Mental Illness Study Guide

Study Guide Quiz 4 – Mental Illness (Style A)

Lithium

  • Definition and Uses

    • Lithium is utilized as a mood stabilizer for bipolar disorder, particularly for managing manic episodes.

  • Pharmacokinetics

    • It takes approximately 10 days to reach its full therapeutic effect.
    • Lithium is primarily excreted by the kidneys.

  • Therapeutic Range

    • The therapeutic range for lithium is between 0.6 to 1.2 mEq/L; for acute mania, it can be higher, up to 1.5 mEq/L.

  • Signs of Toxicity

    • Symptoms indicating lithium toxicity include:
    • Nausea
    • Vomiting
    • Diarrhea
    • Tremor
    • Slurred speech
    • Confusion

  • Prevention of Toxicity

    • To prevent toxicity, it is essential for individuals to maintain a fluid intake of 2 to 3 liters daily, along with adequate sodium intake.

Major Depressive Disorder (MDD)

  • Definition

    • MDD is characterized by a persistent depressed mood lasting at least two weeks.

  • Symptoms

    • Common symptoms of MDD include:
    • Low energy
    • Changes in sleep patterns
    • Changes in appetite
    • Feelings of guilt
    • Hopelessness
    • Suicidal thoughts

  • Causes

    • MDD may arise from an imbalance in neurotransmitters or due to situational stressors.

  • Treatment Options

    • Treatment typically includes:
    • Selective Serotonin Reuptake Inhibitors (SSRIs)
    • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
    • Monoamine Oxidase Inhibitors (MAOIs)
    • Tricyclic antidepressants
    • Psychotherapy

  • Nursing Care

    • Focused on ensuring safety, providing support, and promoting realistic goal setting for patients.

Obsessive Compulsive Disorder (OCD)

  • Definition

    • OCD is defined by the presence of recurring intrusive thoughts (obsessions) and repetitive behaviors (compulsions).

  • Behavioral Characteristics

    • Compulsive behaviors, such as handwashing or checking, typically serve to reduce anxiety.

  • Treatment Options

    • Effective treatments for OCD include:
    • SSRIs
    • Cognitive-behavioral therapy (CBT)

  • Nursing Approach

    • Initially allow the rituals to occur, and subsequently help the patient limit these behaviors gradually.

Suicide

  • Definition

    • Suicide is characterized by direct or indirect self-harm with the intent to die.

  • Risk Factors

    • Factors increasing suicide risk include:
    • Depression
    • Post-Traumatic Stress Disorder (PTSD)
    • Schizophrenia
    • Substance abuse

  • Warning Signs

    • Indications that a person may be considering suicide comprise:
    • Giving away possessions
    • Expressing feelings of hopelessness
    • Developing a suicide plan

  • Nursing Care

    • Essential nursing interventions include:
    • One-on-one monitoring of the patient
    • Removal of harmful objects from the vicinity
    • Implementation of a no-suicide contract with the patient.

Alzheimer’s Disease

  • Overview

    • Alzheimer’s Disease is the most prevalent form of dementia, characterized by gradual, irreversible memory loss and confusion.

  • Causes

    • The disease is associated with the presence of amyloid plaques, neurofibrillary tangles, and brain shrinkage.

  • Risk Factors

    • Identifiable risk factors include:
    • Aging
    • Genetic predisposition
    • History of head trauma

  • Treatment Options

    • Commonly used treatments include:
    • Cholinesterase inhibitors (e.g., Donepezil)
    • Memantine

  • Nursing Care

    • Nursing care strategies focus on:
    • Ensuring patient safety
    • Providing orientation aids
    • Offering family support.

Dementia

  • Definition

    • Dementia is classified as a chronic progressive loss of memory and reasoning abilities.

  • Known Symptoms

    • Symptoms may include:
    • Aphasia: Difficulty in verbal communication.
    • Apraxia: Difficulty in performing purposeful movements despite having normal motor functioning.
    • Agnosia: Inability to recognize objects or people.

  • Nature of Dementia

    • It is an irreversible condition; consequently, nursing care emphasizes safety, routine, and support for caregivers.

Delirium

  • Definition

    • Delirium is described as an acute, reversible confusion with a sudden onset.

  • Causes

    • Common causes include:
    • Infections
    • Medication side effects
    • Metabolic imbalances

  • Symptoms

    • Symptoms experienced may consist of:
    • Confusion
    • Hallucinations
    • Restlessness
    • Anxiety

  • Nursing Care

    • Focused on ensuring a safe environment, providing a calm atmosphere, and addressing the underlying cause.

Anxiety / Acute Anxiety

  • Definition

    • Characterized by feelings of unease that accompany physical symptoms like increased heart rate (HR) and muscular tension.

  • Impact of Anxiety Levels

    • Mild levels of anxiety can enhance concentration and focus, while severe anxiety can precipitate a feeling of loss of control.

  • Nursing Care

    • Involves establishing a calm environment, implementing relaxation techniques, and providing short, clear explanations to patients.

