Mental Health Nursing: Mood Disorders, Psychosis, Neurocognitive Disorders, and End-of-Life Care

Comprehensive vocabulary flashcards covering psychiatric-mental health nursing concepts including mood disorders, suicide prevention, schizophrenia spectrum disorders, neurocognitive disorders (delirium and dementias), models of grief and bereavement, and clinical pearls for managing death, dying, and clinician well-being.

Disruptive Mood Dysregulation Disorder

A disorder diagnosed in children who exhibit extreme irritability, temper tantrums, and trouble functioning in school and with peers.

Cyclothymic Disorder

A chronic mood disorder diagnosed when a client alternates between hypomanic symptoms and mild-to-moderate depressive symptoms for at least $2\text{ years}$, with shifts that are less severe than those seen in bipolar I or bipolar II disorder.

Major Depressive Disorder (DSM-5 Criteria)

A mood disorder requiring five or more diagnostic symptoms to be present during the same $2\text{-week}$ period representing a change from previous functioning, where at least one symptom must be depressed mood or loss of interest or pleasure (anhedonia).

Bipolar I Disorder

A mood disorder characterized by the occurrence of at least one manic episode that is not better explained by another clinical diagnosis.

SAD PERSONS Scale

A $10\text{-item}$ suicide risk assessment scoring tool (Sex male, Age $<19$ or $>45$, Depression, Previous attempt, Ethanol, Rational thinking loss, Social supports lacking, Organized plan, No partner, Sickness); scores of $0\text{ to }2$ indicate discharge home with follow-up, $3\text{ to }6$ indicate admission or discharge with close follow-up, and $7\text{ to }10$ necessitate hospital admission.

Suicide Prevention Strategies (CDC Framework)

A comprehensive public health approach consisting of seven core strategies: strengthen economic supports, strengthen access to and delivery of suicide care, create protective environments, promote connectedness, teach coping and problem-solving skills, identify and support people at risk, and lessen harms to prevent future risk.

Electroconvulsive Therapy (ECT) Nursing Protocol

A psychiatric procedure where electrical current induces therapeutic seizures lasting $45\text{ to }60\text{ seconds}$; nursing responsibilities include keeping the client NPO for $6\text{ to }8\text{ hours}$, discontinuing benzodiazepines, administering rapid anesthesia and paralytics, and inflating a lower-leg blood pressure cuff above systolic pressure prior to muscle relaxant injection to observe motor seizure activity in the great toe.

Mania Nutritional Interventions

Providing high-calorie, nutrient-dense finger foods (such as milkshakes, cheese, nuts, and sandwiches) that allow the client to maintain adequate hydration and caloric intake while pacing or in constant motion.

Psychosis

A mental state defined by a disruption or disconnection with reality, manifested through disturbances in thinking and sensory perception such as delusions and hallucinations.

Schizophrenia Spectrum Disorder (DSM-5-TR Criteria)

A disorder diagnosed by the presence of two or more characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior, or negative symptoms) for at least $1\text{ month}$, with continuous signs of disturbance persisting for at least $6\text{ months}$ and causing significant social or occupational dysfunction.

Symptoms of Schizophrenia (Positive, Negative, and Cognitive)

The three symptom domains of schizophrenia: positive symptoms reflect an excess of normal functions (hallucinations, delusions, disorganized speech); negative symptoms reflect a deficit or loss of normal functions (alogia, anergia, anhedonia); and cognitive symptoms involve neurocognitive deficits (slow processing, poor concentration, memory impairment).

Anosognosia

A neurological condition and common barrier to psychiatric treatment wherein a client has an inability to recognize or perceive their own illness or mental health condition.

Phases of the Nurse-Client Relationship (Peplau)

A four-stage interpersonal framework: Orientation (establishing rapport, acknowledging illness), Identification (working together on problems, client begins understanding condition), Exploitation (actively utilizing interventions and therapies toward goals), and Resolution (termination, rehabilitation, and independent client functioning).

Extrapyramidal Symptoms (EPS)

Drug-induced movement disorders caused by dopamine-blocking antipsychotics, presenting as acute dystonia, akathisia (motor restlessness), pseudoparkinsonism, and tardive dyskinesia.

Command Hallucinations Assessment

A direct communication technique in schizophrenia wherein the nurse specifically asks, "What are the voices saying to you?" to identify directives that order the client to harm themselves or others.

Delirium

An acute, fluctuating cognitive disturbance characterized by impaired attention, altered level of consciousness, and disorganized thinking, typically triggered by underlying medical factors (e.g., infection, dehydration, drug toxicity) and reversible with prompt intervention.

Dementia (Major Neurocognitive Disorder)

A chronic, progressive decline in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) that impairs independence in everyday activities and occurs without an altered level of consciousness.

Alzheimer's Disease Neuropathology

A progressive neurodegenerative disorder histopathologically marked by the accumulation of extracellular amyloid plaques and neurofibrillary tangles, leading to severe cerebral cortical atrophy, ventricular enlargement, and progressive loss of cognitive functioning.

