What does withdrawal symptoms of amphetamine and cocain result in?
Dysphoria
Fatigue
Sleep disturbances
Increased appetite
What are some side effects of benzos?
Sedation
Lightheadedness
Ataxia
Decreased cognitive function
Benzo effects: What is anterograde amnesia
Difficulty recalling events that occur after dosing
What happens with benzo toxcity?
Resp. depression Lethargy Confusion Severe hypotension Cardiac arrest
Benzo. What are the paradoxical responses?
Insomnia Excitation Euphoria Anxiety Rage
Benzo. What are withdrawal effects?
Anxirty Insomnia Diaphoresis Tremor Light deadness
Benzo. Does withdrawal occur frequently with short term use?
NO. Occurs infrequently with short term use
What CNS effects do these belong to?
- Tremor
- Restlessness
- Anorexia
- Insomnia
- Agitation
- Increased motor activity
- Compulsive behavior
- Paranoia
- Hallucinations
- Agressive behavior
Cocaine
What are the GI and renal effects of cocaine?
Decrease in GI motility (constipation), urinary difficulity, occasionally cause diarrhea
What is the sexual functioning from use of cocaine?
Coital urge–some men experience sexual dysfuntion–most experience powerful aphrodisiac
Clients with a coexisting substance disorder along with a mental disorder
Dual diagnois
What therapy: Involves more therapist to client interaction than classic psychoanalysis
Psychotherapy
Therapeutic process of assessing unconscious thoughts and feelings, and resolving conflict by talking to a psychoanalyst
Psychoanalysis
The group is formed and them members can come in or leave freely during that time group is held
Open group
Predetermined, fixed time frame; everyone joins at same time, and no new members can join after the group has started
Closed group
Leader completely controls the direction and structure of the group without allowing group or decision making to solve problems
Autocratic
Supports group interaction and decision making to solve problems
Democratic
The group process progresses without any attempt by the leader to control the direction
Laizzez faire
Members of this type of led group become frustrated and confused, productivity and morale is low
Laissez fiare
What are 6 areas to assess for a healthy family?
- Communication
- Self concept reinforcement
- Family member expectations
- Handling differences
- Family interactional patterns
- Family climate
Areas to assess for a healthy family: Congruency bweteen nonverbal/verbal, direct, open, honest, and clear
Communication
Areas to assess for a healthy family: Each member valued INDEPENDENTLY
Family member expectation
Areas to assess for a healthy family: Handling differences–how are disagreements death with?
In an open manner with a feasible solution that is agreed upon with all
Areas to assess for a healthy family: How behavior behaves; “family rules”–rules should promotes needs of all family members
Family interactional patterns
Family therapy: What happens when boundaries are rigid or diffuse?
Maladaptation
Family therapy: What is enmeshment
Exaggerated correctness among family members
Family therapy: Enmeshment occurs in response to diffuse boundaries in which there is what?
- Over investment
- Over involvement
- Lack of differentiation between individuals or subsystems
Family therapy: What is scapegoating?
A family member is the target of projection; assumes the role assigned to them
Family therapy: defined as a state of sever chronic disequilibrium and discord, with recurrent threats of separation; marital skew is when there is lack equal partnershep
Marital schism
Family therapy: Lack of equal partnership between spouses
EX: Wife is dominant and puts husband down in front of kid–confuses kids
Martial skew
Family therapy: What does reframing do?
Encourage spouse to reframe the way we view one another
EX: Construction worker husband has dirty shoes–wife gets mad for making house dirty again–INSTEAD with reframing..the wife should view is dirty ness as a sign of love that he goes to work to provide for family
Family therapy: A 3 person emotional configuration that is considered a basic building block of the family system
Triangulation
A therapeutic community as a means of treatment ..TEAMWORK
Milieu
*interdisciplinary team all working towards the same goal
What is the goal of milieu?
Manipulate enviornment so all aspects of patients hospital experience is therapeutic
- carefully planned
- structure
- inclusion of family, outside community, etc
A menu of the treatments a pt is receiving and how they can best learn based on those treatments
Milieu
An acute, time limited (4-6 weeks) event during which a client experiences an emotional response tat cannot be managed with the clients normal coping mechanism
Crisis
What are the 6 types of crisis?
- Dispositional
- Anticipated life
- Traumatic stress
- Reflecting psychopathology
- Developmental
- Psychiatric emergencies
What type of crisis: an acute response to an external situation
Dispositional
What type of crisis: A normal life cycle transitions that may be anticipated but over which the individual feel a lack of control
Anticipated life
What type of crisis: Precipitated by an unexpected external stressor over which the individual has little/no control and as a result of which he/she feels overwhelmed and defeated
Traumatic stress
What type of crisis: Preexisting psychopathology has been instrumental in precipitation the crisis or it significant impairs or complicate adaptive resolution
Reflecting psychopathology
What type of crisis: Caused by situations that trigger emotions related to unresolved conflicts in ones life
Developmental
What type of crisis: General function has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility
Psychiatric emergencies
What are factors that influence the way an individual copes with crisis ?
- Individual perception of event
- Availability of situational supports
- Availability of adequate coping mechanisms
Crisis: What is Robert and Ottens 7 stage crisis intervention model?
stage 1: Psychosocial assessment
stage 2: Establish rapport
stage 3: Identify crisis precipitants
stage 4: Handle emotions
stage 5: Explore alternatives
stage 6: Action plan
stage 7: Follow up
What is the desired outcome of crisis treatment?*
To restore person to pre-crisis level of functioning
Is it okay for preg mom to do ECT?
Yes–much safer than meds
What trimesters is it okay for preg mom to do ECT?
All
ECT is used to treat what?
MAJOR DEPRESSION
Mania
Schiz.
What should happen for ECT to be effective?
Cause grand mal seizure
What does induction of grand mal seizure for ECT do?
Increase neurotransmitters
ECT: How long should seizure last?
25-60 seconds
ECT: How long should electricity be placed?
0.2-0.8 seconds
ECT: Decrease or discontinue meds that lower seizure threshold ____ before ECT
Several days
ECT: When should MAOI and lithium be discontinued?
2 weeks before procedure
ECT: What needs to be monitored?
HTN and cardiac conditions bc short term HTN may occur after procedure
20 min before ECT what is injected?
Atropine sulfate to decrease sectretions and counteract any vagal stimulation
Before ECT, do what?
- VS and mental status
- Make sure client and fam know the procedure
- IV line inserted/maintained till full recovery
What do nurses do during ECT?
- Put bite guard in
- Apply electrodes to scalp
- Anestesia adminsitered–intubation–100% oxygen
- Give muscle relaxer
- Place cuff on arm/leg to monitor seizure activity
What do nurses do after ECT?
- Asses client stable and transfer
- Assess LOC, VS, cardiac status, O2 sat
- PLACE CLIENT ON LEFT SIDE to facilitate drainage and prevent aspiration
- Assess for gag reflex/swallow
- Transfer out and back to facility within 30-60 min post proc.
What are complications of ECT?
- Memory loss/confusion
- Reactions to anesthesia
- ECG changes
- Headache, muscle soreness, nausea
- Relapse of depression
A noninvasive therapy that uses magnetic pulsations to stimulate specific ares of the brain
TMS (transcranial magnetic stimulation)
Provides electrical stimulation through the vagus nerve though a device that is implanted under the clients chest
VNS (vagus nerve stumulation)
What are adverse effects of VNS?
Voice changes
Dysphagia
Neck pain
The restoration to a former and/or better state or condition
Recovery model
4 major dimensions of recovery model?
- Health
- Home
- Purpose
- Community