Mental health final

serotonin syndrome

change in mental status, confusion, restlessness, myoclonus (quick jerking movement), hyperreflexia, ^HR, labile blood pressure, diaphoresis, tremor, fever, DEATH

transference vs. countertransference

• transference - pt TO nurse

• countertransference - nurse TO pt

tardive dyskinesia

• protrusion and rolling of the tongue

• lip smacking

• chewing motion

• facial dyskinesia

• involuntary movement of the body

acute dystonia

involuntary contractions of muscles - face, head, neck, larynx

akathisia

can’t stay still

psueudoparkinsonian

mimic’s parkinsons, tremors, shuffling gait, muscle stiffness, drooling

neuroleptic malignant syndrome (NMS)

• usually caused by dehydration or high potency drugs (Haldol)

• s/s:

  • altered LOC

  • hyperpyrexia (temp 101 - 103F)

  • muscle rigidity

  • autonomic hyperactivity - ^HR, ^BP

clozeril (clozapine)

• antipsychotic

• can cause agranulocytosis - monitor WBC weekly for 6 months then biweekly

• normal WBC - 4,000 - 11,000

s/s of major depression

• anhedonia - inability to feel pleasure

• depressed, irritable, anxious

• complain of pain or other somatic distress

• crying spell or inability to cry

veracity

being trustworthy and honest

fidelity

loyalty and faithfulness to the professionj

justice

fair and equal treatment

beneficence

be kind and charitable to all patients

positive symptoms for schizophrenia

• delusions

• hallucinations - sensory

• disorganized speech

  • Loose associations - illogical

  • Word salad - jumble of words

  • Clanging - rhyming, rapping

  • Echolalia

  • Neologism - creating new words

• Thinking

  • Lack of planning skills or concrete thinking

negative symptoms

• Flat affect

• Apathy - feelings of indifference

• Avolition - lack of motivation for goals

• Anhedonia - loss of interest

• Alogia - decreased speech 

what’s a hallucination?

• sensory experience (command)

• seeing, hearing, feeling, smell, taste

MAOI diet

• DON’T eat tyramine-rich foods

  • can get extremely sick, stroke, MI

  • hypertensive crisis

• aged and matured cheese, aged, and fermented fish, or meat, tap beer, sauerkraut fermented soy sauce

ativan

• used to taper down for alcohol withdrawal

• used for anxiety

xanax

• bad interaction with alcohol

• can get dependence and withdrawal with benzo’s

  • symptomns similar to alcohol + postural hypotension

  • seizures may occur after withdrawal

nursing interventions for OCD

make more time for their compulsion

illness anxiety disorder (hypochondriasis)

exaggerated interpretation/intense fear of serious illness (they don’t have it)

conversion disorder

• functional neurological disorder, symptoms permit avoidance of stress

• “la belle indifference” - being okay with neurological symptoms with no medical reasoning

factitious disorders (fabrication)

• imposed on self - delibrate symptoms fabrication

• imposed on another - munchausen by proxy

  • s/s occurring only in parents presence

anorexia nervosa

• reduction in food intake

• extensive exercising

• clinical manifestations:

  • CV symptoms everything is low (low HR, low BP)

  • brittle and dry everything

  • hypokalemia

bulimia nervosa

• compulsive eating - binging + purging

• clinical manifestations: CV (low HR, high BP)

how do you know when someone has a substance use disorder?

• substance interferes with their ability to fulfill their role obligations

• unable to cut down or control substance - attempts are unsuccessful

• tolerance to drug

• withdrawal when discontinued

• intense cravings for substance - take more time trying to procure substance or recover from effects

• relationship problems

alcohol withdrawal

• alcohol is a CNS depressant

• occurs 2-3 days after last drink

• symptoms may last 3-5 days

  • restless

  • N/V

  • sweaty

  • shaky

  • ^HR, ^BP

  • delirium tremens - severe memory disturbance, agitation, anorexia, and hallucinations

• complications - auditory hallucinations, seizures

Wenicke’s encephalopathy