PMHNP Comprehensive Questions and answers 100% ACCURATE. Rated A

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PMHNP Comprehensive Questions and answers 100% ACCURATE. Rated A ______________ may accelerate rapid cycling - ✔✔-Antidepressants _______, ________, _________, cyclosporine, disulfiram, hydral... izine, and Isoniazid may cause manic symptoms. - ✔✔-Captopril, cimetidine, corticosteroids _____% increased risk if relative has BD disorder Type I - ✔✔-24 _____% increased risk if relative has BD disorder Type II - ✔✔-5 _____% increased risk if relative has MDD - ✔✔-25 (General) Family System Concepts (vs. Bowens Family Systems Therapy) - ✔✔-System - any unit based on feedback - the family Family System - how members operate together Family System Theory based on idea that one can't understand a member/part w/o understanding how all family members operate together (system) Family rules could be overt or covert Boundaries - barriers that protect & enhance functional integrity of families, individuals & subsystems Boundaries types: Clearly defined - maintain individual separateness; emphasizing belongingness Rigid/inflexible - lead to distant relationship & disengagement Diffuse - blurred, indistinct, lead to enmeshment % of Bipolar patients with rapid cycling - ✔✔-20 1. Management of health status - ✔✔-health assessment, health history, physical exam, screening and diagnostic testing, diagnosing, prescribing meds and other treatment modalities, evaluating core outcomes 1st significant psychiatric nursing theory - ✔✔-Peplau therapeutic nurse patient relationship/interpersonal 2 herbals that interact w/ Coumadin and increase anti-coagulant effect - ✔✔-Omega-3 fatty acids and Vitamin E (& maybe fish oil) 2 most common types of structural imaging - ✔✔-CT: 3D view of brain structures; density; inexpensive; cannot differentiate gray and white matter MRI: Series of 2D images that represent the brain; separates white and gray matter; expensive and many contraindications 2 systems activated by the amygdala in response to threat - ✔✔-HPA axis sympathetic (ANS) nervous system activation ("fight or flight") 2. Maintenance of nurse-client relationship - ✔✔-Displaying environment of trust and respect, maintaining healthy boundaries, engaging in therapeutic communication 3 parts of the brain "fear circuit" - ✔✔-sensory thalamus cortex amygdala 3. Teaching/coaching - ✔✔-Health promotion/disease prevention, risk reduction, coaching toward behavioral change 4 nucleotide bases - ✔✔-Adenine (A), Thymine (T), Cytosine (C) and Guanine (G) 4. Professional Role - ✔✔-Serving as client advocate, utilizing information and technology in health care, using interdisciplinary collaboration and consultation, practicing ethically, showing leadership, undertaking professional development, participating in policy making. 5. Managing/negotiating health cae delivery systems - ✔✔-Decision making with regard to cost, access, and efficacy; applying business strategies to practice; negotiating legislative change when needed. 6. Monitoring quality of care - ✔✔-Evaluating quality of care, incorporating continuous quality improvement into practice. 7. Providing culturally sensitive care - ✔✔-Remaining culturally sensitive when assessing client's symptoms and his or her perceptions of symptoms. 25% women, 12% men - ✔✔-Risk during reproductive years A major depressive episode immediately precedes or follows the manic episode in what percentage of patients? - ✔✔-60 A TCA also used for enuresis and ADHD - ✔✔-Pamelor A TCA also used for enuresis and separation anxiety - ✔✔-Tofranil (imipramine) A TCA also used for insomnia - ✔✔-Sinequan (doxepin) A TCA approved for OCD: - ✔✔-Anafranil (clomipramine) A TCA with multiple uses that include chronic pain, insomnia, sciatica, fibromyalgia, trigeminal neuralgia and diabetic neuropathy. - ✔✔-Elavil. Abnormal brain structures associated with schizophrenia - ✔✔-ENLARGED ventricles SMALLER frontal and temporal lobes Cortical atrophy Decreased cerebral blood flow Hippocampal reduction WIDENED cortical sulci Diffuse decrease in volume of white and gray matter Absorption - ✔✔-Method