question

emotion or feeling; tone of reaction to persons and events

answer

affect

question

excessive motor activity, usually not purposeful and associated with internal tension

answer

agitation

question

ability to relieve anxiety or emotional tension, also called antianxiety agent

answer

anxiolytic medication

question

abnormal slowness of movement; sluggish physical and mental responses

answer

bradykinesia

question

no voluntary movement, physical rigidity; fixed position may be maintained for hours

answer

catatonia

question

mental process of comprehension, judgment, memory

answer

cognitive

question

appearance or exacerbation of a mental disorder

answer

decompensate

question

false belief firmly held though contradicted by social reality

answer

delusion

question

loss of cognitive and intellectual functions sufficiently severe to interfere with social and occupational functioning

answer

dementia

question

impairment in uttering words due to diseases that affect oral and pharyngeal muscles

answer

dysarthria

question

electroshock therapy; a form of somatic therapy in which an electric current is used to produce convulsions; primarily used to treat depression

answer

Electroconvulsive Therapy (ECT)

question

feeling of well-being; in psychiatry, abnormal or exaggerated sense of well-being

answer

euphoria

question

false sensory perception in the absence of an actual external stimulus

answer

hallucination

question

a mental impression derived from misinterpretation of an actual sensory stimulus; a false perception

answer

illusion

question

wakefulness; inability to sleep in the absence of noise or other disturbance

answer

insomnia

question

fine, downy hair

answer

lanugo

question

a mental disorder that usually involves the use of unconscious defense mechanisms as a means of coping; individual is not out of touch with reality

answer

neurosis

question

failure to carry out prescribed healthcare plan, for example, failure to take medications as prescribed

answer

noncompliance

question

mental disorder characterized by delusions of persecution

answer

paranoia

question

erosion of enamel and dentin as a result of chemical and mechanical effects

answer

perimylolysis

question

persistent, unrealistic pathologic fear or dread out of proportion to the stimulus from a particular object or situation

answer

phobia

question

a premonitory symptom; a symptom indicating the onset of disease

answer

prodrome

question

a significant major mental disorder that so greatly impairs perception, thinking, emotional response, and/or personal orientation that the individual loses touch with reality

answer

psychosis

question

treatment of emotional, behavioral, personality, and psychiatric disorders by means of individual or group verbal or nonverbal communication with the patient

answer

psychotherapy

question

a medication that alters the mind; the major categories are antipsychotic, antianxiety, antidepressant, and antimanic agents

answer

psychotropic medication

question

involuntary movements of the mouth, lips, tongue, and jaws, usually associated with long-term use of antipsychotic medication

answer

tardive dyskinesia

question

A ______ or _____ disorder is a complex, clinically significant behavioral or psychological syndrome or pattern that is associated with present distress or disability. The causes may be related to behavioral, psychological, or biologic dysfunction in the individual.

answer

psychiatric mental

question

Principles of _____ consent are applied for patients of all ages with mental disorders. Many patients with mental disorders are capable of signing their own consent form.

answer

informed

question

a complex, chronic mental disorder. Disturbances in feeling, thinking, and behavior significantly impair function to a level below normal for the individual

answer

Schizophrenia

question

a major psychotic illness in which the individual may be out of touch with reality. Symptoms include delusions, hallucinations, disorganized thinking, and incoherence

answer

Schizophrenia

question

The onset is usually between the ages of ___ and ___ in males, and 25 and 35 in _____. The onset can be gradual or abrupt. Most people have a slow developing prodromal phase in which there is a gradual appearance of signs and symptoms. Some patients remain chronically ill, while others have periods of remission and recurrence. Although the cause is not understood, genetic factors can make an individual more vulnerable.

answer

15 and 24 women

question

phases of the schizophrenia are described as ____, _____, and _____.

answer

prodromal, active, and residual

question

Rates of alcohol and other drug abuse are _____ among patients with schizophrenia.

answer

high

question

The response to initial treatment of schizophrenia can be a _____ of the long-term prognosis. The prognosis has generally been considered guarded to poor. Evidence shows that although deterioration may occur during the early years, the condition may stabilize with treatment during middle age.

answer

predictor

question

The objectives of treatment are to ____or ______ the delusions, hallucinations, and other symptoms and to enable the patient to function in daily living.

