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COMMONLY ASKED PSYCHIATRIC NURSING TOPICS in the ACTUAL EXAM. 19.

Diazepam (valium) is commonly administered to combat status


epilepticus.
A. PSYCHIATRIC DRUGS 20. Bone marrow depression and Steven-Johnson’s Syndrome (severe
1. Psychiatric drugs are preferably given after meal except minor pruritus and blood-shot eyes) are worst effects of anticonvulsants.
tranquilizers (anxiolytics). 21. Lithium carbonate is the drug of choice for manic patients.
2. Haloperidol is commonly given for psychotic patients. 22. Tegretol could also be given for bipolar manic client due to its mood
3. Extrapyramidal Syndrome (EPS) is commonly caused by stabilizing effect.
Haloperidol. 23. 3gms of Sodium and 3L of fluids per day are recommended for
4. Cogentin and Benadryl are drugs usually administered to decrease patients under lithium therapy.
symptoms of EPS. 24. Nausea and Vomiting are early signs of lithium toxicity.
5. Clozaril causes Agranulocytosis and Leukopenia. 25. Mannitol and Diamox are antidotes used to lower the toxicity
6. Diazepam (valium) is commonly prescribed for individuals with (lithium).
anxiety disorder. 26. Cognex and Aricept are drugs used to treat Dementia. These drugs
7. Sedation is a common effect of diazepam (valium) thus, safety increases liver enzymes, therefore liver function test is required
should be prioritized. (ALT/AST).
8. Paxil and Zoloft are antidepressants under the category of Serotonin 27. Ritalin and Dexedrine are drugs commonly prescribed for children
Selective Reuptake Inhibitors (SSRI’s) that can cause Sexual with ADHD. Insomnia and Anorexia are side effects of these drugs.
Dysfunction. Growth suppression is the worst effect.
9. Tofranil and Elavil are commonly prescribed for depressed clients
under the category of Tricyclic Antidepressants (TCA’s). B. PERSONALITY THEORIES
10. Hypotension and Urinary retention are anticholinergic side effects 1. Commonly asked Developmental milestones in the board exam
of TCA’s. according to Erickson:
11. MAOI’s (Parnate, Nardil, Marplan) should not be given along with a. trust vs. mistrust (0-1 or Infancy).
Tyramine rich foods e.g. Avocado, Banana, Cheese (except cream b. initiative vs. guilt (3-6 or Preschooler).
and cottage), and Soy sauce (hint: usually processed and fermented c. identity vs. role confusion (12-19 or Adolescence).
foods contain tyramine). d. intimacy vs. isolation (20-40 or Young Adult).
12. Sedation is an expected effect of antidepressants.
13. Energizing the patient to commit suicide is a paradoxical effect of 2. Piaget’s Cognitive Development Theory
antidepressants therefore suicidal precaution should be instituted. a. Logical thinking (Concrete Operational) is present in ages 7-
14. Levodopa is the drug of choice for patients with Parkinson’s disease 12 years old.
15. Drowsiness and hypotension are side effects of L-dopa. b. Abstract thinking (Formal Operational) is expected for 12
16. Dilantin is usually administered for patients with grand mal seizure years old and above.
(tonic-clonic).
17. Gingival hyperplasia is associated with Dilantin use. Meticulous oral
care is required.
18. Tapering the drug is strongly required if an anticonvulsant is
withdrawn to avoid status epilepticus (this is due to abrupt
withdrawal of the drug).

