Mental Exam 3

Arctic hysteria

alaska natives

abrupt episode of extreme excitement followed by seizure and coma

nursing: assessment and safety

brain fog/fag

west africa

sudden unexplained headache and difficulty concentrating

nursing: minimize environmental stimuli

mal de ojo (evil eye)

spain and latin america

stronger person hazing at weaker one can cause illness

nursing: culturally appropriate eye-contact

windigo

native americans, central and NE canada

a state of extreme anxiety

nursing: deep-breathing exercise, minimize environmental stimuli, don’t touch the patient

Mourning

cultural and religious expression of grief; it involves RITUALS practices that facilitate acceptance and integration

nursing role: facilitate rituals (unless it interfering with health or safety)

Disenfranchised grief

it can be complicated by cultural norms that don’t encourage the expression of grief

in some cultures, men may be expected to remain reserved in their grief

in other cultures grief right can be denied

nurse role: screen for depression and self harm behaviors

Cultural consideration

nurse role: bereavement support group: sharing of mutual experiences to help individuals/families cope with their loss and grief

CIWA scoring

0-9 minimal/absent

>20 severe

Impact score and likelihood of MHI

300+ → about 80%

150-299 → about 50%

less than 150 → about 30%

nonadherence

giving up

major defining characteristic of phase 3 crisis

internal resources/motivation

goals

external resources/motivation

support groups

How does biofeedback help asthma

it helps gain control over your body’s physiological responses to stress

autonomous control/locus of control

comparison to a successful experience

cardiac self efficacy; log/self-monitoring table tool

biofeedback techniques with patients with asthma

perceived facilitators

looking up additional resources and facilitators, transportation

denial

presenting facts/reality

treatment with interferons

screen for depression before the start of interferons

phase one abuse: tension building

examples: “i am fine… my eye is black because i stayed up all night” “his work stress and all financial commitments cause his adrenaline to increase this is reflected in his voice tone”

victim’s defense mehanism: denial

phase two abuse: serious battering

examples: “its all my fault” “I deserve it… i provoked him”

victim’s defense mechanism: rationalization/justification

phase three abuse: honeymoon

examples: “he is so generous and sweet”

victims defense mechanism: reaction formation

primary abuse prevention

education of the community regarding the risks of abuse

secondary abuse prevention

screening activities that occur within the community to identify victims of abuse early on and intervene or stop the abuse

tertiary prevention

emergency treatment and counseling to provide long term support to victims of abuse

delusions (thinking others are talking about them)

don’t defeat → dont say they are not talking about you

instead: define who are the other people are . offer to change place, remove client if it becomes unsafe

delusion (persecution/paranoid)

don’t say “no one will kill you”

instead say “you are safe. I have here for you”

don’t defend “the food is not poisoned, let me taste it” WRONG

instead offer alternative food that the client can select and open themselves

neologisms

made-up words

echolalia

repeats the words that are spoken to him (parrot talk)

catatonic stupor

motionless for long periods of time, coma-like

concrete thinking

inability to grasp the essential meaning of a statement/act rather than the literal meaning of it

phenothiazines

mainly to control the positive symptoms of schizophrenia

monitor for extrapyramidal effects

long-acting antipsychotics

haldol, prolixin

mainly with clients who require supervision with medication regiments

haldol can be given every 4 weeks

prolixin can be given every 7-28 days

atypical antipsychotics

to control both the positive and negative effects of schizophrenia

metabolic effects

extrapyramidal effects

parkinsonism: occurs 1-4 after treatment

akathisia: occurs 1-6 weeks after treatment

dystonia: occurs 1-2 days after treatment

tardive dyskinesia: develops late in treatment