and rate at which drugs leave the site of administration Absorption of oral medications - ✔✔-Normally occurs in the small intestine and then is ultimately metabolized by the liver Account for the differences in the way enzymes - ✔✔-Metabolize drugs Acculturation - ✔✔-Process by which the person acquires the culture of the society that he or she inhabits Acculturation - ✔✔-The process by which the person acquires the culture of the society that he or she inhabits Acetylcholine - ✔✔-Cholinergic neurotransmitter synthesized by the basal nucleus of Meynert; precursors are acetylcoenzyme A and choline Acetylcholine - ✔✔-is decreased in Alzheimer's disease and impaired memory is increased in Parkinson Acetylcholine - ✔✔-synthesized by the basal nucleus of Meynert Precursors are aceylcoenzyme A and choline Acetylcholine decrease thought to cause.... - ✔✔-Alzheimers and Impaired memory Acetylcholine increase thought to cause... - ✔✔-Parkinsoian symptoms ACTH - ✔✔-motor control, learning, memory, sleep, and dreams. Helps with balance. Decrease in Alzheimer's disease Action primarily to increase serotonin levels in CNS by inhibiting their reuptake: - ✔✔-Selective Serotonin Reuptake Inhibitors (SSRIs) Adenine is always paired with - ✔✔-Thymine Adjourning - ✔✔-preparation is being made to end the group. Both members and leaders express their feelings about each other and termination. A discussion and overview of what has been learned as well as what issues will still need to be worked on take place. Adrenocorticotropin hormone (ACTH) - ✔✔-Released by pituitary in response to CRH by hypothalamus Adverse effects of ECT - ✔✔-Possible cardiovascular effects, systemic effects (headaches, anorexia, muscle aches, drowsiness) and cognitive effects such as confusion and memory difficulties Aggression turned inward theory of MDD - ✔✔-Freud agnosia - ✔✔-disorganization of perception and recognition Agonist effect - ✔✔-Drug binds to receptors and activate a biological response Agonist effect - ✔✔-Drug binds to receptors and activates a biological response Agoraphobia is always diagnosed in relation to... - ✔✔-Presence or absence of panic disorder Agraphestesia - ✔✔-Inability to identify letter drawn on the skin AIMS - ✔✔-Abnormal Involuntary Movement Scale for 8 and older 12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics Rating 0-4, >2 to diagnose TD and reduce dose AIMS (adverse treatment effects) - ✔✔-Abnormal Involuntary Movement Scale for 8 and older 12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics Rating 0-4, >2 to diagnose TD and reduce dose Akathisia - ✔✔-Motor restlessness; inability to remain still Akinesia - ✔✔-Absence of movement; difficulty initiating motion, subjective feeling of lack of motivation to move Often mistaken for laziness ALP - ✔✔-44-147 ALT - ✔✔-5-35. ALT 5-35 - ✔✔-an enzyme produced by the liver that acts as a catalyst in the transamination necessary for amino acid production. Elevated in liver disease, damage. Depakote can increase, safe to use up to 2 times normal limit Alterations in pharmacokinetics - ✔✔-Hepatic cytochrome P450 enzyme interactions can induce or inhibit the metabolism of certain drugs. Altruism - ✔✔-meeting the needs of others in order to discharge drives, conflicts or stressors Amino acids include... - ✔✔-glutamate GABA glycine aspartate Amitryptyline/Elavil 50-300 mg comments - ✔✔-chronic pain and insomnia use amnesia - ✔✔-disfunction of memory processes amnesia is typically a ___ lobe problem - ✔✔-temporal amygdala - ✔✔-fear response. Amygdala - ✔✔-Responsible for mediating mood, fear, emotion, and aggression; also responsible for connecting sensory smell information with emotions amygdala functions - ✔✔-mediates mood, fear, emotion, aggression connects smell information with emotions ANA Code of Ethics - ✔✔-- Use Code of Ethics for Nurses with Interpretive Statements to guide practice - Deliver care in a manner that preserves and protects patient autonomy, dignity, and rights - Is aware of and avoids using the power inherent in the therapeutic relationship to influence the patient in ways not related to the treatment goals - Maintains patient confidentiality within legal and regulatory parameters - Serves as a patient advocate protecting patients' rights and assisting patients in developing skills for self advocacy - Maintains a therapeutic and professional patient-nurse relationship with appropriate professional role boundaries Analysis of variance (ANOVA) - ✔✔-Tests the difference among 3 or more groups Analysis of Variance (ANOVA) - ✔✔-Tests the difference among 3 or more groups ANOVA - ✔✔-analysis of variance - tests difference of 3 or more groups Antagonist effect - ✔✔-Bind to the receptor but do not activate a biological response Antagonist effect - ✔✔-Drug binds to the receptor but does not activate a biological response Antiadrenergic dirty side effects associated with TCAs: - ✔✔-Orthostatic hypotension (from alpha 1 receptor blockade) Anticholinergic dirty side effects associated with TCA's: - ✔✔-Dry mouth, blurred vision, constipation, memory problems. Caused due to muscarinic receptor blockade. anticipatory guidance - ✔✔-Information provided in advance to help people deal more effectively with events during lifespan Anticonvulsant mood stabilizers are often considered first-line agents in treatment of BD and ______ first-line treatment for rapid cyclers. - ✔✔-Always Anticonvulsant theory of ECT - ✔✔-Exerts an anticonvulsant effect, which then produces an antidepressant effect. Antidepressants may worsen the _______ process. - ✔✔-Kindling Antihistaminergic dirty side effects associated with TCAs: - ✔✔-Sedation and weight gain from histamine receptor blockade aphasia - ✔✔-disruption of language function aphasia typically originates in the ___ lobe - ✔✔-frontal (Broca's area) or temporal (Wernicke's area) Appearance, speech, affect, mood, thought process, thought content (including suicidal thoughts/behaviors); cognition, orientation, memory, concentration, abstraction, judgment - ✔✔- Mental Status Exam apraxia - ✔✔-disturbance in the organization of voluntary action area of brain for motor functions - ✔✔-precentral gyrus area of brain for sensory functions - ✔✔-postcentral gyrus area of brain for visual functions - ✔✔-occipital cortex area of the brain responsible for: expressive language intelligence (cognitive functioning) executive function motor function (voluntary movement, coordination of movement) personality - ✔✔-functions of the frontal lobe area of the brain responsible for: higher cognitive functioning working memory personality - ✔✔-functions of the prefrontal lobe area of the brain responsible for: initiation of movement, especially fine movement contains the extrapyramidal motor system learned automatic actions (e.g. walking, driving) coordination of movement reflexes, muscle tone, posture - ✔✔-functions of the basal ganglia (corpus striatum) area of the brain responsible for: primary sensory cortex taste reading / writing symbolic recognition topographic sense - ✔✔-functions of the parietal lobe area of the brain responsible for: receptive speech & language comprehension primary auditory area memory emotion (limbic system) integration of vision with other sensory information - ✔✔-functions of the temporal lobe area of the brain responsible for: vision integration of vision with other sensory information - ✔✔-functions of the occipital lobe Areas of Mini mental status exam (MMSE) - ✔✔-Assess the following areas: orientation, memory, attention and calculation, recall, naming, repeat, three stage verbal command, written command, write a sentence, intersecting pentagon's Aspartate - ✔✔-Excitatory neurotransmitter that works with glutamate Aspartate - ✔✔-Excitatory neurotransmitter, works with glutamate ASRS-1 - ✔✔-Adult ADHD Self-Report Scale, 16 and older Two-part Screening Part A: 6 questions, 4 symptoms suggest ADHD Part B: 12 questions to clarify and quantify ASRS-1 (ADHD) - ✔✔-Adult ADHD Self-Report Scale, 16 and older Two-part Screening Part A: 6 questions, 4 symptoms suggest ADHD Part B: 12 questions to clarify and quantify Associated with lithium toxicity - ✔✔-Coarse hand tremors Association cortex/frontal lobe - ✔✔-Allows for multimodal sensory input to trigger memory