answer

reduce alleviate

question

Conventional antipsychotic drugs are used to block ______ receptors and are effective against positive symptoms with less effect on negative symptoms: phenothiazines (chlorpromazine [Thorazine]); butyrophenones (haloperidol [Haldol]); thioxanthenes (thiothixene [Navane]).

answer

dopamine

question

A side effect of antipsychotic medication that causes involuntary mouth and jaw movements is called what? A) Akathisia B) Dysarthria C) Dystonia D) Tardive dyskinesia

answer

D) Tardive dyskinesia is the correct answer. Tardive dyskinesia is involuntary mouth and jaw movements, often a side effect associated with antipsychotic medications. All other answers are other possible side effects of antipsychotic medications. Akathisia is restlessness or pacing. Dysarthria is difficult speech. Dystonia is muscle contractions.

question

overall degeneration of health factors may have occurred because of neglect of diet, exercise, sleep, general cleanliness, personal grooming, and oral care. Concurrent alcohol and/or other drug abuse, as well as smoking, can influence dental and periodontal health. Xerostomia can lead to an increase in rampant dental caries.

answer

Oral Implications of Schizophrenia

question

Elective dental and dental hygiene treatment is not carried out during an acute exacerbation. Treatment is undertaken when the patient's symptoms are reasonably controlled by medications. If the patient decompensates during a dental or dental hygiene appointment, immediate referral is needed. Telephone numbers of the patient's physicians are kept in an easily accessible location for quick referrals.

answer

Appointment Planning for Schizophrenia

question

Because schizophrenia is often a lifelong disorder, planning for future oral health is essential. Review medical and medication history; analyze drugs for possible side effects, which require appointment modifications. Review consultation notes from the mental health physician relative to medications, alcohol or other substance use, and medical-legal competence for informed consent. Plan a simple routine. For a series of appointments and maintenance, use a familiar, organized routine that is comfortable for the patient. Decrease stimulation; create a restful atmosphere; if background music is present, keep it low and soft. Provide instruction in oral care. Help the patient to improve the level of personal oral care on a daily basis. When applicable, evaluate the patient's personal caregiver for attitude and knowledge and provide information and instruction. Use a mouth prop to assist the patient with tardive dyskinesia. The patient does not have control of mouth movements and can appreciate stability.

answer

Appointment Interventions

question

The primary _____ disorders are major depressive disorder and bipolar disorder.

answer

mood

question

Onset for major depression is usually the mid-20s and is more common in ____ than ____.

answer

women men

question

Bipolar disorder begins about age __ and is equally common in men and women.

answer

20

question

a disturbance marked by apathy, fear, sadness, and loss of mobility and energy

answer

depression

question

Antidepression medications are the primary _______ for individuals with depression. In addition, treatment may include lifestyle changes, correction of sleep disorders, new diet and eating patterns, and exercise, along with counseling and practical psychotherapy. Hospitalization may be indicated when potential danger of suicide or harm to others exists.

answer

treatment

question

Often the initial therapy for depressive illness.

answer

SSRIs (selective serotonin reuptake inhibitors). Specific products: fluoxetine (Prozac); sertraline (Zoloft); paroxetine (Paxil); fluvoxamine (Luvox)

question

____ often a serious side effect of antidepressant drugs.

answer

Xerostomia

question

a major mood disorder in which episodes of varying degrees of mania (elation) and depression occur

answer

Bipolar disorder

question

characterized by excessive elation, hyperactivity, and accelerated thinking and speaking

answer

Mania

question

both pharmacotherapy and psychosocial therapy are used during all phases of the disease

answer

treatment of bipolar disorder

question

Lithium may cause dysgeusia and impart a _____ taste in the mouth.

answer

metallic

question

Dental and dental hygiene appointments usually are _______ until the patient is under medical control.

answer

postponed

question

______- to ______-month maintenance appointments may be needed. Patient instruction may be difficult due to a short attention span. Use direct, simple instructions.

answer

3 to 4

question

A patient with bipolar disorder who takes lithium may complain of: A) bleeding when brushing B) tooth hypersensitivity C) metallic taste in mouth D) sores in the mouth

answer

C) Metallic taste in mouth is the correct answer. Lithium can cause dysgeusia and impart a metallic taste in the mouth.

