mental health b

  • s/s of ETOH withdrawal

    • sweating/diaphoresis

    • hand tremors

    • elevated BP and HR

    • anxiety

    • vomiting

  • risk factors for substance abuse disorders (sud)

    • family h/x

    • multiple dui charges

    • starting drinking early

    • admits to getting drunk and drinking recreationally

    • s.o is threatening separation (alcoholics often only seek treatment bc of external pressure, whether it be family, legal, or employment)

  • defense mechanisms

    • compensation

    • conversion; change anxiety into physical symptoms w.o no physiological cause

    • denial

    • displacement; redirection into smthing that is more acceptable and less threatening

      • e.g. being upset bc of work but taking it out on family

    • dissociation

    • identification; taking on the characteristics of another

    • intellectualization; scrutinize events only using facts and no feelings

      • thinking disconnected from feelings

      • pt will deal w. situations on a cognitive lvl and ignore the emotional aspect

    • introjection; incorporation of outside world into perceptions of self

    • rationalization; validate irrational thoughts, feeling, actions by using explanations that are sensible to the person talking and those listening

      • making excuses for own shortcomings

      • e.g. receive bad grade but blame it on the teacher being mean; stating that they harm their s.o bc they do not listen

    • reaction formation; control behaviors or feelings that are offensive by displaying ones that are opposite

      • behaving opposite the way one feels

      • e.g. not wanting children but becoming a ‘super’ parent

    • regression

    • repression; unconsciously keeping things from thought

    • splitting; incapable of recognizing positive and neg. characteristics of self or others as total entity

    • sublimination; unconscious act of replacing socially acceptable, productive, responsible behaviors w. ones that are improper, immature, damaging

    • suppression; actively keeping things from thought

    • undoing; attempt to erase something

      • e.g. buying one’s s.o a gift after cheating on/harming them

    • projection; attributes to others unacceptable thoughts and feelings

  • pt must be completely substance free in order to recover

    • recover includes being aware of the consequences of alcohol abuse and benefits of abstaining

  • ocd pt interventions

    • accept the ritualistic behavior, provide structured environment, provide physical needs, offer alternative activities, guide decisions while minimizing choices, encourage socialization, admn ssri

    • can allow them to conduct ritualistic behaviors but still move on to other tasks, as denying them that can trigger panic lvls and anxiety

    • cannot control ritualistic behavior until pt understands the precipitating factors

  • mandatory to report suspected or identified child abuse to appropriate agencies

  • side effects of ssri

    • dizziness

    • taste changes (encourage frequent oral care)

    • libido decrease

    • diarrhea

    • nausea

  • indications of heroin use

    • constricted pupils

    • decreased respirations

    • drowsiness/sedation

    • slurred speech

    • initial euphoria followed by dysphoria

    • decreased coughing

    • decreased libido/delayed ejaculation/impotence/failed orgasm

    • hypotension

    • fecal impaction

  • indications of cocaine use

    • pupillary dilation

    • tachy or bradycardia

    • altered BP

    • sweating/chilld/n&v

    • weight loss

    • talkativeness

    • hypervigilence

    • pacing

    • psychomotor agitation

    • episodes of violence, fighting, grandiosity, visual or tactile hallucinations

  • indications of LSD

    • flashbacks

    • hallucinations, intensified feelings and perceptions

    • synesthesia (mixed senses, seeing sound and hearing colors)

    • impaired judgement

    • bizarre behavior

    • paranoid, fear of losing mind

    • dilated pupils

    • increased cardiac activity

  • indications for weed

    • injected/reddened conjuctivae

    • tachy

    • dry mouth

    • increased appetite

  • indications for PCP/angel dust (originally animal anesthetic)

    • hallucinations

    • psychotic or violent behavior

    • htn and tachy

    • blank stare

    • rigid muscles

    • ataxia

    • nystagmus (strange movements of the eyes)

    • motor seizures

    • resp failure

    • death

  • pt d/x with personality disorder ~ needs are primarily met via manipulation

    • pts have trouble perceiving and relating to situations and others

    • more likely to be impulsive, ingratiating, deceitful

  • goal of group therapy ~ members can learn new ways to cope w. stress and develop insight into their behaviors

    • also can function to increase self esteem

  • depressed pt

    • do not leave alone

    • do not force them to socialize until basic needs are met or they are in a state to do so

  • reason for etoh abuse

    • escapism

    • cover up for other issues

  • conversion rxn ~ ‘la belle indifference’, pts where the conversion of a mental conflict into somatic forms often appear calm and unconcerned with their physical manifestations

    • symptoms

      • blindness

      • paralysis

      • convulsions w.o loss of consciousness