Mini-Mental State Examination (MMSE) Staging

A cognitive screening assessment scored out of $30$ points used to categorize the progression of Alzheimer's disease: mild impairment ($22\text{ to }26$), moderate impairment ($18\text{ to }20$), and severe impairment ($0\text{ to }10$).

Lewy Body Dementia (LBD)

A neurodegenerative dementia characterized by the presence of abnormal protein deposits (Lewy bodies) in the brain, clinically manifesting as fluctuating cognition, recurrent visual hallucinations, spontaneous parkinsonism, REM sleep behavior disorder, and extreme neuroleptic sensitivity.

Frontotemporal Lobar Degeneration (FTLD)

A group of neurocognitive disorders characterized by progressive degeneration of the frontal and temporal lobes, causing behavioral variants (marked disinhibition, loss of empathy, apathy, hyperorality) or language variants (primary progressive aphasia), often associated with tau (MAPT), GRN, or C9ORF72 genetic mutations.

Traumatic Brain Injury (TBI) Severity Ratings

A clinical classification system based on Glasgow Coma Scale (GCS) score, loss of consciousness (LOC), and posttraumatic amnesia (PTA): Mild (LOC $<30\text{ minutes}$, PTA $<24\text{ hours}$, GCS $13\text{ to }15$); Moderate (LOC $30\text{ minutes to }24\text{ hours}$, PTA $24\text{ hours to }7\text{ days}$, GCS $9\text{ to }12$); Severe (LOC $>24\text{ hours}$, PTA $>7\text{ days}$, GCS $3\text{ to }8$).

MIND Diet

A neuroprotective dietary pattern combining the Mediterranean and DASH diets—emphasizing green leafy vegetables, berries (strawberries, blueberries), nuts, olive oil, fish, and beans while eliminating or restricting alcohol and red meat—to slow cognitive decline.

Five Stages of Grief (Kübler-Ross Model)

A non-linear model describing emotional reactions to impending death or profound loss: Denial, Anger, Bargaining, Depression, and Acceptance.

Dual Process Model of Grief

A framework describing coping with bereavement through oscillation between loss-oriented coping (processing grief, experiencing emotional pain, denial) and restoration-oriented coping (adjusting to identity changes, attending to daily tasks, developing new routines).

Task (TEAR) Model of Grief

A structured four-task model of bereavement: T = To accept the reality of the loss, E = Experience the pain of grief, A = Adjust to change and an environment without the deceased, R = Reinvest emotional energy into a new reality.

Four Phases of Grief (Bowlby & Parkes)

A developmental framework outlining the progression of grief through four phases: Phase 1 (Shock and numbness), Phase 2 (Yearning and protest), Phase 3 (Despair and disorganization), and Phase 4 (Reorganization and recovery).

Disenfranchised Grief

A grief response experienced when an individual's loss is not openly acknowledged, socially validated, or publicly mourned, often occurring with stigmatized relationships (ex-spouses, LGBTQ+ partners, extra-marital partners), stigmatized causes of death (suicide, overdose, HIV/AIDS), or non-death losses (infertility, dementia).

Prolonged Grief Disorder (PGD)

A persistent and disabling bereavement reaction characterized by intense longing or preoccupation with the deceased lasting beyond culturally accepted norms (typically exceeding $6\text{ to }12\text{ months}$), leading to severe functional impairment.

Professional Quality of Life (ProQOL) Framework

A conceptual model assessing professional well-being in caregivers, divided into Compassion Satisfaction (pleasure derived from helping others) and Compassion Fatigue, which further splits into Burnout and Secondary Trauma.

Moral Distress

The psychological, emotional, and physical suffering (headaches, gastrointestinal upset, sleep disturbances, nightmares) experienced by clinicians when institutional barriers or ethical conflicts prevent them from doing what they believe is ethically correct.

The Pause

A brief $30\text{- to }45\text{-second}$ bedside moment of collective silence practiced by the healthcare team immediately following a patient's death or failed resuscitation to honor the deceased individual and emotionally ground clinicians.

Cheyne-Stokes Respirations and Death Rattle

Natural end-of-life respiratory patterns consisting of irregular rhythmic cycles of apnea alternating with deep breaths (Cheyne-Stokes) and audible crackling or gurgling sounds caused by secretions pooling in the hypopharynx (death rattle).

GRIEV_ING Framework

An evidence-based communication mnemonic for delivering bad news and death notification: Gather the family, Resources mobilized, Identify yourself and the deceased, Educate using plain terms, Verify death explicitly, Space for silence and emotion, Inquire for questions, Nuts and bolts (autopsy, belongings, donation), Give contact and follow-up resources.

Cumulative Grief

An emotional compounding effect seen frequently among nurses working in intensive care, oncology, or geriatrics, occurring when multiple losses are experienced in rapid succession without adequate recovery time between deaths.