Mental Health Exam 2.0

Lexapro is used for patients ........ and above with .............

12

depression

Fluoxetine (Prozac) can be used in patients 7 and above for .....

or 8 and above for .......

OCD

Depression

Clonidine is used for ........ and for patients...... and above

ADHD

6

Methylphenidate (Concerta) is used for .........

ADHD

Nortriptyline (TCA); used for ....... has effects on heart so must get EKG done before admin

Depression

Herb used to treat mild to moderate depression, has several interactions

......... ........... ............

St. Johns Wort

herb used to treat anxiety, hard on liver. (Interactions; antiparkisons and benzos) ..........

Kava

Herb that has been proven safe for use of depression

(Can cause serotonin syndrome if taken with MAOIs)

...........

SAM-e

Herb used for sleep disorders and anxiety (Negates effects of warfarin, MAOIs and Phenytoin)

..........

Valerian

Herb used for anxiety and sedation (Interacts with Anticoagulants, CNS drugs)

......... (Often a tea)

Chamomile

Herb used for cardiovascular and cognitive effects (anxiety and muscle relaxation); can increase PTT with anticoagulants

..........

Angelica

Ginseng and Yohimibine are herbs that should not be taken with ......... patients (can exacerbate symptoms)

psychotic

Herb used for Dementia/Alzheimers, effective antidote for Erectile Dysfunction. (INCREASES anticoagulant effects)

...........

Ginkgo

CBD can elevate ........ enzymes

Liver

Vitamin .... and ...... used in combo for cognitive decline (Alzheimers)

C and E

Vitamin ..... and ....... can be used for depression

D and Folate

....... group;

Teaches patient and families related to the dynamics of illness, symptoms, relapse, management and dealing with crisis.

Illness

..... group;

Teaches patients how to administer meds, side effects, explanation of type of dose of medication and provide support to limit relapse

Medication

......-.......group;

Help identify and discuss certain problems, discuss and develop. new solutions, decide on alternative method and how to use it

Problem-Solving

......... ......... group;

Teach and adapt coping mechanisms

Stress management

...... ........ groups;

Teach, develop and practice skills to enhance interactions with others. Focus on realistic day to day needs of the patient.

Social skills

...... groups;

Reinforce or maintain existing strengths, rather than to confront or change behaviors or defenses. The nurse facilitates the orientation to time, person, and place; rules and routines of the unit; and behavioral expectations, including some limit setting.

Maintenance

....... groups;

Help patients increase self-esteem, expression of feelings, and social interaction. Games, drawing, etc.

Activity

..... -......... groups;

Typically voluntarily patient will go. Leader is typically someone that has also dealt with the same things as the other members (AA)

Self-help

.......... patient;

Monopolizes the entire group session to the extent that others feel they do not have the opportunity to participate.

Dominant

How to deal with a ........ patient;

"Cathy, you are doing well in contributing to our session today, but I would like to hear what others are thinking."

Dominating

...... patient;

The patient might be quiet because of anxiety or fear of saying the wrong thing. Patients with chronic schizophrenia find relating in group sessions to be difficult and threatening.

Uninvolved

How to deal with a .......... patient;

"It's hard to talk about ourselves in the group, but I know that everyone here has something important to share."

OR periodically asking

"What are your thoughts on this?"

Uninvolved

......... patient;

Might mask a patient's fear, unresolved anger, or even hurt toward others.

Hostile

How to deal with a ...... patient;

"Melody, you sound angry today. What happened?" or "Tell us about it." The nurse directly confronts this patient in a supportive manner and attempts to help the patient deal with her thoughts and feelings.

Hostile

...... patient;

May make it difficult for others in the group, due to the patient making inappropriate comments or when hallucinations/delusions are voiced to the group.

Distracting

How to deal with a ..... patient;

The nurse could use empathy, focus on the underlying need, present reality, and refocus the group

OR

The patient who verbalizes a sexually inappropriate comment can be handled by the nurse using limit setting.

Distracting

....... groups;

Typically groups deal with medication, the dynamics and management of illness, problem-solving, stress management, anger management, social skills, basic living skills, and relapse prevention (involves pt and family)

Psychoeducational

The assault cycle is made up of ........ phases

5

(1) of the assault cycle; ...........

+1 and +2 levels of anxiety

The stress-producing event occurs, initiating the stress responses (associated with overwhelming emotions of fear).

Nurses role: convey empathy, offer medication (PRN), use clear, calm and simple statements, normalize patients feelings.

