Review Flashcards on Personality Disorders, Mood Disorders, Suicide, Therapeutic Communication and Psychopharmacologic Agents

Flashcards to help review key concepts related to personality disorders, mood disorders, suicide, therapeutic communication, and psychopharmacologic agents covered in the lecture notes.

What are personality disorders characterized by?

Inflexible and maladaptive traits that cause significant interference with functioning or emotional distress.

List some maladaptive or dysfunctional personality traits.

Negative behavior toward others, anger and/or hostility, irritable/labile moods, lack of guilt, impulsive behavior, irresponsibility, risk-taking, mistrust, exhibitionism, dependency, and eccentric perceptions.

Name the personality disorders that belong to Cluster A.

Paranoid, Schizoid and Schizotypal personality disorders.

Name the personality disorders that belong to Cluster B.

Borderline, Antisocial, Narcissistic, and Histrionic personality disorders.

Name the personality disorders that belong to Cluster C.

Obsessive, Avoidant, and Dependent personality disorders.

What percentage of the general population is affected by personality disorders?

10% to 20%

What percentage of people with a primary diagnosis of major mental illness also have a coexisting personality disorder?

30% to 50%

What are the biologic theories related to the etiology of personality disorders?

Temperament, including harm avoidance, novelty seeking, reward dependence, and persistence.

What is the focus of psychopharmacology in the treatment of personality disorders?

Symptom management, targeting cognitive-perceptual distortions, affective symptoms, aggression, and anxiety.

What nursing interventions are appropriate for paranoid personality disorder?

Formal, business-like approach; involving the patient in the plan of care; idea validation before action.

What nursing interventions are appropriate for schizotypal personality disorder?

Self-care, social skills, and community functioning support.

What nursing interventions are appropriate for schizoid personality disorder?

Improved functioning in the community.

What are some key assessment findings in antisocial personality disorder?

Deceit/manipulation, false emotions, no empathy, narrowed view of the world, poor judgment, egocentricity, and using relationships to serve own needs.

What therapeutic interventions are important for antisocial personality disorder?

Establishing a therapeutic relationship, promoting responsible behavior through limit setting and confrontation, problem solving, emotional control using timeout, and enhancing role performance.

What key characteristics are assessed in borderline personality disorder?

Unstable interpersonal relationships, self-image, and affect; marked impulsivity; dysphoric mood; polarized extreme thinking (splitting); and dissociation.

What are the nursing interventions for borderline personality disorder?

Ensuring safety (no self-harm contract), therapeutic relationship (structured, with limit setting), strict adherence to boundaries, communication skills training, coping and emotion control, reshaping thinking patterns, and structuring daily activities.

What are the characteristics of Histrionic Personality Disorder?

Excessive emotionality, attention seeking, insincerity, need to be the center of attention, exaggeration of relationships

What are the characteristics of Narcissistic Personality Disorder?

Grandiosity, need for admiration, lack of empathy, arrogant or haughty attitude, superior view, fragile, vulnerable self- esteem, ambitious

What are the characteristics of Avoidant Personality Disorder?

Social discomfort, low self-esteem, hypersensitivity to negative evaluation

What are the characteristics of Dependent Personality Disorder?

Need to be taken care of; submissive; clinging

What are the characteristics of Obsessive-Compulsive Personality Disorder?

Perfectionism; formal, serious; orderliness a priority; problems with decision making, judgments; low self-esteem; harsh self-evaluations

What are some common symptoms of Major Depressive Disorder?

Sad mood, lack of interest in life activities, changes in eating habits, hypersomnia or insomnia, impaired concentration, worthlessness, hopelessness, thoughts of death/suicide, overwhelming fatigue, and negative thinking.

What are some of the medical treatments and psychotherapies used for Major Depressive Disorder?

Electroconvulsive therapy (ECT), Interpersonal therapy, Behavior therapy, Cognitive Therapy and Transcranial Magnetic Stimulation.

What is Anhedonia and what disorder is it associated with?

Loss of pleasure from previously enjoyed experiences and is associated with Major Depressive Disorder.

What are some key signs assessed in Bipolar Disorder?

