PMH Exam 3

Neurodevelopmental, Personality and Disruptive Behavior Disorders w/ substance abuse

When is autism diagnosed and with what symptoms?

early age w/ social impairmnt, delayed developmental milestones (speech etc) hypersensitivity or focus on a topic

What meds are typically given to manage symptoms of autism?

2nd Gen Antipyschotics: risperidone

SSRIs

Nursing interventions for autism?

structured environment to avoid sensory overload

What is the tx/ meds for ADHD?

1. CBT/reward program

2. Meds: Adderall/ Ritalin

What is the difference between ODD and CD?

CD is generally more aggressive/ violent

What is the intervention/ med given for disruptive behavior disorders? (ODD/CD)

limited choices/ clear boundaries and Risperidone

What are positive symptoms of schizophrenia?

• hallucinations

• delusions

• Word salad speech/ Catatonia

What are negative symptoms of schizophrenia?

• anhedonia (lack of pleasure)

• avolition (lack of motivation)

• alogia (lack of speech)

What are the guidelines to diagnose brief psychotic diroder?

symptoms for <1 month

What are the guidelines to diagnose schizophreniform?

1-6 months of symtoms

What are the guidelines to diagnose schizophrenia?

symptoms for >6 months

What is schizoaffective disorder?

 Features of schizophrenia combined with a major mood disorder (Bipolar or Depressive type)

1st Gen Antipsychotics (typical) used for schizophrenia? Risk factors?

Haloperidol, Chlorpromazine

Risks: EPS (dystonia, parkinsonism), TD (face twitching), anticholinergic effects (dry mouth, urinary retention)

What is the mechanism of antipyschotics?

Lower high dopamine

What drug is often used to manage extrapyramidal symptoms (EPS)?

benztropine

2nd Gen Antipsychotics (atypical) used for schizophrenia? Risks of each?

1. Risperidone

2. Clozapine: WBC count risk, report signs of INFECTION

   1. Metabolic syndrome (weight gain)

What are signs of Neuroleptic Malignant Syndrome (NMS)? Tx?

LIFE THREATENING rxn to antipsychotics with fever, tachy, muscle rigidity

tx: stop med, IV fluids, muscle relaxant (dantrolene)

What are cluster A personality disorders? (odd/eccentric)

• Paranoid

• Schizoid

• Schizotypal

What are cluster B personality disorders? (dramatic)

• antisocial

• borderline

• histrionic

• narcissistic

What are cluster C personality disorders? (anxious)

• avoidant

• dependant

• OCD

What is the most important staff intervention for patients with a cluster B personality disorder (dramatic)?

unified staff communication to prevent splitting

What is the gold standard for tx of Borderline?

DBT

What are s/s of alcohol withdrawal?

tachy, tremors, HTN, anxiety (assess with CIWA protocol)

What is the gold standard for alcohol withdrawl?

Benzodiazepines (lorazepam, chlordiazepoxide)

What are delirium tremors (DT) with alcohol withdrawal?

Medical emergency usually occurring 48-72 hours after the last drink. Severe agitation, visual/tactile hallucinations, severe autonomic hyperactivity

What drug is used for long term control of alcohol withdrawl?

Naltrexone

What withdrawals are typically life threatening?

alcohol, benzos, barbiturates NOT opiods

What are s/s of opioid OD? tx?

Respiratory depression, coma, pinpoint pupils (assess with COWs scale)

Narcan

What are signs of stimulant intoxication?

dilated pupils, tachy, HTN, euphoria

What is the tx for nicotine?

replacement therapy, bupropion

What are patients receiving stimulant meds (ritalin/ adderall) for ADHD at risk for? Monitor what?

Assess high BP/HR and weight loss /appetite

What is the term for an acute painful involuntary muscle contraction caused by antipsychotics?

Dystonia

What are the most common characteristics of NMS?

fever, encephalopathy, rigidity

Which med is FDA approved for irratability associated with autism?

risperidone

What is a common side effect of typical antipsychotics?

extrapyramidal symptoms (EPS)

What is the primary cause of death in opioid OD?

respiratory distress

What deficiency causes encephalopathy?

Thiamine B1

What is a sign of opioid intoxication?

pinpoint pupils

What is the most common med class used for alc withdrawl?

benzos

Which disorder involves persistent violation of others rights and major social rules?

(CD) conduct disorder

What is a common side effect of atypical antipyschotics?

Hyperlipidemia (HLD)

what is there term for scars along veins associated with repeated IV drug use? and are they common?

track lines, common but check for infection

Which symptoms indicate a medical emergency with cloazapine?

fever, sore throat, infection symptoms