Psychiatry Chapter 22 Flashcards

Questions and Answers

What is organic brain syndrome?

A dysfunction of the brain caused by abnormal physical or physiological function.

People at a higher risk for suicide include all of the following, EXCEPT:

Single females

Divorced individuals

Married males younger than 30 years

Married males older than 30 years (correct)

What is the first step in assessing a patient with a behavioral emergency?

Ensure your safety.

What is the single most significant factor that contributes to suicide?

Depression. Signup and view all the answers

When assessing a patient with a behavioral crisis, what should you do?

Be direct and clearly state your intentions. Signup and view all the answers

Which of the following conditions or factors would be the LEAST likely to result in a change in behavior?

Antihypertensive medications Signup and view all the answers

Which of the following conditions or situations would MOST likely make excited delirium worse?

Alcohol withdrawal Signup and view all the answers

What is a correct statement regarding the physical examination of a patient with a behavioral problem?

The patient's emotional state may be determined by noting facial expressions, pulse rate, and respirations. Signup and view all the answers

What finding would be MOST suggestive of dysfunction of a patient’s central nervous system?

Rapid eye movement. Signup and view all the answers

Which of the following are types of psychological disorders? (Select all that apply)

Schizophrenia Signup and view all the answers

Most people with a mental illness have another __.

mental problem. Signup and view all the answers

What should you always assume about mental health patients?

They may want to hurt you, be manipulative, and may need to be restrained. Signup and view all the answers

What is defined as activities of daily living?

The basic activities a person usually accomplishes during a normal day. Signup and view all the answers

What is altered mental status defined as?

A change in the way a person thinks and behaves that may signal disease in the CNS or elsewhere. Signup and view all the answers

How is behavior defined?

How a person functions or acts in response to his or her environment. Signup and view all the answers

What is a behavioral crisis defined as?

The point at which a person's reactions to events interfere with activities of daily living. Signup and view all the answers

What is depression defined as?

A persistent mood of sadness, despair, and discouragement. Signup and view all the answers

What is excited delirium defined as?

A serious behavioral condition in which a person exhibits agitated behavior combined with disorientation, hallucinations, or delusions. Signup and view all the answers

What other names is excited delirium known by?

Agitated delirium Signup and view all the answers

What is a functional disorder defined as?

A disorder in which there is no known physiological reason for the abnormal functioning of an organ or organ system. Signup and view all the answers

What is organic brain syndrome defined as?

Temporary or permanent dysfunction of the brain. Signup and view all the answers

What is positional asphyxia defined as?

Restriction of chest wall movements and/or airway obstruction. Signup and view all the answers

What is posttraumatic stress disorder defined as?

A delayed stress reaction that develops after a horrifying ordeal involving physical harm or the threat of physical harm. Signup and view all the answers

What is a psychiatric disorder defined as?

An illness with psychological or behavioral symptoms and/or impairment in functioning caused by a disturbance. Signup and view all the answers

What is a psychiatric emergency defined as?

An emergency in which abnormal behavior threatens a person's own health and safety or the health and safety of another person. Signup and view all the answers

What is psychosis defined as?

A mental disorder characterized by the loss of contact with reality. Signup and view all the answers

What is schizophrenia defined as?

A complex mental disorder whose onset typically occurs during early adulthood. Signup and view all the answers

What is the MOST appropriate way to manage the situation for a 38-year-old male with schizophrenia who is screaming and throwing things?

Approach the patient and calm him by placing your hand on his shoulder. Signup and view all the answers

What should you do for a 40-year-old male with a wrist injury after losing his job?

Calmly identify yourself to the patient. Signup and view all the answers

A behavioral crisis interferes with which of the following?

All of these answers are correct. Signup and view all the answers

When does a general impression of the patient typically form for an EMT?

At a distance when the patient is first seen. Signup and view all the answers

Everyone exhibits some signs and symptoms of mental illness at some point in life __________.

but that does not mean a person is mentally ill. Signup and view all the answers

From a mental health standpoint, an abnormal or disturbing pattern of behavior is a matter of concern if it lasts for at least:

1 month. Signup and view all the answers

Signs of excited delirium include:

Diaphoresis, tachycardia, and hallucinations. Signup and view all the answers

The two basic categories of diagnosis a physician will use for behavioral crises or psychiatric emergencies are __________.

Physical and psychological Signup and view all the answers

What is the most common misconception surrounding mental illness?

Feeling 'bad' or 'depressed' means that you must be 'sick.' Signup and view all the answers

When a psychiatric emergency arises, a patient is most likely to exhibit which of the following behaviors?

Any behaviors that are a violent threat to the patient, EMTs, or others. Signup and view all the answers

When caring for a patient experiencing excited delirium, what should the EMT remember?

