ifc psyche

7/27/2019 Ifc Psyche

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PSYCHIATRIC

NURSING

IFC


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HOW TO ANSWER QUESTIONS

B Be consistent

E - Encourage verbalization

H Have a sound knowledge on

cultural diversityA Acknowledge feelings

V Voluntarily/ involuntarily

admitted px do not lose their rightto consent

E Empathize


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NURSING DIAGNOSIS

In the local board, oneof five questions

pertains to nursingdiagnosis


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INEFFECTIVE INDIVIDUAL COPINGANXIETYSUBSTANCE ABUSE

CRISIS

RAPE

BATTERED WIFE


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ALTERED THOUGHT PROCESSSCHIZOPHRENIAALZHEIMERS

DEMENTIA

AMNESIA

MENTALRETARDATION


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SELF-ESTEEM DISTURBANCEBATTERED WIFEANXIETY

DISORDERSDEPRESSION

B-A-D shape


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RISK FOR INJURYSUICIDALALZHEIMERS

MANIC

ADHD

MENTALRETARDATION


8/199

INEFFECTIVE INDIVIDUAL COPINGANXIETYSUBSTANCE ABUSE

CRISIS

RAPE

BATTERED WIFE


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PSYCHOPHARMACOLOGY


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OBSESSIVE-COMPULSIVE

TOFRANIL

DEPRESSION ANTI-DEPRESSANT (NARDIL)

MANIC LITHIUM CARBONATE;THORAZINE (acute mania)

ADHD RITALIN

SCHIZOPHRENIA HALDOL/ THORAZINE

ANXIETY DIAZEPAM

AVERSION THERAPY ANTABUSE (DISULFIRAM)

COCAINEWITHDRAWAL

DIAZEPAM; TOFRANIL


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C- antipsychotics,

neuroleptics, majortranquilizers

H- decreased overt orpositive manifestations

of psychosisE- p.c.


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C- rise slowly, avoidsunlight

Report

sorethroat,fever,muscularrigidity

disorder takes 6-8 weeksfor full therapeutic effect


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K monitorBP and temperature

Blood levels

Adverse effect


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Neuroleptic malignant syndrome

F feverE encephalopathy

V v/s unstable

E elevated enzymes

(CPK)

R rigidity of muscles


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LITHIUM


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LITHIUM

C mood stabilizer anti manic H decrease hyperactivity/manic

episodes

Initial effect 10-14 days

Full therapeutic effect 3-4 weeks

E after meals with milk or food

LITHIUM


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LITHIUM

C antipsychotics given withlithium for immediate management

Diet Na 6-10 grams a day;fluids- 3 liters per day

Avoid caffeine, diuretics and

activities that increaseperspiration

LITHIUM


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LITHIUM

K Monitor serum level at least oncea month(A.M. 12 hours after the lastdose)

maintenance dose 0.5 1.2 mEq / L acute level 1.5 mEq / L

the elderly 0.4 1.0 mEq / L

LITHIUM


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LITHIUM

Antidote for toxicity Mannitol (Osmitrol)

Acetazolamide (Diamox)


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ANTIDEPRESSANTS

C anti-depressants H decreased signs and

symptoms ofdepression(increased appetiteand sleep

E p.c.


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TRICYCLIC ANTIDEPRESSANTS

C TCA; prevents reuptake ofnorepinephrine

Hincreased appetite andadequate sleep

E p.c.

C therapeutic effect after 2-3weeks

K hypotention, tachycardia


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IMIPRAMINE(TOFRANIL)

AMITRIPTYLINE(ELAVIL)


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MONOAMINE OXIDASE INHIBITOR

C MAOI; ANTIDEPRESSANTS Hincreased appetite and

adequate sleep

E p.c.

C report headache; 2-3 weeks

effect

K hypertensive crisis


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Avoid TYRAMINEA avocado

B banana

C cheddar, aged cheese

S soysauce, preserved foods


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TRANYLCYPROMINE(PARNATE)

PHENELZINE (NARDIL)ISOCARBOXAZID

(MARPLAN)

SELECTIVE SEROTONIN REUPTAKE


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INHIBITOR (SSRI)

C anti-depressants; increaselevel of serotonin

H decreased signs andsymptoms of depression

E p.c.

