Comprehensive Nursing Review: Mental Health, Maladaptive Conditions, and Nutrition Across the Lifespan

Vocabulary practice flashcards covering ego defense mechanisms, therapeutic communication techniques, substance use disorders, clinical nutrition across the lifespan, energy balance, and nutrient metabolism.

Compensation

An ego defense mechanism characterized by overachievement in one area to offset real or perceived deficiencies in another area, or attempting to overcome a perceived weakness by emphasizing a more desirable trait.

Conversion

An ego defense mechanism in which an emotional conflict is expressed through the development of a physical symptom, usually sensorimotor in nature (such as sudden blindness or paralysis without organic cause).

Denial

An ego defense mechanism involving the refusal to acknowledge the presence or reality of an unbearable condition, event, or problem, or how one enables the situation to continue.

Displacement

An ego defense mechanism in which intense feelings, emotional reactions, or impulses are unconsciously transferred from an original target to a less-threatening person or object.

Dissociation

An ego defense mechanism involving dealing with emotional conflict or trauma through a temporary alteration in consciousness, identity, or memory, creating a feeling of detachment from reality.

Introjection

An ego defense mechanism whereby an individual unconsciously accepts and incorporates the qualities, attitudes, beliefs, and values of another person as their own.

Projection

An ego defense mechanism involving the unconscious blaming or attributing of one's own unacceptable inclinations, thoughts, impulses, or prejudices onto another person or external object.

Rationalization

An ego defense mechanism in which an individual attempts to give a logical, plausible, or socially acceptable explanation to excuse unacceptable behavior and protect self-respect or avoid guilt.

Reaction Formation

An ego defense mechanism wherein a person develops conscious attitudes and behaviors that are the exact opposite of what they genuinely think, feel, or desire to do.

Regression

An ego defense mechanism in which an individual moves backward to an earlier developmental stage or prior method of behaving in order to feel safe or have basic needs met.

Repression

An unconscious ego defense mechanism that excludes emotionally painful, anxiety-provoking thoughts, memories, or unacceptable impulses from conscious awareness.

Suppression

The conscious, deliberate exclusion of disturbing, unacceptable thoughts, impulses, or feelings from immediate awareness.

Sublimation

An ego defense mechanism in which unacceptable sexual or aggressive impulses are unconsciously channeled into socially acceptable, constructive activities or goals.

Undoing

An ego defense mechanism in which a person uses a specific acceptable act, behavior, or communication to make up for or negate a previous unacceptable act or transgression.

Splitting

A defense mechanism in which an individual views anxiety-provoking persons, objects, or situations as completely all good or all bad, failing to integrate positive and negative traits.

Therapeutic Communication

A purposeful, goal-directed, interpersonal, information-transmitting professional communication process that promotes client understanding, emotional expression, and participation in care.

Active Listening

A communication process wherein the nurse demonstrates verbal and nonverbal attentiveness to the client's message and actively verifies understanding through feedback and restatement.

SOLER

A mnemonic outlining essential nonverbal behaviors for active listening: Sitting and squarely facing the client, Open posture, Leaning toward the client, Eye contact maintenance, and Relaxed posture.

Nontherapeutic Verbal Responses

Communication barriers that impede client expression of ideas or feelings, including asking "why" questions, giving personal opinions, changing the subject, offering false reassurances, and showing sympathy instead of empathy.

Peplau's Four Levels of Anxiety

A psychiatric-mental health nursing framework classifying anxiety into mild (heightened perception, restlessness), moderate (narrowed perceptual field, selective inattention, tremors), severe (greatly reduced perceptual field, scattered focus, hyperventilation), and panic (loss of contact with reality, dysregulated motor behavior, extreme agitation).

Aggression Escalation Phase

The second phase of aggression wherein the client moves toward loss of control; nursing interventions require taking charge using a direct approach, providing calm and firm voice directions, encouraging time to cool off, and calling for staff assistance.

