Exam 1

• self-stigma: negative attitude or internalized shame

  institutional stigma: government policies limiting opportunities for people with mental illness

  public stigma: negative attitudes towards others
• bias

  implicit: decisions unconsciously influenced by pre-existing beliefs

  explicit: being aware of pre-existing beliefs and making decisions based on them
• CJM & nursing process

  recognize cues (assessment)

  analyze cues (analysis)

  prioritize hypotheses (analysis)

  generate solutions (planning)

  take action (implementation)

  evaluate outcomes (evaluation)
• what are the components of an MSE?

  appearance, behavior, speech, mood, affect, thoughts, perception, cognition, insight, judgement
• communication techniques

  SOLER: square, open, leaning forward, eye contact, relax

  SURETY: sit at an angle, uncross legs, relax, eye contact, touch, your intuition

  LISTEN: look interested, involve, stay on task, test, evaluate, neutralize
• peplau's interpersonal theory

  pre-interaction: nurse self-evaluation

  orientation: establish boundaries / goals, patient presents need

  working: mutual trust, progress to goals

  termination: goals are met, new goals developed
• interpersonal theory

  role of interpersonal relationships, social development, and culture in the formation of personality
• behavioral theory

  encourages patient to identify maladaptive behaviors and coping skills

  intervention: help patient obtain healthy coping skills
• cognitive behavioral therapy

  acknowledges feelings, encourages alternative actions or ways to assess own thinking and behavior

  intervention: help with coping
• psychoanalytic theory

  id: subconscious, seeks pleasure, no form of reality or consequence

  super-ego: allows mind to control impulses (ideal self and conscience)

  ego: creates balance between pain and pleasure, function of self-preservation
• erikson's psychosocial developmental stages

  birth to 18 months: trust vs mistrust

  18 months to 3 years: autonomy vs shame and doubt

  3 to 6 years: initiative vs guilt

  6 to 12 years: industry vs inferiority

  12 to 20 years: identity vs role confusion

  20 to 30 years: intimacy vs isolation
• neurotransmitters

  dopamine: excitatory; involved in mood, sleep, learning

  serotonin: inhibitory; involved in mood, sleep

  norepinephrine: excitatory; involved in heart, intestines, alertness

  histamine: involved in GI, allergic response, cardiac stimulation

  GABA: inhibitory; involved in brain function, sleep

  glutamate: excitatory; involved in memory, learning

  acetylcholine: inhibitory and excitatory; involved in muscle action, memory
• symptoms of serotonin syndrome

  diaphoresis, tachycardia, dilated pupils, restlessness, hyperreflexia, irritability, psychosis, muscle rigidity, loss of coordination
• extrapyramidal symptoms

  parkinsonian symptoms, tardive dyskinesia, acute dystonia
• main AE of clozapine

  agranulocytosis
• teaching for clozapine

  candy/water for dry mouth, increase fluids and fiber, fall risk, photosensitivity
• AIMS

  abnormal involuntary movement scale
• general AE of antipsychotics

  anticholinergic symptoms
• main drugs for ADHD

  stimulants
• lithium & lithium toxicity

  most common s/s of toxicity: nausea, vomiting, ataxia

  early toxicity > 1.5mEq/L

  advanced toxicity 2-2.5mEq/L

  severe toxicity > 2.5mEq/L
• lithium toxicity s/s

  early: poor coordination, confusion, coarse tremors, vomiting, diarrhea

  advanced: seizures, stupor, blurred vision, jerking motor movements, respiratory complications

  severe: coma, severe respiratory complications, death
• withdrawals

  alcohol: excess glutamate release

  opioid: excess norepinephrine release