2-3 weeks initial effect

3-4 weeks full effect

ANTIDEPRESSANTS



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ANTIDEPRESSANTS

C/K side effectsTremors,

decreased libido,NAVDA,

insomnia


INHIBITOR (SSRI)

ANTIDEPRESSANTS



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ANTIDEPRESSANTS

FLUOXETINE (PROZAC)SERTRALINE (ZOLOFT)

PAROXETINE (PAXIL)


INHIBITOR (SSRI)


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p

ANTIANXIETY


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ANTIANXIETY

C anxiolytic; muscle relaxant H decreased anxiety, adequate

sleep

E before meals

C avoid driving (drowsiness),

avoid alcohol, caffeine (altereffects of drugs)

K administer separately,

incompatible with other drugs

ANTIANXIETY


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ANTIANXIETY

(benzodiazepines) DIAZEPAM (VALIUM)

OXAZEPAM (SERAX) CHLORDIAZEPOXIDE

(LIBRIUM)

CHLORAZEPATE DIPOTASSIUM(TRANXENE)

ALPRAZOLAM (XANAX)


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ANTABUSE (DISULFIRAM)


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C anticholinergic; unpleasnt rxnwith alcohol

H patient avoids alcohol

E after abstaining from alcoholfor 12 hours

C

avoid alcohol-based substances K monitor disulfiram reaction;

miver function tests



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M mouthwash O OTC remedies

F fruit flavored extracts

F food sauce made of wine

A aftershave lotion

V vinegar S skin products

tin


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tin

ALCOHOL WITHDRAWAL


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ALCOHOL WITHDRAWAL

H hallucinations (visual, tactile) I increased vital signs

T tremors

S sweating, seizuresOutcomes of alcoholism

B brain damage

A alcoholic hallucinosis

D death


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PRIORITIES


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SAFETY

SUICIDAL

PATIENT IN CRISIS

ALZHEIMERS

ADHD

MANIA


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NUTRITION

MANIC

ADHD

CATATONIC

DEPRESSED

ALCOHOLIC


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CIRCULATION

CATATONIC

PATIENT IN

RESTRAINTS


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DETOXIFICATION

ALCOHOLISM

SUBSTANCE ABUSE


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SOCIALIZATION

WITHDRAWN

CATATONIC

DEPRESSED


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CRISIS INTERVENTION

RAPE

CHILD ABUSE

BATTERED WIFE

MULTIPLE CRISIS


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REALITY ORIENTATION

SCHIZOPHRENIA

ALZHEIMERS

DEMENTIA


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ADL ASSISTANCE

PX WT REGRESSEDBEHAVIOR

ALZHEIMERS

DISORGANIZED

SCHIZOPHRENIA


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THERAPEUTICCOMMUNICATIONCORE CONCEPTS


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To initiate conversationGIVING BROAD-OPENING

GIVINGRECOGNITION


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To build trust/ rapportGIVINGINFORMATION

USE OF SILENCE


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To gather informationFOCUSINGVALIDATING

REFLECTINGRESTATING


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To close a conversation

SUMMARIZING


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DEFENSE

MECHANISM


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DISORDER DEFENSE MECHANISM

CATATONICSCHIZOPHRENIA

REPRESSION

DISORGANIZED

SCHIZOPHRENIA

REGRESSION

MANIC REACTION

FORMATIONDEPRESSION INTROJECTION

ANOREXIA SUPRRESSION


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DISORDER DEFENSE MECHANISM

OBSESSIVECOMPULSIVE

UNDOING

PHOBIA DISPLACEMENT

ALCOHOLISM D.R.I.P.

