Mental Health Final

Panic attack management

1. VS

2. ECG

3. administer alprazolam (Xanax) are prescribed

neuroleptic malignant syndrome

emergency manifestations: hyperthermia, muscle rigidity, autonomic instability, psuedoparkisonism, catatonic stupor, evevated CPK

management:

1. discontinue antipsychotic → ICU admission

2. bromocriptine (parlodel): reverse the hypodopaminergic state

3. dantrolene: skeletal muscle relaxer → helps improve muscle rigidity

4. hydration and cooling

5. monitor cpk

hypertension crisis

manifestation: life-threatening reaction secondary to ingesting tyramine-containing foods with MAOI. Headache, stiff neck, sweating, tremor, increased temp.

management:

1. immediate emergency treatment

2. adrogenic blockers

3. chlorpromazine

lithium toxicity

management:

1. gastric lavage

2. osmotic diuretic: mannitol

3. ICU admission and treatment

benzodiazepine overdose

manifestations: confusion, restlessness, agitation, coma, drowsiness, difficulty breathing

management:

1. administer activated charcoal

2. check vital signs every 15 minutes

3. start IV access

4. seizure precaution

5. administer flumazenil (romazicon)

anticholinergic effect

management:

1. hold medication

2. emergency cooling measures

3. prepare for urinary catheterization

opioid overdose/intoxication

manifestation: depressed RR, pupil constriction, cyanosis, LOC

management:

1. Maintain airway & provide O2

2. administer naloxone

3. neuro assessment

4. cardiac monitoring

tardive dyskinesia

management:

1. immediately hold and report early signs of tardive dyskinesia (usually vermiform movements of the tongue) to the provider → antipsychotoc will be changed

dystonia/acute dystonic reaction

management:

1. respiratory emergency

2. anticholinergic meds: cogentin/benztropine

grief and loss-response infants, toddlers, and pre-school

• crying and regression

• looking for/asking about the deceased

grief and loss-response school aged

play death stories

withdrawal not looking forward to holiday time

mood liability

comparison of grief and loss-response adolescents

most risky age

risk taking behaviors

risk for suicide

CAGE

C - cut down

A - annoyed

G - guilty

E - eye-opener

used to prevent substance and screen for alcohol use

two “yes” responses indicate alcohol abuse and dependence

IMPORTANT: this tool can’t assess for possible hostile or hazardous

AUDIT test

screens for alcohol and risk taking behaviors

provides a simple method of early detection of hazardous and harmful alcohol use

score of 8 or higher identifies alcohol use disorder

MAST

includes alcohol, risk taking, and physiologic well being

mood dysregulation disorder

emotional disorder

temper: demands, crying

unpredictable tiggers; temper outburts, observed in multiple settings

onset: age 6-18

impulse control disorder

behavioral disorder

aggression and violence

tiggers: identifiable stressors

onset: typically between ages of 13 to 21 years

autism spectrum disorder

characterized by a withdrawal of the child into the self and into a fantasy of his of her own creation

“lack of social skills”

oppositional deficient disorder

• characterized by disobedience, argumentativeness, irritability, and negative outbursts

• they are often notably impaired in the ability to make friends and avoid conflict with adults and/or authority figures

• goals include increasing responsibility for behavior and increasing problem-solving skills

conduct disorder

• physical fighting

• running away from home

• lying, stealing

• cruelty to animals

• use of alcohol, drugs

dramatic play

acting out an anxiety-producing situation such as allowing the child to be a doctor

creative play

can help a child express themselves

for example, drawing pictures of themselves, their families, and peers

these are especially useful when children are unable to express themselves verbally