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how long does a crisis take to resolve?
4-6wks
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what are the three types of crisis? explain them.
maturational - new developmental stage is reached. (married).
situational - unanticipated. (loss of jbo, loved one, abortion)
disasters/adventitions - not part of everyday life (pstd, acute stress disorder)
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what crisis is getting married?
A) maturational
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what crisis is an abortion?
B) situational
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what crisis is a crime violence?
A) disasters
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what are the phases of crisis?
phase 1) threat. anxiety. problem solving. defense mechanisms to lower anxiety.
phase 2) fails? trial and error. discomfort. disorganized.
phase 3) panic. automatic relief (withdrawal, flight). compromise.
phase 4) anxiety overwhelm. depression. confusion. violence. suicide.
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who is intervention therapy for?
the healthy pt that is functioning well, but is overwhelmed and can't function.
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how long is short term intervention therapy?
1-6 wks.
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what is the usual way women commit suicide?
overdose.
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higher risk for suicide: single or divorced?
divorced.
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what are the at-risk ages for men for suicide?
15-19 then after 65. white men 80yo and older at greatest risk.
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does suidide rates increase or decrease with women older then 65?
decrease.
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greater risk for suicide: catholics or no religion?
no religion
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highest risk: euro, african, indian americans?
euro.
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higher suicide rates in lower or upper class?
upper. (dentist, lawyers, insurance agents).
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is slashing wrists a low-risk or high-risk way of going out?
low.
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what is the 4 common characteristics of a personality disorder?
- inflexibility to repsond to stress
- disability in workplace
- provoke interpersonal conflict
- capacity to cause irks and distress in others
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what are some defense mechanisms that people with personality d/o use?
repression, suppression, regression, undoing, splitting
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what is the defense mechanism: splitting?
characterize people as "all good" or "all bad".
you're the best person in the world.
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what is schizophreniform d/o?
same as shizo but duration is at 1-6 months. might be given to those that look like they have it, but not for 6 months.
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what is a brief psychotic d/o? how does one get it?
sudden onset of psychosis (hallus, delu, catatonic) for at least 1 day but less then 1 month. extreme stress. the return to premorbid.
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what is schizoaffective d/o?
schizo with mood d/o.
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what is a delusional d/o? what is the related syndrome, Capgras, all about?
- nonbizzare delusions for at least 1 month. may not be socially impaired.
- Capgras is where you think that someone you know is replaced by an imposter.
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what is a shared psychotic d/o?
one delusional person shares the delusion with a close person. (father/daughter both with delusions)
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what is induced psychosis?
drugs
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what are positive symptoms of schizo?
hallucinations, deluions, bizzare behavior, abnormal speech.
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what are negative symptoms of schizo?
flat affect, no speech, apathy, anhedonia, no attention
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how can you handle hallucinations?
- - understanding the pt's experience and response.
- - non threatening.
- - eye contact
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what are some interventions for delusions?
- - understand the delusion
- - clarify and suggest a more reality based perspective
- - focus on reality-based events
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what are some interventions for paranoia?
- - focus on reduce anxiety and fear.
- - food in commercially sealed packaging
- - secure environment
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what are the common meds used for schizo?
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one of the SE of AP meds is anticholinergic toxicity. what is that? what are the interventions?
life-threatening. hot. dry skin. non reactive pupils.
hold all meds. implement cooling measures (ice bath, cooling blanket).
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what are the interventions for a pt that is suffering from the AP SE pseudoparkinsonism what is the onset?
administer prn antiparkinsonian agent. towel for excess saliva. 5-30days.
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what interventions are you gonna do with a pt that is suffering from acute dystonic reactions?
antiparkinson agent. they may fear choking. understand the event. avert mistrust of meds.
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what interventions can you do for akathesia?
antiparkinson agent. consult med change.
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what interventions can you do for tardive dyskinisia?
no known treatments. discontinuing drugs rarely relieves sx. consult med change.
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what dangerous SE does clozapine have? why would you still use it though?
agranulocytosis. risk for seizures. dramatic improvement for those that didn't react to previous AP.
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does AAP have a high risk for tardive dyskinesia?
no.
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pt has wt gain while on AAP. is this normal?
yes.
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what are the 4 main symptoms of schizo?
alt in thinking, speech, perception, behavior.
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