Final Study Guide PDF (Fall 2024)

**Study Guide for Final Test (Fall 2024)** **Core Concepts:** **1. Ethical and Legal Principles in Nursing** - **Veracity:** Emphasizes truth-telling. - **Autonomy:** Respecting a client's right to make their own decisions. - **Section 12 (72-hour psychiatric hold):** Purpose is to pr...

**Study Guide for Final Test (Fall 2024)** **Core Concepts:** **1. Ethical and Legal Principles in Nursing** - **Veracity:** Emphasizes truth-telling. - **Autonomy:** Respecting a client's right to make their own decisions. - **Section 12 (72-hour psychiatric hold):** Purpose is to provide **immediate psychiatric evaluation and stabilization.** - **Rogers Order:** Issued when a client cannot make informed decisions about treatment. **2. Therapeutic Communication Techniques** - **Effective Techniques:** - Using silence - Active listening - Encouraging discussions of feelings - **Avoid:** - Giving false reassurance - Probing - Defending others unnecessarily **3. Suicide Risk Assessment** - Key Risk Factors: - History of PTSD or hopelessness. - Lack of support systems. - Access to lethal means (e.g., firearms). - **Safety Planning:** - Develop a collaborative safety plan. - Restrict access to lethal means. - Provide resources like crisis hotline contact. - Success Indicator: The client identifies a support system and can articulate a plan for managing feelings of hopelessness. **4. Personality Disorders** - **Borderline Personality Disorder (BPD):** - Features: Splitting, self-harm, unstable relationships. - Nursing Priority: Set and enforce boundaries while encouraging adaptive coping mechanisms. - **Paranoid Personality Disorder:** - Features: Persistent suspicion, distrust. - Nursing Priority: Establish trust and provide clear information. **5. Mood Disorders** - **Major Depressive Disorder (MDD):** - Symptoms: Persistent sadness, psychomotor retardation, flat affect, and loss of interest. - Treatment: Cognitive-behavioral therapy (CBT), SSRIs. - Suicide Red Flags: Increased energy after starting antidepressants. - **Bipolar Disorders:** - **Mania:** Grandiosity, decreased sleep, psychosis (severe cases). - Treatment: Lithium, olanzapine for agitation. **6. Psychotic Disorders** - **Schizophrenia:** - Positive Symptoms: Delusions, hallucinations. - Negative Symptoms: Flat affect, avolition. - Treatment: Second-generation antipsychotics (e.g., clozapine). Monitor WBC count for clozapine. **7. Substance Use Disorders** - **Alcohol Use Disorder:** - Withdrawal Symptoms: Irritability, tremors, sweating. - Priority in Detox: Administer benzodiazepines (e.g., chlordiazepoxide) and monitor for withdrawal symptoms. - **Medications:** - **Disulfiram (Antabuse):** Deterrent; causes unpleasant reactions with alcohol. **8. Trauma-Informed Care** - Key Principles: - Identify and discuss triggers. - Avoid retraumatization (e.g., forcing discussions of trauma). - Promote peer support and collaboration. **9. Cognitive Disorders** - **Alzheimer's Disease:** - Symptoms: Sundowning (evening agitation), memory loss. - Interventions: Minimize environmental stressors, establish structured routines. **10. General Pharmacological Management** - **SSRIs:** Side effects include weight gain and sexual dysfunction. - **MAOIs:** Avoid tyramine-rich foods (e.g., aged cheese, wine) to prevent hypertensive crises. - **Lithium:** Monitor for hand tremors and increased thirst as normal side effects. **Practice Tips:** 1. Review case studies and prioritize nursing interventions. 2. Memorize symptoms and treatments for major conditions (e.g., MDD, PTSD, bipolar). 3. Focus on identifying therapeutic and non-therapeutic communication. **Key Practice Questions:** 1. **Ethical Principles:** - Which principle focuses on truth-telling? **Answer:** Veracity. 2. **Suicide Prevention:** - What is the priority intervention for a client with suicidal ideation and access to firearms? **Answer:** Develop a safety plan and restrict access to lethal means. 3. **Personality Disorders:** - What is the hallmark feature of BPD? **Answer:** Splitting. 4. **Substance Use:** - What medication prevents alcohol consumption by causing unpleasant effects? **Answer:** Disulfiram (Antabuse). 5. **Pharmacology:** - What is a common side effect of SSRIs? **Answer:** Weight gain and sexual dysfunction. **Study Tips for Success:** 1. **Categorize Information:** Break down disorders by symptoms, nursing interventions, and treatments. 2. **Repetition:** Practice with flashcards or quiz questions. 3. **Clinical Application:** Focus on scenarios and apply theoretical knowledge to client care.