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holistic man
nurs 211 (psychoanalytical theories)
| Question | Answer |
|---|---|
| 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
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