SCHIZOPHRENIA REGRESSION

PARANOID SCHI. PROJECTION


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ALZHEIMERS DISEAE


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ALZHEIMER S DISEAE

M.P. : Degeneration, atrophy of thebrain cortex leading to impaired brainfunctioning

VeI M: progressive memory


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VeI.M: progressive memoryloss

Lab : no specific

NDx: altered thoughtprocess

N.I.: 5Cs (calendar, clock.Colors, consistency,COGNEX/TACTRINE)


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SCHIZOPHRENIA


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SCHIZOPHRENIA

Split MindBleuler

ASSOCIATIVE LOOSENESS

AUTISM

APATHYAMBIVALENCE

ics

CATATONIC DISORGANIZED PARANOID


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ics

ACUTE INSIDUOUS ABRUPT

ABNORMALMOTORBEHAVIOR

BIZARREBEHAVIOR

SUSPICIOUS,IDEAS OFREFERENCE

REPRESSION REGRESSION PROJECTION

IMPAIREDMOTORACTIVITY

IMPAIREDSOCIALFUNCTIONING

POTENTIAL FORINJURY

CIRCULATIONNUTRITION

ASSISTANCEWITH ADL

NUTRITIONSAFETY

GOOD

PROGNOSIS

POOR GOOD


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PERSONALITY

DISORDERS


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Borderline

fears separations

Splitting

Suicidal attempst


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Anti-social habitually

breaks the law

low self-esteem;

No guilt
http://images.google.com/imgres?imgurl=http://www.cerebromente.org.br/n07/doencas/withoutconscience.jpg&imgrefurl=http://www.cerebromente.org.br/n07/doencas/biblio.htm&h=343&w=386&sz=15&hl=en&start=4&um=1&tbnid=peo-1p5pTMpInM:&tbnh=109&tbnw=123&prev=/images?q=antisocial+personality&um=1&hl=en&sa=Ghttp://images.google.com/imgres?imgurl=http://www.cerebromente.org.br/n07/doencas/withoutconscience.jpg&imgrefurl=http://www.cerebromente.org.br/n07/doencas/biblio.htm&h=343&w=386&sz=15&hl=en&start=4&um=1&tbnid=peo-1p5pTMpInM:&tbnh=109&tbnw=123&prev=/images?q=antisocial+personality&um=1&hl=en&sa=G


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Dependent incessant

demands

forattention

from others
http://images.google.com/imgres?imgurl=http://ec1.images-amazon.com/images/I/416E477WMML.jpg&imgrefurl=http://www.bookrags.com/research/personal-dependency-eos-03/&h=475&w=337&sz=28&hl=en&start=11&um=1&tbnid=cacfnaxDI-LgmM:&tbnh=129&tbnw=92&prev=/images?q=dependent+personality&um=1&hl=en&sa=G


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Schizoid withdrawn,

last to catch

up infashion,

introvert, aloof
http://images.google.com/imgres?imgurl=http://webpages.charter.net/micah/hb.jpg&imgrefurl=http://www.metafilter.com/36098/schizoid-personality-disorder-bipolar-disorder-and-sociopathic-tendencies-oh-my&h=195&w=200&sz=8&hl=en&start=6&um=1&tbnid=SF-ezX9BTTLl4M:&tbnh=101&tbnw=104&prev=/images?q=schizoid+personality&um=1&hl=en&sa=G


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Shizotypal bizarre

behaviour,

silly laughter
http://images.google.com/imgres?imgurl=http://images.quizilla.com/M/MO/MOO/moonflower246/1129477492_Gothic_Art.jpg&imgrefurl=http://guinnesswench.spaces.live.com/blog/cns!2ED2BB1AC0E108D!3807.entry&h=400&w=300&sz=19&hl=en&start=1&um=1&tbnid=cmaoVCzeP4DIbM:&tbnh=124&tbnw=93&prev=/images?q=schizotypal+personality&um=1&hl=en&sa=G


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Histrionicwants to

be the

center of

attention
http://images.google.com/imgres?imgurl=http://img238.imageshack.us/img238/4883/jane16to.jpg&imgrefurl=http://writhesafely.wordpress.com/2006/06/27/my-personality-disorder-could-use-some-attention/&h=400&w=263&sz=43&hl=en&start=7&um=1&tbnid=UzJMWnWv0cS6AM:&tbnh=124&tbnw=82&prev=/images?q=histrionic+personality&um=1&hl=en&sa=G


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Avoidant fears

rejection

andcriticism
http://images.google.com/imgres?imgurl=http://www.qactive.co.uk/personality/images/avoidant.jpg&imgrefurl=http://meryine.blogspot.com/2007/07/apd.html&h=237&w=250&sz=18&hl=en&start=7&um=1&tbnid=k9uje6j63vxHpM:&tbnh=105&tbnw=111&prev=/images?q=avoidant+personality&um=1&hl=en&sa=G


