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Mental Health Problems Flashcards

Review the different types of mental health problems, hallucinations and delusions, and ECT. (63 cards)

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1
Q

Why are psychiatric clients admitted to the hospital?

A

Because of suicidal or homicidal tendencies, or because they are unable to care for themselves such as a drug addiction or another psychological disorder.

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2
Q

What is the priority when working with a client with a mental health problem?

A

Keep the client SAFE by preventing them from harming themselves or someone else:

  • Implement suicide precautions
  • Restraints if client is violent
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3
Q

What is the difference between a psychotic and a non-psychotic mental health problem?

A
  • Psychotic clients are not grounded in reality and can have delusions and hallucinations. They do not realize that they have a problem.
  • Non-psychotic clients understand that they have a problem such as depression or anxiety, but aren’t sure how to manage it.
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4
Q

What are the main psychotic disorders?

A
  • bipolar
  • schizophrenia
  • schizotypical
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5
Q

What is the treatment for psychotic clients?

A
  • antipsychotics
  • therapeutic communication focuses on presenting reality and acknowledging feelings
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6
Q

What are the main non-psychotic disorders?

A
  • depression and anxiety
  • Post-traumatic stress disorder (PTSD)
  • Obsessive-compulsive disorder (OCD)
  • phobias
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7
Q

What is the treatment for non-psychotic clients?

A
  • antidepressants and anxiolytics
  • therapeutic communication focuses on getting client to open up about problem and learning how to cope and problem solve
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8
Q

Describe:

Anxiety

A

A feeling of apprehension, uncertainty, or dread.

It is a normal response to stress and can be mild to severe.

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9
Q

Describe:

Panic

A

A severe type of anxiety where death can occur.

Clients can experience panic attacks.

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10
Q

Signs and symptoms:

Severe anxiety

A
  • increased tremors
  • pounding heart
  • hyperventilation
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11
Q

Interventions:

Anxiety

A
  • provide a quiet environment
  • promote relaxation techniques
  • monitor vital signs and give anxiolytics
  • don’t force client into situations that cause anxiety
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12
Q

What are therapeutic communication techniques for a client with mild to moderate anxiety?

A
  • ask client to identify what and how they feel
  • encourage discussion of feelings
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13
Q

What are the immediate interventions for severe anxiety and panic?

A
  • stay with client
  • provide clear, simple instructions
  • use a low-pitched voice
  • give anxiolytics
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14
Q

Describe:

Generalized anxiety disorder

A

An unrealistic anxiety about everyday worries that persist for more days than not for at least 6 months.

It is not associated with any other mental health or medical problem.

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15
Q

Describe:

Post-traumatic stress disorder (PTSD)

A

When a client experiences a psychologically traumatic event and experiences scary flashbacks.

The symptoms last at least 1 month and can occur months to years after the event.

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16
Q

Interventions:

Post-traumatic stress disorder

A
  • encourage client to talk about feelings
  • encourage recognition between feelings and traumatic experience
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17
Q

Describe:

Phobia

A

An irrational fear of an object, activity, or situation. The phobia can cause severe anxiety and panic.

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18
Q

Interventions:

Phobia

A
  • allow client to discuss fears
  • teach relaxation techniques
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19
Q

Describe:

Obsessive-compulsive disorder (OCD)

A

A preoccupation with thoughts or impulses. It is brought on by anxiety and the need for control.

Ritual behaviors are performed such as constant handwashing or checking the locks.

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20
Q

Interventions:

Obsessive-compulsive disorder

A
  • help client recognize what caused behavior
  • let client do behavior unless safety is an issue
  • set limits on behavior
  • provide activities to distract from behavior
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21
Q

Describe:

Somatic symptoms

A

Also known as the “hypochondriac”. The client frequently thinks there is a medical problem when there is NO medical problem.

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22
Q

Interventions:

Somatic symptoms

A
  • put a time limit on letting client discuss symptoms
  • don’t respond with positive enforcement about physical complaints
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23
Q

Describe:

Conversion disorder

A

When a mental health issue is converted into physical symptoms.

Example: a client that was emotionally abused becomes blind.

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24
Q

Interventions:

Conversion disorder

A

Let client talk about relating the physical symptoms with their feelings.

