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PSYC Test 2

Crisis Intervention / Ethical / Sexual Assault

Sudden event in one's life which disturbs homeostasis, in which one's usual coping skills are compromised crisis
3 types of crisis maturational / situational / adventitious
loss of job, death of loved one, abortion, severe mental/physical illness is example of? situational crisis (usually anticipated)
overwhelming perception of event; usually resolved in 4-6wks; strugg for equalibirium crisis
unplanned, crisis of disaster, accidental(flood, rape, fire, assault, murder) adventitious crisis
interruption in stage of growth/development(midlife crisis) maturational crisis
3 short term meds used for crisis antidepressants, sedatives/hypnotics, benzodiazepines (antianxiety)
4 Phases of crisis Phase 1 = exposure to stressor, Phase 2 = trial & error, Phase 3 = fight/fligt (anxiety increases to severe/panic level) Phase 4 = Breaking point (depression, suicide, confusion, personality disorganization)
3 Counseling Strategies Primary (client education), Secondary (crisis intervention), Tertiary (rehab)
2 main goals of crisis intervention client safety & decrease anxiety
True/False ? = Person in crisis, assumed to be mentally health & has functioned well in past, just presently in state of disequalibirum TRUE
4 important factors in assessment of client safety, perception of event, support system, coping skills
Provide safety, assess problem, crisis intervention is what type of counseling strategy Secondary
teach coping skills, assist client in making life changes, educate client is what type of counseling strategy primary
CISD, Rehab, shelters, promoting optimal level of functioning is what type of crisis intervention? tertiary
Used to debrief staff, schoolchildren, rescue/healthcare workers after tragic event CISD (critical incident stress debriefing)
Consists of 7 phase group meeting in safe controlled environment Critical incident stress debriefing (CISD)
Crisis can lead to what 3 things? Personality disorder, Dissociative disorder, depression
Any type of sexual activity that victim doesnt want/agree to Sexual Assault
Ex: RAPE, but can be over phone/internet, Can be inappropriate touching / intercourse Sexual assault
CRIME of violence, aggression, anger & power. Weapon used is SEX. Nonconsensual. Person usually KNOWN (69%) Rape
Occurs in 1 in 6 women.Most people suffer: LONG TERM & SEVERE emotional TRAUMA Rape
4 date rape drugs GSB, Rohypnol, Ketamine, Burundanga
Most common/least common rapes? What do each experience? Most common = marital/date rape - EXPERIENCE: depression & sexual distressLease Common = stranger - EXPERIENCE: depression, fear & anxiety
Similiar to PTSD. Contains an: Acute phase & Long-term reorganization phase Rape-Trauma Syndrome
Occurs immediately & LASTS up to 2wks after rape. Emotions are EXPRESSED (crying, laughing) or CONTROLLED (confusion, numb) ACUTE phase of Rape-Trauma Syndrome
What phase of crisis does feelings of helplessness occur (since coping skills failed)? Also experience confusion & disorganization Phase 2 (Trial & Error)
Deals w/persons present problem & resolution of IMMEDIATE crisis only; Nurse takes ACTIVE, DIRECT role Crisis intervention
lessens time person is mentally disabled DURING a crisis: (counseling strat) Secondary Care
promotes mental health & reduces mental illness (counseling) primary care
support 4 those RECOVERING from disabling mental state tertiary care
Occurs 2 or more wks after RapeConsists of: Intrusive thoughts, increased motor activity, increase motional liability, fear & phobias Long-Term Reorganizational phase of Rape-Trauma syndrome
Increased motor activity is ? (Long-Term Reorganization) moving, changing phone#'s, contacting old friends
Increased motional liability would be? crying, mood swings, depression, intense anxiety
intrusive thoughts are? nightmares, flashbacks, insomnia, re-experiencing event
fears & phobias associated w/long-term reorganization is: fear of outside/inside, fear of being alone/in crowds, fear of males, avoidance of significant others, fear of sexual encounters
True/False : Rape is usually NOT impulsive act, most are PLANNED & over 50% involve a weapon True
situation that requires choice between morally conflicting alternatives Ethical Dilemma
known to every society & most members of society comform to these norms Social Norm
3 Methods of changing human behavior Behavior Modification Tech / psychotherapy / psychotropic drugs
values related to human conduct; Right/wrong of actions or Good/Bad of motives Ethics
Ethical conecpts w/in scope of nursing, medicine & allied health Bioethics
5 principles of Bioethics Autonomy / Beneficence / Fidelity / Justice / Veracity
Principles of Bioethics: 1. Treat everyone the same(fair & equal)2. (Nonmaleficence) Do NOT harm (loyal)3. Always tell the TRUTH 1. Justice2. Fidelity3. Veracity
Bioethic Principles: 1. Act on others BEHALF2. RESPECT client decisions 1. Beneficence2. Autonomy
PERSONAL beliefs Values
process of SELF discovery where PERSONAL values & value ranking are identified Values Clarification
what a person is entitled to have, do or recieve from others w/in limits of the law Rights
Nice to know, but do NOT override lawCan influence lawsApproved by ANA Code of Ethics
2 TYPES of Law Statutory & Common
Type of law enacted by legislative body (Nurse Practice Act) Statutory
