Psychology and Mental Health Nursing Exam 1

operant conditioning

reinforcement of a behavior based on a reward, can be positive or negative (skinner)

developemental task of infancy

Achieving basic trust versus mistrust through consistent caregiving and meeting infant needs. ( erickson)

cognitive therapy

focuses on how thinking changes behavior and mental health

SSRI

A group of antidepressants that interact with the serotonin neurotransmitter system to regulate mood, arousal, and attention. Common examples include Fluoxetine (Prozac), Sertraline (Zoloft), and Escitalopram (Lexapro)

SNRI

A group of antidepressants that inhibit both the serotonin and norepinephrine neurotransmitter systems. Examples include Venlafaxine (Effexor) and Duloxetine (Cymbalta)

MAOI

A group of antidepressants that function by inhibiting monoamine oxidase, an enzyme that normally metabolizes and inactivates neurotransmitters such as serotonin and norepinephrine in the synapse. Examples include Phenelzine (Nardil) and Tranylcypromine (Parnate). It is critical to note that combining them with SSRIs (or too many other serotonergic agents) can lead to Serotonin Syndrome, a dangerous reaction characterized by agitation, fever, and rigidity

TCA

A class of antidepressants that includes medications such as Amitriptyline (Elavil) and Nortriptyline (Pamelor). Research indicates that certain ethnic groups, such as African Americans, may respond more rapidly to TCAs but may also experience a higher risk of side effects

NRI

A group of antidepressants that selectively interact with the norepinephrine neurotransmitter system. An example provided in the sources is Atomoxetine (Strattera)

SARI

A group of antidepressants that act as both antagonists and reuptake inhibitors within the serotonin system. Trazodone (Desyrel) is the example listed for this class

neurotrasmitters

chemical messengers between neurons, send signals

dopamine

A neurotransmitter involved in reward, motivation, and regulating movement.

Gaba

calming, inhibatory, antianxiety neurotransmitter

glutamate

excitatory neurotransmitter

serotonin

A neurotransmitter that plays a key role in mood regulation, sleep, and appetite.

antipsychotics

block dopamine

extrapyramidal syndrome

A set of drug-induced movement disorders that may occur with antipsychotic medications, characterized by symptoms such as tremors, rigidity, and bradykinesia.

clarazil

risk of agranulocytosis, may present early with sore throat and fever

agranulocytosis

A potentially life-threatening condition characterized by a dangerously low level of white blood cells, increasing the risk of infections. may result from taking clarazil

cognition

Refers to an individual's current mental processes. Evaluation involves assessing orientation (recognition of person, place, and time), memory (both recent and remote), the ability to concentrate (e.g., repeating days of the week backward), and the capacity for abstract versus concrete thinking

perception

The process of receiving and interpreting sensory information. Assessment focuses on identifying hallucinations, which are false sensory experiences that do not exist in reality. These can involve any of the five senses, with auditory hallucinations being the most common, followed by visual ones

thought process

Describes how the client thinks and the organization of their ideas. Nurses monitor for disorganized patterns such as flight of ideas (fragmented or unrelated ideas), loose associations (ideas with no evident relation), word salad (unconnected words), and tangential or circumstantial thinking

judgement

The ability to interpret one’s environment or situation correctly and to adapt behavior and decisions accordingly. Impaired judgment may be reflected in behaviors that show a lack of reasonable care for oneself or others

insight

The ability to understand the true nature of one’s own situation and to accept personal responsibility for it. A client demonstrates poor insight if, for example, they place all blame on others for their own behaviors or fail to recognize their own need for treatment

agnosia

difficulty naming objects

apraxia

difficulty performing motor functions

aphasia

difficulty speaking

DSM 5

the current official guidebook for categorizing and diagnosing psychiatric mental health disorders in the United States

It provides a standard language and criteria for classification and focuses on the clinical syndromes or patterns associated with distress, disability, or increased risk of suffering

Importantly, it classifies the disorders people have, not the people themselves

positive mental health

characterized by the ability to reach one's full potential, cope with stressors, be productive, and make meaningful contributions to society

stigma

a negative view or belief that leads someone to view a person with mental illness as inferior, dangerous, or unstable. It is a major barrier to treatment and recovery, often leading to social isolation and reduced opportunities for relationships, employment, and housing

milieu therapy

uses the total environment—including the people, setting, structure, and emotional climate—as a tool for healing

operant conditioning

a learning process through which behaviors are modified by reinforcement or punishment, shaping future actions based on consequences.

cognitive therapy

Focuses on immediate thought processing and how a person perceives their experience. The goal is to identify and modify negative, maladaptive patterns of thinking and replace them with rational thoughts

