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holistic man

nurs 211 (psychoanalytical theories)

Psychoanalytic Theory – Freud: believed basic character was formed by the age of ___; what are the 3 major components of personality; 5; id, ego, superego;
Psychoanalytic Theory – Freud: ego- when is it developed; ego is the balance between what; this maintains the role of ___ 4-6months; id and superego; the person
Psychoanalytic Theory – Freud- superego: when does it develop; this is the __ judge; aka; between the ages 3-6yrs; moral; "angel"
Psychoanalytic Theory – Freud felt consciousness was formed when child was ___ for bad behavior; too rigid superego may develop poor ___ punished; self esteem
Psychoanalytic Theory – Freud
Interpersonal Theory – Sullivan: this is based on the influence of ___ on the development of personality; how many stages of development; did he accepted the freud theory; to what age does it go to compared to the freud theory; what was he influenced by; social processes; 8 stages; yes; older age- freud only goes to 5; sue Indians and war;
Interpersonal Theory – Sullivan: he felt children were powerless and weak when it came to what; you need to master and develop ___ before you can move onto the next level; ppl commonly get stuck at what level; influence of the caregiver; prior; identity level;
Interpersonal Theory – Sullivan: the stages of development need to occur in ___; order;
Interpersonal Theory – Sullivan: name the stages in order; trust Vs. mistrust, autonomy vs. shame and doubt, intiative vs. guilt, industry vs. inferiority, indentity Vs.role confusion, intimacy vs. isolation, generativity vs. stagnation, ego integrity vs. despair
Interpersonal Theory – Sullivan- trust vs. mistrust: what is age group; who can cause issues in this stage birth-18months; primary caregiver
Interpersonal Theory – Sullivan- autonomy vs. shame and doubt: what age group; 18 mo-3 years
Interpersonal Theory – Sullivan- intiative vs guilt: what age group 3-6 years
Interpersonal Theory – Sullivan- industry vs. inferiority: what age group; children become more aware of what; children begin to do things; if ridiculed they may develop what 6-12 yrs; themselves as an individual; right; inferiority
Interpersonal Theory – Sullivan- indentity VS role confusion: what age; adolescents are concerned by how they are view by__; they experiment with what; 12-20 yo; others; activites and behaviors
Interpersonal Theory – Sullivan: intimacy vs. isolation- what age; they begin to focus on what relationships; if individual is scared of rejection they may do what; 20-30 yrs; intimate; isolate;
Interpersonal Theory – Sullivan- generativity vs. stagnation: what age; if pt is selfcentered this may cause dissatisfaction with productivity if they do not contribute to ___ 30-65 yo; society
Interpersonal Theory – Sullivan- ego integrity vs. despair: age; they contemplate what at this age; if they do not feel as if they accomplished enough they will feel ___ 65 yrs-death; productivity; despair
object relation: Mahler- this is based on the separation-individuation process of what 2 ppl; are there phases; what are the phases infant and mother or primary caregiver; yes; autistic stage, symbiosis stage, individuation/acceptance stage
object relation: Mahler- nurse needs to assess what; child initially sees themselves as extension of whom; later what does the child do; the clients level of individuation from primary caregivers; mom; sees themselves as a separate person
object relation: Mahler- infant is dependent on mom for what a basic needs
cognitive development- piaget: the premise that human intelligence is an extension of what; studied how ___ grow; biological adaptation and physical environment adaptation; children;
cognitive development- piaget: what are the 3 stages; what is preoperational thinking; what is concrete operational thinkning preoperiational, concrete thinking, formal operational; magical thinkning, child does not understand object permanence; begins to understand more about objectpermanense
cognitive development- piaget: when do children begin to think logically; belief was we need to change ___ thoughts; this started what therapy; what is cognitive therapy 11-16yo; automatic; cognitive behavioral therapy; changing those automatic thoughts and helps us understand why we react and behave the way we do
maslow's hierarchy of needs: we need to start where before we can progress; how long does this take to occur on the bottom; years
maslow's hierarchy of needs: what are the needs in orders; the physiological needs, security needs, love and belonging needs, esteem needs, need for self-actualization
