Nursing Bullets: Psychiatric Nursing IV
Nursing Bullets: Psychiatric Nursing IV
- Fugue is a dissociative state in which a person leaves his familiar surroundings, assumes a new identity, and has amnesia about his previous identity. (It’s also described as “flight from himself.”)
- In a psychiatric setting, the patient should be able to predict the nurse’s behavior and expect consistent positive attitudes and approaches.
- When establishing a schedule for a one-to-one interaction with a patient, the nurse should state how long the conversation will last and then adhere to the time limit.
- Thought broadcasting is a type of delusion in which the person believes that his thoughts are being broadcast for the world to hear.
- Lithium should be taken with food. A patient who is taking lithium shouldn’t restrict his sodium intake.
- A patient who is taking lithium should stop taking the drug and call his physician if he experiences vomiting, drowsiness, or muscle weakness.
- The patient who is taking a monoamine oxidase inhibitor for depression can include cottage cheese, cream cheese, yogurt, and sour cream in his diet.
- Sensory overload is a state in which sensory stimulation exceeds the individual’s capacity to tolerate or process it.
- Symptoms of sensory overload include a feeling of distress and hyperarousal with impaired thinking and concentration.
- In sensory deprivation, overall sensory input is decreased.
- A sign of sensory deprivation is a decrease in stimulation from the environment or from within oneself, such as daydreaming, inactivity, sleeping excessively, and reminiscing.
- The three stages of general adaptation syndrome are alarm, resistance, and exhaustion.
- A maladaptive response to stress is drinking alcohol or smoking excessively.
- Hyperalertness and the startle reflex are characteristics of posttraumatic stress disorder.
- A treatment for a phobia is desensitization, a process in which the patient is slowly exposed to the feared stimuli.
- Symptoms of major depressive disorder include depressed mood, inability to experience pleasure, sleep disturbance, appetite changes, decreased libido, and feelings of worthlessness.
- Clinical signs of lithium toxicity are nausea, vomiting, and lethargy.
- Asking too many “why” questions yields scant information and may overwhelm a psychiatric patient and lead to stress and withdrawal.
- Remote memory may be impaired in the late stages of dementia.
- According to the DSM-IV, bipolar II disorder is characterized by at least one manic episode that’s accompanied by hypomania.
- The nurse can use silence and active listening to promote interactions with a depressed patient.
- A psychiatric patient with a substance abuse problem and a major psychiatric disorder has a dual diagnosis.
- When a patient is readmitted to a mental health unit, the nurse should assess compliance with medication orders.
- Alcohol potentiates the effects of tricyclic antidepressants.
- Flight of ideas is movement from one topic to another without any discernible connection.
- Conduct disorder is manifested by extreme behavior, such as hurting people and animals.
- During the “tension-building” phase of an abusive relationship, the abused individual feels helpless.
- In the emergency treatment of an alcohol-intoxicated patient, determining the blood-alcohol level is paramount in determining the amount of medication that the patient needs.
- Side effects of the antidepressant fluoxetine (Prozac) include diarrhea, decreased libido, weight loss, and dry mouth.
- Before electroconvulsive therapy, the patient is given the skeletal muscle relaxant succinylcholine (Anectine) by I.V. administration.
- When a psychotic patient is admitted to an inpatient facility, the primary concern is safety, followed by the establishment of trust.
- An effective way to decrease the risk of suicide is to make a suicide contract with the patient for a specified period of time.
- A depressed patient should be given sufficient portions of his favorite foods, but shouldn’t be overwhelmed with too much food.
- The nurse should assess the depressed patient for suicidal ideation.
- Delusional thought patterns commonly occur during the manic phase of bipolar disorder.
- Apathy is typically observed in patients who have schizophrenia.
- Manipulative behavior is characteristic of a patient who has passive– aggressive personality disorder.
- When a patient who has schizophrenia begins to hallucinate, the nurse should redirect the patient to activities that are focused on the here and now.
- When a patient who is receiving an antipsychotic drug exhibits muscle rigidity and tremors, the nurse should administer an antiparkinsonian drug (for example, Cogentin or Artane) as ordered.
- A patient who is receiving lithium (Eskalith) therapy should report diarrhea, vomiting, drowsiness, muscular weakness, or lack of coordination to the physician immediately.
- The therapeutic serum level of lithium (Eskalith) for maintenance is 0.6 to 1.2 mEq/L.
- Obsessive-compulsive disorder is an anxiety-related disorder.
- Al-Anon is a self-help group for families of alcoholics.
- Desensitization is a treatment for phobia, or irrational fear.
- After electroconvulsive therapy, the patient is placed in the lateral position, with the head turned to one side.
- A delusion is a fixed false belief.
- Giving away personal possessions is a sign of suicidal ideation. Other signs include writing a suicide note or talking about suicide.
- Agoraphobia is fear of open spaces.
- A person who has paranoid personality disorder projects hostilities onto others.
- To assess a patient’s judgment, the nurse should ask the patient what he would do if he found a stamped, addressed envelope. An appropriate response is that he would mail the envelope.
- After electroconvulsive therapy, the patient should be monitored for post-shock amnesia.
- A mother who continues to perform cardiopulmonary resuscitation after a physician pronounces a child dead is showing denial.
- Transvestism is a desire to wear clothes usually worn by members of the opposite sex.
- Tardive dyskinesia causes excessive blinking and unusual movement of the tongue, and involuntary sucking and chewing.
- Trihexyphenidyl (Artane) and benztropine (Cogentin) are administered to counteract extrapyramidal adverse effects.
- To prevent hypertensive crisis, a patient who is taking a monoamine oxidase inhibitor should avoid consuming aged cheese, caffeine, beer, yeast, chocolate, liver, processed foods, and monosodium glutamate.
- Extrapyramidal symptoms include parkinsonism, dystonia, akathisia (“ants in the pants”), and tardive dyskinesia.
- One theory that supports the use of electroconvulsive therapy suggests that it “resets” the brain circuits to allow normal function.
- A patient who has obsessive-compulsive disorder usually recognizes the senselessness of his behavior but is powerless to stop it (ego-dystonia).
- In helping a patient who has been abused, physical safety is the nurse’s first priority.
- Pemoline (Cylert) is used to treat attention deficit hyperactivity disorder (ADHD).
- Clozapine (Clozaril) is contraindicated in pregnant women and in patients who have severe granulocytopenia or severe central nervous system depression.
- Repression, an unconscious process, is the inability to recall painful or unpleasant thoughts or feelings.
- Projection is shifting of unwanted characteristics or shortcomings to others (scapegoat).
- Hypnosis is used to treat psychogenic amnesia.
- Disulfiram (Antabuse) is administered orally as an aversion therapy to treat alcoholism.
- Ingestion of alcohol by a patient who is taking disulfiram (Antabuse) can cause severe reactions, including nausea and vomiting, and may endanger the patient’s life.
- Improved concentration is a sign that lithium is taking effect.
- Behavior modification, including time-outs, token economy, or a reward system, is a treatment for attention deficit hyperactivity disorder.
- For a patient who has anorexia nervosa, the nurse should provide support at mealtime and record the amount the patient eats.
- A significant toxic risk associated with clozapine (Clozaril) administration is blood dyscrasia.
- Adverse effects of haloperidol (Haldol) administration include drowsiness; insomnia; weakness; headache; and extrapyramidal symptoms, such as akathisia, tardive dyskinesia, and dystonia.
- Hypervigilance and déjà vu are signs of posttraumatic stress disorder (PTSD).
- A child who shows dissociation has probably been abused.
- Confabulation is the use of fantasy to fill in gaps of memory.