Wernicke's Encephalopathy

An acute, life-threatening neurological disorder caused by thiamine ($\text{vitamin B}_1$) deficiency associated with chronic alcohol use disorder, characterized clinically by nystagmus, ataxia, and confusion.

Korsakoff's Syndrome

A chronic, irreversible neurological memory disorder marked by severe retrograde and anterograde amnesia and confabulation resulting from untreated thiamine ($\text{vitamin B}_1$) deficiency.

Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar)

A validated 10-item instrument used across clinical settings to quantify the severity of alcohol withdrawal symptoms and guide symptom-triggered pharmacotherapy; scores under $10$ generally do not warrant medical management.

Clinical Opiate Withdrawal Scale (COWS)

An 11-item diagnostic rating scale used in inpatient and outpatient settings to serially evaluate the severity of opioid withdrawal symptoms such as tachycardia, gastrointestinal upset, tremor, and pupillary dilation.

Naloxone

A fast-acting opioid receptor antagonist administered intranasally or by injection that reverses life-threatening central nervous system and respiratory depression during an acute opioid overdose.

Three Waves of the Opioid Epidemic

A public health framework describing the rise in opioid overdose deaths since 1999: Wave 1 began with prescription opioids in 1999, Wave 2 with heroin in 2010, and Wave 3 with synthetic opioids (especially illicitly manufactured fentanyl) in 2013.

WITHDRAWAL Mnemonic (Neonatal)

A mnemonic identifying signs of neonatal narcotic abstinence syndrome: Wakefulness, Irritability, Tremulousness/temperature variation/tachypnea, Hyperactivity/high-pitched cry/hyperreflexia/hypertonus, Diarrhea/diaphoresis/disorganized suck, Respiratory distress/rhinorrhea, Apnea, Weight loss or failure to gain, and Lacrimation.

Mandated Reporter

A professional legally required by state law (such as nurses, educators, and social workers) to report suspected abuse, neglect, or exploitation of children, vulnerable adults, and older adults to protective agencies or law enforcement.

Body Mass Index (BMI)

An anthropometric calculation relating weight to height ($\text{kg/m}^2$); defined as underweight ($< 18.5$), healthy/normal weight ($18.5\text{--}24.9$), overweight ($25\text{--}29.9$), and obese ($\text{BMI } \ne 30$).

Nutrigenomics

The study of the interaction between dietary intake and an individual's genetic code, focusing on how specific nutrients and bioactive compounds can induce or suppress gene expression.

Nutrigenetics

A branch of nutritional genomics that identifies specific genetic variations or mutations within an individual to determine vulnerability to dietary triggers, diseases, or metabolic dysfunction (such as lactose intolerance or celiac disease).

Functional Foods

Whole foods, along with fortified, enriched, or enhanced foods, that provide physiologically active compounds offering potential health benefits beyond basic nutrition when consumed regularly in a varied diet.

Estimated Average Requirement (EAR)

A Dietary Reference Intake standard reflecting the average daily nutrient intake level estimated to meet the metabolic requirements of $50\%$ of healthy individuals in a specific life stage and gender group.

Recommended Dietary Allowance (RDA)

A Dietary Reference Intake standard that specifies the daily intake sufficient to meet the nutrient requirements of nearly all ($97\%\text{--}98\%$) healthy individuals in a particular life stage and sex group; used as a goal for individual intake.

Adequate Intake (AI)

A recommended average daily nutrient intake level based on observed or experimentally determined approximations of healthy individuals, utilized when evidence is insufficient to establish an EAR and RDA.

Tolerable Upper Intake Level (UL)

The highest average daily nutrient intake level that is unlikely to pose a risk of adverse health effects to $97\%\text{--}98\%$ of healthy individuals in the general population.

Acceptable Macronutrient Distribution Range (AMDR)

A range of daily intake for an energy nutrient associated with reduced chronic disease risk while providing adequate essential nutrients; for adults, carbohydrates are $45\%\text{--}65\%$, fats are $20\%\text{--}35\%$ (or $25\%\text{--}35\%$), and proteins are $10\%\text{--}35\%$ of daily kcal.

