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Mental Health

Module 1 & 2: Introduction to Psychiatric Care

The ability to "cope with and adjust to the recurrent stresses of living in a acceptable way" Mental health
Inherited characteristics, childhood nurturing, life circumstances Factors that influence mental health
The severity of client's illness, the level of dysfunction, suitability of the setting for treatment, level of cooperation, client's ability to pay for services Factors that determine inpatient care
Facility that provides services to people with mental problems within their home environments; clients are able to remain within their communities, associating with the real world Outpatient care
Delivers foods to individuals in their homes Meals on wheels
Food and clothing that is made available to women based on income eligibility WIC - Women, Infants, and Children
Purpose is to stabilize the client and assist with crisis, refer to appropriate community resources Emergency Department (ED)
Offers a protected, supervised environment within the community Residential Programs (group homes)
Providing the client with the information to make certain decisions Advocacy
How does advocate help client's? Protects client's rights, helps clarify expectations, provides support, and acts on behalf of the client's best interest
Evaluates families; studies environmental and social causes of illness; conducts family therapy and admits new clients Psychiatric social worker
Has an advanced degree, specialized training in art therapy; encourages members to analyze artwork, adjunct to the care team in diagnosis and treatment of children Expressive therapist
Has an advanced degree, specialized training in recreational therapy; uses pet therapy, psychodrama, poetry and music therapy Recreational therapist
What populations are at high risk for developing mental health problems? Substance abuse, homeless, elderly, families, adolescence & children, rural residents, people with HIV, have suicidal thoughts, people with anxiety, depression or panic disorders
The right of people to act for themselves and make personal choices, including refusal of treatment Autonomy
Obligation to keep your word; client relies on you and your credibility grows or diminishes depending on how well you keep your promises; Do what you say, or don't say it Fidelity
Any act that threatens a client; no physical contact need occur, just a threatening action Assault
When touching occurs without the client's permission; make sure the client understands what you are going to do before you do it Battery
Taking photographs without consent of client Invasion of privacy
Detaining a competent person against his or her will; both physical and verbal intimidation are included False imprisonment
The omission (or commission) of an act that a reasonable and prudent person would (or would not) do Negligence
Failure to exercise an accepted degree of professional skill that results in injury, loss, or damage Malpractice
An agreement between the client and caregiver that documents knowledge of and agreement of treatment Informed consent
When a client originates the request for mental health services Voluntary admission
Process for institutionalization initiated by someone other than the client (physicians, police, and representatives of a county administrator may commit an individual for emergency treatment without a warrant) Involuntary admission
What is the legal framework for practice in the state? Professional Nurse practice act
Developed by specific health care discipline. Set of guidelines that provide measurable criteria for nurses, clients, and others to evaluate the quality & effectiveness of the nursing care provided Standards of practice
In situations where serious harm or death may occur, mental health professionals have a specific duty to protect potential victims from possible harm; what is this duty? Duty to warn
Learned pattern of behavior that shapes out thinking and serves as the basis for social, religious, and family structure Culture
An oversimplified mental picture of a cultural group; may take negative, positive, or traditional form Stereotype
Set of assumptions, values, beliefs, attitudes, and behaviors of a group. Members predict one another's actions and react accordingly Shared
Although culture defines the dominant values; beliefs, and behaviors, it does not determine al the behaviors in any group Individual behavior
Use of ______, how ________ is perceived and received; form of non-verbal communication Touch
Area that surrounds the client - an invisible "bubble" that travels with a person Space
Area the client needs to gain control over to claim for themselves Territory
The concept of __________ is rooted in a cultures basic orientation; Problems with __________ may be based in the client's cultural orientation or psychiatric illness. Time
Attempt to overcome feelings of inferiority or make up for deficiency Compensation
Refusal to acknowledge conflict and thus escapes reality of situation Denial
Putting of one's own unacceptable thoughts, wishes, emotions onto others Projection
Use of a "good" (but not real) reason to explain behavior to make unacceptable motivation more acceptable Rationalization
Coping with present conflict or stress by returning to earlier more secure stage of life Regression
Unconscious channeling of unacceptable behaviors into constructive, more socially approved areas Sublimation
Removal of conflict by removing anxiety from consciousness Suppression
Sensorimotor, preoperational, concrete operations, and formal operations Piaget's developmental stages
Trust/Mistrust Infancy (Birth to 1 yr)
Autonomy/Shame & Doubt Early childhood (1-3 yr)
Initiative/Guilt Preschool (3-6 yr)
Industry/Inferiority School age (6-12 yr)
Identity/Diffusion Adolescence (12-18 yr)