Peplau’s Interpersonal Therapy

Redefined nursing as an interpersonal process where the nurse-patient relationship is the primary tool for healing

preorientation

The initial phase in Peplau's Interpersonal Therapy, where the nurse gathers preliminary information about the patient and their needs before the actual therapeutic process begins.

orientation

The phase in Peplau's Interpersonal Therapy where the nurse and patient meet, establishing rapport and understanding the patient's needs, this is when they set the termination date

working

The phase in Peplau's Interpersonal Therapy where the nurse and patient establish goals and a plan for the therapeutic relationship, focusing on the patient's needs.

termination

The final phase in Peplau's Interpersonal Therapy, where the nurse and patient review progress, conclude the therapeutic relationship, and discuss the patient's future needs. Occurs when problems are resolved; involves ending the relationship and managing feelings of loss

SSRIs

antidepressants that work by inhibiting the reuptake of serotonin, allowing it to remain longer in the synapse and enhancing mood regulation.

don't cause sedation, hypotension, anticholinergic effects, or cardiotoxicity.

SNRIs

Serotonin-Norepinephrine Reuptake Inhibitors

dual-action antidepressants that inhibit the reuptake of both serotonin and norepinephrine, making them effective for depression that hasn't responded well to SSRIs alone.

TCAs

tricyclic acids

an older class of antidepressants that work primarily by blocking the reuptake of norepinephrine and, to a lesser degree, serotonin. This prevents these neurotransmitters from being degraded and increases their levels at the synapse.

not used as often because they have a lot of side affects

MAOIs

monoamine oxidase inhibitors

an older class of antidepressants that work by inhibiting the enzyme monoamine oxidase (MAO), which normally breaks down neurotransmitters like norepinephrine, dopamine, epinephrine, and serotonin. By blocking this enzyme increase the levels of these mood-regulating neurotransmitters.

usually avoided due to dangerous drug and food reactions

antidepressants

-pram, -oxamine, and -oxetine

gaba

the brain's primary inhibitory neurotransmitter.reduces anxiety and relaxes muscles

Benzodiazepines

A class of medications primarily used to treat anxiety, insomnia, and seizures by enhancing the effect of the neurotransmitter GABA in the brain.

zepam or zolam

Benzodiazepines often end in

lithium

is used for bipolar disorder/mania; it has a low therapeutic index, requiring blood level monitoring (0.6–1.2 mEq/L for chronic therapy)

dopamine

nvolved in movement, emotional health, and judgment. Increased in Schizophrenia/Mania; decreased in Parkinson’s

norepinephrine

Regulates mood and alertness during "fight or flight" situations. Increased in mania/anxiety; decreased in depression

serotonin

Affects mood, sleep, and appetite. Decreased in depression and linked to suicide risk

acetylcholine

Plays a role in learning and memory; decreased in Alzheimer’s

extrapyramidal symptoms

Movement disorders that result from antipsychotic medication, including tremors and rigidity.

acute dystonia

A type of extrapyramidal symptom that involves sudden, muscle contractions or spasms, often occurring within hours of medication initiation.

pseudoparkinsonism

A type of extrapyramidal symptom resembling Parkinson's disease, characterized by tremors, stooped posture, masklike face, often occurring due to antipsychotic medication.

akathisia

A type of extrapyramidal symptom characterized by a feeling of inner restlessness and an uncontrollable need to be in constant motion, often seen as a side effect of antipsychotic medications.

neuroleptic malignant syndrome

A life-threatening reaction to antipsychotic medications, characterized by severe muscle rigidity, fever, autonomic instability, and altered mental status.

metabolic effects

antipsychotics increase risk for ________ like weight gain and risk of diabetes

anticholinergic affects

dry mouth, blurred vision, constipation

agranulocytosis

a potentially severe side effect of certain antipsychotic medications, involving a dangerously low level of white blood cells, which increases the risk of infections. clozapine!!!

clozapine

an cause agranulocytosis, a sudden drop in white blood cell count. Priority teaching includes monitoring for fever, malaise, and ulcerative sore throat, and the necessity of regular blood workc

empathy

The ability to perceive and communicate understanding of the client's feelings (distinct from sympathy, which may project the nurse's own feelings)

autonomy

right of clients to make descisions about their own healthcare

beneficence

duty to do good

nonmaleficence

to do no harm

justice

fairness for every patient

veracity

being honest

fidelity

keeping promises

delirium

Rapid onset, brief duration, fluctuating consciousness, and disorganized thought processes; it is transient and clears when the underlying cause is treated

dementia

Gradual onset, progressive deterioration, and consciousness is usually unaffected. Key deficits include aphasia (language), apraxia (motor), agnosia (object recognition), and executive function loss

psychomotor retardation

a slowing down of physical movements, thought processes, and speech that commonly occurs in depression. It's one of the observable physical manifestations of mood disorders.