and lead to decision making. AST - ✔✔-5-40 AST 5-40 - ✔✔-measures the level of the enzyme that catalyzes the reversible transfer of an amino between the amino acid, aspartate, and alphaketoglutamic acid. Elevated when there is cellular damage to the liver, myocardium, skeletal muscles, pancreas or brain astereognosis - ✔✔-inability to distinguish objects (such as paperclip) based on touch, parietal lesion Astereognosis - ✔✔-The inability to recognize objects by touch alone, even though there is normal sensation in the hands. It may be due to problems in the parietal lobe. atypical antipsychotics - ✔✔-D2 and 5HT2a blockade: treat both positive and negative symptoms of schizophrenia AUDIT-C - ✔✔-Alcohol Use Disorders Identification Test - Consumption, > 13 Documents use and frequency in prior year 0-4, F >3 = positive, M >4 = positive, >8 = hazardous drinking AUDIT-C (Alcohol and drug use) - ✔✔-Alcohol Use Disorders Identification Test - Consumption, > 13 Documents use and frequency in prior year 0-4, Female >3 = positive, Male >4 = positive, score>8 = hazardous drinking auditory area of brain - ✔✔-temporal cortex auditory hallucinations originate in the ___ lobe - ✔✔-temporal Autonomic instability, restlessness, agitation, myoclonis, hyperreflexia, hyperthermia, diaphoresis; altered sensorium, tremor, cills, diarrhea and cramps, ataxia, headache and insomnia: - ✔✔-Symptoms of serotonin syndrome Autonomic nervous system - ✔✔-Regulates internal body functions to maintain homeostasis; conveys info from the CNS to smooth muscle, cardiac muscle, and glands; responsible for involuntary movement; divided into the sympathetic nervous system and the parasympathetic nervous system Autonomic nervous system - ✔✔-Regulates internal body functions to maintain homeostasis; conveys information from the CNS to smooth muscle, cardiac muscle, and glands; responsible for involuntary movement; divided into the sympathetic nervous system and the parasympathetic nervous system autonomy - ✔✔-doing for self Autonomy - ✔✔-Doing for self Autosomal dominant conditions - ✔✔-may be present in more than one generation and in up to 50% of offspring when one parent is affected (such as Marfan syndrome) Autosomal dominant conditions... - ✔✔-May be present in more than one generation and in up to 50% of offspring when one parent is affected Avoid abrupt withdrawal of TCAs due to - ✔✔-Significant abstinence syndrome BAI - ✔✔-Beck Anxiety Inventory, 17 and older Assesses 21 symptoms of anxiety, 0-36 scores BAI (Anxiety) - ✔✔-Beck Anxiety Inventory, 17 and older .Assesses 21 symptoms of anxiety, 0-21= very low,22-35= moderate,36+= serious anxiety BARS - ✔✔-Barnes Akathisia Rating Scale for 8 and older 4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and/or SSRIs BARS (adverse treatment effects) - ✔✔-Barnes Akathisia Rating Scale for 8 and older 4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and/or SSRIs Basal ganglia - ✔✔-Complex feedback system to modulate and stabilize somatic motor activity information conveyed from the CNS to skeletal muscle. I contains the caudate and the putamen. BDI-2 - ✔✔-Beck Depression inventory, 13 and older presence and impact of depressive symptoms 21 items, <10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe BDI-2 (Depression) - ✔✔-Beck Depression inventory, 13 and older presence and impact of depressive symptoms 21 items, <10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe Beck - ✔✔-CBT Behavioral Therapy - Arnold Lazarus - ✔✔-focuses on changing maladaptive behaviors by participation in active behavioral techniques such as exposure, relaxation, problem solving and role playing Belladonna - ✔✔-Anxiety Beneficence - ✔✔-promoting well being and doing good Beneficience - ✔✔-Promoting well being and doing good Benzo teratogenic risks - ✔✔-Floppy baby Cleft palate biological risk factors - ✔✔-hx of mental illness, poor nutrition, poor health Biological theories of Bipolar Disorder (BD) - ✔✔-Neurotransmitter deregulation; gamma-aminobutyric (GABA) deregulation; increased noradrenergic activity; voltage-gated ion channel abnormalities; abnormalities lead to abnormal