maslow's hierarchy of needs: what are the physiological needs; what are the security needs; the need for food, water shelter and clothing; the basic need for social security in a family and society that protects against hunger and violence;
maslow's hierarchy of needs: what are the love and belonging needs; what are the esteem needs; the need for belonging, to receive and give love, appreciation; the need to be unique individual with self respect and to enjoy general esteem from others;
maslow's hierarchy of needs: what are the needs for self actualization; he believed that in love and belonging we occur in ___ experience purpose, meaning and realizing all inner potential; pairs
mental health: def the successful adaptiation to stressors from the internal or external environment, evidenced by thoughts, feelings and behaviors that are age-appropriate and congruent with local and cultural norms
mental illness: def; it is evidenced by what; change perceptions and let them know that stressors are everywhere andthey need to find ways to adapt maladaptive responses to stressors from the internal or external environment; thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individuals social, occupational or physical functioning;
Psychological Adaptation to Stress: anxiety- def; what type of anxiety is adaptive and provide motivation; what else can mild anxiety do a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness; mild; prepared ppl for action, increases activity, enhanced learning
Psychological Adaptation to Stress: anxiety- is mild anxiety a problem; what happens in moderate; no; perceptual field diminishes, less alert to events in environment, concentration decreases, not the best for learning, muscle tension,restless tone of voice or speech may elevate, learning can still occur
Psychological Adaptation to Stress: what happens in severe; perceptual field is so diminished that concentration centers on one detail only or on many extraneous details, difficulty completing simple tasks, palpations of heart, diarrhea, stress hormones in overrides
Psychological Adaptation to Stress: what happens in panic the most instense state, cannot focus on one detail, misperceptions, hallucination, loss of contact with reality,feelings of terror, delerious
Psychological Adaptation to Stress : what are short term meds we can give for these benzos (Ativan, Xanax)
Psychological Adaptation to Stress: behavioral adaption responses to anxiety- at mild level what type of coping skills occur; healthy ways to adapt to coping pacing,rr increases, bp increases, hr increases, chews nails, increase smoking,gamble, shop, bake, crying, laughing; walking, jogging, DB, sit, meditate
Psychological Adaptation to Stress: at moderate to severe level that remains unresolved over and extended period of time what can happen; example of physical issues; what are these complaints called; number of physiological issues; abdominal pain,HA, backache, N/V, depression and isolation; somatic;
Psychological Adaptation to Stress repressed severy anxiety can result in psychoneurotic patterns of behaving what are these examples phobias
Psychological Adaptation to Stress: at mild to moderate level what are the anxiety defense mechanisms compensation, denial, displacement, identification, intellectualization, introjection, isolation, projection, rationalization, reaction formation, regression, repression, sublimation, suppression, undoing
go back over defense mechanisms
cultural differences: what are types of communication; what is paralanguage; what is the goal for space distancing; verbal,nonverbal, touch; the speed tone, and pitch of voice; 18 inches, 3 feet in social area
cultural differences: all interventions you use and behaviors you observe will be influenced by what; def acculturation; children observe whom; NA have to look up to; a pts culture; a way a culture acquires its behaviors; a way a culture acquires its behaviors; adults; tribe;
cultural differences: in NA who is honored; therapeutic communiation is dependent on what; NA have what type of affect; older adults; pt being able to undserstand us; flat;
cultural differences: what do americans value in time; our meals are based on time or hunger; are meds timed; NA worship past or present; NA follow time; punctuality and efficiency; time; yes; present; no-also do not worry about the future;
cultural differences: NA- what dothey use for illness; NA medical issues shaman,crystal gazing, herbs roots remedies; ETOH abuse, suicide, BP control;