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25
# Describe: Dissociative disorder
When a client **develops different personalities to deal with a traumatic event**.
26
# Interventions: Dissociative disorder
* encourage discussion of feelings and experiences * focus on strengths and skills
27
# Describe: Bipolar mood disorder
**Extreme changes in mood**, going from mania to depression.
28
# Interventions: Bipolar mood disorder
* ignore or distract grandiose thinking * present reality * set limits on behavior * provide high calorie finger foods * no group activities when manic and aggressive
29
# Describe: Depression
An **unpleasant feeling** after some type of loss. ## Footnote Many times there is no obvious cause of it.
30
# Interventions: Depression
* assess for suicidal tendencies * make a contract for suicide * gentle encouragement for simple activities
31
# Describe: Schizophrenia
When the client experiences **illogical, disorganized thoughts** such as delusions and hallucinations.
32
# Signs and symptoms: Schizophrenia
* delusions/hallucinations * talk to themselves and repetitive speech * may be completely still or put their body in strange positions (catatonic behavior) * negative symptoms (diminished emotional expression)
33
What are **delusions**?
A **false belief** with evidence showing that it's false.
34
What are some **examples of a delusion**?
* client thinks they are very powerful * partner is cheating * are being singled out for harm ## Footnote All evidence would show that none of the delusions are true.
35
# Interventions: Delusions
* ask client to describe delusion for safety reasons * don't say the delusion doesn't exist (to them it does exist) * focus on feelings that the delusion causes * set limits on delusion * focus on reality-based topics
36
How would the nurse **respond** to a client who is delusional and is reporting *"the person in the mail truck is the FBI and they want to kill me!"*
1. **Address feelings** - "It sounds like you are scared" 2. **Focus on reality** - "That is the mailman delivering the mail"
37
What are **hallucinations**?
When the client **senses something that isn't real**. ## Footnote This can include hearing, tasting, smelling, feeling, and seeing things that aren't there.
38
# Interventions: Hallucinations
* ask to describe hallucination for safety reasons * don't pretend it's real, but don't deny the hallucination either * focus on reality instead * don't touch the client * distract client with an easy activity
39
What is a **personality disorder**?
When the client's **inflexible behavior impairs life functioning and relationships.** ## Footnote It is usually NOT associated with substance abuse.
40
What are the **Cluster A Personality disorders**?
* schizoid * schizotypal * paranoid ## Footnote These clients have a hard time forming relationships and tend to be paranoid.
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# Describe: Schizoid Personality Disorder
When a client **cannot form personal relationships.** ## Footnote They lack emotion and interest in others.
42
# Describe: Schizotypal Personality Disorder
When a client is **suspicious, paranoid, or uses magical thinking.**
43
# Describe: Paranoid Personality Disorder
When the client is **suspicious, argumentative, and critical of others.**
44
What are the general **interventions** for Cluster A Personality Disorders? * schizoid * schizotypal * paranoid
Due to the "paranoid" tendency of Cluster A Personality Disorders, do not laugh or whisper in front of them. ## Footnote These clients are typically NOT admitted to the hospital since they are not usually violent or a harm to themselves.
45
What are the **Cluster B Personality Disorders**?
* histrionic * narcissistic * borderline ## Footnote These clients have a tendency to be manipulative and overly dramatic.
46
# Describe: Histrionic Personality Disorder
When the client is **overly dramatic and expressive.** ## Footnote These clients are frequently admitted due to suicide attempts.
47
# Describe: Narcissistic Personality Disorder
When the client has an **increased sense of self-importance.** ## Footnote They frequently lack empathy and sensitivity.
48
# Describe: Antisocial Personality Disorder
When the client can **seem charming but are actually very manipulative.** ## Footnote They can be irresponsible, selfish, cannot maintain relationships, and tend to be irritable and hostile. These clients are frequently admitted because of risk of harming others.
49
# Describe: Borderline Personality Disorder
When the client is **impulsive, unpredictable, and manipulative.** They tend to see everything as either all good or all bad. ## Footnote These clients have a tendency for self-mutilation.
50
What are the general **interventions** for Cluster B Personality Disorders? * histrionic * narcissistic * borderline
* set limits on behavior * discuss consequences for unacceptable behavior * remove from group if aggressive or attention-seeking behavior occurs * provide praise for non-manipulative and positive behavior in social situations ## Footnote Cluster B Personality Disorders have a tendency to be **manipulative and overly dramatic:**
51
Regardless of the mental health disorder, how should the nurse respond to clients that are **having feelings that could harm themselves or someone else?**
Encourage clients to **discuss feelings** instead of acting the feelings out.
52
# Describe: Alzheimer's and Dementia
**Intellectual deterioration.** First there is short-term memory loss and then long-term memory loss. ## Footnote Eventually, the client forgets how to care for themselves.
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# Interventions: Alzheimer's and Dementia
* room close to the nurses' station * provide safety measures for wandering * put familiar objects around * have a routine and simple tasks * avoid stimuli if agitated * don't argue or force activity * encourage discussion of feelings * provide caregiver support * Anti-alzheimer meds
54
Why should sedative medications like anxiolytics be avoided by clients that have Alzheimer's or dementia?
Sedatives can cause more confusion.
55
What are **communication disorders?**
When the client has **a hard time communicating** for a variety of reasons. ## Footnote Causes are from hard of hearing, eye disorders, CVA, and other neurological issues.
56
How should the nurse **talk to a client with a communication disorder?**
* firm volume, calm and low-pitched voice * speak slowly with simple words * don't yell or speak in a loud voice * stand in front of client and maintain eye contact * repeat questions, don't rephrase questions
57
What is **sundowners**?
A condition in which older clients **get more confused in the evening.**
58
What are the interventions for **confused and agitated** clients?
* first rule out any physical problem * provide a calm environment * allow wandering in a safe place * don't argue and don't force any activity * orient frequently * avoid sedatives as it usually causes more agitation * provide simple activities like folding washcloths
59
What is **Electroconvulsive treatment (ECT)**?
**Inducing a seizure to provide relief for severe mental health problems** such as severe depression, bipolar and schizophrenia. ## Footnote It is used when medications or other therapies aren't working.
60
Is informed consent needed for a client receiving electroconvulsive treatment (ECT)?
Yes! ## Footnote ECT is an invasive procedure that include risks.
61
# Interventions: **Electroconvulsive treatment (ECT)**
Client will receive **muscle relaxers and anesthesia** to prevent full body seizures. Also assess for breathing.
62
What is the **characteristic symptom** after ECT?
Confusion.
62
What is the nursing care after a client has undergone ECT?
* assess vital signs * re-orient
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