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

Mengapakah antidepresan trisiklik amat berbahaya dalam dos berlebihan?

  1. AIa menurunkan tekanan darah sedikit sahaja dan jarang memerlukan rawatan
  2. BIa tiada kesan dalam dos berlebihan
  3. CIa boleh menyebabkan aritmia jantung dan sawan yang membawa maut
  4. DIa hanya menyebabkan mengantuk ringan
2.Kejururawatan kesihatan mentalSukar

The daughter of a man with moderate dementia says she is exhausted, is not sleeping and feels guilty for getting angry with him. What is the most helpful nursing response?

  1. AAcknowledge her strain and discuss support such as respite care and carers' groups
  2. BTell her that good daughters do not get angry with their parents
  3. CAdvise her to take on more responsibility for his care so that she feels less guilty
  4. DSuggest that she stops visiting him for a few months so that she can rest and forget about her guilt
3.Psikologi klinikalSederhana

Dalam model ABC Ellis, apakah maksud "B"?

  1. AKepercayaan (Beliefs) tentang peristiwa pencetus
  2. BTingkah laku (Behaviour) yang mengikuti peristiwa
  3. CSensasi badan (Bodily sensations) semasa tekanan
  4. DLatar belakang (Background) klien
4.Psikologi klinikalSukar

Seorang pesakit mengalami gejala psikotik selama setahun; selama beberapa minggu dia mengalami halusinasi tanpa sebarang episod mood, manakala pada masa lain psikosis berlaku semasa episod kemurungan major. Diagnosis manakah yang paling berkemungkinan?

  1. AGangguan kemurungan major dengan ciri psikotik
  2. BGangguan skizoafektif
  3. CGangguan delusi
  4. DGangguan bipolar I
5.FarmakologiSederhana

During a rapid infusion of vancomycin, a patient develops flushing and a red rash on the face, neck and upper body. What is the most likely cause and action?

  1. AA normal effect; increase the infusion rate to finish sooner
  2. BA sign that the infection is spreading; give a second dose
  3. CAn infusion reaction; stop or slow the infusion and inform the prescriber
  4. DAcute kidney failure; stop all IV fluids and antibiotics at once
6.FarmakologiSukar

A woman with epilepsy who takes an antiepileptic drug plans to become pregnant. Which advice is standard?

  1. AStop all antiepileptic drugs straight away as soon as she stops contraception
  2. BTake folic acid before conception and seek specialist review of her medication
  3. CNo change is needed, as antiepileptics carry no risk in pregnancy
  4. DAvoid folic acid because it lowers drug levels

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: C · Ia boleh menyebabkan aritmia jantung dan sawan yang membawa maut

Mengapa ini jawapannya

Dos berlebihan trisiklik menyebabkan aritmia, QRS yang melebar, hipotensi, sawan dan koma. Bagi pesakit yang berisiko bunuh diri, preskripsi mungkin dihadkan kuantitinya.

Jawapan

C · Ia boleh menyebabkan aritmia jantung dan sawan yang membawa maut
2.Kejururawatan kesihatan mental

Jawapan: A · Acknowledge her strain and discuss support such as respite care and carers' groups

Mengapa ini jawapannya

Caregiver strain is common and can affect both the carer and the patient. Recognising it, and offering respite, practical support and carers' groups, helps the carer continue safely.

Jawapan

A · Acknowledge her strain and discuss support such as respite care and carers' groups
3.Psikologi klinikal

Jawapan: A · Kepercayaan (Beliefs) tentang peristiwa pencetus

Mengapa ini jawapannya

Dalam model ABC, peristiwa Pencetus (Activating event) membawa kepada Akibat (Consequences) emosi melalui Kepercayaan (Beliefs) seseorang. Mengubah kepercayaan yang tidak rasional mengubah akibatnya.

Jawapan

A · Kepercayaan (Beliefs) tentang peristiwa pencetus
4.Psikologi klinikal

Jawapan: B · Gangguan skizoafektif

Mengapa ini jawapannya

Gangguan skizoafektif melibatkan episod mood bersama gejala skizofrenia, serta sekurang-kurangnya dua minggu psikosis tanpa episod mood. Dalam kemurungan psikotik, psikosis berlaku hanya semasa episod mood.

Jawapan

B · Gangguan skizoafektif
5.Farmakologi

Jawapan: C · An infusion reaction; stop or slow the infusion and inform the prescriber

Mengapa ini jawapannya

Rapid vancomycin infusion releases histamine, causing flushing and itching of the upper body (formerly called "red man syndrome"). It is managed by stopping or slowing the infusion, and sometimes with an antihistamine.

Jawapan

C · An infusion reaction; stop or slow the infusion and inform the prescriber
6.Farmakologi

Jawapan: B · Take folic acid before conception and seek specialist review of her medication

Mengapa ini jawapannya

Folic acid before and in early pregnancy reduces the risk of neural tube defects. Medication should be reviewed before conception, but drugs should not be stopped suddenly because uncontrolled seizures are also dangerous.

Jawapan

B · Take folic acid before conception and seek specialist review of her medication

ExamProblems · examproblems.com/courses/mental-health-nursing