Intimacy/Isolation Young Adult (18-25 yr)
Generativity/Stagnation Middle Adulthood (25-65 yr)
Integrity/Despair Maturity (65-death)
Established human needs into a hierarchy Maslow
Breathing, food, water, sex, sleep, homeostasis, excretion Physiological
Security of body, of employment, of resources, of morality, of the family, of health, of property Safety
Friendship, family sexual intimacy Love/Belonging
Self-esteem, confidence, achievement, respect of others, respect by others Esteem
Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts Self-actualization
Mainstream of health care practices in the modern world is based on methods of treatment; Practitioners use medical and surgical methods to treat disease and injury by finding what's wrong and fixing it. (includes medications) Allopathic Medicine
Includes practices and treatments that agree or "work with" allopathic therapies Complimentary Medicine
Practices and treatments that are used instead of conventional (allopathic) medicine Alternative Medicine
Manipulation of muscles and connective tissue to relax the body and enhance well-being Massage
Music and sound therapy have successfully been used to treat stress, depression, grief, schizophrenia and autism Expressive therapy
Why are animal-assistive therapies used? They are consistent and non-judgmental. They are always accepting and help ease loneliness. Work with animals has been found to promote socialization, increase empathy, encourage responsibility and commitment, and foster communication
What helps us to avoid the negative effects of stress? Learning to control the body's flight or fight response
How do we control the body's flight or fight response? Progressive relaxation, guided imagery and creative visualization; these can benefit the client as they don't interfere with other allopathic methods of treatment
Medications that act on the body's nervous system by altering the delicate chemical balances within that system Psychotherapeutic drugs
Adrenergic - prepares body for fight or flight, HR & output increases, vessels in stomach constrict, pupils will dilate, bronchioles in lungs expand, increase in blood sugar & fatty acids for fuel, digestive & excretory processes are slowed Sympathetic Nervous System
Cholinergic - used to conserve energy and provide balance; HR slows, decrease in circulating blood volume, sphincters relax, intestinal and glandular activity increases Parasympathetic Nervous System
What are four classes of psychotherapeutic drugs? Mood stabilizers, anxiety agents, antidepressants, antipsychotics
Common to all persons but if it interferes with out ability to function, it becomes a disorder Anxiety
Another name for antianxiety agents Anxiolytics or "minor tranquilizers"
Ativan, Valium, Librium Benzodiazepines - oldest anxiolytic, fast acting but potential for dependency and withdrawal symptoms if stopped abruptly
Azaspirones Used for anxiety (anxiolytic)
Can take typically 1-4 weeks before relief is noticed. However, side effects may be experienced soon after starting therapy. Any signs of toxicity (headaches, stiff neck, palpitations) should be reported to physician immediately Antidepressants
Are often NOT used due to serious adverse reactions and interactions with food and drugs and strong dietary restrictions MOAI's - Monoamine Oxidase Inhibitors
What medications do you avoid if you are taking a MOAI? Other MOAIs and tricyclic antidepressants which may cause hyperpyrexia, severe convulsions, hypertensive crisis and death
Aged cheeses, avocados, bananas, beer, liver, red wine Foods to avoid when taking MOAI's
Drug currently being used to treat anxiety disorders, seizures and neuropathic pain Lyrica
Anti-cholinergic side effects of antidepressants Dry mouth, nose, eyes, urinary retention, sedation, blurred vision, and excessive sweating
Lithium Anti-manic; maintain balanced diet, liquid, and salt intake (DON'T use salt substitute) S/E: fine hand tremor, increased thirst & urination, nausea, anorexia, diarrhea/constipation
What can cause severe CNS depression when mixed with antipsychotics? Alcohol, antianxiety, antihistamines, antidepressants, barbiturates (Demerol and Morphine)
When can antacids be given when taking antipsychotics? 2 hours after taking medication
Vomiting, extreme hand tremor, sedation, muscle weakness, and dizziness S/S of possible lithium toxicity
0.6-1.2 mE/qL initially 0.8-1 mE/qL long term use Therapeutic levels for lithium
Why does a patient taking lithium have to watch sodium intake? Lithium and sodium compete for elimination from kidneys; increase in salt increases lithium elimination; decrease in salt decreases lithium elimination
What happens when lithium levels are too high? Uncomfortable & possible life threatening toxicity
What happens when lithium levels are too low? Manic behaviors return
How do you instruct a patient to take lithium? Must take medication on regular basis at same time daily; if they miss a dose, they must wait until the next scheduled time to take medication
Thorazine, Haldol, Zyprexa, Seroquel, Risperdal Antipsychotics; s/e: pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia, drowsiness, headache, blurred vision
Inability to sit still, pacing etc. Akathisia
Irreversible side effect of long-term treatment that produces involuntary repeated muscle movements in the face, trunk, and extremities (arms and legs) Tardive dyskinesia
Serious and potentially fatal side effect with unstable vital signs, fever, confusion, muscle rigidity, tremor, incontinence Neuroleptic malignant syndrome (NMS)
Assess clients, coordinate care, administer medications, monitor & evaluate client responses, teach clients about their medications Nurses responsibilities relating to psychotherapeutic drug administration
Created by: tandkhopkins
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