Psychiatric Mental Health Nursing: Neurocognitive, Substance Use, and Eating Disorders

Comprehensive vocabulary flashcards covering psychiatric mental health nursing concepts, including history, defense mechanisms, substance use disorders, pharmacology, eating disorders, and neurocognitive disorders.

Deinstitutionalization

The historical movement aimed at allowing as many mentally ill individuals as possible to return to the community and lead as normal a life as they could, facilitated by the advent of psychotropic medications in the 1950s.

Nurse Practice Act

A state-specific statute and set of legal regulations that dictates the authorized scope of nursing practice within that particular state.

Phenothiazines

The first class of psychotropic (psychoactive) medications introduced in the 1950s that served as a keystone in facilitating deinstitutionalization.

National Institute of Mental Health (NIMH)

A federal agency established in 1946 to conduct and support research on mental health disorders.

Substance Use Disorder (SUD)

A diagnostic category in DSM-5 combining abuse and dependence into a graded severity of mild, moderate, or severe, characterized by cognitive, behavioral, and physiological symptoms showing continued substance use despite significant problems.

Co-occurring Disorder (Dual Diagnosis)

The simultaneous presence of a substance use disorder alongside an independent psychiatric disorder in the same individual.

Polydrug Use

The concurrent or sequential use of multiple substances, often used to counteract or enhance effects of another drug, which increases complications and life-threatening synergistic effects.

Codependence

A maladaptive relational pattern in which significant others lose their identity and purpose by existing solely for the substance abuser, inadvertently enabling addictive behaviors and shielding them from the consequences of their actions.

Denial (Substance Use)

A defense mechanism wherein an individual minimizes or refuses to acknowledge their substance problem or its negative consequences, even in the presence of overwhelming evidence.

Projection

A coping style whereby a substance user blames external individuals or circumstances for their drinking or drug use to avoid taking personal responsibility for unacceptable behavior.

Rationalization

A defense mechanism in which a person justifies intolerable substance use by generating plausible excuses (e.g., 'I drink to fit in at parties'), reinforcing denial.

Minimizing

A coping strategy where a substance abuser reduces the perceived significance, value, or harmful impact of their behavior to evade conflict (e.g., 'You worry too much').

Manipulation

A behavioral tactic of playing one person against another to obtain one's desires, conceal an addiction, or deflect blame when recovery attempts fail.

Grandiosity

An attitude of exaggerated superiority and irresponsibility, often displaying a marked disregard for others' feelings, which is particularly prominent during acute intoxication.

Binge Drinking

A drinking pattern that raises blood alcohol concentration (BAC) to $0.08\,\text{g/dL}$, typically occurring after consuming $4$ drinks for women or $5$ drinks for men within approximately $2\,\text{hours}$.

Alcohol Withdrawal Syndrome

A cluster of symptoms occurring $4$ to $12\,\text{hours}$ after cessation or reduction of heavy alcohol intake, characterized by autonomic hyperactivity (elevated blood pressure, tachycardia, fever), hand tremors, insomnia, nausea, hallucinations, and tonic-clonic seizures.

Delirium Tremens (DTs)

A severe and extreme manifestation of alcohol withdrawal characterized by impaired consciousness, disorientation, gross memory deficits, vivid hallucinations, and severe tremors.

CIWA-Ar

The Clinical Institute Withdrawal Assessment for Alcohol Scale, a standardized scoring tool used in hospitals to assess withdrawal severity and guide medical detoxification regimens for alcohol, opioids, and benzodiazepines.

Disulfiram (Antabuse)

The first FDA-approved medication for alcohol dependence that produces a severe adverse reaction (palpitations, nausea, vomiting, headache, dyspnea) when alcohol is ingested; strictly contraindicated in severe heart disease.

Naltrexone (Revia, Vivitrol)

An opioid antagonist available as an oral tablet (Revia) or extended-release injection (Vivitrol) that blocks euphoric sensations from alcohol and opioids; the patient must be opioid-free before initiation.

Acamprosate (Campral)

An FDA-approved drug that reduces alcohol cravings in abstinent patients undergoing recovery, serving as an alternative to naltrexone in patients with liver disease.

Topiramate (Topamax)

An anticonvulsant medication that has demonstrated therapeutic promise in reducing alcohol cravings and consumption.

Alcoholics Anonymous (AA)

An international, self-supported 12-step mutual aid fellowship run by recovering peers using first names only, centered on admitting powerlessness over alcohol to achieve and sustain sobriety.