balances of intracellular and extracellular levels of neurotransmitters, which cause disruption of electric signal transmission in brain; kindling; long-lasting, epileptogenic changes induced by daily subthreshold brain stimulation; brain overly sensitive to electrical stimuli, neuronal misfiring occurs - may occur without stimuli. Biological theory for bipolar disorder - ✔✔-GABA deregulation Increased noradrenergic activity Voltage gated ion channel abnormalities Abnormalities lead to abnormal balances of intracellular and extracellular levels of neurotransmitters Bipolar illness affects - ✔✔-Behavioral, affective, cognitive & somatic symptoms Bipolar Type I - ✔✔-Characterized by occurrence of one or more manic and mixed episodes Bipolar Type II - ✔✔-Characterized by occurrence of one or more major depressive episodes accompanied by at least one manic or hypomanic episodes Black Cohosh - ✔✔-menopausal symptmos, premenstrual syndrome and dysmenorhea, blindness or visual field defects are a problem of the ___ lobe - ✔✔-occipital Blocking - ✔✔-Sudden stopage of speech attributed to losing though or forgetting what was being talked about BMI - ✔✔-20 - 25 Normal 26 - 29 Overweight 30 - 35 Obese Watch for weight gain with 2nd generation antipsychotics, Depakote and Remeron Patient on Carbamazepine (tegretol) or clozapine with high temp: Agranulocytosis Patient on Carbamazepine (tegretol) or Lamotrigine (Lamictal) with a rash: Stevens Johnson syndrome Borderline, histrionic, narcissistic, avoidant and dependent. - ✔✔-Dysthymic disorder is associated with these personality disorders. Bowen - ✔✔-Family systems theory BPRS - ✔✔-Brief Psychiatric Rating Scale, 18 and older Assesses psychopathology (+, - and affective) with schizophrenia, not for screening or DX BPRS - ✔✔-most widely used evaluation of sx severity over time used at PFP BPRS (Psychosis) - ✔✔-Brief Psychiatric Rating Scale, 18 and older Assesses psychopathology in patients suspected of having schizophrenia (+, - and affective) not for screening or DX 0-9 negative, 10-20= possible SAD, 21+= SAD likely Bradykinesia, hyperkinesia, or dystonia suggest disease or damage to the... - ✔✔-damage to the basal ganglia (corpus striatum) Brain damage, including that from stroke and trauma - ✔✔-Depression is a acommon comorbidity in individuals who have experienced these events Brain stem - ✔✔-Includes the midbrain, pons, medulla, cerebellum, and reticular formation system. Is made up of cells that produce neurotransmiters. Brief hospitalization is often required for many psychiatric illnesses. What are the primary reasons? - ✔✔-Safety, compliance with treatment, rapid stabilization Bromocriptine (Parlodel) and dantrolene (Dantrium) - ✔✔-Treatment for NMS BUN - ✔✔-6-20 BUN - ✔✔-10-20 mg/dL BUN - ✔✔-10-20, increased in impaired kidney function, significant dehydration, measure with lithium Bupropion/Wellbutrin (NDRI) 150-450 mg side effects SR 150-400 mg XL 150-450 mg - ✔✔-Headache, nervousness, tremors, tachycardia, insomnia, decreased appetite Contraindicated in patients with seizures, eating d/o SR offers BID dose XL offers once dailly Can increase energy level Also used for ADHD and smoking cessation Caution with caffeine and in people with panic disorder CAGE - ✔✔-Cut down Annoy you about it Guilty Eye Opener (AID-Altered to Include Drugs) CAGE-AID - ✔✔-IDs problem drinking or druging, 13 and older (C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs CAGE-AID (Alcohol and drug use) - ✔✔-IDs problem drinking or druging, 13 and older (C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs calcium - ✔✔-8.8-10.5. 