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w/i, scope, hx, lega

nursing 211 class one

history: what did dorthea dix do for the mentally ill; who was the first psych nurse and developed the school of psych nursing; lobbied in congress for them; linda Richards;
history: who is called the father of psychiatric and developed sofa therapy and cognitive therapy; Sigmund freud;
history: insulin therapy- what was done this would drop BG so low that they would have a seizure in order to change behavior causing the pt to become anoxic and have a seizure, then glucose was given
history: ECT- this therapy evokes what in a pt; this stimulated the different neurotransmitters in the brain causing what affect; is it done today; what is different now; a seizure; a happier pt; yes; pt is sedated and intubated
history: when was the first mental health act; the first mental health act occurred in response to what; in 1946; during and after WWII;
history: when did psychopharmacology occur; what were the 1st meds; in the 1950s; thorozine and lithium
history: who developed the framework for psych nursing; what was her emphasis on; hildegarde peplau; nurse client relationship stating relationship is established with trust
history: deinstitutionalization movement- who initiated this and why; what was Kennedy's goal; pres. kennedy bc sister was mentally ill; did not feel that everybody had to be institutionalized
history: have number of days in psych hospital increased of decreased; what was created as a guidline for dx; decreased; DRGs and DSM
community mental health nursing: examples of primary prevention; examples of secondary prevention; examples of tertiary prevention; wearing a helmet for contact sports, teaching kids and teens the effects of drugs and ETOH; depression screening, support groups; monitoring their money and where they are living, getting a ward of the court
scope of practice: what do we do in assessment; who should we get data from; what do we diagnose with; what should outcomes be; plan should have whose imput; gather data; pt, family, neighbors, teachers; NANDA; measurable,realistic and include a time estimate; pt;
ethical principles: def autonomy; def nonmaleficence; def justice; def veracity let them make decisions if they can unless they are at risk to themselves; obstaining from negative acts towards others; all individuals should be treated equal and fairly; adhering to the truth, do not be misleading and do not lie to the pt
ethical principles: nursing decision making model- def gather facts, identify the conflicting moral positions, identify key participants, consider passible options and act, eval the outcomes
topics ethical concern in psychiatric nursing practice: pt have the right to refuse ___; when can the pt not refuse psych meds; pt have the right to the least restrictive ___; psychotropic meds; unless the client presents a danger to others; treatment alternative
topics ethical concern in psychiatric nursing practice: what are the cultural factors; pt has culture, doc has culture, staff have culture, community has culture;
topics ethical concern in psychiatric nursing practice: name others; moral distress, client advocacy,
ethics: what is the nursing code of ethics called; our scope of practice is based on what; what is QSEN; what is the goal with qsen; ANA; what our license is; this is to make sure that students and nurses are aware of quality and safety; to maintain a safe environment for pts and others on the unit
defamation of character: def libel; def slander; how do we respect privacy; assault is what; battery is what; if something was maliciously written; if something wasmaliciously spoken inform pt prior to searching belongings; threat; actual abuse
jahoda's characteristics of mental health: ppl should have a positive attitude towards ___; when was this written; what should be maintained; what is accurate perception of reality; def environmental mastery; self; 1920-30s'; balance in life, work,fam time and personal time; we know our life is what it is; satisfaction with our role in our life and among others lives
def mental illness; is mental illness a reason itself for one to go psych hospital a disability involving loss of contact with reality and nonpsychotic disorders that causes impairment in functioning or emotional distress; no
united states mental health laws: what are the 2 types of admissions; voluntary and involuntary;
united states mental health laws: voluntary admission- def; how long do these pt have to stay admitted; they willfully accept the admitting tx; at least 3 days;
united states mental health laws: involuntary hospitalization- where do they usually come; why do ppl bring them there; do these pt feel like they need to be hopsitalized to the er by police or family; bc of a safety threat to themselves or others; no;
united states mental health laws: involuntary hospitalization- who files the first petition; who writes the 1st certification; who files 2nd certification; within how many hours does psychiatrist need to see them; whomever brought them to the ER: ER doctor; phsyciatrist; with in 24 hours;