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Paranoid extreme

mistrust and

suspiciousness
http://images.google.com/imgres?imgurl=http://www1.istockphoto.com/file_thumbview_approve/2268126/2/istockphoto_2268126_paranoid_man.jpg&imgrefurl=http://www.1ravanpezeshk.blogfa.com/post-41.aspx&h=380&w=377&sz=42&hl=en&start=6&um=1&tbnid=IhZY3iG0A2VZGM:&tbnh=123&tbnw=122&prev=/images?q=paranoid+personality&um=1&hl=en&sa=G


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Passive-Aggressive

Expresses

anger

throughpassivity or

aggression

E h ti N i i ti
http://images.google.com/imgres?imgurl=http://www.steadyhealth.com/articles/user_files/4542/Image/passive_aggressive.jpg&imgrefurl=http://www.steadyhealth.com/articles/Passive_Aggressive_Personality_Disorder_a289_f137.html&h=201&w=155&sz=7&hl=en&start=8&um=1&tbnid=48hcHeJpQZcdKM:&tbnh=104&tbnw=80&prev=/images?q=passive-aggressive+personality&um=1&hl=en&sa=G


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Emphatic Narcissistic

believe that

they are

special andthey demand

special

attention
http://images.google.com/imgres?imgurl=http://static.sxc.hu/l/lu/lucianotb/544769_85700317.jpg&imgrefurl=http://shellyivey.blogspot.com/2007/05/were-all-narcissistic.html&h=1680&w=1680&sz=875&hl=en&start=15&um=1&tbnid=8tRwjT-QsIwMRM:&tbnh=150&tbnw=150&prev=/images?q=narcissistic+personality&um=1&hl=en&sa=G


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OBSESSIVE-COMPULSIVE DISORDER


82/199

M.P. : intrusive thoughts and repetitiveactions performed under strong senseof pressure


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I.M: ritualistic behaviorLab : no specific

NDx: AnxietyN.I.: provide time for the

rituals; assess level ofanxiety


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ANOREXIA NERVOSA


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M.P. : FEAR OF GAINING WEIGHT

VeI.M: AMENORRHEA


87/199

Lab : decreased K,hypoglycemia

NDx: body imagedisturbance

N.I.: monitor weight;family therapy


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A amenorrhea


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N no organic factor for wt loss

O obviously thin but feels fat

R refusal to maintain ideal weight

E epigastric discomfortsX sx/ symptoms like hiding food

I intense fear of wt gain

A always thinking about food


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ELECTROCONVULSIVE THERAPY


92/199

mechanism of actionunclear

70 150 volts

0.5 2 seconds 6 12 treatments

intervals of 48 hours



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indicators of effectivenessoccurence of generalized tonicclonic seizures

indications depression , maniaand catatonic schizophrenia

contraindications:fever , IICP,

fracture,retinal det., cardiac d/o consent



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AT SO4-decrease secretionsAnectine (Succinylcholine)-

muscle relaxationMethohexital Sodium

(Brevital )- anesthetic agent



95/199


70 150 volts





96/199







97/199


muscle relaxationMethohexital Sodium

(Brevital )- anesthetic agent


98/199

NCM 5

Characteristics of a Profession


99/199

ALTRUISMAUTONOMY

AUTHORITY

ACCOUNTABILITY

DISTINCT IDENTITY

CODE OF ETHICS


100/199


101/199

SULLIVANS STAGES OFPERSONALITYDEVELOPMENT


102/199

Birth 18 Months Infancy18 months 6 years Childhood6 9 years Juvenile9 12 years Preadolescence12 14 years Early Adolescence14 21 years Late Adolescence


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FreudsPsychosexualTheory

0 18 mos


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0 18 mos.(ORAL STAGE)

Area of gratification: Mouth18 mos. 3 years(ANAL STAGE)

Area of gratification: Bowelelimination

3 6 years

(PHALLIC STAGE)

Area of gratification:

Reproductive organs

6 12 years(LATENCY, quiet

stage)