MyPlate Food Guide

A visual USDA dietary guideline illustrating meal proportions across five essential food groups: grains and vegetables covering slightly over half the plate, fruits and protein covering approximately one quarter each, plus a side of dairy.

Glycemic Index

A measure of how rapidly blood glucose concentrations rise after consuming a specific carbohydrate-containing food compared to a standardized reference food.

Cereal Grain Structure

The structural composition of a typical cereal grain, consisting of the nutrient-dense inner germ, the large starchy endosperm, and the outer fiber-rich protective bran layer.

Soluble Fiber

Dietary fiber that dissolves in water to form viscous gels (found in oat bran, barley, legumes, and apples), functioning to lower serum cholesterol, regulate postprandial blood glucose, and enhance satiety.

Insoluble Fiber

Dietary fiber that does not dissolve in water (derived from wheat bran, vegetables, and fruit skins), which accelerates gastrointestinal transit, increases fecal bulk, and decreases intracolonic pressure.

Glycerides Structure

The chemical configuration of true dietary fats, consisting of a glycerol backbone esterified to one fatty acid (monoglyceride), two fatty acids (diglyceride), or three fatty acids (triglyceride).

Essential Fatty Acids

Polyunsaturated fatty acids required for physiological functioning that cannot be synthesized endogenously, specifically linoleic acid (an omega-6 PUFA) and alpha-linolenic acid (an omega-3 PUFA).

Trans-Fatty Acids

Unsaturated fatty acids chemically altered through commercial partial hydrogenation to increase firmness and shelf life, which raise LDL cholesterol and contribute to cardiovascular disease.

Amino Acid Pool

The dynamic internal reserve of free amino acids maintained primarily by dietary protein digestion and cellular catabolism, regulated by the liver and utilized for protein synthesis or energy production.

Complete Protein

A dietary protein source containing all nine essential amino acids in sufficient quantities and correct ratios to sustain tissue growth, repair, and nitrogen equilibrium (predominantly animal sources and soybeans).

Incomplete Protein

A plant-based food protein that lacks or contains an inadequate quantity of one or more essential amino acids, necessitating mutual supplementation (protein complementation) to supply complete protein needs.

Negative Nitrogen Balance

A state in which total nitrogen excretion exceeds total dietary nitrogen intake, indicating excessive tissue catabolism and muscle wasting, typically observed during starvation, critical illness, severe trauma, or immobility.

Positive Nitrogen Balance

A metabolic state in which dietary nitrogen intake exceeds nitrogen excretion, indicating net anabolism and new tissue synthesis, as seen during periods of rapid growth, pregnancy, and recovery from injury.

Albumin

A circulating plasma protein synthesized by the liver that generates oncotic pressure to retain fluid within the intravascular compartment and transports hormones, medications, and nutrients.

Dysphagia

Difficulty in chewing or swallowing that impairs food and liquid transit from the oral cavity into the stomach, presenting a high risk for aspiration, chemical pneumonitis, and undernutrition.

Enteral Tube Access Routes

Anatomical pathways used to deliver tube feedings directly into the digestive tract, including the nasogastric tube (NGT) for short-term gastric feeding, percutaneous endoscopic gastrostomy (PEG) for long-term gastric access, and percutaneous endoscopic jejunostomy (PEJ) directly into the small intestine.

Total Parenteral Nutrition (TPN)

The intravenous administration of complete hypertonic nutritional support—including glucose, amino acids, electrolytes, vitamins, minerals, and lipid emulsions—administered exclusively via a dedicated central venous line.

Colostrum

A thick, yellowish pre-milk fluid secreted by the mammary glands during the first $2\text{--}3\text{ days}$ postpartum; rich in proteins and secretory immunoglobulin A (IgA) to confer early passive immunity to the neonate.

Basal Metabolic Rate (BMR)

The rate of energy expenditure required to sustain involuntary, life-supporting cellular and autonomic functions at rest in an awake, postabsorptive state; increased by fever and growth, decreased by aging, starvation, and sleep.