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Mental Health
Module 3 & 4 - Introduction to the Psychiatric Care Environment
| Question | Answer |
|---|---|
| 7 principles of mental health | Develop mutual trust, explore behaviors & emotions, encourage responsibility, encourage effective adaptation, & provide consistency |
| What are coping mechanisms? | Resources used to decrease discomforts of stress |
| Psychomotor, cognitive, and affective | Coping mechanisms |
| Efforts to cope directly with the problem; hitting, fighting, confrontation | Psychomotor (physical) |
| Efforts to neutralized by changing meaning of problem | Cognitive (intellectual) |
| Actions taken to reduce emotional stress; no efforts are made to solve the problem; ego defense mechanisms such as denial and suppression | Affective (emotional) |
| Multi-category guide used to aid physicians with mental health diagnosis | DSM-IV |
| Assessment, Diagnosis, Planning, Intervention, Evaluation | Nursing Process |
| Includes information about both the physical and psychological functions of an individual | Health history |
| Age, Gender, Ethnicity, Belief system, Income, Education | Sociocultural assessment areas |
| Unresponsive emotions | Flat effect |
| Excessive feelings of well being | Euphoria |
| Motor restlessness, often seen with anxiety | Agitation |
| Having both positive and negative feelings | Ambivalence |
| Perceptions that have no external stimulus; someone hears a voice that no one else hears | Hallucinations |
| Alterations in perceptions that have a basis in reality; external stimuli are present, but the client perceives them differently (client perceives person that is walking down the hall as a wolf) | Illusions |
| Rapid changes from one thought to another unrelated thought | Flight of ideas |
| False beliefs that cannot be correct by reasoning or explanation | Delusions |
| Strong fears of certain things, places, or situations | Phobias |
| Includes events that occurred within the last 2 weeks; Alzheimer's, anxiety, and depression are diseases that may contribute to loss | Recent memory |
| Involves not being able to recall birth place, schools attended, ages of family members, and background; long term loss is seen in patients with organic physical problems such as conversion & dissociative disorders | Remote memory |
| Takes place within oneself and are commonly referred to as our "self-talk" or "self-dialogue"; conversations we have with ourselves when solving problems, making plans, and reacting emotionally | Intrapersonal communications |
| Listening, open ended questions, restating, focusing, reflection, and silence | Therapeutic Communication Techniques |
| Failure to listen, parroting, and giving advice | Non-therapeutic techniques |
| Client repeats last word heard | Echolalia |
| Being aware of clients circumstances, don't be judgmental; be empathetic | Therapeutic relationship |
| Trust, Empathy, Autonomy, Caring, Hope | Components of the therapeutic relationship |
| Risk taking process whereby an individual's situation depends on the future behavior of another person | Trust |
| The ability to recognize and share emotions of another person without actually experiencing them | Empathy |
| Ability to direct and control one's activities or destiny | Autonomy |
| The energy that allows caregivers to unconditionally accept all people, even when they are most unlovable | Caring |
| Multidimensional dynamic life force characterized by confident yet uncertain expectation of achieving a future good | Hope |
| Acceptance, Rapport, Genuineness | Characteristics of a therapeutic relationship |
| What are the phases of therapeutic relationship? | Preparation, Orientation, Working, and Termination |
| Gather all data or information; may review past medical records, current records, interactions with others in clients life, and looks for recurring patterns of behavior to develop a picture of the client | Preparation phase |
| Develop mutual trust; establishes caregiver as significant in life of client | Orientation phase |
| Identify and address client's problem(s) | Working phase |
| Assist client to review what was learned and transfer this learning to interactions with others | Termination phase |
| Client may stop taking medications because of distressing side effects; others simply feel that they do not need their medications; whatever the reason, caregivers are in excellent position to monitor and encourage | Non-compliance |
| Client's emotional response, based on earlier relationships. Ex: client had a bad experience with a previous nurse, therefore client treats current nurse poorly | Transference |
| Barrier in the therapeutic relationship based on the caregivers inappropriate emotional response. Ex: problems at home trickle into the care of the client and takes it out on the client | Countertransference |