Triggering

(2) of the assault cycle; ............

+2 and +3 levels of anxiety

Responses represent escalating behaviors that indicate a movement toward the loss of control (characterized by illogical and irrational thoughts).

Nurses role: Take charge with calm and firm directions, prepare for a 'show of concern', ask the staff to be on standby if need of assistance.

Escalation

(3) of the assault cycle; ........

+3 and +4 levels of anxiety

During this period of emotional and physical crisis, loss of control occurs (anger and rage are expressed to defend oneself).

Nurses role: Initiate intensive nursing care, administer PRN medications to calm patient down.

Crisis

(4) of the assault cycle; ........

+3 and +2 levels of anxiety

In this period of cooling down, the person slows down and returns to normal responses (fear of danger wanes).

Nurses Role: continue care for patient, assess patient and staff injuries, evaluate patients process toward stage 5.

Recovery

(5) of the assault cycle; ......

+2 and +1 levels of anxiety

In this period, the person attempts reconciliation with others (despair over disconnection occurs).

Nurses Role: Process incident with patient, validate the patients feelings, gradually reduce restraint and seclusion of the patient, facilitate reentry into the unit.

Postcrisis depression

Suicidal .........;

involves a person's thoughts and wishes related to wanting to die.

Ideation

Suicidal .......;

Involve an individual's declaration of intent to end their life.

threats

Suicidal ......;

Coping strategies used by suicidal individuals; these nonlethal self-injury acts include cutting or burning the skin and ingesting small amounts of drugs.

gestures

Suicidal .....;

Are the actual implementation of a self-injurious act with the express purpose of ending one's life.

attempt

...... suicide;

Term used exclusively when individuals have successfully ended their lives.

Completed

More than 90 percent of patients who complete suicide are those w/ ....... ..........

mental illnesses

ADHD;

Typically comorbid with depression, anxiety, ODD, OCD and tic disorder.

Scale used: NICHQ (ages 6-12)

Must hallmark symptoms for ....... months or longer

MUST be present by AT LEAST the age of ......... and impact social, academic or social performance.

6

12

ODD;

Comorbid with ADHD

(pattern of anger and irritability symptoms)

deliberately, blames, annoys others, argues with adults.

Diagnosis made when ....... or more symptoms are present for at least ......... months when interacting with at least one individual who IS NOT a sibling.

4

6 months

Conduct disorder;

Must have ...... or more symptoms for diagnosis

More prevalent in males and involves a persistent and repetitive behavior in which the basic right of others are violated.

(Aggression towards people or animals, destruction of property, deceitfulness or theft, serious violation of rules.)

3

OCD, Tourettes and PTSD are all apart of ....... disorders.

anxiety

Symptoms of ........ in children;

nightmares, intrusive memories, hyper vigilance. Can be caused by a single traumatic event, long term abuse or a victim of being a bystander of the abuse.

PTSD

........ ......... ...........;

Comorbid with ADHD, depression, anxiety and sometimes seizure disorders.

deficits in social communication and interactions, restricted repetitive behaviors and interests.

3 Levels

Symptoms must be present in early childhood but may be delayed to a later age when social demands start.

Autism Spectrum Disorder

Avoid products with ....... herbs, avoid herbs from different ........, buy only from reputable sources (....) or ...... seal of approval

Multiple

different

USP or NSF

Typical stay in inpatient acute facilities

....-..... days

3-10

The goal of ........ therapy is to use leisure, recreation, and sport activities to treat, improve, or maintain the physical, mental, and emotional well-being of patients served

recreational

....... abuse;

Organized sexual physical and psychological abuse which is systemic and sustained over long periods of time, victims are often children, involves use of rituals with multiple abusers (Cult)

Ritual

Treatment for ...... abuse;

Dialectal behavior therapy, EMDR (teach with sounds and tapping on face to decrease anxiety when having flashbacks), Cognitive behavior therapy, multi systemic therapy, drug therapy (Controversial as drugs may be part of the abuse), SSRI (PTSD)

Ritual

....... .........;

control over a person for purposes of exploitation including sexual forced labor, slavery, servitude's and removal of organs.

Human trafficking

Risks for ...... ....... and ......... abuse;

poverty, young age, limited education, lack of family support, living in high crime areas.

Human trafficking and ritual

........... ........;

not sexually motivated but involves a fear tact to prevent rejection or need to immobilize and humiliate the victim

Sexual violence