Area of gratification: None(energy is diverted to play

activity)

Area of gratification: Organs12 21 yearsGENITAL STAGE


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AUTISM


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AUTISM

Treatable but not curableMore common among boys

Usually diagnosed at age 2Main Problem: Interpersonal

functioning

i M l k


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i.M.: lacks eye

contact; loves tospin objects

Lab: no specificNDx: Impaired

social interaction

Nursing interventions


109/199

Tantrum involves

headbanging = place a helmeton the head

Communication all vowels =speak in clear, simple, shortterms

Perceptive disturbancesensory integration exercises

Routines consistency


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Acute stress disorder


111/199

Acute stress disorder

Exposure to traumatic eventLack of emotions

Psychic numbingDetachment, derealization

AMNESIADuration: 2 days 4 weeks


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ADHD


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ADHD

Main Problem: decreasedattention span

I.M.:

I impulsivity

H hyperactivity

I inattention

e D Difficulty in remaining


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D - Difficulty in remainingseated

E Easily distracted

F Fidgets

I Interrupts others

C Child exhibits hyperactivity

I Indulges in dangerousactivities

T - Talkative

Nursing interventions


115/199

Give foods that can beeaten on the run

RITALIN(methylphenidate)

Safety

Limit caffeine

RITALIN (METHYLPHENYDATE)


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C stimulant

H decreased hyperactivity

E after meals (anorexia);

morning/ 6 hours before bedtime(insomnia)

C may cause growth retardation

K monitor growth & development


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SOMATIZATION DISORDER


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Recurrent and multiplesomatic complaints ofseveral years duration and

seemingly withoutphysiologic causes

MALINGERING
http://images.google.com/imgres?imgurl=http://psychological.com/images/somatoform-2.jpg&imgrefurl=http://www.syrianmeds.net/forum/showthread.php?t=6761&h=123&w=104&sz=6&hl=en&start=3&um=1&tbnid=FGRPeYQmbFiyYM:&tbnh=89&tbnw=75&prev=/images?q=Somatization&svnum=10&um=1&hl=en&sa=N


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fabricating or exaggeratingthe symptoms ofmental orphysical disorders for a

variety of motives

BODY DYSMORPHIC DISORDER
http://en.wikipedia.org/wiki/Mental_disorderhttp://en.wikipedia.org/wiki/Mental_disorder


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Imagined defect onappearance which is out ofproportion to any organic

problem.

CONVERSION DISORDER


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Loss or alteration of physicalfunction that suggest aphysical disorder related to

expression of apsychological conflict.


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Post-traumatic Stress Disorder


123/199

Reexperiencing of reactionsto a past traumatic event viarecurrent Nightmares,

flashbacks and psychicnumbing


124/199

SCHIZOPHRENIA


125/199

Split MindBleuler

ASSOCIATIVE LOOSENESSAUTISM

APATHY

AMBIVALENCE

ics

CATATONIC DISORGANIZED PARANOID


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ACUTE INSIDUOUS ABRUPT

ABNORMALMOTORBEHAVIOR

BIZARREBEHAVIOR

SUSPICIOUS,IDEAS OFREFERENCE

REPRESSION REGRESSION PROJECTION

IMPAIREDMOTORACTIVITY

IMPAIREDSOCIALFUNCTIONING

POTENTIAL FORINJURY

CIRCULATIONNUTRITION

ASSISTANCEWITH ADL

NUTRITIONSAFETY

GOODPROGNOSIS

POOR GOOD

C- antipsychotics,l ti j


127/199

neuroleptics, majortranquilizers

H- decreased overt orpositive manifestations

of psychosisE- p.c.

C- rise slowly, avoid


128/199

C rise slowly, avoid

sunlight Report

sorethroat,fever,muscularrigidity

disorder takes 6-8 weeksfor full therapeutic effect


129/199

K monitor

BP and temperature

Blood levelsAdverse effect

Neuroleptic malignant syndrome


130/199

F feverE encephalopathy

V v/s unstableE elevated enzymes

(CPK)R rigidity of muscles

ADVERSE EFFECT MANAGEMENT

NMS Bromocriptine or Amantadine(d i i )


131/199

(dopamine agonist)Dantrolene (Dantrium) muscular

relaxant

Dystonia Diphenhydramine,Benztropine,

Diazepam, LorazepamPseudoparkin-sonism

Antiparkinsonian,Anticholinergic

Akathisia Anticholinergic,

Benzodiazepines,Beta- blockers

Tardive dyskinesia early referral-dose reduction,no anticholinergics

C d i i


132/199

C- dopaminergic oranti-cholinergic

H- decrease tremorsand rigidity in 2-3 days

E- p.c.

