Section 1
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ADHD
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Date created
Mar 1, 2020
Cards (60)
Section 1
(50 cards)
ADHD
The inability to sit still, failure to complete tasks, easily distracted, lasting six months, impulsive.
Somatization DisorderU
Rosie Morales, an 18-year-old who recently relocated from Puerto Rico with her family, began having symptoms soon after arriving in New York. She has multiple complaints. These complaints range from a stomach ache, headaches, and muscle pains. After her fourth visit to the doctor with no physical findings to justify her symptoms, she is convinced she needs to see another doctor.
Bulimia
Jennifer Evans, a 20-year-old student, presents to the ER with suicidal ideations and some confusion. She has an irregular heart rate. Her mother accompanies her and provides a recent history. Jennifer vomits after each meal and has diarrhea. Lab results show low potassium and low sodium. Questioning reveals Jennifer has been laxatives liberally.
ETOH Dependence.
Mr. Hanks, visits his wife of nine years, who is in the hospital for back surgery. She is now second day post-op and not doing well. Her temperature is up, her skin is diaphoretic, she is complaining of severe headache, her BP is 165/110. She is having tactile hallucinations and is extremely restless.
Paranoid Schizophrenia
Becky Watson, 25 years old, presents to the ER with audio and visual hallucinations. Patient "rides a horse" through the halls, irritable, strikes out at staff at intervals, responding to hallucinations. She speak in garbled sounds. Her affect is flat, her mood is sad, and she shows little or no motivation.
Panic Disorder with Agoraphobia
Anxiety so intense causes person to fear death, fear more episodes, afraid of crowds or open spaces, lasting at least one month.
Antisocial Personality Disorder
Harold Williams, 58, CEO of a local pharmaceutical company, has been married four times and is now divorced and living with his girlfriend. He has six grown children. He is estranged from his children and seems unaffected by their lack of involvement in their lives. He presents with back pain. Upon questioning him about his current back pain, he has prescription bottles from several pharmacies. He claims he has no refills available for pain medication. He appears to be tense and in pain. He also complains about his extended ER wait time before seeing you. He tells you that he heard another patient say that you always make patients wait for treatment.
Moderate Stress-patient feels overwhelmed and troubled
Offer a cool beverage Respect need for personal space Actively dialogue with patient to share feelings Create activities for distraction Explore alternatives coping mechanisms Help patient focus on the here and now
PTSD
Tom Marshall, a 33 yo combat veteran, recently returned from Afghanistan, is complaining of poor concentration. His history includes an inability to keep a job, and unstable relationships. He has been married twice, and has one child by each wife. He also has legal issues pending involving domestic violence and nonpayment of child support. He shares that she sleeps poorly and often has flashback or nightmares of combat days. He frequently uses alcohol or other substances to relax. He is easily angered and has been in several fights at local clubs and at a past employment positions.
Major Depressive Disorder
Lasting at two weeks, feeling sad, empty or tearful (anhedonia), insomnia or hypersomnia, worthlessness, poor concentration, and suicidal ideation.
PTSD
Arthur Silverstein, a 68-year-old Vietnam who was imprisoned by Viet Cong and severely abused during the war. He subsequently has been unable to maintain long-term relationships or consistent employment. He is now homeless and experiencing flashbacks and nightmares.
Dementia
Roger McClusky, 70yo, arrives at the ER accompanied by his daughter who states her father is irritable, anxious, keeping to himself, and has problems sleeping. She states it is getting worse and is concerned about memory loss in recent events.
Dissociative Amnesia
Cannot remember anything concerning recent past experience, and cannot function in daily activities. No previous evidence of dementia.
Panic Disorder with Agoraphobia
Elliot Simpson, 42 yo, is brought in by ambulance with chest pain, nausea, accelerated heart rate and fears death. EMTs reported difficulty with patient who was resistant to leaving his house. His labs are all negative. Patient states he has been unable to leave house for the past few months.
PTSD
Veteran returns from a combat-related tour of duty in Iraq. He cannot remember who he is or anyone in his family. Upon finding him some time later, he does not recognize his family nor is he able to remember anything. After six months, he begins to remember seeing battle buddies mortally wounded during combat.
