Mental Health Disorders and Treatments

Anxiety

• Characterized by excessive worry, nervousness, and apprehension
• Symptoms include restlessness, fatigue, difficulty concentrating, muscle tension, insomnia, and gastrointestinal distress

Benzodiazepine Classification Information for RNs:

• Classified as Schedule IV drugs due to their potential for dependence and abuse
• Used to treat anxiety, insomnia, and muscle spasms
• Include drugs like alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan)

Lithium

• Mood stabilizer used to treat bipolar disorder
• Effective in reducing manic episodes and preventing relapse
• Requires regular blood monitoring due to potential for toxicity
  • Lithium toxicity can cause tremors, confusion, seizures, and kidney damage
  • Lithium levels should be maintained within the therapeutic range to minimize side effects

Alcohol Use Disorder (Withdrawal):

• Symptoms can range from mild to severe and can include anxiety, insomnia, tremors, seizures, and delirium tremens (DTs)
• DTs is a life-threatening complication characterized by confusion, agitation, hallucinations, and autonomic instability
• Withdrawal is commonly managed with medications like benzodiazepines and supportive care

Heroin Withdrawal Cues

• Symptoms include muscle aches, cramps, diarrhea, vomiting, sweating, and restlessness
• Can be uncomfortable but is not typically life-threatening

PTSD (Post-Traumatic Stress Disorder)

• Characterized by intrusive memories, avoidance of trauma-related stimuli, negative thoughts and feelings, and hyperarousal
• Often develops following a traumatic event like war, assault, or natural disaster

OCD (Obsessive-Compulsive Disorder)

• Characterized by obsessions (intrusive thoughts) and compulsions (repetitive behaviors)
• Compulsions are often performed to relieve anxiety caused by obsessions, although they are usually not directly related to the obsessions

Anger/Aggression

• Can be triggered by a variety of factors, including frustration, stress, and feeling threatened or attacked
• Manifestations may include verbal abuse, physical violence, and destructive behavior

Preassaultive Violence Manifestations

• Can include:
  • Increasing anxiety and tension
  • Restlessness and pacing
  • Verbal abuse and threats
  • Facial expressions such as anger, hostility, and narrowed eyes
  • Nonverbal cues like clenched fists, muscle tension, and a flushed face

Therapeutic Communication

• A technique used to establish a trusting and supportive relationship with patients
• Key elements include active listening, empathy, respect, and genuineness

Therapeutic Relationship Phases

• Orientation phase: Establishing rapport and trust
• Working phase: Addressing the patient's needs and goals
• Termination phase: Review and discuss successes, coping mechanisms, and transitioning back to the community

Inpatient Care and Priorities

• Focuses on safety, stabilization, and treatment of acute mental health issues
• Prioritization of patient needs is based on severity, potential for harm, and risk factors

Milieu Environment

• Therapeutic setting where all aspects of the environment are designed to promote healing and recovery
• Includes physical aspects like safety and comfort, as well as social interactions and therapeutic activities

Eastern Culture Beliefs

• Often place an emphasis on the importance of family, tradition, and spirituality
• May have different views on mental illness compared to Western cultures

Antidepressant Categories:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs)
• Monoamine oxidase inhibitors (MAOIs)
• Atypical antidepressants

Tardive Dyskinesia

• A neurological disorder characterized by involuntary movements, especially of the face, tongue, and extremities
• Often a side effect of long-term use of antipsychotic medications

Extrapyramidal Symptoms (EPS)

• Include a range of movement disorders, such as tremors, muscle stiffness, and involuntary muscle movements
• Can be associated with the use of antipsychotic medications

Anticonvulsants (Mood Stabilizers)

• Used to treat bipolar disorder and other mood disorders
• Examples include valproic acid (Depakote) and lamotrigine (Lamictal)

Crisis Care Priority Interventions

• Ensure safety of the patient and others
• De-escalate the situation and reduce anxiety
• Determine the immediate needs of the patient and provide appropriate support

3 Types of Crisis and How They Are Manifested

• Situational Crisis: Triggered by a specific event, such as a job loss or death in the family
• Developmental Crisis: Related to normal transitions in life, such as adolescence or retirement
• Existential Crisis: Involves questioning life's meaning and purpose, often triggered by major life changes or profound personal losses

Alprazolam Contraindications/Education

• Contraindicated in patients with:
  • Acute narrow-angle glaucoma
  • Hypersensitivity to benzodiazepines
• Patient Education
  • Avoid alcohol and other CNS depressants
  • Can cause drowsiness and impairment, avoiding driving or operating machinery
  • Can lead to dependence, taking as directed and not stopping abruptly

Haloperidol Side Effects

• Can cause EPS like akathisia, dystonia, and parkinsonism
• Also can cause drowsiness, dizziness, and weight gain

Olanzapine Side Effects

• Can include weight gain, drowsiness, dry mouth, and constipation
• Also, increased risk of metabolic syndrome

Clozapine Adverse Effects

• Can include agranulocytosis (a potentially life-threatening decrease in white blood cells)
• Requires regular blood monitoring

Mental Status Exam (MSE)

• A structured assessment of a patient's mental state
• Evaluates appearance, behavior, mood, affect, thought content, and cognition

Cognitive Behavioral Therapy (CBT)

• Psychotherapy that focuses on identifying and changing negative thoughts and behaviors
• Teaches patients coping skills and problem-solving strategies

MAOIs Adverse Effects

• Can interact with certain foods and medications
• Potential for hypertensive crisis with tyramine-containing foods like aged cheeses, cured meats, and some wines

Citalopram Education

• Important to take the medication as prescribed
• May take several weeks for to see full therapeutic effects
• Common side effects include nausea, headache, and sexual dysfunction

Methadone Education

• Used to help manage opioid withdrawal and prevent relapse
• Requires regular monitoring and dose adjustments
• Can be habit-forming

Resilience

• The ability to adapt to and cope with adversity
• Includes factors such as self-efficacy, optimism, and social support

Boundary Blurring

• Inappropriate or unhealthy mixing of personal and professional relationships
• Can lead to conflict of interest and unethical behavior

HIPAA Confidentiality Rights

• Protects the privacy of patient health information
• Health care providers should only disclose information with patient consent or legal authorization

Inpatient Criteria

• Typically involves an assessment of the patient's mental status, risk factors, and need for intensive treatment
• Criteria may vary but can include imminent danger to oneself or others, severe symptoms, or lack of support

Autonomy

• Respect for the patient's right to make their own decisions about their care
• Essential for ethical and patient-centered care

Restraints are Used For

• Only used as a last resort to prevent harm to the patient or others
• Must be used according to protocol and require ongoing monitoring

Stress Manifestations

• Can manifest both physically and psychologically
• Physical symptoms may include muscle tension, headaches, fatigue, and digestive issues
• Psychological symptoms may include anxiety, irritability, difficulty concentrating, and poor sleep

Stress Interventions/Education

• Stress management techniques can include exercise, relaxation techniques, and mindfulness practices
• Patient education may include information about healthy lifestyle choices and stress reduction strategies

Eustress/Distress

• Eustress: Positive stress that can motivate and challenge us
• Distress: Negative stress that can overwhelm and lead to health problems

Defense Mechanisms:

• Unconscious psychological mechanisms that protect us from anxiety and stress
• Examples include denial, repression, projection, and displacement

This quiz covers key concepts related to anxiety, benzodiazepines, lithium treatment, and alcohol use disorder. It is essential for understanding common mental health issues and their pharmacological interventions. Test your knowledge on symptoms, classifications, and treatment protocols.