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Download NURS 250 Mental Health Exam 2025 2026. QUESTIONS WITH CORRECT AND VERIFIED ANSWERS. A+ and more Exams Nursing in PDF only on Docsity!
GRADED At. Depression S&S Depressed mood plus SIGECAPS Depression S&S SIGECAPS: S Sleep Depression S&S SIGECAPS: I Interest (anhedonia) Depression S&S SIGECAPS: G Guilt Depression S&S SIGECAPS: E Energy Depression S&S SIGECAPS: C Concentration Depression S&S SIGECAPS: A Appetite Depression S&S SIGECAPS: P Psychomotor Retardation/Agitation Depression S&S SIGECAPS: S (2) Suicide How to Diagnosis Major Depressive Disorder 5 out of these 9 symptoms for 2 or > weeks Avolition lack of motivation Anergia lack of energy Anhedonia inability to experience pleasure Seasonal Affective Disorder Melatonin Secretion Suicidal Levels ITGAC): G Gesture Suicidal Levels ITGAC): A Attempt Suicidal Levels ITGAC): C Completion Suicide Prevention Plan Safe environment Warning signs Internal coping Strategies Positive distractions (people/places) Who to contact for help (friends/family) Professional Agencies Safety Precautions for Depressed Patients SP1; ensure meds are swallowed, contract for safety Nutrition/Hydration/Elimination for Depressed Patients Small high calorie/high protein Therapeutic Communication to Interactions/Encounters with Clients with Depressive Disorders Use short concise sentences Make observations Use direct questions Allow time for the patient to process & respond Listen for hidden messages Avoid cliche comments Non-Pharmacological Tests/Procedures for patients with Depressive Disorders Dexamethasone Suppression Test (DST) PET Scans (blood flow) Light Therapy Electroconvulsive Therapy (ECT) Transcranial Magnetic Stimulation Vagal Nerve Stimulation Deep Brain Stimulation (R/F Hemorrhaging) CBT (reframe how they think) How to assess if medications are effective in Depressive Disorders Mood/A ffect Side Effects to look for in medications with Depressive Disorders DWI (driving while impaired) Hypertensive Crisis -MAOIs and Tyramine in foods (cheese, avocados, pepperoni, salami, OTC cold products) -Phentolamine (Regitine) often given to decrease BP Orthostatic Hypotension -TCAs create conduction issues (instruct patient to rise slowly and maintain hydration) Central Serotonin Syndrome Symptoms SHIVERS: S Shivering Central Serotonin Syndrome Symptoms SHIVERS: H Hyperreflexia/myoclonus Central Serotonin Syndrome Symptoms SHIVERS: I Increased Temp Central Serotonin Syndrome Symptoms SHIVERS: V Vital sign instability (tachycardia & increased BP) Central Serotonin Syndrome Symptoms SHIVERS: E Encephalopathy (mental status changes) Central Serotonin Syndrome Symptoms SHIVERS: R Restlessness Central Serotonin Syndrome Symptoms SHIVERS: S (2) Sweating & Large Stool Treatment of Central Serotonin Syndrome Hold meds Transfer patient to unit Cooling blankets Dantrolene (Skeletal Muscle Relaxant) increase in level of production for at least 4 days Manic S&S Onset between 18-30 Mood: elevated, expansive, irritable Speech: loud-rapid, punning, poor judgment, clanging, vulgar Weight loss Grandiose Distracted Hyperactive Decreased need for sleep Inappropriate dress Flight of ideas Caring for Clients with Bipolar Disorders-Mania: Assess Assess mood, behavior, thought process & content plus speech Caring for Clients with Bipolar Disorders-Mania: Ensure Ensure safe, reduced stimuli environment, adequate sleep/rest, hygiene & elimination Caring for Clients with Bipolar Disorders-Mania: Provide Provide on the go high protein/high calorie nutrition and hydration Caring for Clients with Bipolar Disorders-Mania: Incorporate Incorporate distractions Caring for Clients with Bipolar Disorders-Mania: Employ Employ limit setting as needed Caring for Clients with Bipolar Disorders-Mania: Monitor Monitor for signs of lithium toxicity Caring for Clients with Bipolar Disorders-Mania: Diet Small, frequent meals -increased protein, increased calories