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64 Cards in this Set
- Front
- Back
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Estimated number of adults in the US with SMI |
9.8 million in 2014. 4.2% of all adults. |
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SMI |
Serious Mental Illness |
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A mental illness impairs one or more of what three things |
- Cognition. - Emotions. - Behavior. |
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Number of adults in the US with any mental illness |
43.6 million in 2014. 18.1% of all adults. |
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__ in __ adults suffer from a diagnosable mental disorder annually |
1 in 4 |
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What percentage of Americans will meet the criteria for a psychiatric disorder at some point within their lifetime? |
46% |
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DSM IV - Axis I |
Clinical Disorders |
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DSM IV - Axis II |
Personality Disorders, Mental Retardation |
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DSM IV - Axis III |
General Medical Conditions |
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DSM IV - Axis IV |
Phychosocial and Environmental Problems |
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DSM V GAF |
Global Assessment of Functioning. Score of 0-100 |
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What GAF score is typically bad enough that the patient is hospitalized? |
40 or below
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What is a normal GAF score? |
60-100 |
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What changes did the DSM V bring in contrast to the DSM IV? |
Took away the axis system. Mental health disorders now the same as medical conditions. |
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WHODAS |
Disability rating scale. Replaced GAF. |
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Most common preventable cause of death in the US |
Suicide |
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More than ___% of all violent deaths in the US are by suicide |
50 |
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Males complete suicide at a ___x greater rate than females |
4 |
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__x more suicide attempts are made by females than males |
3 |
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___ million people think about suicide |
8 |
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______________ people attempt suicide per year |
750,000 |
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Suicide risk is ____________ in the immediate period after discharge from a hospital |
increased |
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Do most suicide people want to die? |
No |
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Suicide Risk Factors vs Warning Signs |
Risk factors make it more likely that a person will consider suicide. Warning signs indicate an immediate risk. |
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T/F: There are a large number of people who complete suicide that had never attempted it before. |
True |
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Biggest suicide warning sign for a teenager |
Dramatic mood changes. Anxiety, restlessness, agitation |
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What is the primary tool in a Therapeutic Relationship |
yourself |
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Boundary crossing vs boundary violation |
Crossing - deviation from typical therapeutic activity that may be harmless. Violation - deviation that is harmful, or potentially harmful, to the patient. |
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Transference |
Patient transfers feelings for someone else onto the therapist |
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Countertransference |
Therapist transfers their feelings onto the patient |
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Hildegard Peplau's phases of therapeutic relationship |
1. Pre/Orientation Phase. 2. Working Phase. 3. Termination/Resolution Phase. |
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In therapeutic communication, should the nurse worry about saying the wrong thing? |
If the nurse is coming from a place of empathy, non-judgement, honesty, and openness, it's hard to say the "wrong thing" |
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What percent of communication is nonverbal? |
90% |
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"Alarm system" of the brain |
the amygdala |
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Is the amygdala mature at birth? |
yes |
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Basal ganglia |
Multiple select areas situated at the base of the forebrain. Highly interconnected with the cerebral cortex, thalamus, and brainstem. Involved in voluntary motor responses |
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Is stress important to brain development? |
Yes. Helps build healthy coping mechanisms and problem solving skills |
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MAO |
Monoamine oxidase. Enzymes that break down, among other things, neurotransmitters that are left in the synaptic cleft. |
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What neurotransmitter is released by the motor neurons at the neuromuscular junction to activate muscles? |
Acetylcholine |
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What is acetylcholine involved in |
Learning, memory, wakefulness, attention, and movement. Is the neurotransmitter used in the neuromuscular junction, but is also used within the CNS. |
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There are ___ receptors for dopamine |
5 |
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Antipsychotics work on which dopamine receptor? |
D2 |
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How can dopamine in the tuberoinfundibular pathway be affected by antipsychotics, and what effect might this have? |
Antipsychotics often block dopamine. Dopamine in this tract blocks prolactin, which causes lactation. Thus, blocking the dopamine may actually cause lactation to occur. Even in men. |
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What side effects may occur as a result of an antipsychotic's effects on the mesolimbic pathway? |
Lack of motivation, appears almost like a depression. Physiologically, depletion of dopamine in this pathway will decrease the extent that an animal is willing to go to obtain reward. |
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The mesolimbic pathway is also called the |
reward pathway |
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Alogia |
Also called poverty of speech. Lack of additional, unprompted content seen in normal speech. Considered a form of aphasia. |
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What side effects may occur as a result of an antipsychotic's effects on the mesocortical pathway? |
Flat affect, avolition, and poverty of speech. |
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What side effects may occur as a result of an antipsychotic's effects on the nigrostriatal pathway? |
Decrease in motor control. Lack of dopamine in this pathway is actually what is associated with Parkinson's, so you can actually get symptoms similar to that disease. |
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Serotonin syndrome |
Group of potentially serious side effects that can occur if serotonin-increasing drugs are combined. SSRIs, SNRIs, MAOIs, tricyclics, and drugs such as amphetamines, tramadol, Zofran, etc, can all help cause this. |
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How long might it take for serotonin-altering drugs to take effect? |
8-12 weeks |
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A client wants to discontinue their SSRI. Their psychiatrist agrees with this. What consideration should the client be explained about? |
The need to taper it. You shouldn't suddenly stop taking a serotonin-altering drug. |
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Wellbutrin should not be given to a patient with a history of |
seizures |
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In terms of overdose potential, which class of antidepressant is most lethal? |
Tricyclic antidepressants |
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Tricyclic antidepressants and SNRI's. Which would typically be tried first |
SNRI. Tricyclics are typically second-line therapy and not tried first. |
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What key neurotransmitters are affected by MAOIs |
Serotonin, norepinephrine, and dopamine |
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What line of therapy are MAOIs, typically? |
Last line, used if other antidepressants haven't worked. Used for atypical depression. |
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Why are MAOIs typically not used as first-line treatment for depression? |
Although they are effective, there are a number of potentially dangerous adverse effects and interactions with other substances. |
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Antipsychotics block what key receptor |
D2 receptors |
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Extrapyramidal Side Effects typically include what |
Dystonias, pseudoparkinsonian symptoms, akathisia, tardive dyskinesia |
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Neuroleptic malignant syndrome |
a life-threatening idiosyncratic reaction to antipsychotic drugs characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction. Medical emergency. |
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Most common mood stabilizers |
- Depakote (valproic acid). - Tegretol (carbamazepine). - Lithium. - Lamictal (lamotrigine). |
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QPRT |
Suicide Assessment Q - Question. If yes, then 6 more W questions. P - Persuade to get help. R - Accepts a referral. T - Risk Management Plan. |
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Akathisia |
Constant repetitive movements, or feeling of needing to be constantly moving. "Inner restlessness". Examples are rocking back and forth, "marching" in place, fidgeting Can be a side effect of antipsychotics. |
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Dystonia |
Disorder characterized by repeated or sustained muscle contractions, resulting in twisting or repetitive movements or abnormal postures. |
