Kejururawatan Kesihatan Mental: pek ulang kaji kilat

Lembaran formula, langkah kaedah utama untuk setiap topik dan 6 soalan latihan, dengan penyelesaian penuh di bahagian belakang.

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1Formula dan kaedah

Kejururawatan kesihatan mental

Kaedah

  1. Tentukan sama ada terdapat risiko segera: bunuh diri, keganasan, kecemasan akibat ubat atau penyakit fizikal.
  2. Bertindak untuk keselamatan dahulu: perhatikan, alihkan alat yang boleh digunakan, redakan ketegangan, hentikan ubat yang berbahaya, dapatkan bantuan.
  3. Pilih respons terapeutik: akui perasaan, kemukakan realiti, elakkan jaminan palsu dan soalan “mengapa”.
  4. Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.

2Soalan latihan

1.Kejururawatan kesihatan mentalSederhana

Which communication approach is best with a patient who has paranoid personality disorder?

  1. ABe clear, honest and business-like, and explain the reasons for actions
  2. BTalk about the patient with colleagues in whispers within his sight
  3. CBe very warm and joke often to put the patient at ease
  4. DAvoid explaining anything so that the patient does not become suspicious
2.Kejururawatan kesihatan mentalSukar

A patient who has taken haloperidol for many years now has repeated lip smacking and tongue movements. Which action is most appropriate?

  1. AGive benztropine, because it reliably reverses these movements
  2. BReport the movements, assess them with a scale such as the AIMS and ask for a medication review
  3. CReassure the patient that the movements will soon stop on their own
  4. DIncrease the haloperidol dose, because a higher dose suppresses the abnormal movements of the mouth and tongue
3.Psikologi klinikalSederhana

Pengaktifan tingkah laku merawat kemurungan terutamanya dengan:

  1. AMeningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
  2. BMeneroka konflik zaman kanak-kanak secara terperinci
  3. CMendedahkan seseorang kepada sensasi badan yang ditakuti secara berperingkat
  4. DMenetapkan tempoh rehat sepenuhnya
4.Psikologi klinikalSukar

Penyelidikan emosi terluah (expressed emotion) menunjukkan bahawa kambuh dalam skizofrenia lebih berkemungkinan apabila keluarga menunjukkan:

  1. ASokongan yang mesra dan tenang
  2. BPerbualan kerap tentang cuaca
  3. CKritikan tinggi, permusuhan dan penglibatan emosi yang berlebihan
  4. DTahap hubungan yang rendah
5.FarmakologiSederhana

A patient uses a salbutamol (albuterol) inhaler and a corticosteroid inhaler at the same time of day. Which order is usually taught?

  1. AUse both in the same breath to save time
  2. BUse the steroid first, then the salbutamol right after without any gap
  3. CUse the salbutamol first, wait a few minutes, then use the steroid
  4. DThe order does not matter and no waiting is needed
6.FarmakologiSukar

A toddler swallowed many of his mother's iron tablets. He has vomiting and bloody diarrhoea. Which drug may be used to bind iron?

  1. AActivated charcoal given by mouth
  2. BDeferoxamine (desferrioxamine)
  3. CAcetylcysteine
  4. DNaloxone

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: A · Be clear, honest and business-like, and explain the reasons for actions

Mengapa ini jawapannya

People with paranoid personality disorder are distrustful and may misread friendliness or jokes as hostility. Honesty, consistency and clear explanations reduce suspicion.

Jawapan

A · Be clear, honest and business-like, and explain the reasons for actions
2.Kejururawatan kesihatan mental

Jawapan: B · Report the movements, assess them with a scale such as the AIMS and ask for a medication review

Mengapa ini jawapannya

These are signs of tardive dyskinesia, which can be permanent. Early detection and review of the antipsychotic are key; anticholinergic drugs do not treat tardive dyskinesia and may worsen it.

Jawapan

B · Report the movements, assess them with a scale such as the AIMS and ask for a medication review
3.Psikologi klinikal

Jawapan: A · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai

Mengapa ini jawapannya

Pengaktifan tingkah laku menjadualkan aktiviti yang mendatangkan keseronokan atau penguasaan, memutuskan kitaran penarikan diri dan peneguhan rendah. Ia rawatan berasaskan bukti untuk kemurungan.

Jawapan

A · Meningkatkan penglibatan dalam aktiviti yang memberi ganjaran dan bernilai
4.Psikologi klinikal

Jawapan: C · Kritikan tinggi, permusuhan dan penglibatan emosi yang berlebihan

Mengapa ini jawapannya

Emosi terluah yang tinggi meramalkan kadar kambuh yang lebih tinggi; intervensi keluarga yang mengurangkannya merendahkan kadar kambuh.

Jawapan

C · Kritikan tinggi, permusuhan dan penglibatan emosi yang berlebihan
5.Farmakologi

Jawapan: C · Use the salbutamol first, wait a few minutes, then use the steroid

Mengapa ini jawapannya

The bronchodilator opens the airways so that the inhaled steroid can reach further into the lungs. A short wait between the inhalers is usually advised.

Jawapan

C · Use the salbutamol first, wait a few minutes, then use the steroid
6.Farmakologi

Jawapan: B · Deferoxamine (desferrioxamine)

Mengapa ini jawapannya

Iron poisoning can cause GI bleeding, shock, metabolic acidosis and liver failure. Deferoxamine chelates iron and is used in serious poisoning; activated charcoal does not bind iron.

Jawapan

B · Deferoxamine (desferrioxamine)

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