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3. Kohlberg’s Moral Theory 6. Involuntary muscle movements (motor tics) and vocalizations
a. Toddlers and Preschoolers are guided by punishment and (vocal tics) are hallmark signs of Tourette Syndrome (TS).
obedience orientation (Preconventional). 7. TS is genetically transmitted.
b. School- age children are rules oriented and viewed
accidents as punishment for bad behavior (Conventional E. COMMONLY ASKED PSYCHIATRIC PROBLEMS in ELDERLY
Morality). 1. Parkinson’s disease (PD) results from decreased dopamine and
c. Teenagers and Adult individuals are guided by ethics as a increased level of acetylcholine due to degeneration of substantia
basis of our conscience. nigra.
4. Freud’s Psychosexual Theory 2. Tremors (pill rolling and resting), Rigidity (cog wheel), and Shuffling
a. Foundation of personality, id, and stranger’s anxiety develop gait (scissors gait) are common symptoms of Parksonism.
during Oral Stage (0-1 year old). 3. L-dopa is the drug of choice for PD.
b. Toilet training (2 years old), temper tantrums, and 4. Alzheimer’s disease (AD) is due to decrease Acetylcholine (Ach) and
separation anxiety are common during the Anal Stage (1-3 Cognex
years old). (or Aricept as another drug of choice) is usually administered to
c. Fear of mutilation and Complexes (oedipal and elektral) improve memory.
develop during the Phallic Stage (3-6 years old). 5. Altered thought process is the priority nursing diagnosis for AD.
d. Silahis behavior (bisexuality) is associated with the absence 6. Confabulation and hyperorality are commonly seen in patients with
of a “father figure” and is only resolved in latency stage AD.
when the child identifies the parent of the same sex.
F. ANXIETY and ANXIETY DISORDERS
C. SCHIZOPHRENIA 1. Alertness is a characteristic of mild anxiety.
1. Increased dopamine level is the main problem in patients with 2. Client with moderate anxiety will have narrowed perception and
Schizophrenia. selective inattention.
2. Hallucination and Delusion are positive signs of schizophrenia. 3. Greatly reduced perception and many scattered detail are
3. Safety (self and others) and offering Sealed Foods are main nursing manifestations of severe anxiety.
interventions to Paranoid Schizophrenic patients. 4. During Panic-attack, reality is distorted.
4. Major Tranquilizers (Haldol, Thorazine, Clozaril) are drug of choice 5. Flashback is the hallmark symptom of Post-traumatic Stress
for schizophrenics. Disorder (PTSD).
5. Altered thought process is the priority nursing diagnosis. 6. Systematic Desensitization (gradual exposure to specific fear) is the
best management for Phobic Disorders (Phobias).
D. CHILDREN and ADOLESCENTS Psychiatric Conditions
1. Safety and Nutrition (finger foods) should be prioritized for ADHD. G. EATING DISORDERS (Anorexia nervosa and Bulimia nervosa)
2. Impulsiveness, Hyperactivity, and Inattention are hallmark signs of 1. Refusal to eat is the main problem in Anorexia nervosa.
ADHD. 2. Amenorrhea and Lanugo are symptoms of Anorexia nervosa.
3. Ritalin and Dexedrine are drugs commonly administered for ADHD. 3. Lack of control over eating (binge eating and purging) is the main
4. Provide helmet for Autistic children, head banging is common. problem in Bulimic clients.
5. Poor-mother child relationship is the possible etiology of Autism 4. Russel signs (callus on fingers) and Perimyolysis (front teeth
(most accepted psychobehavioral theory). erosion) are commonly seen in Bulimia nervosa.

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5. Altered nutrition: less than body requirement is the priority
nursing diagnosis for eating disorders. J. CRISES INTERVENTIONS
6. Socialization and staying with the client during snack or meal 1. Safety and Reporting of cases within 48 hours to authorities are
prevents them from exercising or inducing vomiting. highest in priority for child abuse case (Brgy. Captain, Police Station,
7. Weight gain is an indication that nursing intervention(s) especially DSWD, Bantay Bata).
for anorexic client is(are) effective. 2. Provide shelter for battered wives.
3. Gather evidence (no bathing nor changing of clothes) for a
H. MOOD DISORDERS (Bipolar manic and Major Depression) suspected rape case for legal purposes.
1. All depressed clients are potentially suicidal. 4. Ineffective individual coping is the priority nursing diagnosis for
2. Depression is associated with decreased level of norepinephrine victims of abuses.
and serotonin.
3. Introjection (blaming self) is a common defense mechanism used K. CONCEPTS ON DEATH and DYING
during depression. 1. Denial, Anger, Bargaining, Depression, and Acceptance (DABDA) are
4. Antidepressants and ECT are therapies used to treat depression. grief reactions according to Kubler-Ross.
5. Mania is associated with increased level of norepinephrine and 2. Hearing ability is the last to disappear in a dying person.
serotonin. 3. Flat EEG is the most accepted criterion or definition of death
6. Projection (blaming others) is commonly used as defense 4. Between 9-10 years old develops the universal concept of death,
mechanism by manic patients. that it is a permanent biology
7. Lithium is the drug of choice to lessen symptoms of mania.
8. Finger foods (usually in tetra packs) and avoidance of stimulants are
recommended diets for manic clients.

I. SUBSTANCE ABUSE and DEPENDENCE


1. Alcohol is a CNS depressant by nature and the most widely abused
drug according to WHO.
2. Normal alcohol blood level is less than 1 % or 100 mg%.
3. Narcotics are the second widely abused drugs (next to alcohol).
4. Wernicke’s-Korsakoff’s Syndrome is (are) neurologic complication(s)
of alcoholism that results from severe vit. B1 deficiency (thiamine).
5. Antabuse (disulfiram) is the drug used for alcohol Aversion Therapy.
6. Narcotics usually constrict pupils.
7. Yawning indicates brain hypoxia and is common in heroin
withdrawal.
8. Perforated nasal septum is a physical complication of cocaine, a
stimulant.
9. Hallucination, Pica, and Blood-shot eyes are common
manifestations of a person using Marijuana.
10. Amotivational Syndrome (absence of motivation) is a withdrawal
effect of Marijuana.
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