Al-Anon

A specialized 12-step support organization patterned after Alcoholics Anonymous designed to provide mutual support for the family members and friends of individuals with alcoholism.

Alateen

A 12-step support group program adapted from AA specifically created to support teenagers affected by the drinking of a family member or close contact.

Adult Children of Alcoholics (ACOA)

A recovery fellowship branch modeled after AA for adults who grew up in dysfunctional, alcoholic households and did not receive treatment during childhood.

Methadone

A synthetic, long-acting opioid agonist that eliminates opioid cravings and blocks euphoria without inducing acute intoxication, administered daily via federally licensed opioid treatment programs.

Buprenorphine (Subutex)

A partial opioid agonist and antagonist prescribed in office-based settings by certified addiction specialists to suppress opioid withdrawal symptoms and cravings.

Suboxone

A combination medication containing buprenorphine and naloxone, formulated in sublingual or injectable forms to manage opioid withdrawal while discouraging intravenous abuse.

Naloxone (Narcan)

A fast-acting, short-duration opioid antagonist used to reverse life-threatening respiratory depression in acute opioid overdoses, available as an intranasal formulation approved by the FDA in 2015.

Clonidine (Catapres)

A centrally acting alpha-2 adrenergic agonist used during detoxification to suppress autonomic hyperactivity symptoms of opioid withdrawal and bridge transitions off methadone.

Flumazenil

A specific benzodiazepine receptor antagonist indicated for the rapid reversal of sedative and depressant effects resulting from benzodiazepine overdose.

Phencyclidine (PCP)

An illicit dissociative anesthetic causing impulsive behavior, nystagmus, hypertension, and reduced pain response; treated with quiet environments, gastric lavage, and urinary acidification using cranberry juice or ammonium chloride, while avoiding phenothiazines.

Flunitrazepam (Rohypnol)

A potent benzodiazepine-related club drug termed the 'date rape' drug due to its ability to induce rapid sedation, anterograde amnesia, and complete physical incapacitation.

MDMA (Ecstasy)

A club drug and synthetic stimulant-hallucinogen that can precipitate a severe serotonin depletion syndrome several days following ingestion.

Inhalants

Volatile chemical substances (e.g., glue, gasoline, aerosol sprays) widely accessible to youth that produce brief intoxication lasting $15$ to $45\,\text{minutes}$, risking sudden cardiac arrhythmia, chemical airway burns, and permanent CNS damage.

Cocaine

A powerful central nervous system stimulant that causes pupillary dilation, tachycardia, transient venospasms leading to stroke or myocardial infarction, and nasal perforation with long-term insufflation.

Cannabis Detection Window

The biochemical timeframe in which marijuana metabolites remain identifiable in human urine toxicology screens, extending up to $7\,\text{days}$.

Amphetamine Detection Window

The biochemical timeframe during which amphetamine derivatives (such as methamphetamine) remain detectable in urine testing, lasting up to $3\,\text{days}$.

Behavior Modification Reinforcement in Eating Disorders

A targeted behavioral nursing intervention where positive verbal reinforcement is provided strictly for complying with caloric intake and healthy food choices rather than weight changes.

Body Image Disturbance (Anorexia)

A nursing diagnosis where an emaciated client views themselves as fat; interventions involve refraining from overreacting or offering insincere praise, listening attentively, and actively discussing positive traits unrelated to weight.

Alois Alzheimer

The German neurologist who in 1906 first identified the distinct progressive neurodegenerative disease of the brain that bears his name.

Agnosia

The neurological loss of the ability to identify or recognize familiar sensory stimuli and objects, seen as a manifestation of Alzheimer's disease.

Agraphia

The acquired neurological impairment or loss of the ability to write and draw, occurring as a symptom of Alzheimer's disease.

Apraxia

The inability to execute purposeful, learned motor acts despite possessing intact physical motor and sensory capacity, characteristic of Alzheimer's disease.

Pseudodementia

A clinical syndrome where severe major depression mimics dementia, characterized by acute symptom progression, equal recent and remote memory loss, frequent 'I don't know' responses, intact spatial orientation, and severe affective distress.

Neurocognitive Disorder (NCD)

A chronic, progressive syndrome marked by slow onset, greater impairment in recent memory than remote memory, frequent confabulation, disorientation, and symptom worsening as the day progresses.