Communicating with a patient with Bipolar Speak in firm calm, neutral manner (not with fast speech) Use short concise sentences Maintain consistency with unit rules & expectations Use distraction techniques Expected = weight gain, N&V, thirst, diarrhea, fine hand tremors, goiter, & hypothyroidism can occur Confusion, coarse hand tremors, incoordination, EEG changes to large dilute urine output, hypotension and death Medications for Bipolar Disorders: Anticonvulsants Divalproex Sodium Carbamazepine Lamotrigine (common; causes Steven Johnson Syndrome) Medications for Bipolar Disorders: Antipsychotics Olanzapine Risperidone -manage agitation Safe Psychotropic Medication Administration for Bipolar Teach Patients to: -Get blood levels drawn -Look for signs of toxicity -Drink 1500 to 3000 mL daily -Keep same sodium intake -Notify health provider ---before taking OTC meds ---if severe diaphoresis, severe diarrhea or excess vomiting develops (may need to STOP Lithium) ---Lithium is often tapered when discontinuing it Schizophrenia Spectrum Disorders Delusion Disorder Schizophreniform Disorder Schizoaffective Disorder Delusion Disorder - fixed, persistent, false belief system lasting > 1 month (eg, a woman who genuinely believes she is married to a celebrity when, in fact, she is not). - functioning not impaired - can be shared by individuals in close relationships (folie 4 deux). Schizophreniform Disorder Psychotic disorder involving the symptoms of schizophrenia but lasting less than 6 months. Schizoaffective Disorder Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder. Anhedonia (lack of pleasure) Alogia (poverty of thought) Affective Symptoms of Schizophrenia Suicidality Hopelessness Dysphoria Schizophrenia symptoms DISRUPTS social/interpersonal occupation self-care quality of life Managing the Hallucinations Determine type, command, frequency, & pattern of hallucinations STOP technique Competing noise (music) Go to mall or place where others are Journaling Managing Delusions Avoid arguing Provide an opportunity to discuss Assess content of delusions Focus on reality Therapeutic Communication with a patient with Schizophrenia Do not whisper around the patient Allow additional time for them to respond Make observations Use "voicing doubt" Present reality Safety Measures for Patients with Schizophrenia Suicidality Anosognoisa Water intoxication (polydipsia, polyuria, hyponatremia, seizures, cerebral edema, & death) Assess cigarette smoking Patient cheeking meds Anosognosia denial of illness Painful muscle freezing due to involuntary muscle spasms Occurs EARLY in treatment (after hours of taking med) Responds to anticholinergic medications (sometimes parenterally are needed) Ex: torticollis; Oculogyric crisis; Laryngeal-pharyngeal constriction Treatment: parenteral anticholinergics Tardive Dyskinesia Abnormal uncontrollable body movements due to hypersensitivity of dopamine receptors Occurs LATE in treatment (after about 6 months) Ex: lip smacking and other facial movements (AIMS tool) Prevention = drug holidays (do not take drug on certain days of month) New meds = Valbenazine (Ingrezza) and Deutetrabenazine (Austedo) Psuedo-Parkinsonism Mask like face, muscular rigitiy, shuffling gait. Akathisia restlessness, irritability, & patient can't sit still most common symptom and very disturbing to patients Metabolic Syndrome Weight gain, dyslipidemia, and altered glucose metabolism caused by atypical antipsychotic drugs, hypertension. Catatonia excitement = rocking back and forth stupor = posturing (waxy flexibility) Neuroleptic Malignant Syndrome (NMS) caused by too much dopamine being blocked emergency life-threatening hyperpyrexia is hallmark symptom muscle rigidity, tremors, altered level of consciousness, tachycardia, hypertension, incontinence, elevated WBCs and CPK enzymes treat with muscle relaxants (Dantrium) and dopaminergic (Parlodel) Neuroleptic Malignant Syndrome (NMS) S&S (FEVER): F Fever (> 103 f) 