C- avoid sudden position


133/199

changeAvoid Vit. B6 and CHON rich foods

Avoid alcohol-increases

sedative effectsK-check BP- orthostatic

hypotensiondrugs not withdrawn abruptly


134/199

NCM 5 SERIES - 1


135/199

ANXIETY


136/199

BEC ALM

A DMINISTER MEDICATIONS

L ISTEN

M INIMIZE ENVIRONMENTAL

STIMULI


137/199



138/199


70 150 volts





139/199







140/199


muscle relaxation

Methohexital Sodium(Brevital )- anesthetic agent

CAGE questionnare

H f lt d d t Cut


141/199

Have you ever felt you needed to Cut

down on your drinking? Have peopleAnnoyed you by

criticizing your drinking?

Have you ever felt Guilty aboutdrinking?

Have you ever felt you needed a drink

first thing in the morning (Eye-opener) to steady your nerves or to

get rid of a hangover?


142/199

CRISIS INTERVENTION


143/199

A way of entering into the lifesituation of the clients to helpthem mobilize their resources

and to decrease the effect of acrisis inducing stress.

Phases of Crisis


144/199

DenialIncreased tension

DisorganizationAttempts to reorganize


145/199

NCM 5 SERIES - 2


146/199

NCM 5 SERIES 2

NEUROLEPTICS (PHENOTHIAZINE)


147/199

antagonizes dopamine inthe CNS

blocks Cholinergic,Histaminic, Adrenergicneurotransmitters


148/199

LITHIUM


149/199

C mood stabilizer anti manic

H decrease hyperactivity/manicepisodes

Initial effect 10-14 days Full therapeutic effect 3-4 weeks

E after meals with milk or food

LITHIUM


150/199

C

antipsychotics given withlithium for immediate management

Diet Na 6-10 grams a day;

fluids- 3 liters per dayAvoid caffeine, diuretics and

activities that increase

perspiration

LITHIUM


151/199

K Monitor serum level at least once

a month(A.M. 12 hours after the lastdose)

maintenance dose 0.5 1.2 mEq / L

acute level 1.5 mEq / L

the elderly 0.4 1.0 mEq / L

LITHIUM


152/199

Antidote for toxicity Mannitol (Osmitrol)

Acetazolamide (Diamox)


153/199

ANTIDEPRESSANTS


154/199

C anti-depressants

H decreased signs andsymptoms of

depression(increased appetiteand sleep

E p.c.



155/199

C TCA; prevents reuptake ofnorepinephrine

Hincreased appetite and

adequate sleep E p.c.

C therapeutic effect after 2-3weeks

K hypotention, tachycardia



156/199

IMIPRAMINE(TOFRANIL)

AMITRIPTYLINE(ELAVIL)



157/199

C MAOI; ANTIDEPRESSANTS

Hincreased appetite andadequate sleep

E p.c.

C report headache; 2-3 weeks

effect K hypertensive crisis



158/199

Avoid TYRAMINE

A avocado

B banana

C cheddar, aged cheeseS soysauce, preserved foods



159/199

TRANYLCYPROMINE(PARNATE)

PHENELZINE (NARDIL)ISOCARBOXAZID

(MARPLAN)

SELECTIVE SEROTONIN REUPTAKEINHIBITOR (SSRI)


160/199

C anti-depressants; increaselevel of serotonin

H decreased signs and

symptoms of depression E p.c.