neurotransmitters: they play an important role in what; they are the target for the mechanism of action in what type of meds; human emotions and behaviors; psychotropic
neurotransmitters: major categories- what is the cholinergic neurotransmitter; what are the monoamines; what are the amino acid ones; what are the neuropeptides; acetylcholine; norepi, dopamine, serotonin; GABA, glycine, glutamine; endorphins, somatostatin
neurotransmitters: dopamine too little cause what; dopamine too much causes what; what is the feel good one depression, mania and schizo; endorphins
limbic system: aka __ brain; what is the areas purpose; emotional; emotional decision making, where we feel our anxiety, anger and fear;
cortex: who uses this more; what type of decision making; adults; rational decisions;
neurotransmitters are involved in the limbic or the cortex both
how do psychotropics work: receptors- they are molecules that are situated where; they are the binding site for what; where do meds have effect in the neurotransmitting process; on the cell membrane; neurotransmitters; on the synaptic cleft;
how do psychotropics work: receptors- the synaptic cleft is inbetween what; the pre and post synaptic sites;
how do psychotropics work: reuptake- this is the process of ___ inactivation; the neurotransmitter is inactivated how; where is it reabsorbed into; neurotransmitter; it is reabsorbed; the presynaptic neuron from whick it had been released ;
neurotransmitters: monoamine- name them; too little dopamine =__; too much =___; too little norepi =__; too much norepi =___; dopamine, norepinephrine, acetylcholine; parkinsons; depression; mania, schizo; depression; mania, anxiety and schizo
anticholingeric effect: what are some nursing interventions; why do they need to change positions slowly encourage to chew gum, suck on mints, photosensitivity, high fiber diets, bc of low bp
what is Cogentin used for EPS
what serious thing can MAOs cause hypertensive crisis
MAO: hypertensive crisis- where will pain be; where will HA be located; what will be stiff; what GI issues; what sun issues; what is HR; what is BP; what happens to pupils HA, chest; occipital; neck; N/V; photophobia; high; high; dilate
MAO: hypertensive crisis- what causes this tyrine effect in foods
TCA (tricyclics): they are named this for what reason; why are they given at night they are toxic when; why are they toxic in overdose; bc of their chemistry; b/c of drowsiness; in overdose; they increase the QT interval
TCA: what neurotransmitter do they block inadvertently; the blocking ofacetacholine causes what effects; increased QT interval can cause what acetacholine; anticholinergic effects; a seizure
serotonin syndrome: begins in minutes of what; what happens to consciousness; what are athe s/s of altered consciousness; do we sweat more or less; what happens to BP; what happens to muscles; a drug to drug interaction; it is altered; confusion, hallucinations, agitation, drowsiness; more; high; tremors, rigidity and hyperflexia;
serotonin syndrome: what is the tx; what is periactin; when can this occur; do we have a lab test to monitor for serotonin syndrome periactin; a %HT antagonist; when new serotonin med added or when dosage of said serotonin reuptake med is increased; no;
Action of Benzodiazepines: this depresses what; where does it depress the CNS; examples of these meds; dose should be started low or high; are they addictive the CNS; at the limbic system, reticular activating system cortex; Ativan. Xanax, ambien; low; yes
lithium: is this a natural or manmade element; this causes a shift in what levels; used to treat what; what needs to be monitored closely; what is theurapeutic range; WHAT IS toxic level natural; water and lytes; bipolar, depression, and sometimes schizo and suicidal idiations; the blood level ofdrug; 0.5-1.2; >1.5
EPS is seen with what antipsychotics normally typical antipsychotics
Typical antipsychotics: name them; chlorpromazine (thorazine), fluphenazine (prolixin), haloperidol (Haldol), thioridazine (mellaril)
Atypical antipsychotics: name them; gain of ___ often occur with these; olanzapine (zyprexa), risperidone (Risperdal), quetiapine (Seroquel), Geodon, abilify; weight
Atypical antipsychotics: what one is risky for elderly to take due to stroke; with what med should there cataract screening; what one is especially at risk for wt gain; what ones at risk for prolonged QT interval; what one causes HA, N; risperidone; seroqual; zyprexa; Geodon; abilify;
Atypical antipsychotics: what one can incite mania; what one can cause agranulocytosis; abilify; clozaril;
