Nursing Bullets: Psychiatric Nursing IV

  1. 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.”)
  2. In a psychiatric setting, the patient should be able to predict the nurse’s behavior and expect consistent positive attitudes and approaches.
  3. 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.
  4. Thought broadcasting is a type of delusion in which the person believes that his thoughts are being broadcast for the world to hear.
  5. Lithium should be taken with food. A patient who is taking lithium shouldn’t restrict his sodium intake.
  6. A patient who is taking lithium should stop taking the drug and call his physician if he experiences vomiting, drowsiness, or muscle weakness.
  7. The patient who is taking a monoamine oxidase inhibitor for depression can include cottage cheese, cream cheese, yogurt, and sour cream in his diet.
  8. Sensory overload is a state in which sensory stimulation exceeds the individual’s capacity to tolerate or process it.
  9. Symptoms of sensory overload include a feeling of distress and hyperarousal with impaired thinking and concentration.
  10. In sensory deprivation, overall sensory input is decreased.
  11. 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.
  12. The three stages of general adaptation syndrome are alarm, resistance, and exhaustion.
  13. A maladaptive response to stress is drinking alcohol or smoking excessively.
  14. Hyperalertness and the startle reflex are characteristics of posttraumatic stress disorder.
  15. A treatment for a phobia is desensitization, a process in which the patient is slowly exposed to the feared stimuli.
  16. Symptoms of major depressive disorder include depressed mood, inability to experience pleasure, sleep disturbance, appetite changes, decreased libido, and feelings of worthlessness.
  17. Clinical signs of lithium toxicity are nausea, vomiting, and lethargy.
  18. Asking too many “why” questions yields scant information and may overwhelm a psychiatric patient and lead to stress and withdrawal.
  19. Remote memory may be impaired in the late stages of dementia.
  20. According to the DSM-IV, bipolar II disorder is characterized by at least one manic episode that’s accompanied by hypomania.
  21. The nurse can use silence and active listening to promote interactions with a depressed patient.
  22. A psychiatric patient with a substance abuse problem and a major psychiatric disorder has a dual diagnosis.
  23. When a patient is readmitted to a mental health unit, the nurse should assess compliance with medication orders.
  24. Alcohol potentiates the effects of tricyclic antidepressants.
  25. Flight of ideas is movement from one topic to another without any discernible connection.
  26. Conduct disorder is manifested by extreme behavior, such as hurting people and animals.
  27. During the “tension-building” phase of an abusive relationship, the abused individual feels helpless.
  28. 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.
  29. Side effects of the antidepressant fluoxetine (Prozac) include diarrhea, decreased libido, weight loss, and dry mouth.
  30. Before electroconvulsive therapy, the patient is given the skeletal muscle relaxant succinylcholine (Anectine) by I.V. administration.
  31. When a psychotic patient is admitted to an inpatient facility, the primary concern is safety, followed by the establishment of trust.
  32. An effective way to decrease the risk of suicide is to make a suicide contract with the patient for a specified period of time.
  33. A depressed patient should be given sufficient portions of his favorite foods, but shouldn’t be overwhelmed with too much food.
  34. The nurse should assess the depressed patient for suicidal ideation.
  35. Delusional thought patterns commonly occur during the manic phase of bipolar disorder.
  36. Apathy is typically observed in patients who have schizophrenia.
  37. Manipulative behavior is characteristic of a patient who has passive– aggressive personality disorder.
  38. 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.
  39. 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.
  40. A patient who is receiving lithium (Eskalith) therapy should report diarrhea, vomiting, drowsiness, muscular weakness, or lack of coordination to the physician immediately.
  41. The therapeutic serum level of lithium (Eskalith) for maintenance is 0.6 to 1.2 mEq/L.
  42. Obsessive-compulsive disorder is an anxiety-related disorder.
  43. Al-Anon is a self-help group for families of alcoholics.
  44. Desensitization is a treatment for phobia, or irrational fear.
  45. After electroconvulsive therapy, the patient is placed in the lateral position, with the head turned to one side.
  46. A delusion is a fixed false belief.
  47. Giving away personal possessions is a sign of suicidal ideation. Other signs include writing a suicide note or talking about suicide.
  48. Agoraphobia is fear of open spaces.
  49. A person who has paranoid personality disorder projects hostilities onto others.
  50. 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.
  51. After electroconvulsive therapy, the patient should be monitored for post-shock amnesia.
  52. A mother who continues to perform cardiopulmonary resuscitation after a physician pronounces a child dead is showing denial.
  53. Transvestism is a desire to wear clothes usually worn by members of the opposite sex.
  54. Tardive dyskinesia causes excessive blinking and unusual movement of the tongue, and involuntary sucking and chewing.
  55. Trihexyphenidyl (Artane) and benztropine (Cogentin) are administered to counteract extrapyramidal adverse effects.
  56. 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.
  57. Extrapyramidal symptoms include parkinsonism, dystonia, akathisia (“ants in the pants”), and tardive dyskinesia.
  58. One theory that supports the use of electroconvulsive therapy suggests that it “resets” the brain circuits to allow normal function.
  59. A patient who has obsessive-compulsive disorder usually recognizes the senselessness of his behavior but is powerless to stop it (ego-dystonia).
  60. In helping a patient who has been abused, physical safety is the nurse’s first priority.
  61. Pemoline (Cylert) is used to treat attention deficit hyperactivity disorder (ADHD).
  62. Clozapine (Clozaril) is contraindicated in pregnant women and in patients who have severe granulocytopenia or severe central nervous system depression.
  63. Repression, an unconscious process, is the inability to recall painful or unpleasant thoughts or feelings.
  64. Projection is shifting of unwanted characteristics or shortcomings to others (scapegoat).
  65. Hypnosis is used to treat psychogenic amnesia.
  66. Disulfiram (Antabuse) is administered orally as an aversion therapy to treat alcoholism.
  67. 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.
  68. Improved concentration is a sign that lithium is taking effect.
  69. Behavior modification, including time-outs, token economy, or a reward system, is a treatment for attention deficit hyperactivity disorder.
  70. For a patient who has anorexia nervosa, the nurse should provide support at mealtime and record the amount the patient eats.
  71. A significant toxic risk associated with clozapine (Clozaril) administration is blood dyscrasia.
  72. Adverse effects of haloperidol (Haldol) administration include drowsiness; insomnia; weakness; headache; and extrapyramidal symptoms, such as akathisia, tardive dyskinesia, and dystonia.
  73. Hypervigilance and déjà vu are signs of posttraumatic stress disorder (PTSD).
  74. A child who shows dissociation has probably been abused.
  75. Confabulation is the use of fantasy to fill in gaps of memory.
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