| Persons behavior becomes a threat to safety of self/others; People within the environment are not able/willing to support the mentally troubled person; person perceives him/herself as unable to cope or maintain behavioral control | Criteria for inpatient admission |
| Becomes a way of life for many chronically mentally troubled individual; revolving door syndrome | Recidivism |
| Physical properties of an environment have an effect on clients | Physical surroundings |
| Can agitate or hyper-activate an individual | Environment temperature and humidity |
| Can trigger delusions or hallucinations | Flickering lights |
| Can result in overstimulation and aggressive behaviors | Bright lights |
| Can present inaccurate stimuli, resulting in misperceptions of actual objects | Lighting too low |
| Can have a calming or agitating effect on clients | Environmental noise |
| Active process of receiving information and examining reactions to messages received; "Maintaining eye contact and receptive nonverbal communication | Listening |
| Encouraging client to select topics for discussion; "What are you thinking about?" | Broad openings/Open ended questions |
| Repeating main thought expressed by client; "you say that your mother left when you were 5 years old?" | Restating |
| Attempting to put into words vague ideas or unclear thought of client; asking client to explain what he/she means; "I'm not sure what you mean. Could you tell me about that again" | Clarification |
| Directing back client's ideas, feelings, questions, and content; "You're feeling tense and anxious, and it's related to a conversation you had with our husband last night?" | Reflection |
| Lack of verbal communication for therapeutic reason; Sitting with client and nonverbally communicating interest and involvement | Silence |
| The foundation of therapeutic relationships | Trust |
| Who defines professional boundaries | Caregiver; must be balanced because one cannot focus on the client and the self at the same time |
| Provides information regarding a client's physical state and the need for medication | Physician |
| Assesses the client's family, work, and social interactions | Social worker |
| Learns about the client's nutritional status | Dietitian |
| Explore the client's emotional and cognitive (intellectual) functioning | Psychiatrist and Psychologist |
| Assesses how the illness or disability affects the client's activities of daily living | Nurse |
| Contribute information through their observations and interactions with the client | Other care providers |
| Tool that is used to facilitate diagnosis and guide clinical practice | DSM-IV |
| Uses the DSM-IV to make mental health diagnoses | Physician |
| Assessment, Diagnosis, Planning, Interventions, Evaluation | Nursing (therapeutic) Process |
| Is continual and involves interviewing client & family members, reviewing charts and lab values | Assessment |
| Data sorted into related areas, and problems are identified (Priority problems first, such as ABC's) | Diagnosis |
| "Expected outcomes" then are used to monitor the clients progress (coping may occur in harmful, unsafe ways) | Planning |
| Planned actions are implemented; medications, leading group therapy | Interventions |
| Effectiveness of care is determined; ex: patient with major social phobia went grocery shopping and bought groceries | Evaluation |
| Concentrates on the cultural, social, and spiritual aspects of an individual | Sociocultural assessment |
| Six areas of sociocultural assessment | Age, Gender, Ethnicity, Belief system, Income, Education |
| What is assessed in health history? | General appearance, speech, motor activity, and behavior during the interaction |
| The part of consciousness that perceives, sorts, and combines information | Sensorium and cognition (upper level thinking) |
| What nursing interventions are used to help with memory | Calendars and clocks |
| Immediate memory | Having client repeat three words that have relation to one another |
| What are clients with a clear sensorium oriented to? | Time, place, and person |
| Messages sent and received without the use of words | Non-verbal communication |
| How is nonverbal communication expressed? | Appearance, body motions, use of space, and non-language sounds |
| Concentrating on the speaker, listening objectively, making sure nonverbal messages match verbal messages, following up, and clarifying | Therapeutic listening skills |
| What must you do in order to communicate effectively with mentally and emotionally troubled clients? | Realize that every interaction is part of the total therapeutic process, climate of trust and respect must be established, and clients need a routine |
| According to Maslow, what needs must be met before higher levels can met? | Physiological needs |
| Clients who follow prescribed treatments | In compliance |
| What percentage of patients do not comply with their prescribed therapeutic course? | Forty to eighty |
Created by:
tandkhopkins
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