united states mental health laws: involuntary hospitalization- within how many hours do they need to be seen by the court; the judge determines if they need to be what; do they lose the right to refuse meds; how long does the UCO (under court order) last with in 72 hours; kept involuntarily under court order; yes; 2-3 months
Michigan law: person requiring tx is one who ___; harm to self or others, unable to meet own basic needs, judgment is impaired,
united states mental health laws: when can transfers occur; once a pt is admitted voluntary or involuntary how long do they need to stay within an institution or from institution to institution; at least 3 days
united states mental health law: def of competency; who determines competencies; the ability of a person to perform certain tasks; the court;
forensic psychiatry: involves mental health issues r/t what; def civil procedures; they determine when a defendant ___ the legal system; determining when mentally ill person requires legal guardianship; competent
united states mental health laws: insanity defense- def a person by virtue of mental illness cannot know and appreciate the nature of criminal act and cannot control her behavior due to mental illness
discharge: when is pt discharged when treatment goals have been met, when client is safe, with agreement to a treatment plan for follow-up care, if involuntary and probate judge finds that he/she is not a person requiring treatments
united states mental health laws: duty to warn- is this a legal obligation; when did this law become enacted; yes; in the case of vitally tarasoff Vs. the regents of the university of cali in 1969 the pt stated to the psychiatrist that he was going to kill girlfriend and he did so now the doctor has a duty to warn;
duty to warn: def if a professional believes a client is a danger to others the professional has a legal responsibility to protect the potential victim
rights of children or minors: when did this happen; this protects what; what is the nurses relationship regarding child's rights 1970s; the liberty of minors; interventions that protect the child, supporting the familys decision making ability while supporting the child's best interest and ensuring the child is treated fairly
disability rights: americans with disabilities act- individuals must have a disability deemed to be permanent by whom; law does not protect whom the federal government to be protected; individuals using illegal drugs or actively involved in alcoholism
clients' rights: due process- this is a constitutional right based on what amendment; what are the specifics in commitment cases the 14th; client must be informed of procedural processes decision maker will be impartial, client has the right to be heard and represented by counsel
client rights: right to treatment- many states mandate what to outpatient community tx; def of the least restricted alernatives public funds; states mandated to provide least restrictive programs- not always a wide continuum of services
client rights: informed consent def; pt now signs a waiver consenting to take psych meds bc of all the side effects;
what are the 4 necessary elements for legal consent person must be capable of consenting, person must have the ability to refuse consent, person must habe adequate information for consent or have agreed to waive right to information, consent must not be illegal
right to refuse medication: when was it established; nurse may not forcibly give __ unless client is seen as an imminent danger to self or others; who cannot refuse meds more than 15 years ago; meds; pt under court order (UCO)
restraints and seclusion: we must use the least restrictive ___ first; restraints need what; the orders are ___ limited; if restrained how often does pt need to be observed restraints; a doctors order; time limited with periodic review;q15min
somatic therapies: ECT- aka; is this inpatient or outpatient; is it done voluntary or involuntary; competent person has the right to what electroconvulsive therapy; outpatient only; voluntary; agree or refuse ECT
examples of lawsuits that occur in psychiatric nursing; breach of confidentiality, defamation of character, libel, slander, invasion of privacy, assault, battery, false imprisonment
APA def of mental illness clinically significant behavioral or psychologic syndrome associated with distress or disability, impairment in functioning and not merely an expectable response to a particular event
DSM: aka; def; how many axis diagnostic statistical manual; manual that has the criteria for the illness and supporting tx;5;
DSM: what is axis 1; ex clinical syndrome; what is axis 2; ex of axis 2; def axis 3; ex axis 3; clinical syndrome; major depression, psychosis, bipolar; developmental or personality disorder; MMR (mild mental retardation); physical disorders; DM, CHF, Pain
DSM: def axis 4; ex axis 4; def axis 5; what can the score of the GAF be severity of psychosocial stressors rated from 1-6; no job, divorce, DUIs, kicked out of apartment; GAF- global assessment function; 1-100
Created by: jmkettel