Panic Disorder with Agoraphobia
Ralph Santoro, is a 36-year-old, married father of three children who works from home. He avoids crowds and has a list of friends and family who accommodate his many requests to bring he needs to his home. He has short periods of anxiety and pain that usually peak in 10 minutes or less. He arrives at the ER with both chest pain and numbness and tingling in his hands.
Paranoid Schizophrenia
Scott Davis, a 21-year-old, with no prior psychiatric history, is brought to the ER by his family. He is refusing to bathe, thinks food is poisoned, and will only eat wrapped foods. Suddenly, he is talking to imaginary people, and his speech is nonsensical. Panic
Antisocial Personality Disorder
Tom Richards, age 25, has a history of adolescent behavior problems, including animal abuse and aggressive behaviors. He is intoxicated and has recently been engaged in physical assaults at a local bar.
Panic Level- person is physically and emotionally exhausted from stress. The ability to cope and exert self-control is virtually non-existent.
Assess potential for injury to self/others Conduct debriefing of unit community Call for therapeutic team support Call Physician for onsite assessment Conduct debriefing of staff and patient post-containment.
Dementia
Slow onset forgetting most recent events, inability to process new information, easily confused, can be depressed or anxious, lacking familiarity.
PTSD
Experienced overwhelming negative event in life characterized by nightmares, flashbacks of the traumatic events, withdrawn in denial or over anxious and panicky. Afraid of crowds, hypervigilant, unable to return to previous functioning levels.
ADHD
Charles Stark, 51 years old, appears to never sit or relax. He starts tasks and almost never completes them. He often makes quick decisions that are not always in the best interest. He frequently takes risks that are financially unsound or life threatening. These behaviors have been occurring for several months.
Bulimia
Robin West, 19 yo female, reports eating a gallon of ice cream, a bag of potato chips, an a dozen chocolate chip cookies, followed by three slices of pizza- all in the middle of the night. She tells her PCP that she feels guilty because she is making herself vomit, but she still gaining weight. She is starting to take laxatives and depressing is escalating.
ETOH Dependence
John Lewis, 35 years of age, presents after being picked up by police for domestic violence. He is admitted to the psychiatric unit and has had an uneventful first day. On the second day, he develops elevated blood pressure, diaphoresis, and fine hand tremors, along with a headache, nausea, and anxiety. Mild/Normal
Bipolar Maniac
Sally Stoval, a 25 yo, states she will be an astronaut. She is exhibiting promiscuous behaviors, but is also very religious, evidenced by her constant preaching. Her speech is pressured. She is sleeping poorly, worrying about her large credit card debt.
Dementia
Mary English, a 78-year-old widow, is sitting and staring at the wall. She gets up and starts walking to her room and stops because she does not remember which room is hers.
Bipolar Maniac
Inflated self esteem, grandiosity, decreased need for sleep, excessive talking, flight of ideas, easily distracted, engaging in risky activities physical or financial.
Dementia
Dave Nelson, 64-years-old, arrives in the ER accompanied by his wife who says she cannot manage him at home anymore. During assessment, he is unable to stay seated and is not easily directed. When asked questions directly, he often mumbles words that cannot be understood. His wife states that he has not taken his medication for the past two days.
Bulimia
An eating disorder characterized by binge eating and purging or consuming a large amount of food in a short amount of time, followed by an attempt to rid oneself of the food content (purging)
Dissociative Amnesia
Betty Parmen, 31 yo, upon awakening in the morning, goes to her son's room and finds it empty. She becomes hysterical. She cannot remember what happened last week. Her husband reports that their 15-month-old son Steven was hospitalized and placed on a ventilator. He died last week and the funeral was three days ago. Betty remembers none of this.
Dementia
Bob McKay, 70 years old, arrives at ER accompanied by his daughter who states her father is irrational, irritable, anxious, isolative, and is having sleeping problems. This appears to be getting worse, and the patients daughter is concerned about memory loss, especially in recent events.