Sudden death can occur if the patient's violence is not controlled. Signup and view all the answers

Which of the following is a good guideline for physical examination of any patient?

Avoid touching without permission. Signup and view all the answers

Which of the following is an example of a psychiatric emergency?

A person violently attacking family members. Signup and view all the answers

Which of the following is considered an organic brain syndrome?

Alzheimer dementia Signup and view all the answers

Which term applies to a state of delusion in which the patient is out of touch with reality?

Psychosis Signup and view all the answers

Why might EMTs encounter a larger proportion of violent patients than the population at large?

EMTs respond to patients who, by definition, are having an emergency. Signup and view all the answers

How should you manage a 45-year-old female who has frequent thoughts of suicide?

Ask the patient if she has developed a suicidal plan. Signup and view all the answers

What is the most appropriate question to ask regarding a 32-year-old male patient with a history of combat-related nightmares?

Were you shot at or under fire? Signup and view all the answers

Which of the following findings is LEAST predictive of a patient's potential for violence in a domestic dispute?

His large body size Signup and view all the answers

For patients with clinical depression, care is most often provided by:

A psychologist. Signup and view all the answers

A 24-year-old male patient who is delusional was found to have progressive hallucinations. What is he most likely suffering from?

Schizophrenia. Signup and view all the answers

In which position should you restrain a physically uncooperative patient?

Lateral decubitus Signup and view all the answers

How should you assess a very agitated patient experiencing hallucinations after being subdued by a Taser?

Limit physical contact with the patient as much as possible and avoid interrupting him if he is attempting to communicate with you. Signup and view all the answers

What is the MOST important for the EMT to remember about suicidal patients?

Be homicidal as well. Signup and view all the answers

Common causes of acute psychotic behavior include all of the following, EXCEPT:

Alzheimer disease. Signup and view all the answers

What should you do when a 78-year-old female with acute behavioral change presents?

Inquire about the possibility of head trauma. Signup and view all the answers

When assessing a patient displaying bizarre behavior, what should the EMT consider?

An acute medical illness may be causing the patient's behavior. Signup and view all the answers

The term 'behavioral crisis' is MOST accurately defined as:

Any reaction that interferes with activities of daily living or is deemed unacceptable by others. Signup and view all the answers

Any attempt to physically restrain a patient should involve __________.

Law enforcement Signup and view all the answers

When responding to a psychiatric emergency, it is recommended that the EMT obtain vital signs __________.

Only when doing so will not exacerbate the patient's distress Signup and view all the answers

What should the EMT determine regarding the chief complaint of a psychiatric emergency?

All of these answers are correct. Signup and view all the answers

Which of the following considerations is the most important for the EMT during the scene size-up step of managing a psychiatric emergency?

Do you need to call for law enforcement as additional resources? Signup and view all the answers

Which of the following is an example of a psychiatric disorder?

Depression Signup and view all the answers

A disorder where the abnormal operation of an organ cannot be traced to an obvious change in the structure or physiology of the organ system is called __________.

A functional disorder Signup and view all the answers

A chronic feeling of sadness or despair is defined as:

Depression Signup and view all the answers

A person's response to their environment is defined as:

Behavior Signup and view all the answers

Patients with mental health disorders are often __________.

Misunderstood Signup and view all the answers

Which of the following might help the EMT differentiate between 'normal' depression and mental illness?

The amount of time that the patient remains feeling 'blue' Signup and view all the answers

During a psychiatric emergency, the EMT should be able to __________.

Predict whether the patient will become violent Signup and view all the answers

What is positional asphyxia?

Restriction of chest wall movements and/or airway obstruction; can rapidly lead to sudden death. Signup and view all the answers

What is behavior?

What you can see of a person's response to the environment. Signup and view all the answers

What should you do for a 22-year-old male patient who attempted to kill himself?

Open the patient's airway and assess his respirations. Signup and view all the answers

What should you ask the daughter of a 66-year-old male with bizarre behavior?

Ask how her father normally behaves. Signup and view all the answers

What is a functional disorder?

Physiological disorder in the absence of a structural abnormality. Signup and view all the answers

How should you manage a patient with a history of schizophrenia and violent threats?

Request a police officer to accompany you in the ambulance. Signup and view all the answers

What is reflective listening?

A technique used to gain insight into a patient's thinking, which involves repeating in question form what the patient has said. Signup and view all the answers

What are general guidelines for managing a patient with a behavioral emergency?

Being prepared to spend extra time with the patient. Signup and view all the answers

What should you do immediately after physically restraining a violent patient?

Reassess the patient's airway and breathing. Signup and view all the answers

What is the EMT's responsibility when caring for a patient with a behavioral emergency?

Diffuse and control the situation and safely transport the patient. Signup and view all the answers

What differentiates a behavioral crisis from a psychiatric emergency?

