NCLEX Review: Mental Health Disorders Anxiety Disorders Generalized Anxiety Disorder (GAD) Excessive worry lasting 6 months or more Symptoms: Restlessness Muscle tension Fatigue Poor concentration Sleep disturbance Panic Disorder Sudden intense fear with: Chest pain Palpitations Shortness of breath Feeling of doom Nursing: Stay with client Calm environment Short/simple communication Phobias Irrational fear of object/situation Treatment: Exposure therapy CBT SSRIs sometimes used OCD (Obsessive-Compulsive Disorder) Obsessions = intrusive thoughts Compulsions = repetitive behaviors to reduce anxiety Nursing: Do not suddenly stop rituals Set limits gradually Encourage coping skills PTSD Triggered after traumatic event Symptoms: Flashbacks Hypervigilance Nightmares Avoidance Priority: Safety Trauma-informed care Depression Disorders Major Depressive Disorder Symptoms SIGECAPS: Sleep changes Interest loss Guilt Energy low Concentration poor Appetite changes Psychomotor changes Suicidal thoughts Nursing Priorities Suicide assessment Nutrition/hydration Sleep/rest Medication adherence Medications SSRIs Examples: Sertraline Fluoxetine Teachings: Takes weeks to work Do not stop abruptly Watch for serotonin syndrome Serotonin Syndrome Symptoms: Agitation Fever Tremor Hyperreflexia Diarrhea Bipolar Disorder Mania Symptoms Mnemonic: DIG FAST Distractibility Indiscretion Grandiosity Flight of ideas Activity increased Sleep deficit Talkative Nursing Care Reduce stimulation Set firm limits High-calorie finger foods Encourage rest Medications Mood Stabilizers Lithium Anticonvulsants Lithium Toxicity Therapeutic level: 0.6–1.2 mEq/L Toxic signs: Tremor Vomiting Confusion Ataxia Severe diarrhea Important: Maintain sodium/fluid intake Dehydration increases toxicity risk Schizophrenia Spectrum Disorders Positive Symptoms Things added: Hallucinations Delusions Paranoia Disorganized speech Negative Symptoms Things lost: Flat affect Social withdrawal Anhedonia Lack of motivation Hallucination Nursing Response Present reality “I do not hear the voices.” Assess for command hallucinations Delusions Do NOT argue. Respond: “I understand this feels real to you.” Antipsychotics First Generation Haloperidol Risk: EPS Tardive dyskinesia Neuroleptic malignant syndrome (NMS) Second Generation Olanzapine Risperidone Risk: Weight gain Diabetes Metabolic syndrome EPS Symptoms Acute dystonia Akathisia Parkinsonism Tardive dyskinesia Treatment: Benztropine Diphenhydramine Neuroleptic Malignant Syndrome Medical emergency: Fever Rigidity Confusion Elevated CK Personality Disorders Cluster A Odd/eccentric Paranoid Schizoid Schizotypal Cluster B Dramatic/emotional Antisocial Borderline Histrionic Narcissistic Borderline Personality Disorder Fear of abandonment Splitting staff Self-harm risk Nursing: Consistent boundaries Team communication Cluster C Anxious/fearful Avoidant Dependent Obsessive-compulsive personality disorder Eating Disorders Anorexia Nervosa Severe restriction Distorted body image Bradycardia Electrolyte imbalance Priority: Monitor cardiac status Daily weights Observe after meals Bulimia Nervosa Binge/purge behavior Normal weight often seen Complications: Hypokalemia Dental erosion Substance Use Disorders Alcohol Withdrawal Starts within hours after last drink

Generalized Anxiety Disorder (GAD)

Excessive worry lasting 6 months or more, characterized by symptoms such as restlessness, muscle tension, fatigue, poor concentration, and sleep disturbance.

Panic Disorder

A disorder characterized by sudden intense fear with symptoms like chest pain, palpitations, shortness of breath, and feelings of doom.

Phobias

Irrational fear of an object or situation, often treated with exposure therapy, Cognitive Behavioral Therapy (CBT), and sometimes SSRIs.

Obsessions

Intrusive thoughts associated with Obsessive-Compulsive Disorder (OCD).

Compulsions

Repetitive behaviors performed to reduce anxiety, commonly seen in Obsessive-Compulsive Disorder (OCD).

Post-Traumatic Stress Disorder (PTSD)

A mental health condition triggered by experiencing or witnessing a traumatic event, symptoms include flashbacks, hypervigilance, nightmares, and avoidance.

Major Depressive Disorder (MDD)

Depression marked by symptoms such as sleep changes, interest loss, guilt, low energy, poor concentration, appetite changes, psychomotor changes, and suicidal thoughts.

Serotonin Syndrome

A potentially life-threatening condition caused by increased serotonergic activity in the central nervous system, symptoms include agitation, fever, tremor, hyperreflexia, and diarrhea.

Bipolar Disorder

A mood disorder characterized by alternating periods of mania and depression, with mania symptoms summarized by the mnemonic DIG FAST.

Lithium Toxicity

A condition resulting from high levels of lithium, symptoms include tremor, vomiting, confusion, ataxia, and severe diarrhea.

Positive Symptoms of Schizophrenia

Symptoms that add to the individual's experience, such as hallucinations, delusions, paranoia, and disorganized speech.

Negative Symptoms of Schizophrenia

Symptoms that reflect a loss of normal functions, such as flat affect, social withdrawal, anhedonia, and lack of motivation.

Neuroleptic Malignant Syndrome (NMS)

A medical emergency characterized by fever, rigidity, confusion, and elevated creatine kinase (CK) levels, associated with antipsychotic medication.

Cluster A Personality Disorders

Personality disorders characterized as odd or eccentric, including paranoid, schizoid, and schizotypal types.

Anorexia Nervosa

An eating disorder characterized by severe restriction of food intake, distorted body image, bradycardia, and electrolyte imbalance.

Bulimia Nervosa

An eating disorder characterized by binge eating followed by purging, often with individuals maintaining a normal weight.

Alcohol Withdrawal

Symptoms occurring within hours after the last drink, including tremors, anxiety, tachycardia, seizures, and delirium tremens.

Opioid Overdose

A potentially fatal condition characterized by respiratory depression and pinpoint pupils, typically treated with naloxone.

Suicide Precautions

Strategies to prevent suicide, focusing on high-risk clients with prior attempts, specific plans, accessible means, and feelings of hopelessness.

Therapeutic Communication

Effective communication techniques in nursing that include open-ended questions, reflection, silence, and clarification.