Question | Answer |
name freud stages: | Oral(B-18mo)
anal(18-36mo)
phallic/oedipal(3-5y)
latency(5-11/13y)
genital(11-13y) |
describe (B-18mo) stage | Oral- major site of tension/gratification is mouth, lips, tongue; ie: biting/sucking. Id present @ birth, Ego develops from rudimentary structure present @birth |
describe (18-36mo) stage | Anal-anus & surrounding area are major source of interest
-voluntary sphincter control acquired |
describe (3-5y) stage | Phallic/oedipal-genitals focus of intrest, stimulation, & excitment
-penis is organ of interest for both sexes
-penis envy for girls
-masturation common
-oedipus complex in boys & girls |
describe (5-11y) stage | Latency- resolution of oedipus complex
-sex drive channelled into school activites
-formation of superego**
-final stage of psychosexual development |
describe (11-13y) stage | Gential- begins w/puberty & biologic capacity for orgasm; involves capacity for true intimacy |
name Erikson's stages (psychosocial) first 4: | trust vs. mistrust (infant)
autonomy Vs. shame/doubt (toddler)
intitiative Vs. guilt (preschool)
industry vs. inferiority (schoolage) |
name Erikson's stages last 4 | identity vs. role confusion (adolescense)
intimacy v isolation (young adult)
generativity v stagnation (middle adult)
ego integrity v despair (maturity) |
explain Eriksons trust v mistrust | Hope(infant)- viewing world as safe & reliable; relationships nurturing, dependable, & stable |
explain Eriksons autonomy v shame/doubt | Will(toddler)- acheiving a sense of control & free will |
explain eriksons initiative v guilt | Purpose(preschool)-beginning of conscience; learning to manage conflict & anxiety |
explzin eriksons industry v inferiority | competance(schoolage)-emerging confidence in abilities; taking pleasure in accomplishments |
explain eriksons identity v role confusion | Fidelity(adolescence)-formulating a sense of self & belonging |
explain eriksons intimacy v isolation | Love(young adult)-forming adult, loving relationships & meaningful attachments to others |
explain eriksons generativity v stagnation | Care(middle adult)-being creative/productive; establishing next generation |
explain eriksons ego integrity v despair | Wisdom(maturity)-accepting responsibility for 1 self & life |
who is Hildeard Peplau? | nursing theorist who developed the concept of the Therapeutic Nurse-Patient Relationship. |
4 phases of the nurse-pt relationship | orientation
identification
exploitation
resolution |
phase 1 orientation | directed by nurse, engages client in tx, giving explainations & info, & answering questions. |
phase 2 identification | client works independantly w/nurse, expresses feelings & begins to feel stronger |
phase 3 exploitation | client makes full use of the services offered |
phase 4 resolution | pt no longer needs pro. services & gives up dependant behavior. relationship ends |
6 roles of nurse in the therapeutic relationship | stranger-offering pt same courtesy as stranger
resource person-giving specific answers to questions in larger context
teacher-helping client learn formally or informally |
6 roles of nurse in relationship cont'd | leader-offering direction to pt or group
surrogate-being substitute for other like parent/sibling
counsler-promoting experiences leading to health for pt like expressing feelings. |
mild anxiety | sharpened senses
inc. motivation
alert
enlarged percetual feild
can solve prob
effective learning
restless
butterflies
sleepless
irritable
hypersensitive to noise |
moderate anxiety | selectivelt attentive perceptual feild limited to task
can be redirected
cant connect thoughts
muscle tension
diaphoresis
pounding pulse
headache
dry mouth
higher voice pitch |
moderate anxiety cont'd | inc rate of speech
GI upset
frequent urination
inc automatisms |
severe anxiety | perceptual feild on 1 detail or scattered details
cant complete tasks
cant solve prob or learn
behavior of anxiety relief but ineffective
feels awe,dread,horror
not redirected |
severe anxiety cont'd | severe headache
N/V, diarrhea
trembling
rigid stance
vertigo
pale
tachycardia
chest pain
crying
ritualistic behavior |
panic anxiety | perceptual field only on self
cant process environmental stimuli
distorted perceptions
loss of rational thought
personality disorganization
doent recognize danger
possibly suicidal |
panic anxiety cont'd | delusions or hallucination possible
cont communicate verbally
either cannot sit or totally mute & immobile
mat bolt & run |
psychoanalysis | takes months or years to complete (rich mans therapy) |
ID | innate desires
pleasure seeking
aggression
sexual impulse |
Super ego | moral ethical values parental |
Ego | mature
adaptive
the balance between the two
behavior |
deinstitutionalization | Tx for pts in the least restrictive environments possoble. shift from state hospitals to community facilities. Lead to the revolving door effect |
revolving door effect | shorter hospital stays, but the pts return back to hospitals more frequently. |
define mental disorder | clinically significant behavioral or psychological syndrome or pattern that pccurs in an individual & is associated w/present distress or disability or w/inc risk of suffering death, pain, disability, or imp loss of freedom |
mental health | multifaceted & has many infuential factors. catagorized as individual, interpersonal, & social/cultural |
what is the DSM-IV-TR | outlines specific Dxs. provides standerdized nomenclature & language for all mental health pros. differentiates Dxs & defining charectaristics. assists in IDing underlying c/o disorders |
Axis I | IDs all major psyc disorders EXCEPT mental retardation & personality disorders
ie:depresison, schizo, anxiety,substance-related disorders |
AxisII | reporting mental retardation & personality disord. & prominant maladap[tive personality features & defense mechanisms |
AxisIII | current med conditions are potentially relevant to understanding or managing persons mental disor. & med conditions that may contribute to understanding pt |
AxisIV | psycsocial & environmental problems that amy affect Dx, Tx, & porg. of Dx. ie:problems w/support goups, social environment, occupation, housing, economics, access to HC, & legal system |
AxisV | Global Assessment of Functioning. scale of 0-100 on CURRENT level of functioning. Dr may give score out of last 6mo or Year. Pt must leave hiigher w/what they came in with |
managed care | control balance b/t quality & cost of care. ppl recieve care based on need rather than request |
case management | case-by-case basis to provide necessary services while containing cost. Manager coordinates all needs for pt |
standard of practice: Assessment | psyc nurse collects comprehensive health data that is pertinant to pts health of situation |
standard of practice: Dx | psyc nurse analyzes assess data to determine Dx of problems, including level of risk |
standard of practice: outcome ID | psyc nurse IDs expected outcomes for a plan individualized to pt or situation |
standard of practice: planning | psyc RN develops plan that prescribes strategies & alternatives to attain expected outcomes |
standard of practice: implementation | psyc RN impliments the ID plan |
standard of practice: 5a coordination of care | psyc RN coordintes care delivery. |
Linda Richards | first psyc nurse (1940) |
Milieu Therapy | community of therapy where clients interact with one another. Ex: practicing interpersonal skills, giving feedback abt behavior to each other,& working together as a group to solve everyday problems |
psychosocial interventions | nursing activites that enhance clitent's social & psyc functioning & improve social skills, interpersonal relationships, & communication |