipsychotics Contraindications

- Dementia-related psychosis (increased mortality)

- severe metabolic disorders

Quick Summary: Typical (First-Generation)

Focus on positive symptoms but have more motor side effects (EPS, dystonia, tardive dyskinesia).

Quick Summary: Atypical (Second-Generation)

Treat both positive and negative symptoms (like apathy and withdrawal) with fewer motor symptoms but more metabolic risks (weight gain, diabetes)