Nursing Bullets: Psychiatric Nursing II

  1. Defense mechanisms protect the personality by reducing stress and anxiety.
  2. Suppression is voluntary exclusion of stress-producing thoughts from the consciousness.
  3. In psychodrama, life situations are approximated in a structured environment, allowing the participant to recreate and enact scenes to gain insight and to practice new skills.
  4. Psychodrama is a therapeutic technique that’s used with groups to help participants gain new perception and self-awareness by acting out their own or assigned problems.
  5. A patient who is taking disulfiram (Antabuse) must avoid ingesting products that contain alcohol, such as cough syrup, fruitcake, and sauces and soups made with cooking wine.
  6. A patient who is admitted to a psychiatric hospital involuntarily loses the right to sign out against medical advice.
  7. “People who live in glass houses shouldn’t throw stones” and “A rolling stone gathers no moss” are examples of proverbs used during a psychiatric interview to determine a patient’s ability to think abstractly. (Schizophrenic patients think in concrete terms and might interpret the glass house proverb as “If you throw a stone in a glass house, the house will break.”)
  8. Signs of lithium toxicity include diarrhea, tremors, nausea, muscle weakness, ataxia, and confusion.
  9. A labile affect is characterized by rapid shifts of emotions and mood.
  10. Amnesia is loss of memory from an organic or inorganic cause.
  11. A person who has borderline personality disorder is demanding and judgmental in interpersonal relationships and will attempt to split staff by pointing to discrepancies in the treatment plan.
  12. Disulfiram (Antabuse) shouldn’t be taken concurrently with metronidazole (Flagyl) because they may interact and cause a psychotic reaction.
  13. In rare cases, electroconvulsive therapy causes arrhythmias and death.
  14. A patient who is scheduled for electroconvulsive therapy should receive nothing by mouth after midnight to prevent aspiration while under anesthesia.
  15. Electroconvulsive therapy is normally used for patients who have severe depression that doesn’t respond to drug therapy.
  16. For electroconvulsive therapy to be effective, the patient usually receives 6 to 12 treatments at a rate of 2 to 3 per week.
  17. During the manic phase of bipolar affective disorder, nursing care is directed at slowing the patient down because the patient may die as a result of self-induced exhaustion or injury.
  18. For a patient with Alzheimer’s disease, the nursing care plan should focus on safety measures.
  19. After sexual assault, the patient’s needs are the primary concern, followed by medicolegal considerations.
  20. Patients who are in a maintenance program for narcotic abstinence syndrome receive 10 to 40 mg of methadone (Dolophine) in a single daily dose and are monitored to ensure that the drug is ingested.
  21. Stress management is a short-range goal of psychotherapy.
  22. The mood most often experienced by a patient with organic brain syndrome is irritability.
  23. Creative intuition is controlled by the right side of the brain.
  24. Methohexital (Brevital) is the general anesthetic that’s administered to patients who are scheduled for electroconvulsive therapy.
  25. The decision to use restraints should be based on the patient’s safety needs.
  26. Diphenhydramine (Benadryl) relieves the extrapyramidal adverse effects of psychotropic drugs.
  27. In a patient who is stabilized on lithium (Eskalith) therapy, blood lithium levels should be checked 8 to 12 hours after the first dose, then two or three times weekly during the first month. Levels should be checked weekly to monthly during maintenance therapy.
  28. The primary purpose of psychotropic drugs is to decrease the patient’s symptoms, which improves function and increases compliance with therapy.
  29. Manipulation is a maladaptive method of meeting one’s needs because it disregards the needs and feelings of others.
  30. If a patient has symptoms of lithium toxicity, the nurse should withhold one dose and call the physician.
  31. A patient who is taking lithium (Eskalith) for bipolar affective disorder must maintain a balanced diet with adequate salt intake.
  32. A patient who constantly seeks approval or assistance from staff members and other patients is demonstrating dependent behavior.
  33. Alcoholics Anonymous advocates total abstinence from alcohol.
  34. Methylphenidate (Ritalin) is the drug of choice for treating attention deficit hyperactivity disorder in children.
  35. Setting limits is the most effective way to control manipulative behavior.
  36. Violent outbursts are common in a patient who has borderline personality disorder.
  37. When working with a depressed patient, the nurse should explore meaningful losses.
  38. An illusion is a misinterpretation of an actual environmental stimulus.
  39. Anxiety is nonspecific; fear is specific.
  40. Extrapyramidal adverse effects are common in patients who take antipsychotic drugs.
  41. The nurse should encourage an angry patient to follow a physical exercise program as one of the ways to ventilate feelings.
  42. Depression is clinically significant if it’s characterized by exaggerated feelings of sadness, melancholy, dejection, worthlessness, and hopelessness that are inappropriate or out of proportion to reality.
  43. Free-floating anxiety is anxiousness with generalized apprehension and pessimism for unknown reasons.
  44. In a patient who is experiencing intense anxiety, the fight-or-flight reaction (alarm reflex) may take over.
  45. Confabulation is the use of imaginary experiences or made-up information to fill missing gaps of memory.
  46. When starting a therapeutic relationship with a patient, the nurse should explain that the purpose of the therapy is to produce a positive change.
  47. A basic assumption of psychoanalytic theory is that all behavior has meaning.
  48. Catharsis is the expression of deep feelings and emotions.
  49. According to the pleasure principle, the psyche seeks pleasure and avoids unpleasant experiences, regardless of the consequences.
  50. A patient who has a conversion disorder resolves a psychological conflict through the loss of a specific physical function (for example, paralysis, blindness, or inability to swallow). This loss of function is involuntary, but diagnostic tests show no organic cause.