2-3 weeks initial effect3-4 weeks full effect

ANTIDEPRESSANTS



161/199

C/K side effectsTremors,

decreased libido,NAVDA,

insomnia

ANTIDEPRESSANTS



162/199

FLUOXETINE (PROZAC)SERTRALINE (ZOLOFT)

PAROXETINE (PAXIL)

p


163/199

ANTIANXIETY

C i l ti l l t


164/199

C anxiolytic; muscle relaxant

H decreased anxiety, adequatesleep

E before meals C avoid driving (drowsiness),

avoid alcohol, caffeine (alter

effects of drugs) K administer separately,

incompatible with other drugs

ANTIANXIETY

(b di i )


165/199

(benzodiazepines)

DIAZEPAM (VALIUM)

OXAZEPAM (SERAX)

CHLORDIAZEPOXIDE(LIBRIUM)

CHLORAZEPATE DIPOTASSIUM(TRANXENE)

ALPRAZOLAM (XANAX)


166/199


C ti h li i l t


167/199

C anticholinergic; unpleasnt rxn

with alcohol

H patient avoids alcohol

E after abstaining from alcoholfor 12 hours

C avoid alcohol-based substances

K monitor disulfiram reaction;miver function tests


M th h


168/199

M mouthwash

O OTC remedies

F fruit flavored extracts

F food sauce made of wineA aftershave lotion

V vinegar

S skin products

tin


169/199

ALCOHOL WITHDRAWAL

H hallucinations (visual tactile)


170/199

H hallucinations (visual, tactile)

I increased vital signs

T tremors

S sweating, seizures

Outcomes of alcoholism

B brain damage

A alcoholic hallucinosis D death


171/199

NCM 5 SERIES - 3


172/199

BORDERLINE PERSONALITY DISODER

M P : Instability of mood interpersonal


173/199

M. P.: Instability of mood, interpersonal

relationships and self-image

s/sx

P persistent identity disorder


174/199

p y

E efforts to avoid real/ imaginedabandonement

C chronic feelings of emptiness

U unstable relationship L lack of control of anger

I IMPULSIVENESS

A affective instability

R recurring suicidal threats

ND i i d i l


175/199

NDx : impaired socialfunctioning

N.I:

Consistent, firm

Structured quiet environment

Limit setting


176/199


177/199

NCM 5 SERIES - 4


178/199

ti


179/199

NCM 5 SERIES - 5

MILD ANXIETY


180/199

Increase RR, PR, sweatingAttentive, alert

Minimal use of defensemechanism

MODERATE ANXIETY


181/199

NAVD, restlessnessNarrowed perceptual field

Use of any defensemechanism available

SEVERE ANXIETY


182/199

S/SX become the focus ofattention

Perceptual field greatlynarrowed

Amnesia, dissociation

PANIC


183/199

S/SX of exhaustionignored

Personalitydisorganization

Defense mechanisms fail


184/199

OBSESSIVE-COMPULSIVE DISORDER

M P : intrusive thoughts and repetitive


185/199

M.P. : intrusive thoughts and repetitive

actions performed under strong senseof pressure


186/199

I.M: ritualistic behaviorLab : no specific

NDx: AnxietyN.I.: provide time for the

rituals; assess level ofanxiety


187/199

BIPOLAR DISORDER

M.P. : Hyperactivity alternating with


188/199

M.P. : Hyperactivity alternating with

depression


189/199

I.M: hyperactivity, rapid


190/199

speechLab : norepinephrine,

serotoninNDx: risk for injury

N.I.: safety, finger foods,lithium carbonate

es


191/199

ALZHEIMERS DISEAE

M.P. : Degeneration, atrophy of the


192/199

M.P. : Degeneration, atrophy of the

brain cortex leading to impaired brainfunctioning

VeI.M: progressive memoryloss


193/199

Lab : no specificNDx: altered thought

processN.I.: 5Cs (calendar, clock.

Colors, consistency,COGNEX/TACTRINE)


194/199

ANOREXIA NERVOSA

M.P. : FEAR OF GAINING WEIGHT


195/199

O G G G

VeI.M: AMENORRHEALab : decreased K,


196/199

hypoglycemiaNDx: body image

disturbanceN.I.: monitor weight;

family therapy


197/199

A amenorrhea

N no organic factor for wt loss


198/199

O obviously thing but feels fat R refusal to maintain ideal weight

E epigastric discomforts

X sx/ symptoms like hiding food

I intense fear of wt gain

A always thinking about food


199/199

ifc psyche

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