Mild/Normal Stress
Allowing expression of feelings Employ empathy in communication Demonstrate active listening Help patient identify problems Assist in problem solving Evaluate, explore results, plan
Catatonia
Upon making rounds at the end of your shift on a busy M/S unit, Sam Gregory is lying in bed and does not acknowledge your presence when you enter his room. He does not respond to your verbal questioning, has a flat affect, and mumbles back your words to him. Sam was fine earlier in the shift, and this is a sudden change. When his arm is lifted, it remains elevated.
Major Depressive Disorder
James Thomas, a 52-year-old divorced male, is sitting alone along the wall in the dayroom reading a book. You notice his is not turning any pages. His mood is sad, isolative, and blunted. He has a history of two suicide attempts. Panic
Anorexia
An eating disorder characterized by excessive food restriction and irrational fear of gaining weigh, and a distorted body self-perception. It typically involves excessive weight loss
Somatization Disorder
Joseph Dickson, a 33-year-old engineer,presents with complaints of blindness, joint pain, headache, and erectile dysfunction. For the past year, he has been to several doctors and emergency settings seeking an answer. No evidence of organic cause has been discovered. Panic
Bipolar Maniac
Harry Rogers, age 60, arrives at the ER brought by police. A neighbor complained that he was playing his television very loudly at night with all the lights on in his condominium. Upon knocking on the door to ask him to be quiet and more respectful of the condominium community, he was not able to have a meaningful conversation with his neighbor. Mr. Rogers told his neighbor that he was getting ready to take a trip to the Far East that morning and seemed to jump from topic to topic. The neighbor, frustrated, left and called the police to intervene. When the police spoke to him, they realized that his man was mentally unstable and brought him to the ER. Severe Explain consequences of behavior
Paranoid Schizophrenia
The presence of hallucinations, auditory or visual, or delusions, irrational belief, persecutions, flat affect, no motivation, no speech or minimal, or speaks as word salad.
Somatization Disorder
Person complains of physical illnesses six months or longer, usually four systems affected: pain, GI, sexual including erectile dysfunction or irregular menses, and neurological with paralysis or weakness.
Dissociative Amnesia
Harry Baker, age 41, recently was in a severe motor vehicle accident with his family in the car. His wife and two of his three children were killed. He now remembers none of the event. He does not know where his wife and children are.
Antisocial Personality Disorder
Disrespect for lawful behaviors, repeated lying, interested in only pleasing self first, no guilt or remorse
ADHD
Charles Wheeler, 18 years old, paces in the dayroom. During group, patient constantly interrupts, unable to wait for his turn to speak. He blurts out answers, oblivious to others in the group.
ETOH Dependence
Absence of alcohol consumption produces physical symptoms ranging from mild discomfort to severe tremors, vital sign changes and even death.
Catatonia
Patient observed posturing and staying in the same position for extended periods of time, flat affect, waxy flexibility.
ADHD
Danny Wiles, age 23, has not been able to hold down a job. He states that, when he was in high school, he could not complete tasks, resulting in his not graduating. When attending a group activity, patient was unable to remain seated and focused
ETOH Dependence
Gina Smith, a 56-year-old successful graphic artist recently lost her job and is depressed and anxious. Her liver enzymes are elevated. She is complaining of episodic gastric pain.
Anorexia.
A 26-year-old female, Marcia Johnson, is accompanied by her mother who expresses concern that Marcia is losing weight and eating only very small amounts of food She is 5 feet 10 inches and weighs 98 pounds. She is having heart palpitations. She excels in school and is an accomplished ballerina.
Severe Stress- somatic complaints, agitations, and anger
Begin limit setting Make simple and direct statements Describe behavior needed Notify MD and administer medication Remove other patients from day room Explain consequences of behavior
Major Depressive Disorder
Mary Rothchild, a 36-yo mother of three children, married 15 years, presents with suicidal thoughts without a plan. Her husband accompanies her and states she sleeps most of the time at home and for the past month avoids conversation with him and the children. She was formerly an excellent housekeeper but now she shows no interest. Upon interviewing her, she appears sad but is alert and oriented, and is cooperative to all requests.
Bipolar Maniac
Shirley Stevens, an unmarried 24-year-old, is walking back and forth in the day room. She waves as if she has an audience. She tells you she is practicing her acceptance walk when she crowned Miss America.
Section 2
(10 cards)