Pressured speech, flamboyancy, sexually suggestive behavior, euphoric/grandiose mood, and circumstantiality/tangentiality thinking.

What are the interventions for people with Bipolar Disorder?

Providing safety, meeting physiologic needs, providing therapeutic communication, promoting appropriate behaviors and managing medications.

What mood stabilizer is most appropriate for the treatment of mania associated with bipolar disorder?

Lithium is an antimanic agent, which would be most appropriate for treating a manic patient with bipolar disorder.

What percentage of suicides, are men?

Approximately 72% of suicides are commited by men

What are some key points that a nurse should remember when caring for a client with suicidal ideation?

Take an authoritative role, provide a safe environment using suicide precautions and encourage support systems.

Is family response important when managing clients with suicidal ideation?

Yes it is important, as families often react with guilt, shame and anger.

What should a nurse do when dealing with their own feelings about client suicides?

Practice unconditional positive regard for the person, avoid patient blame, take a nonjudgmental approach and remember that one person can make a difference in another’s life.

What role should the nurse assume when dealing with a patient who is suicidal?

The nurse must take an authoritative role.

What is most important to focus on in Mental health promotion?

Education to address stressors contributing to depressive illness, efforts to improve primary care treatment of depression, and prevention and early detection, and treatment for adolescents.

What is the purpose of therapeutic communication?

Interpersonal interactions focused on the patient's needs that encompass goals to facilitate the nursing process adn effectively meet the standards of client care

What comfortable distance should be used with effective therapeutic communication?

3 to 6 feet

What should a nurse do with active listening?

Concentrate exclusively on what patient says

Define assertive communication

Expression of positive and negative feelings/ideas in open, honest, direct way using Calm, specific factual statements and focusing on “I” statements.

What are the important items to discuss with a client who is starting psychopharmacologic agents?

Check why the medication is given and know the classification of the drug. How will you know if the medication is effective. What is your assessment parameters in monitoring the effects of the drug. Exactly what time should the medication be given. Some drugs are best taken with meals, some after meals, and some on an empty stomach. Other drugs may also be taken without regard to meals. You should know all of these. Client teaching tips. What would you tell your patient to expect. You should be able to give instructions related to the therapeutic and side effects of the drug. Keys to giving it safely. You should be able to identify interventions to counteract the adverse/side effects of the drug.

What are the common indications for Major tranquilizers/antipsychotics/neuroleptics?

Schizophrenia

What is an example of conventional Phenothiazine?

Chlorpromazine (Thorazine)

What Antipsychotic medication is best taken after meals?

Atypical Antipsychotics: Clozapine (Clozaril)

What are some adverse effects of Antipsychotics?

Tardive dyskinesia, NMS (Neuroleptic Malignant Syndrome) Blood dyscrasia and Decreased seizure threshold

What do Anti-parkinsonian drugs treat?

EPS (Extrapyramidal Syndrome)

What adverse side effect should patients on Trihexylphenidyl (Artane) be aware of?

Avoid driving, the drug causes blurred vision

What is a common indication for a Minor Tranquilizers/Anxiolytics?

Anxiety disorders

What should patients avoid when taking Diazepam (Valium)?

Alcohol Intake

What do Tricyclic Antidepressants prevent the reuptake of?

Norepinephrine

What is an important client teaching tip for tricyclic antidepressants?

Therapeutic effects may become evident only after 2 – 3 weeks of intake

What is a potentially dangerous side effect of Amitriptyline (Elavil)?

Cardiac Arrythmias

What is a important teaching point for MAO's?

Report headache; it indicates hypertensive crisis, avoid tyramine containing foods

What are important teaching points for Lithium Carbonate?

Increase fluid intake (3L / day) and sodium intake (3 gm / day) Avoid activities that increase perspiration

What is a normal serum Lithium level?

0.5 – 1.5 meq/L

What is administered if Lithium toxicity occurs?

Mannitol

What is the voltage applied to the patient for ECT?

70 – 150 volts

What nursing action must be taken after ECT?

Turn the patient on his side after to prevent aspiration of saliva

Give examples of contraindications of ECT.

Fever, Increased ICP, Cardiac problems, TB with history of hemorrhage, recent fracture, Retinal detachment and Pregnancy