NUR 215 Mental Health Final

ECT diagnoses

MDD, schizophrenia, acute manic episodes

MDD clinical manifestations

Episodes last over 2 weeks; sad mood, lack of interest in life activities, anhedonia, changes in weight, sleep, energy, concentration, decision making, self-esteem, and goals; some report psychotic symptoms

positive symptoms of schizophrenia

adding; delusions, hallucinations, disorganized thinking speech and behavior

negative symptoms of schizophrenia

subtracting; flat affect, lack of volition, social withdrawal or discomfort

schizophrenia delusions and nursing actions

assess the content and depth of the delusion, don’t support or challenge them, “please explain that to me”, “tell me what you’re thinking about that”

bipolar clinical manifestations

episodes of mania and depression

bipolar medications

lithium to reduce manic episodes, anticonvulsants to stabilize mood, antipsychotics

bipolar nutrition

high calorie, high quality finger foods

mild signs of lithium toxicity

NVD, reduced coordination, drowsiness, slurred speech, muscle weakness

moderate symptoms of lithium toxicity

ataxia, agitation, blurred vision, tinnitus, confusion, hyperreflexia, rash, incontinence, vertigo

severe symptoms of lithium toxicity

cardiac arrhythmia, hypotension, peripheral vascular collapse, seizures, reduced LOC

delirium causes

physiological or metabolic, infection, or drug-related

delirium manifestations

develops over a short period, and fluctuates throughout the day, may experience sensory disturbances and sleep disturbances

schizotypal personality disorder manifestations

pervasive pattern of social and interpersonal deficits, restricted range of emotions, acute discomfort with close relationships; transient psychotic episodes; bizarre speech or dress

anorexia manifestations

may be unable to identify emotions about life events, sense of emptiness, depression and lability in mood, social isolation, low body wieghts, compensatory behaviors (excessive exercise, use of laxatives)

bulimia manifestations

may have normal weight, GI disturbances, lab abnormalities, parotid gland advancement (chipmunk cheeks), dental caries, Russell’s sign (knuckle calluses)

binge eating disorder manifestations

recurrent episodes, no regular use of compensatory behaviors, guilt shame and disgust about eating behaviors, marked psychological distress, likely to be overweight or obese

fluoxetine complications

headaches, nervousness, anxiety, sedation, tremor, sexual dysfunction, anorexia, constipation, ND, and weight loss

cluster A personality disorders

paranoid (pervasive mistrust), schizoid (social detachment, constricted affect), schizotypal (pattern of social and interpersonal deficits)

cluster B personality disorders

antisocial (manipulate), borderline (unstable interpersonal relationships, self-image, and affect, marked impulsivity), histrionic (excessive emotionality and attention seeking), narcissistic (grandiosity, vulnerable self-esteem)

cluster C personality disorders

avoidant (social discomfort, inadequacy and low self-esteem), dependent (need to be taken care of), obsessive compulsive (preoccupation with perfection)

delirium tremens treatment

benzos, correct dehydration, electrolyte imbalances, and vitamin deficiencies

fentanyl complications

bradycardia, DVT, hypocalcemia, hypokalemia, hypomagnesemia, apnea, hypoventilation, respiratory depression

orientation stage of therapeutic communication

establishes the relationship, sets the tone, identifies boundaries

identification stage of therapeutic communication

client presents a need that is not being met, nurse help client identify barriers to wellness

exploitation stage of therapeutic communication

also called the working phase, nurse and client work together toward goals

resolution stage of therapeutic communication

original goals have been met, new goals set, plan for continuity of care is developed

autonomy

right to self-determination and independence

beneficience

one’s duty to benefit or promote the good of others

nonmaleficence

requirement to do no harm, intentional or unintentional

justice

fairness, treating all people equitably

veracity

duty to be honest and truthful

fidelity

obligation to honor commitments and contracts