99% found in bone. major cation for bones and teeth. higher in kids because of bone growth. Calcium 8.8-10.5 - ✔✔-Needed for hormone secretion, transmission of nerve impulses and the contraction of muscles. hypocalcemia causes confusion, paresthesia, hyperreflexia, seizures, prolonged QT, tetany. hypercalcemia causes fatigue, weakness, behavioral vhanges, shortened QT, heart block Calcium, Ca++ - ✔✔-8.8-10.5 <7.0, tetany >11.0, hyperparathyroidism >13.5, hypercalcemic coma, metastatic cancer Can raise BP and is a potent inhibitor of cyp450 system; safer in overdose than TCAs - ✔✔-Effexor (an SNRI) Captopril, cimetidine, corticosteroids, cyclosporine, disulfiram, hydralazine, and ___________ may cause manic symptoms - ✔✔-Isoniazid Carbamazepine ER (Equetro) dosing & facts - ✔✔-200-1600 mg/day No need to obtain blood levels Transient decrease in platelets and WBCs is rare Carbamazepine teratogenic risks - ✔✔-Neural tube defects Carbamazepine/Tegretol 10-20 mg/kg/day side effects - ✔✔-Agranulocytosis aplastic anemia Nausea Dizziness Sedation Headache Dry mouth Constipation Skin rash Montior LFts Cardiac lithium side effects - ✔✔-T wave inversions Dysrhythmias Cardiac side effects associated with lithium - ✔✔-T-wave inversions, dysrhythmias Cardiac side effects associated with TCAs: - ✔✔-EKG changes and cardiac dysrythmias Carrier proteins or reuptake pumps - ✔✔-Transport neurotransmitters out of the synapse and back into the presynaptic neuron to be recycled or reused. Case management - ✔✔-System of controlled oversight and authorization of services and benefits provided to clients. -Coordinating Care, Ensuring Quality Outcomes, Monitoring Plan of Care, and Advocacy. Promote Quality Cost-Effective Outcomes. Categories of neurotransmitters - ✔✔-Monoamines, aminoacids,cholinergics, and peptides Catnip - ✔✔-Sedation CCSD - ✔✔-Cornell Scale for Depression in Dementia 19 items, <6=no significant depression; 8-17=probable major depression; >18=definite depression CCSD - ✔✔-Cornell Scale for Depression in Dementia 19 items, <6=no significant depression; 8-17=probable major depression; >18=definite depression Celexa (SSRI) 20-40 mg side effects - ✔✔-sedation, sexual dysfunction, agitation, yawning, GI, weight gain prolonged QTc in doses above 40 Cell body - ✔✔-Also known as soma; made up of the nucleus and cytoplasm within the cell membrane: Central nervous system (CNS) - ✔✔-Composed of spinal cord and the brain Cerebellum (located in the brain stem) - ✔✔-Maintains equilibrium and acts as a gross movement center (balance, posture) Problems would cause ataxia. Rhomberg test would be used to test cerebellum function. Each hemisphere is ipsalateral (same side control). Cerebral cortex - ✔✔-This area of the brain is responsible for much of the behavior that makes us human: speech, cognition, judgment, perception, and motor function. Cerebral cortex controls the... - ✔✔-Contralateral side of the body (opposite) Speech, cognition, judgment, perception, motor function Cerebrum - ✔✔-Largest part of the brain composed of cerebral cortex, limbic system, thalamus, hypothalamus and basal ganglia Certain medications can cause hypertensive crisis and possible death when administered with an MAOIs. Name them: - ✔✔-Meperidine, SSRIs, decongestants, TCAs, atypical antipsychotics; St. John's wort, Ltrytophan, Ritalin, asthma medications. Certification - ✔✔-Credential that provides title protection Determines scope of practice Is the process by which a professional organization/association certifies that an individual licensed to practice as a professional has met certain predetermined standards Assures the public that an individual has mastery of a body of knowledge Assures that the individual has acquired the skills necessary to function in a particular specialty ANCC only one for psych certification - ✔✔-Is the process by which a professional organization or association certifies that an individual has met pre-determined standards and skills to practice in a specialty area. chamomile - ✔✔-Sedation and anxiety Children taking antidepressants should be monitored closely for - ✔✔-Suicide chloride - ✔✔-98-106 Chloride, Cl - ✔✔-98 - 106 passive transport through sodium major anion in the extracellular fluid Cholinergics - ✔✔-Acetylcholine Chromosomes - ✔✔-Structures of DNA Circadian rhythms control these biological processes that are frequent problems with depressed individuals - ✔✔-Sleep-rest cycle disturbances * Increased cortisol secretions * REM abnormalities Increased emotional reactivity Frequent waking More intensified dreaming Diurnal variations to circadian-related behaviors Decreased arousal and energy levels Decreased