Mental Health Must-Knows

Lack of remorse

• Provide high calorie finger foods. High activity requires more calories.

• “It seems like…”
• “Tell me more about….”
• Allow client to talk openly about the problem
• Explore and allow them to express feelings.
• “Tell me what you know about…”

• Symptoms: agitation, anxiety, restlessness, disorientation, diaphoresis, hyperthermia, tachycardia, nausea, vomiting, tremor, muscle rigidity, hyperreflexia, myoclonus, dilated pupils, ocular clonus, dry mucous membranes, flushed skin, and increased bowel sounds.
• Causes: Selective serotonin reuptake inhibitors (SSRIs), antidepressants such as citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), escitalopram (Lexapro), paroxetine (Paxil, Pexeva, Brisdelle) and sertraline (Zoloft). Serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressants such as desvenlafaxine (Pristiq), levomilnacipran (Fetzima), milnacipran (Savella), duloxetine (Cymbalta, Drizalma Sprinkle) and venlafaxine (Effexor XR). Bupropion. Tricyclic antidepressants, such as amitriptyline and nortriptyline (Pamelor). Monoamine oxidase inhibitors (MAOIs), antidepressants such as isocarboxazid (Marplan) and phenelzine (Nardil). Anti-migraine medications, Pain medications, Lithium, Illicit drugs, Herbal supplements, including St. John’s wort, ginseng and nutmeg, Over-the-counter cough and cold medications containing dextromethorphan (Delsym), Anti-nausea medications.

• Treatment: Methylphenidate
• Effective if child can focus/do homework/school work.

• Provide routine
• Make schedule of daily tasks
• Limit number of choices
• May need to label doors  such as bathroom door. 

Risk factors: possessiveness,  emotional dependence and insecurity, belief in strict gender roles, and desire for power and control. Relationship risk factors include unhealthy family relationships and interactions.

Watch client during and after meals to check for induced vomiting.

Causes temporary memory loss.

• Goal of treatment= weight gain and electrolyte balance (e.g., normal potassium).

Watch for increase energy, especially after initiation of antidepressants.  This is when clients at higher risk for suicide.

• Antipsychotic used for schizophrenia
• Major side effect is agrnulocytosis such as WBC low
• This places client at risk for infection.
• Teach to report fever, sore throat or any signs of infection. 
• Other medications that cause agranulocytosis:  methimazole, propylthiouracil, procainamide, dapsone, sulfonamides, trimethoprim, diclofenac, carbamazepine, phenytoin, and indomethacin.

Maintain eye contact

Assess literacy level first 

• If hearing voices ask, “What are the voices telling you.”
• If paranoid ask, “What makes you think that…”

Encourage client to be assertive.