Psychiatric Nursing Flashcards

A patient with dementia becomes confused and agitated every evening. This is called:

Answer: Sundowning syndrome

Sundowning is a pattern of increased confusion, agitation, wandering, and behavioral disturbance in the late afternoon and evening hours, common in dementia. Contributing factors include fatigue, reduced light, and disrupted circadian rhythm.

What differentiates delirium from dementia?

Answer: Delirium has acute onset and fluctuating consciousness; dementia is gradual and progressive

Delirium is characterized by acute onset (hours to days), fluctuating level of consciousness, and is often reversible when the underlying cause is treated. Dementia develops gradually over months to years with preserved consciousness until late stages.

A patient is started on fluoxetine for depression. When should the nurse tell them to expect improvement in mood?

Answer: 2–4 weeks for full antidepressant effect

SSRIs and other antidepressants have a delayed onset of action. Mood improvement typically takes 2–4 weeks, though sleep, appetite, and energy may improve earlier. Patients must be warned to continue the medication even if they do not feel better immediately.

Which nursing intervention is most important in caring for a patient with active psychosis?

Answer: Establish a calm, consistent, trusting relationship and maintain reality orientation

A consistent, trustworthy therapeutic relationship is the foundation of psychiatric nursing. Engaging in the content of delusions reinforces them; isolation increases paranoia. Brief, clear, reality-oriented communication in a calm environment is most therapeutic.

What is the primary goal of electroconvulsive therapy (ECT)?

Answer: To treat severe treatment-resistant depression and reduce suicide risk

ECT is indicated for severe, treatment-resistant depression, especially with high suicide risk, psychotic features, or when rapid response is needed. It induces a controlled seizure under general anesthesia, producing neurobiological changes that rapidly alleviate depression.

A patient with schizophrenia refuses medication because 'the pills are poison.' What is the most therapeutic response?

Answer: Explore the patient's concerns, provide education, and involve the treatment team in discussing alternatives

Exploring concerns respects autonomy and may reveal specific fears or delusions that can be addressed. Forced medication requires legal process (except emergencies). Shared decision-making and motivational techniques improve long-term medication adherence.