activity patterns * Circular Causality - ✔✔-Family system concept Ongoing feedback loop; actions & reactions that maintain a problem Pts & problems best understood via relationships & interactions in entire family Circumstantiality - ✔✔-Inclusion of unnecessary detail and parenthetical information into the conversation CIWA - ✔✔-severity of EtOH withdrawal syndrome CIWA assess withdrawal and DTs - ✔✔-N/V Tremors Paroxysmal sweats Anxiety Agitation Tactile disturbances Auditory disturbances Visual disturbances Headaches Altered sensorium CIWA Scoring - ✔✔-0-8 mild withdrawal 9-15 moderate Over 15 severe and possible DTs CIWA-Ar - ✔✔-Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised 9 item symptom rating scale, max score 67; <10 does not warrant intervention CIWA-Ar (Treatment assessment) - ✔✔-Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised 9 item symptom rating scale, max score 67; <10 does not warrant intervention CK, creatine kinase - ✔✔-<240, indicates muscle injury of heart, brain, skeletal muscle, elevated in MI, myositis, rhabdomysitis Clanging - ✔✔-Form of loose association in which topics change on the basis of sounds of words rather than meaning of words Clinical history characterized by occurrence of one or more major depressive episodes accompanied by at least one hypomanic episode - ✔✔-Bipolar Disorder, Type II Clinical history characterized by occurrence of one or more manic or mixed episodes - ✔✔-Bipolar Disorder, Type I Clomipramine/Anafranil 100-250 mg comments - ✔✔-approved for OCD 250 mg/day max due to increased seizure risk Clozapine 25-900 mg side effects - ✔✔-CBC weekly first 6 mths, biweekly second 6 mths, then monthly if normal Dose related seizure risk Weight gain, hyperlipidemia, tachycardia, drowsiness, diziness, agranuloyctosis, NMS Cluster A - ✔✔-Odd, unusual, eccentric, asocial Paranoid personality Schizoid personality Schizotypal personality Cluster B - ✔✔-Dramatic, affective, instable (Angry) Antisocial Borderline Histrionic Narcissistic Cluster C - ✔✔-Anxious Avoidant Dependent OCD CNS lithium side effects - ✔✔-Fine hand tremors Fatigue Mental cloudiness Headaches Coarse hand tremors with toxicity Nystagmus CNS side effects of lithium - ✔✔-Fine hand tremors, fatigue, fasciculations, mental cloudiness, headaches, nystagmus. Cognitive Theory - ✔✔-Beck Cognitive Therapy - Aaron Beck - ✔✔-1. Events do not cause anxiety and maladaptive response are the individuals expectations, perceptions, and interpretations of these events that cause anxiety 2. Allows people to view reality more clearly through an examination of their central distorted cognitions 3. Goal is to change the clients irrational belief and faulty conceptions and negative cognitive distortions Collaborative agreement - ✔✔-Protocol that describes what types of drugs might be prescribed and defines some form of oversight board for NP practice collaborative agreement - ✔✔-protocols that describes what types of drugs may be prescribed and form of oversight by nursing boards Commitment Criteria - ✔✔-Person has a diagnosed psychiatric disorder Person is harmful to self or others as a consequence of the disorder Person is unaware or unwilling to accept the nature and severity of the disorder Treatment is likely to improve functioning Common comorbidities with BD - ✔✔-Hypothyroidism and substance abuse Common enzyme inducers - ✔✔-Tagamet, erythromycin, Dilantin, fluoroquinolones, Duloxatine, Grapefruit juice, Ketoconazole,SSRIs: prozac, paxil, and fluvox Common enzyme inhibitors - ✔✔-Bupropion, Carbamazepine, Clomipramine Hypericum (St. John's Worth) Common medications that can induce depression - ✔✔-Beta blockers, steroids, interferon, accutane, some retroviral drugs, neoplastic drugs, benzos, progesterone Common medications that can induce mania - ✔✔-Steroids, INH, antabuse, antidepressants in individuals with bipolar disorder Communication techniques - ✔✔-Broad openings: What brings you here today? Accepting:"I can imagine that it has been very difficult for you." Summarizing: "So let me see if I understand [Show More]

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