extrapyramidal side effects from antipsychotic meds: acute dystonia def; def of akathisia; painful and frightening to the client rapid onset; subjective feelings restlessness, tenseness, inability to sit still;
extrapyramidal side effects from antipsychotic meds: def akinesia; def of dyskinesia; masklike face, no swinging of the arms, hesitancy of speech, decreased muscle strength, shuffling gait; involuntary muscle activity shown by tics, spasms, tremor of face, arms, legs and neck
extrapyramidal side effects from antipsychotic meds: def dystonia; tardive dyskinesia; tongue protrusion, rigidity, complaints of feeling stiff; protrusion of tongue, chewing movement, puffing of cheecks, pelvic thrusting
milieu: aka; def; where does this take place; what is client expected to learn in a therapeutic community; community therapy; a scientific structuring of the environment to effect behavioral changes and to improve psychological health and functioning of the individual; in a therapeutic community; adaptive coping, interaction, and relationship skills
milieu: this adaptive coping can be generalized how in the pts life; we as staff need to emulate what; into other area of there life; positive coping mechanisms and life skills
milieu: every interaction is an opportunity for what; the client owns who's environment; the client owns who's behavior; inappropriate behavior are dealt with when; what is to be avoided therapeutic intervention; their own; their own; when they occur; restrictions and punishment
the psych team:the team's focus is on whom; who makes up the team; the pt; APN, therapist, nurse, phsyciatrist, psychologist, mental health worker;
cognitive therapy: if we can change those thinking ____ we can change into a more positive outlook; patterns;
cognitive therapy:_____ thoughts cause maladaptive behavior and emotional distress irrational
cognitive therapy: our goals are to assist individuals to identify what; dysfunctional patterns of thinking/behaving
physiological, cognitive and behavioral manis of relaxation: what are cognitive manis of stress; what can conteract these s/s of stress confusion, difficulty with concentration, problem solving and learning; relaxation
methods of achieving relaxation: deep breathing exercises- how is relaxation accomplished with this; air is breathed in through nose or mouth; after air is breathed in what is done; exhaled through mouth or nose; allowing the lungs to breath in as much o2 as possible; nose; breath is held for a few seconds; mouth
methods of achieving relaxation: deep breathing exercises- breathing exercises reduce what; what is an advantage of this type; anxiety, depression, irritability, muscular tension and fatigue; it can be accomplished anywhere
methods of achieving relaxation: physical exercise- this provides a natural outlet for the tension produced by the body in its state of ___; after exercise what is restored; physiological equilibrium causes one the feel what arousal/fight or flight; physiological equilibrium; relaxed and revitalized
behavior: when is a behavior considered maladaptive; ageinappropriate, interferes with adaptive functioning, is misunderstood by others in terms of cultural inappropriateness
operant conditioning: who created this; there is a connection between the ___ and response; the connection between the 2 is strengthened or weakened by what; psychologist BF skinner; stimulus and response; the consequences of the response- goof or bad;
operant conditioning: a stimulus that follows a behavior is called a what; reinforcer
operant conditioning: adversive stimulus or punisher def a stimulus that follows a behavioral response and decreases the probability that the behavior will recur
techniques for modifying client behavior: def time out; def modeling; def token; pt removed from environement where the unacceptable behavior is being exhibited; learning new behavior by imitating others; reinforcing desired behaviors by giving tokens, money
peplau's roles of the nurse: de mother surrogate; def technician; def manager; def socializing agent; def health teacher; bathing, feeding, dressing; procedure; milieu management; social activities; education;
the impact of preexisting conditions: both ___ and ___ bring certain preexisting conditions to the exchange that influence both the intended message and the way in which it is interpreted; sender and receiver;
the impact of preexisting conditions: why do values, attitudes and beliefs cause issues; why do culture and religion cause issues; attitudes of prejudice are expressed through negative sterotyping; cultural norms, ideas and customs provide the basis for ways of thinking