Panic Disorder

  • Definition

    • Panic disorder includes sudden episodes of intense fear and panic lasting between 15 to 30 minutes.

  • Symptoms

    • Symptoms during these episodes may include:
    • Chest pain
    • Shortness of breath (SOB)
    • Dizziness
    • Intense fear of dying

  • Nursing Care

    • Approaches include:
    • Staying with the patient during the episode
    • Providing reassurance
    • Teaching relaxation techniques.

Bipolar Disorder

  • Overview

    • Bipolar disorder involves alternating between manic and depressive episodes.

  • Manic Symptoms

    • During manic phases, symptoms typically include:
    • Euphoria
    • High energy levels
    • Impulsive behavior

  • Depressive Symptoms

    • Depressive episodes are characterized by feelings of:
    • Fatigue
    • Sadness
    • Hopelessness

  • Treatment Options

    • Management often includes:
    • Lithium
    • Anticonvulsants
    • Antipsychotics

  • Nursing Care

    • Focus areas include:
    • Providing structure
    • Monitoring lithium levels
    • Ensuring patient safety.

Phobia

  • Definition

    • Phobia is an irrational fear of specific situations or objects that leads to avoidance behavior.

  • Treatment Methods

    • Treatment often entails:
    • Desensitization strategies
    • Relaxation techniques
    • Cognitive therapy

  • Nursing Strategies

    • Nurses support patients through gradual exposure and help reinforce coping techniques.

Post-Traumatic Stress Disorder (PTSD)

  • Definition

    • PTSD is experienced following trauma and is marked by symptoms such as flashbacks, nightmares, and avoidance behaviors.

  • Treatment Approaches

    • Common treatment modalities include:
    • Cognitive Behavioral Therapy (CBT)
    • Exposure therapy
    • SSRIs

  • Nursing Care

    • Nurses should encourage:
    • Emotional expression
    • Ensuring a sense of safety
    • Identifying personal triggers for symptoms.

ECT – Electroconvulsive Therapy

  • Purpose

    • ECT is utilized for severe depression, particularly when medications are ineffective.

  • Mechanism of Action

    • The procedure induces a brief seizure, aiming to balance neurotransmitters in the brain.

  • Nursing Care Steps

    • Important care protocols include:
    • Obtaining signed consent
    • Ensuring the patient is NPO for 6–8 hours before the procedure
    • Maintaining airway during the procedure
    • Providing comprehensive post-care support.

Antidepressants

  • Function

    • Antidepressants are prescribed to improve mood by restoring balance to brain chemicals.

  • Types

    • First-line treatments include:
    • SSRIs
    • SNRIs
    • MAOIs require careful dietary restrictions due to potential side effects.

  • Patient Education

    • It's crucial to inform patients that:
    • Medication effects may take 2 to 4 weeks to manifest and that they should not abruptly discontinue usage.

Mental Health Status Exam

  • Assessment Areas

    • The exam evaluates essential areas such as:
    • Appearance
    • Mood
    • Thought process
    • Cognition
    • Judgment

  • Purpose

    • The Mental Health Status Exam assists nurses in evaluating the patient’s emotional and mental functioning.

Generalized Anxiety Disorder (GAD)

  • Definition

    • GAD is characterized by chronic excessive worry persisting for 6 months or longer.

  • Symptoms

    • Symptoms may include:
    • Fatigue
    • Insomnia
    • Muscular tension
    • Irritability

  • Treatment Options

    • Typical treatment strategies include:
    • Therapy
    • Relaxation techniques
    • Anti-anxiety medications.

Apraxia

  • Definition

    • Apraxia refers to the inability to perform purposeful movements despite having normal motor abilities.

  • Association with Conditions

    • It is commonly observed in patients with dementia and Alzheimer’s disease.

Sundowning Syndrome / Nocturnal Delirium

  • Definition

    • This syndrome is characterized by evening confusion and agitation frequently observed in dementia patients.

  • Nursing Interventions

    • Effective strategies comprise:
    • Maintaining adequate lighting
    • Establishing a consistent routine
    • Creating a calm environment to enhance safety.

Seasonal Affective Disorder (SAD)

  • Definition

    • SAD is a form of depression triggered by reduced sunlight, particularly prevalent during the winter months.

  • Symptoms

    • Symptoms associated with SAD may include:
    • Tiredness
    • Overeating
    • Social withdrawal

  • Treatment Options

    • Effective treatments can include:
    • Light therapy
    • SSRIs
    • Regular exercise.

Discharge Planning for Anxiety

  • Patient Education

    • Key components of discharge planning should focus on:
    • Teaching coping skills
    • Introducing relaxation techniques
    • Ensuring adherence to prescribed medications.

  • Encouraging Continued Care

    • Encourage participation in therapy sessions and promote healthy sleep habits.

Discharge Planning for Depression

  • Patient Education

    • Important areas of focus during discharge include:
    • Emphasizing compliance with medications
    • Arranging for follow-up appointments

  • Encouraging Support