Psychiatric-Mental Health Nursing Review

Flashcards covering continuum of treatment, psychopharmacology, evidence-based nursing practice, and physiological stress responses.

What five zones are illustrated on the Mental Health Continuum gauge?

Excelling, Thriving, Surviving, Struggling, and Crisis.

According to the National Alliance on Mental Illness (NAMI), what proportion of U.S. adults experience mental illness each year?

1 in 5 U.S. adults.

What proportion of U.S. youth aged 6-17 experience a mental health disorder each year?

1 in 6 U.S. youth.

What proportion of U.S. adults experience a Serious Mental Illness (SMI) each year?

1 in 20 U.S. adults.

What are the three tiers of public health prevention in mental health nursing?

Primary prevention (focuses on preventing mental illness by addressing the individual and environment), Secondary prevention (minimizes early symptoms), and Tertiary prevention (reduces long-term or debilitating effects of severe/chronic mental illness).

What step-by-step approach is used for mental health interventions in school-aged children?

The Multitiered System of Support (MTSS), which includes Tier 1 Promotion (Universal), Tier 2 Prevention (Targeted), and Tier 3 Individualized (Intensive) care.

What are the four steps of neurotransmitter synaptic transmission?

1st: The pre-synaptic neuron sends a neurotransmitter (key); 2nd: The neurotransmitter fits into the receptor site (lock); 3rd: The post-synaptic neuron receives instructions on how to function; 4th: Remaining neurotransmitters undergo reuptake, enzymatic inactivation, or diffusion.

What are the severe effects of excess and severe effects of deficit for dopamine?

Severe excess causes disorganized thoughts, loose associations, disabling compulsions, tics, and stereotypic behaviors. Severe deficit causes Parkinson's disease, endocrine changes, and movement disorders.

What therapeutic actions are associated with norepinephrine, and what occurs during a deficit?

Therapeutic actions include alertness, ability to focus attention, priming the nervous system for "fight or flight", sensory arousal, learning, and memory. Deficit causes a dull state, low energy, depression, social withdrawal, and memory loss.

What receptor types does epinephrine act on to provide a rapid response to perceived threats?

Alpha receptors and Beta 1 and 2 receptors.

What role does serotonin play in sleep regulation?

Serotonin serves as a precursor to melatonin, which plays a key role in circadian rhythms, light-dark cycles, jet lag, female reproductive cycles, and seasonal skin pigment changes.

What clinical manifestations result from a deficit of acetylcholine?

Lack of inhibition, poor recent memory, Alzheimer's disease, euphoria, Parkinson's disease, antisocial behavior, manic behavior, and speech blockage.

What is the primary therapeutic action of GABA (amino acid)?

GABA acts as a generalized inhibitor of interneural transmission and reduces aroused aggression, anxiety, and excitation.

What toxic effects occur when glutamate levels are severely elevated?

Elevated glutamate causes neuron damage leading to brain disorders, rage reactions (including harm to others), delusions, hallucinations, migraines, and hyperirritability.

What are the four main stages of pharmacokinetics in the body?

1. Absorption into circulation, 2. Distribution to various tissues, 3. Metabolism or breakdown, 4. Elimination or excretion in urine or feces.

What medication classes serve as first-line pharmacological treatments for anxiety disorders?

SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors).

What black-box warning risk is associated with antidepressant administration in children and adolescents?

An increased risk of suicidal ideation (SI).

What serious adverse effects and metabolic risks are associated with second-generation (atypical) antipsychotics?

Risk for diabetes, metabolic syndrome, increased BMI and weight gain, extrapyramidal symptoms (EPS) such as tardive dyskinesia, Neuroleptic Malignant Syndrome (NMS), and agranulocytosis (specifically with Clozapine).

What assessment tool is utilized to screen for extrapyramidal symptoms such as tardive dyskinesia?

The Abnormal Involuntary Movement Scale (AIMS).

What anticholinergic side effects are associated with benztropine (Cogentin)?

Dry mouth, decreased sweating, blurred vision, constipation (paralytic ileus), urinary retention, elevated temperature, exacerbation of psychosis, and orthostatic hypotension.

What adverse effect of Class II stimulant medications for ADHD requires monitoring in pediatric patients?

Suppression of growth in children.

What forms of evidence are integrated into mental health nursing evidence-based practice?

Literature reviews, qualitative studies, quantitative studies, mixed methods studies, systematic reviews, expert opinion, and clinical experience.

How is Serious Mental Illness (SMI) defined, and what are key examples?

SMI is defined as a mental, behavioral, or emotional disorder causing severe functional impairment in Activities of Daily Living (ADLs). Examples include Bipolar Disorder, Major Depressive Disorder, and Schizophrenia.

How does self-stigma differ from professional stigma in psychiatric care?

Self-stigma leads to low self-esteem, loss of hope, loss of emotional regulation, and reduced treatment compliance. Professional stigma involves negative thoughts or fear of the client by healthcare providers, leading to reduced quality of care.

What six steps comprise the Nursing Process under the Psychiatric-Mental Health Nursing Standards of Practice?

1. Assessment, 2. Diagnosis, 3. Outcomes Identification, 4. Planning, 5. Implementation (subcategories A-H), 6. Evaluation.

How did Hildegard Peplau define the "therapeutic use of self"?

Using aspects of one's personality, experience, values, feelings, intelligence, needs, coping skills, and perceptions to establish beneficial relationships with clients.

How do the Recovery Model and the Rehabilitation Model differ in focus?

The Recovery Model focuses on a process of change through which individuals improve health and wellness, live a self-directed life, and strive to reach their full potential. The Rehabilitation Model focuses on developing independence across intellectual, spiritual, physical, and psychological domains.

Which brain structures initiate the physiological stress response pathway?

The amygdala sends a distress call to the hypothalamus, which activates the Hypothalamic-Pituitary-Adrenal (HPA) axis, autonomic nervous system (ANS), and central nervous system (CNS).

What five behavioral trauma responses are recognized during a threat?

Fight (confronting the threat), Flight (running away), Freeze (inability to move or act), Fawn (pleasing to avoid conflict), and Flop/Faint (collapsing, fainting, or becoming unresponsive).

What are the three stages of Hans Selye's General Adaptation Syndrome (GAS)?

1. Alarm (acute) stage, 2. Resistance stage, 3. Exhaustion stage.

How does the pancreas respond during an acute physiological stress response?

The pancreas releases glucagon, decreases insulin production, and causes blood glucose levels to rise.

How does Panic anxiety differ from Severe anxiety?

In Severe anxiety, all behavior is directed toward relieving anxiety. In Panic anxiety, the client experiences dread, terror, abrupt distress, details blown out of proportion, personality disorganization, loss of rational thought, and inability to process the environment.

What is toxic stress, and how does it affect child development?

Toxic stress is a prolonged or chronic stress response where the body normalizes fear or trauma, leading to biological and neurological changes in the brain and organs, cognitive impairment, and lifelong health issues.

What physiological changes characterize the relaxation response?

The relaxation response places the body at rest, lowers blood pressure and heart rate, and slows the respiratory rate (the opposite of the stress response).