A psychiatric emergency occurs when a person becomes agitated or violent and is a threat to him- or herself or others. Signup and view all the answers

Study Notes

Psychiatric Emergencies

Patients may exhibit bizarre behavior, which can indicate serious psychiatric conditions or crises.
Identifying a patient's mental state involves assessing immediate threats to themselves or others.
General guidelines include ensuring EMT safety first when responding to psychiatric emergencies.

Behavioral Crises

Define as reactions disrupting daily activities or socially unacceptable behavior.
It is crucial to determine if the behavior results from psychological conditions or external factors such as substance use.

Characteristics of Mental Illness

Signs can include hallucinations, delusions, and significant mood changes.
Most people exhibit signs of mental illness temporarily, but this does not equate to a mental diagnosis.

Managing Behavioral Cues

Immediate management should prioritize communication and trust-building rather than force unless absolutely necessary.
Mental health assessments should include understanding prior behaviors and determining specific risk factors such as suicidal thoughts or plans.

Risk Factors and Misconceptions

Misconceptions include beliefs that anyone feeling depressed is mentally ill or that all mentally ill individuals are violent.
Those at higher risk of suicide often include individuals with depression, showcasing the importance of monitoring mood changes closely.

Physical Examination Insights

Careful evaluation of patients with behavioral concerns can reveal vital signs like facial expressions and respiratory changes that reflect their emotional state.

Restraint and Transport Guidelines

When restraining patients, it is crucial to ensure their position does not restrict breathing, opting for lateral decubitus posture.
Continuous reassessment of patients' condition is necessary after any restraint.

Mental Health Disorders

Types of psychological disorders include bipolar disorder, schizophrenia, PTSD, OCD, and major depression.
Awareness of dual diagnoses is paramount; many patients with mental health issues also face additional mental challenges.

Importance of Psychological Insight

Reflective listening is a key technique to understand patients better and guide them through their thought processes.
It is vital to consider potential underlying medical causes when assessing behavioral changes.

Crisis Management Techniques

Maintaining a calm demeanor and being direct in communication fosters a better environment for the patient.
Always approach situations with a risk assessment mindset, weighing potential violence or self-harm against de-escalation techniques.

Professional Support Systems

Psychologists are often the first line of support for individuals experiencing clinical depression.
EMTs should be aware of community resources available for continued patient care post-crisis.

Specific Assessment Techniques

Evaluate vital signs if it won’t exacerbate patient distress, keeping monitoring flexible and responsive to the patient's demeanor.
Engage families and bystanders for additional history which can provide context to the current situation.

Common Emergencies and Responses

Common causes of acute psychotic behavior can include high levels of stress, substance abuse, and medical conditions.
Proper response and transport protocols are crucial in managing patients experiencing a psychiatric emergency effectively.

Potential Complications

Sudden deterioration of a patient may indicate a medical emergency, necessitating immediate attention to vital signs and mental status.
Mental health emergencies can escalate quickly, requiring quick decisions and effective communication with law enforcement when necessary.### Activities of Daily Living
Refers to basic tasks individuals perform daily for self-care and independence.

Altered Mental Status

Indicates a change in cognition and behavior suggesting potential central nervous system disease or other bodily issues.

Behavior

Describes a person's actions or functioning in relation to their environment.

Behavioral Crisis

Occurs when someone's reactions begin to disrupt daily living; escalates to a psychiatric emergency if it leads to significant life interruption.

Depression

Characterized by a lasting state of sadness, despair, and discouragement.

Excited Delirium

A severe behavioral condition featuring agitation, disorientation, hallucinations, or delusions.

Other Names for Excited Delirium

Also known as agitated delirium or exhaustive mania.

Functional Disorder

A type of disorder lacking a clear physiological cause for abnormal organ or system functioning.

Organic Brain Syndrome

Involves temporary or lasting dysfunction of brain activity.

Positional Asphyxia

Results from restricted chest wall movement or airway obstruction.

Posttraumatic Stress Disorder (PTSD)

A delayed reaction to trauma, manifesting after experiences involving physical harm or threats.

Psychiatric Disorder

An illness presenting psychological or behavioral symptoms, potentially caused by social, psychological, genetic, physical, chemical, or biological factors.

Psychiatric Emergency

A situation where abnormal behavior poses risks to the individual's or others' health and safety.

Psychosis

Defined by a mental disorder where there is a disconnection from reality.

Schizophrenia

A complex mental disorder usually emerging in early adulthood, with hallmark symptoms including delusions, hallucinations, disinterest in pleasure, and erratic speech.

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Test your knowledge with these flashcards based on Chapter 22 of Psychiatry. This chapter focuses on case studies involving schizophrenia and related psychiatric emergencies. Prepare to identify symptoms, interventions, and appropriate responses in crisis situations.