Psychomotor agitation

is a state of restlessness and increased motor activity that occurs in depression and other mood disorders

pacing, nail biting, finger tapping

Akathisia

is a type of extrapyramidal symptom (EPS) characterized by an intense feeling of inner restlessness and an irresistible urge to move. It's a common side effect of antipsychotic medications.

extrapyramidal symptom

a drug-induced movement disorder that includes symptoms such as tremors, rigidity, and akathisia.

automatism

refers to repetitive, involuntary activities performed without purpose or conscious awareness during a seizure. These behaviors occur most commonly during focal seizures with impaired awareness (formerly called complex partial seizures).

Catatonia

a specifier used in psychiatric diagnosis to describe a particular set of behavioral symptoms characterized by extreme and abnormal motor behavior. It can occur with schizophrenia spectrum disorders and other conditions.

Chorea

rapid, dance-like, jerky, face limbs and body, random and unpredicatable

Athetosis

slow, writhing, jerky, primarily distal location, continuous flowing movements,

dystonia

Sustained muscle contractions, Twisting, repetitive movements, Abnormal postures

tremor

a rhythmic, involuntary oscillating movement of a body part, most commonly affecting the hands, but can also involve the head, voice, tongue, lips, jaw, and diaphragm.

Euthymic

normal, healthy fluctuations in mood characterized by a relatively stable and balanced mood state, without significant mania or depression.

dysthymic

persistent mood disturbance lasting longer than 2 weeks for melancholic (depressive) feelings, Chronic, long-lasting nature distinguishes it from major depressive episodes

hyperthymic

refers to a persistently elevated, expansive, or irritable mood that represents a chronic temperament style rather than an episodic mood disorder. It's characterized by a baseline mood that is consistently higher than the euthymic (normal) range.

dysphoric

unpleasant emotional state, Feelings of dissatisfaction or unease, May include irritability, restlessness, or anxiety, Opposite of euphoria (intense happiness/well-being)

blunted affecct

a significant reduction or absence of emotional expression.This can manifest as a diminished facial expression, lack of spontaneous gestures, and reduced vocal tone. often seen in mood disorders, schizophrenia, and certain neurological conditions.

flat affect

is an expressionless face that reveals little about what a person is thinking or feeling. It represents a severe reduction or complete absence of emotional expression.

Restricted Affect

• Reduced range of emotional expression

• Limited intensity of affect

• Some emotional display present, but narrower than expected

• Less severe than flat or blunted affect

Pressured Speech

• Rapid rate of speech

• Increased volume or quantity of words

• Difficult or impossible to interrupt

• Sense of urgency in communication

• May jump between topics quickly

• associated with mania

prosody

refers to the melodic and rhythmic qualities of speech, including variations in pitch, tone, stress, rhythm, and intonation that give speech its natural flow and emotional expressiveness.

cadence

refers to the rhythm, flow, and tempo of speech—the pattern of beats and pauses that create the natural pacing of how someone speaks.

Dysarthria

a motor speech disorder involving difficulty articulating words clearly due to muscle weakness or impairment affecting the muscles used for speech. It results from damage to the cranial nerves or the muscles themselves that control speech production

echolalia

is a communication disorder characterized by the repetition of phrases or sentences that have been heard, often without comprehension. It can occur in individuals with autism spectrum disorder, brain injuries, or other developmental conditions.

neologism

is the creation or use of new words or phrases that are not part of the standard vocabulary, often seen in individuals with certain brain injuries or psychiatric disorders.

clang associations

a type of disorganized speech pattern where words are strung together based on their rhyming sounds rather than their logical meaning. The person connects words because they sound alike, not because they make sense together

Circumstantial thought process

• Excessive, non-essential details

• Lengthy, winding explanations

• Overinclusive thinking patterns

• Difficulty distinguishing relevant from irrelevant information

• Eventually reaches the point

tangential thought process

• Starts on topic but drifts away

• Never returns to the original point

• Loses the thread of conversation

• Answers are irrelevant to the question asked

• May jump between loosely related topics

loose associations

• Abrupt shifts between unrelated topics

• No logical connection between ideas

• Listener cannot follow the train of thought

• More severe disorganization than tangential thinking

• Ideas seem to "derail" from one track to another

flight of ideas

• Rapid topic changes

• Superficial connections exist (unlike loose associations)

• Disconnected rambling

• May include word play or puns

• Difficult to interrupt due to speed

perseveration

• Repetitive phrases or words

• Repetitive behaviors or actions

• Worsens with stress or anxiety

• Involuntary and automatic

• Related to memory and language deficits