Psych 1 exam

what is a Diagnostic and statistical manual of mental disorders?

used by psychiatrists to classify mental disorders based on criteria like symptoms and duration.

What is NANDA-I diagnosis?

A nursing diagnosis, developed by NANDA-I focuses on patient responses to health conditions (re.g. risk for self-harm) and guides nursing care rather than medical treatment.

What is classical conditioning by Pavlov?

A learning process that occurs through associations between an environmental stimulus and a naturally occurring stimulus, famously demonstrated by Pavlov's experiments with salivation in dogs and bell triggers.

What is operant conditioning by Skinner?

A learning process in which behaviors are increased by rewards or decreased by consequences or punishments, demonstrated in Skinner's experiments with reinforcement schedules.

Pt with Autism spectrum disorder we want to use the operant conditioning by Skinner to increase the frequency and reinforce a specific behavior.

Neurotransmitter: Serotonin (5-HT)

Used for patients with depression since it helps to improve mood regulation, sleep, and appetite.

Neurotransmiter: Dopamine (DA)

Reward, motivation, movement

Neurotransmitter: Norepinephrine

Alertness, focus, response to stress (sympathetic nervous system)

Neurotransmitter: GABA

primary inhibitor NT, reduces excitability and calms neural activity, contributing to relaxation and anxiety reduction.

Neurotransmitter: Glutamate

Primary excitatory NT, involved in learning and memory

Neurotransmitter: Acetylcholine

Plays a role in muscle movement, attention, memory, and learning. It is involved in both the peripheral and central nervous systems. Primary neurotransmitter for parasympathetic.

You will decreased acetylcholine in alzheimer patients.

How do neurotransmitters communicate by binding to receptors on postsynaptic neurons.

Reuptake inhibitors back the reabsorption of NTs back into the presynaptic cell, increasing the avaliability in the synapse. For example, SSRIs block serotonin reuptake, enhancing mood.

What are the 4 main types of EPS

Dystonia, Akathisia, Parkinsonism, Tardive Dyskinesia

What is dystonia

sudden muscle contractions

what is akathisia

internal restlessness

what is parkinsonism

tremor, rigidity, and bradykinesia due to dopamine deficiency.

what is Tardive dyskinesia

repetitive involuntary facial or body movementts

which antispsychotic medications have bad side effects?

first-generation medications

What is Milieu therapy?

Use of therapeutic environment to support patient healing. It includes safety, structure, supportive staff, and social activities.

What are the key concerns of milieu?

include maintaining patient safety, setting boundaries, and encouraging engagement with peers and staff. These concerns are critical for effective therapeutic interventions and overall patient well-being.

What is assertive community treatment?

A team-based approach for individuals with severe mental illness who have frequent hospitalizations or difficulty engaging with traditional treatment. It provides 24/7 care coordination, medication support, and housing assistance in the community.

What does culturally competent care mean?

Understanding and respecting diverse cultural backgrounds, beliefs, and health practices. It requires awareness of one’s own biases, effective cross-cultural communication, and adapting care plans to meet cultural needs.

What is the nursing process?

ADPIE

What do you do in assessment?

Gather information

What do you do in diagnosis

analyze the data collected during the assessment to identify the patient’s actual or potential health problems.

What is planning?

Planning involves setting prioritized goals and expected outcomes, and selecting nursing interventions to address the nursing diagnoses.

Use of SMART goals (specific, measurable, achievable, realistic, time-bound)

What is implementation?

Implementation is the action phase where the nurse puts the plan into action to achieve the patient’s goals

What is evaluation?

Evaluation is where the nurse determines if the goals and outcomes were met and whether to continue, modify, or stop the plan.

What are some examples of therapeutic communication?

- Active listening
- Using open-ended questions
- Restating or paraphrasing
- Reflecting feelings
- Providing silence
Avoid nontherapeutic techniques like giving advice or false reassurance.

what is lithium used for?

bipolar disorder

What is the therapeutic range of lithium and why is it important to be careful of?

0.8-1.2 mEq/L. It has a narrow therapeutic range.

What are some side effects of lithium?

tremors, GI upset, hypoglycemia, hyperlipidemia, and weight gain.

What are some sighs of lithium toxicity?

Confusion, seizures, arrhythmias.

What should you do to prevent lithium toxicity

stay hydrated!

what rights do the patients have?

Patients have the right to:
- Refuse treatment (unless under court order)
- Be informed about their care
- Request or be assigned legal representation
- Participate in treatment planning
- File grievances
- Access their medical records

what is 5150

72-hour involuntary hold for danger to self/others or grave disability.

what is 5250

14-day hold following 5150.

why would someone go to a court hearing?

Patients can request certification review hearings and habeas corpus to contest holds.

what is tarasoff?

Tarasoff ruling mandates that mental health professionals must warn identifiable victims if a patient poses a credible threat of serious harm to them. This is known as the “duty to warn” or “duty to protect.”

what should the nurse include in documentation for restraints?

-Reason for restraint
- Type and duration
- Behavior before/after
- Alternatives attempted
- Orders from a provider
- Continuous monitoring details
Nurses must follow strict protocols and review requirements hourly.

What tis the Diathesis-stress model?

This model explains that mental illness results from the interaction between a genetic or biological predisposition (diathesis) and environmental stressors. Neither alone is sufficient to cause mental illness, but together they increase risk.

Ex: you can still get through life without getting schizophrenia!

what are the most common therapies used today?

- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Psychodynamic therapy
- Group therapy
- Family therapy
- Medication management

what is pharmacokinetics

how the body affects the drug (absorption, distribution, metabolism, excretion).

what is pharmacodynamics?

how the drug affects the body (mechanism of action, therapeutic and side effects)

what is monoamine hypothesis?

The monoamine hypothesis suggests that depression is caused by a deficiency of monoamine neurotransmitters (serotonin, norepinephrine, dopamine). Many antidepressants aim to increase their levels

what are the stages to therapeutic relationship

1. Pre Orientation: preparing before meeting patient.
2. Orientation: establishing trust and setting goals.
3. Working: implementing care and encouraging change.
4. Termination: ending the relationship, reviewing progress.
Trust-building and boundaries are key in all stages.

what are the two classes of antipsychotic drugs

First-generation (typical) and second-generation (atypical)

What are first generation (typical) antipsychotics

strong D2 antagonists; higher EPS (extrapyramidal symptoms risk).

what are second-generation (atypical) antipsychotics

target both D2 and 5HT2A; lower EPS, higher metabolic syndrome (hyperlipidemia, hypoglycemic risk).

what is primary prevention

prevent illness such as mental health education

what is secondary prevention

early detection (screening for depression)

what is tertiary prevention

reduce impact (rehab and medication adherence)

what are the three stress responses of Selye’s general adaptation syndrome?

Alarm, resistance, exhaustion

what is the alarm stage?

fight or flight. Cortisol stress hormon released.

what is the resistance stage?

Adaptation continues

what is the exhaustion stage?

Prolonged stress leads to body’s resource depletion and illness.