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Psychosocial WK2
| Question | Answer |
|---|---|
| DSM-IV-TR | Diagnosis and Statistical Manual of Mental Disorders, 4th edition, Text Revision; Listing of all psychiatric disorders, including diagnostic criteria, associated features, prevalence, and differential diagnosis; Listing of all psychiatric disorders, inclu |
| Axis I: | Clinical disorders (e.g. schizophrenia, major depression, bipolar disorder) |
| Axis II: | Personality or developmental disorders (e.g. paranoid and borderline personality disorders, mental retardation) |
| Axis III: | General medical conditions that relate to axes I and II or have a bearing on treatment (e.g. endocrine disorders) |
| Axis IV: | Severity of psychosocial stressors (e.g. divorce, housing, educational issues) – most important one |
| Axis V: | Global assessment of functioning, on a scale of 0 to 100 – psychologist makes the determination – most people is 85 to 100; must be at least a 50 to be released from hospital |
| Insight | locus of control (internal and external) – typically 1 dominates the other – -External LOC: belief that you have no control over things in your life; lots of apathy, no self-esteem; not much motivation -Internal LOC: the opposite |
| Outcome Identification | Repeat of goals “whether the goal was met or not” Specifies an adaptive behavior Must be realistic, achievable Written in measurable, behavioral terms |
| Short-term outcomes | attainable in 4-6 days |
| Long-term outcomes | require follow-up after discharge |
| Nursing Diagnosis | Identifies patient problems NANDA diagnoses widely accepted |
| Nursing care plans | Often standardized(clinical pathways, critical pathways) |
| Nursing focus: | Facilitation and education-Verbal strategies to guide problem solving |
| Evaluation | Considers patient progress Might lead to: Reassessment Reformulated nursing diagnoses More realistic outcomes |
| Discharge Summaries | Outcomes achieved Outcomes still to be addressed Patient instructions Medication information Follow-up appointments Referrals Make sure safety is maintained when not in the hospital |
| Individual must adjust to taking on the sick role | allows the person to be excused from everyday activities |
| Psychological Responses to Serious Medical Illnesses | Denial Anxiety Shock Anger Withdrawal – leads to depression |
| Denial | A refusal to admit to being ill Short-term denial can be useful in mobilizing internal resources Long-term usually results in maladaptive behavior patterns – creates coping mechanisms |
| Anxiety | Feelings of apprehension and uncertainty about the illness Can produce sympathetic nervous response (fight-or-flight response) |
| Shock | overwhelming emotion that paralyzes the individual’s ability to process information |
| Anger | response to feeling mistreated, injured, or insulted May be directed inward or outward toward other |
| Withdrawal | Removes self from interaction with others and the environment; Often a sign of depression |
| Nursing Interventions | Provide accurate information that aids in the realistic perception of the situation Encourage ventilation of feelings Provide empathetic gestures (silent physical closeness, holding a hand, giving a hug) Identify family supports and adequate coping me |
| Stigmatizing Medical Illness | can't project our values on others – need to keep our personal feelings out of it Example: HIV, Transgender surgery |
| Human Rights Abuse | Refusing to care for patient Labeling with psych diagnosis Inappropriate psych admission – have clear guidelines now to verify psych admission rationale |
| Delirium & Hospital Based Delirium | ICU Psychosis; elderly develop a sense of delirium |
| Compensation | An individual makes up for a “deficiency” in one area by consciously excelling in or emphasizing another area. |
| Conversion | Emotional conflicts are turned unconsciously into physical symptoms, which provide the individual with some sort of benefit (secondary gain). |
| Denial | Reality is denied, it does not exist. Unconscious refusal to admit an unacceptable idea or behavior. |
| Displacement | Unconsciously expressing or discharging pent up emotions/feelings are expressed toward someone or something other than the source of the emotion, less threatening object |
| Dissociation | Unconscious separation and detachment of emotional significance or painful feelings and affect from an unacceptable idea, situation or object. |
| Identification | Individual incorporates a characteristic (thought or behavior) of another individual or group, but does NOT give up his or her personal identity. Can be conscious or unconscious. Modeling after a respected person. |
| Introjection | A quality or attribute of another (like values/attitudes) is unconsciously internalized as if they were your own. |
| Projection | Unconsciously or consciously, blaming someone else for one’s difficulties or placing one’s unethical desires on someone else |
| Rationalization | Conscious or unconscious process of constructing reasonable explanations to explain, prove and justify one’s behaviors. |
| Reaction formation | The conscious behavior is completely opposite to the unconscious feeling. |
| Regression | Behavior, thought, or feelings used at an earlier stage of development are exhibited, usually unconscious. |
| Repression | The barring from conscious thought of painful, disagreeable thoughts, experiences, and or impulses. Unconscious and involuntary. |
| Sublimation | Sexual or aggressive or instinctual drives/impulses are channeled in socially acceptable ways. Conscious or unconscious process. |
| Suppression | An intentional & conscious exclusion of painful thoughts, experiences, or feelings. (***This is not considered a defense mechanism by some***). |
| Dual Diagnosis | the presence of at least one psychiatric disorder in addition to a substance abuse or dependency problem both are axis 1 Will treat psych disorder 1st and then the substance abuse |
| Co-Morbidity | how is this different? - term assoc. w/ med-surg (having 2 med-surg dxs) |
Created by:
MarieG
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