therapeutic nurse client relationship: def preinteraction phase; def orientation phase; def working phase; def termination phase gather data, prep; introduction, build report; plan; say when you will be back
therapeutic nurse client relationship: pre-interaction phase- obtain what info; examine are own what; ask staff what; determine anticipated what client info from medical record; fears, feelings, anxieties; questions; needs and approaches
therapeutic nurse client relationship: orientation phase- establish what; how establish trust; what contract should be established with this; assess what needs of the client; trust and rapport; introduce self and role, establish time frame; for intervention; psychological, physical, spiritual needs
therapeutic nurse client relationship: orientation phase- formulate ___ dx; establish mutual what; nursing dx; goals;
therapeutic nurse client relationship: working phase- maintain ____; use what model; identify bad ___; trust; problem solving model; behaviors;
therapeutic nurse client relationship: working phase- implement what; eval what nursing interventions; client outcomes
therapeutic nurse client relationship: termination phase- begins when; expected ___ are achieved; what plan is made; feelings regarding what are explored on the first meeting; outcomes; discharge plan; termination
transference: def; client experiences nurse as person from a past (mother, father, previous psychiatrist and significant other)
countertransference: def; this can interfere with what nurse responds to client with feelings from earlier conflicts or relationships; professional boundaries
professional boundaries: the focus of every interaction is on the needs of whom; what should never be discussed; listen how; the client; nurses personal information and experiences; nonjudgemental without advice;
examples of types of testing behaviours attempting a social relationship, askig personal questions, violating personal space, seeking attention from nurse, revealing information to shock nurse, inappropriate touch
interventions for testing behaviours focus on the client's needs, build trust, set consistent limits, respond assertively, assess the meaning of the behavior, seek team assistance;
def of a group a collection of individuals whose association is founded upon shared commonalities of interest, values, norms, purpose
functions of a group; socialization, support, task completion, camaraderie, informational, normative,empowerment, goverance;
def normative, def empowerment; def governance enforces values, norms; power that individuals alone do not have; rules made by a committee with in a larger organization
conditions influencing the group: how can seating arrangement affect the group; what should the size of the group be; not all clients are appropriate for all what; the nurse sits next to the client needing the most support; 6-8; groups
benefits of groups: what are they instillation of hope, mutual sharing, new information, feedback and exploration of conflict, socialization- I am not along, try on new behaviors, cohesiveness/sense of belonging, less costly than individual therapy
roles of nurse in group: def compromiser; def encourager; def follower; def coordinator; def initiator minimize conflict; positive influence; interested audience; leader; begin group discussion
roles of nurse in group: def evaluator; def rule maker; def harmanizer; def questioner; def gatekeeper; assess performance; set standards; make peace; clarify; group acceptance of members
what are the roles of group members; aggressor, blocker, dominator, monopolize, seducer, attention seeker, silent member
individualized teaching: this is based on what; should be at who's level of understanding; addresses what; client's needs; clients; psychiatric needs;
client has the legal right to know what; meds and tx;
therapeutic nurse-client relationship: goals are achieved by what; promote discussion of what; discuss aspects that cannot realistically be changed and ways to what; through problem-solving model; desired changes; cope;
communication: def interpersonal communication; in interpersonal communication who participates; a transaction between the sender and receivers; both the sender and receiver;
communication- it should be what; focus on what; be specific or general descriptive, not evaluative; modifiable behavior; specific
how to listen actively face the client, open posture, lean slightly forward, establish eye contact, relax
Created by: jmkettel