question

The puerperium is the 6-week period after childbirth when the body undergoes physical and physiologic changes. During the entire ______ period, many physiologic and psychological stresses are related to the changes taking place in the mother's life.

answer

postpartum

question

A period of nonpsychotic depression for a few days after giving birth is not uncommon. There may be crying, irritability, and mood shifts.

answer

Postpartum Blues

question

A moderate to severe depression may begin by the second to third week postpartum. Symptoms include excessive fatigue, insomnia, loss of appetite, and loss of interest and enthusiasm.

answer

Postpartum Depression

question

Postpartum or puerperal psychosis is a mood disorder. It may be of a depressive or manic type.

answer

Postpartum Psychosis

question

Pre-existing mental illness, such as bipolar disorder or schizophrenia. Stress. Conflicts about motherhood, such as unwanted pregnancy; fears about mothering; marital problems.

answer

Risk Factors for Postpartum Depression

question

Early. Complaints of insomnia, restlessness, tearfulness, fatigue, and emotional unsteadiness. Progressive. Confusion, irrationality, delirium, and obsessive concerns about the baby. Thoughts of bringing harm to the baby or oneself are not unusual.

answer

Symptoms of Postpartum Depression

question

experienced as apprehension, tension, or dread that results from the anticipation of danger, the source of which is unknown or unrecognized; the result of feeling a threat to the person's being, self-esteem, or identity

answer

Anxiety

question

an emotional or physiologic response to a recognized source of danger

answer

fear

question

True or False? In normal life, some mild anxiety provides an effective stimulus to improved performance. As a psychiatric symptom, anxiety can be excessive, irrational, and beyond the control of the individual.

answer

True

question

characterized by recurrent panic attacks that are usually unexpected

answer

Panic disorder

question

the fear of being in places or situations from which escape might be difficult or embarrassing or in which help might not be available in the event of a panic attack; the fear is of open spaces, of crowds, or of going outside the home alone and away from a safe place

answer

Agoraphobia

question

An initiating traumatic event has occurred outside the range of usual human experience. It may be destruction to the home or family or may result from a manmade disaster, such as war, imprisonment, torture, rape, or other exposure associated with intense horror, fear, or serious threat to life.

answer

Posttraumatic stress disorder.

question

There is persistent, pervasive anxiety and excessive worry but they are not associated with life-threatening fears or "attacks." It may be complicated by depression, alcohol abuse, or anxiety related to a general medical condition.

answer

Generalized anxiety disorder.

question

Treatment of Anxiety Disorders:

answer

Basic therapeutic approach Cognitive-behavioral therapy Pharmacotherapy -Antianxiety medications -Antidepressant medication

question

Antianxiety medications.

answer

Benzodiazepines. Adverse effects: potential for addiction, withdrawal symptoms, diminished alertness (drowsiness), impaired eye-hand coordination, xerostomia.

question

Oral Implications of Anxiety Disorders

answer

hypersensitivity of the teeth, related to patient's general tenseness and irritability, may be present

question

Question regarding ______ ______ ______ for patients with panic disorder.

answer

mitral valve prolapse

question

Anorexia Nervosa Bulimia Nervosa Bulimarexia

answer

Eating Disorders

question

characterized by a refusal of the individual to maintain body weight over the minimal normal weight for age and height. The aversion to eating results in life-threatening weight loss; involves self-imposed starvation that results from an obsessive desire to be thin and a marked fear of gaining weight.

answer

anorexia nervosa

question

a psychiatric compulsive disorder marked by recurrent episodes of uncontrollable binge eating

answer

Bulimia nervosa

question

The individual with bulimia nervosa tends to be socially ________ and more outgoing in contrast to the person with anorexia.

answer

extroverted

question

the chemical erosion of the tooth surfaces by acid from the regurgitation of stomach contents

answer

Perimylolysis

question

Enlargement may occur for 2 to 6 days after a binge.

answer

Parotid gland.

question

True or False? Do not brush after vomiting. Demineralization of the tooth surface by the acid from the stomach starts immediately on contact. Brushing may abrade the demineralized areas.

answer

True

question

Factors to Teach the Patient

answer

Significance of daily personal oral care Dental caries prevention Salivary substitutes for xerostomia Causes and effects of enamel erosion Need for fluoride therapies

Chapter 63: The Patient With a Psychiatric Disorder – Flashcards

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