Type of law that applies to body of principles that eveolve from court decisions made in previous cases Common Law
2 CLASSIFICATIONS of Law Criminal & Civil
addresses PUBLIC WELFARE. Violations are punisahable by imprisonment, loss of license Criminal Law
Injury to patient or Felonies such as: selling narcotics, abuse, theft are example of what classification of law? Criminal Law
addresses reckless conduct of an individual/organization. Violations = monetary compensations Civil Law
Civil wrong for which money damages may be collected by injured party(plaintiff) from wrongdoer(defendant) Tort
Assault, battery, false imprisonment, slander(oral) & liable(written) are what kind of tort? Intentional Tort
Negligence & Malpractice are what kinds of tort? Unintential Torts
Less expensive than hospital & less restrictive threatment setting Outpatient treatment
6 Clients Rights Consent, Communication, Confidentiality, Dignity/Respect, Freedom from Harm, Participation in Plan of Care
Required for specific therapies/treatment (Client Rights) Consent
clients Right to communicate privately w/outside visitors, phone, mail Communication
Clients right to unnecessary physical restraint; isolation, meds, abuse, neglect Freedom from Harm
Clients right that is ethically important but also LEGALLY protected Dignity/Respect
Clients right to share w/only those who have need & right to know Confidentiality
Clients right to be involved in treatment plan participation in Plan of Care
procedure used to challenge unlawful detention by gov; "Free the Person" Writ of Habeas Corpus
Admission sought by client/guardian Voluntary admission
Admission made without clients consent; Client is danger to self/others, client can NOT meed own basic needs Involuntary Admission (Committment)
True/False: Client is NOT capable of consenting to treatment if he is INVOLUNTARLY Admitted FALSE
True/False: With Involuntary admission, requires client retain freedom from unreasonable bodily restraints, rights to refuse meds(including psychotropic & antipsychotic meds) TRUE
3 types of involuntary admission (committment) emergency / temporary / long-term
(Committment) 1-10 daysPrevent dangerous behavior to self/othersAuthorized by police, dr., mental health professional EMERGENCY involuntary committment:
Admission that is longer than 1-10 daysObserve, diagnose, treat person w/mental illnessREQUIRES medical certification by 2 or more drs that person is mentally ill & in need of treatment TEMPORARY (Observational) Involuntary Admission
Admission that lasts 60-180 days (extended care) Committed through court action or medical certification. Still considered competent LONG-TERM (Formal) Involuntary Committment
Preventative measure, allowing court order before onset of a PSYC crisis that would RESULT in an inpatient committment Involuntary OUTPATIENT Commitment
Tied to disability, welfare, housing that says must participate in treatment to avoid inpatient admission & to USE SERVICES Involuntary Outpatient Committment
Requires outpatient treatment for a SPECIFIC time to determine compliance w/ MEDS, ADL"S, & ABILITY TO REINTEGRATE INTO COMMUNITY Conditional Release
UNCONDITIONAL release / termination of client-institution relationship (may be court ordered) Discharge
Requires that medical/pysc care & treatment be provided to ALL persons admitted to public hospital RIGHT to TREATMENT
3 Criterias for "Right To Treatment" 1. Environment must be humane2. Staff must be qualified/sufficient to provide adequate treatment3. Plan of Care must be INDIVIDUALIZED
True/False: "Right to Refuse Treatment" allows client to withdraw consent @ any time & the right to refuse psychotropic drugs TRUE
What client right is being informed of their condition, treatment, risks, benefits, alternatives Right to Informed Consent
Based on persons "Right to Self Determination" Right to Informed Consent
Intervention for the following:behavior is harmful to self/othersAlternative/less restrictive measures are insufficientDecrease in overstimulation is needClient anticipates that controlled environment would be best Restraints / Seclusion
Requires drs written orders, with specific time periods, condition reviewed every 15min, Restraints / Seclusion
When can a nurse use seclusion/restraints WITHOUT a drs orders only in an EMERGENCY (risk of harm to self/others)
Legal duty to maintain patient confdentiality is acting to protect clients Right to Privacy
Do not release info to clients employerDo not release even after persons deathHIV does not give reason to disclose info ALL are an example of Patient Confidentiality
Voluntary act performed w/intent to bring about physical consequence Intentional tort
Ex: Left suicidal client alone w/knife or open window Intentional tort
No PHYSICAL contact, THREAT to use forceEx: Come here or I will give u this injection Assault
Harmful/Offensive TOUCHING of another person"Injecting meds w/out consent" Battery
Act w/intent to confine a person to a specific area False Imprisonment
Recoverable by an injured party in an intentional tort action Punitive damages
act that BREACHES DUTY of DUE CARE & results in or reponsible for persons injuries Negligence
Conduct that EXPOSES client to UNREASONABLE risk of arm through acts of a nurse Breach of Duty
Focus is to eleviate practice of its members by setting standards of excellence Professional Standards of Practice
Created by: dbrust