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Mental Health

Test 1

Who believed that a person's dreams reflect his or her subconscious and have significant meaning, although sometimes the means are hidden or symbolic. Freud
What is Dream analysis ? Primary technique in the used in psychoanalysis that involved discussing a clients dreams to discover their true meaning and significance.
When a therapist tries to uncover the clients true thoughts and feelings by saying a word or asking the client to respond quickly with the first thing that comes to mind. Free association
What are two way to attempt to gain access to a person subconscious? Free association and Dream analysis
What are the four levels of anxiety? Mid, Moderate, Sever and Panic
Who described the 4 levels of anxiety? Hildegard Paplau
This level of anxiety is a positive of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems. The person can take in all available stimuli Mild anxiety
This type of anxiety involves a decreased perceptual field (focus on immediate task only): the person can learn new behaviors or solve problems only with assistance. Another person can redirect the person to the task. Moderate Anxiety
This type of anxiety involves a feeling of dread or terror. The person cannot be redirected to a task. he or she focuses only on scattered details and has physiological symptoms of tachycardia, diaphoresis and chest pain. Sever Anxiety
T or F - A person with sever anxiety may go to the emergency room thinking they are having a heart attack. True
This type of anxiety involves the loss of rational thought, delusions, hallucinations and complete physical immobility and muteness. Person may bolt or run aimlessly, often exposing oneself to injury. Panic Anxiety
This focuses on the immediate thought process. Cognitive theory
Who is credited with with pioneering cognitive therapy in person with depression? Aaron Beck
All _______ _______have the goal of helping the person discover an authentic sense of self. They emphasize personal responsibly for ones self, felling behaviors and choices. existential theories
What are the parts of Freud's conceptual personality structure Id, ego and superego
What is the ID of Freud's conceptual personality structure Part of ones nature that reflects basic or innate sexual impulses. Seeks instant gratification that causes impulsive unthinking behaviors and has no regard for rules of social conventions
What is the Ego of Freud's conceptual personality structure the balancing and mediating force between the id and the superego. Represents mature and adaptive behaviors that allows a person to function successfully in the world
What is the Supego of Freud's conceptual personality structure part of a persons nature that reflects moral and ethical concepts, values, parental and social expectations. In direct opposition to the ID.
What are the 5 roles of nurses in the therapeutic relationship? (6) stranger, resource person, teacher, leader, surrogate and counselor.
Who wrote about the roles of nurses in the therapeutic relationship? Hildegard Paplau
nurses in the therapeutic relationship - offering the client the same acceptance and courtesy that nurse would any stranger. Stranger
nurses in the therapeutic relationship - helping the client learn formally or informally teacher
nurses in the therapeutic relationship - offering direction to the client. Leader
nurses in the therapeutic relationship - serving as a substitute for another such as a parent or sibling. Surrogate
nurses in the therapeutic relationship - promoting experiences leading to health for the client such as expression of feeling Counselor
This involves providing services to people with severe and persistent mental illness to help them live in the community Psychiatric rehabilitation
_____________ __________ focuses on the clients strengths , not just on his or her illness. The client actively participates in program planning Psychiatric rehabilitation
T or F - Psychiatric rehabilitation does not include helping with activities of daily living, socialization or education and hospital care about a persons illness. F - Psychiatric rehabilitation does these things.
These programs are designed to help client manage illness and symptoms, gain access to need services and live successfully in the community Psychiatric rehabilitation
This is a turning point in an individual's life hat produces an overwhelming emotional response. Crisis
What type of crisis - predicable events in the normal course of life, such as leaving home for the first time, getting married , having a baby or beginning a career Maturation crises
What type of crisis - unanticipated or sudden event that threaten the individual 's integrity (death of a loved one, loss of job, or illness situational crises
What type of crisis - includes natural disasters like floods, earthquakes or hurricanes: war, terrorist attacks, riots, rape or murder Adventitious crises
What are the 3 factors that influence whether or not an individual experiences a crisis 1. individuals perceptions of the event 2. availability of emotional supports 3. availability of adequate coping mechanisms
How long does a crises event usually last? What are the 3 possible outcomes 4 to 6 weeks - futioning at the same level or a higher level - positive - or functioning at a lower level - negative
What are social/cultural factors influencing mental health? - lack of resources - violence -homelessness - poverty - unwarranted negative view of the world - discrimination (stigma, racism, classism, agism and sexism)
What are the two types psychotherapy groups? how are they different Open - ongoing and run indefinitely, allowing members to join or leave the group as needed. Closed - structured to keep the same members in the group for a specified number of sessions.
T or F - In open groups if a persons wants to leave the members decide how to handle members who wish to leave the group and the possible addition of new group members. F - this is in closed groups
What are supports groups? Support groups are organized to help members who share a common problem to cope with it. The group leader explores members’ thoughts and feelings and creates an atmosphere of acceptance so that members feel comfortable expressing themselves.
T or F - Support groups often provide a safe place for group members to express their feelings of frustration, boredom, or unhappiness and also to discuss common problems and potential solutions. True
What is one way support group differ from psychotherapy groups? Rules for support groups differ from those in psychotherapy in that members are allowed—in fact, encouraged—to contact one another and socialize outside the sessions.
What is the goal of a psychotherapy group? For members to learn about their behavior and to make positive changes in their behavior by interacting and communicating with others as a member of a group. Groups may be organized around a specific medical diagnosis or a particular issue,
What type of group has the goal to provide information to members on a specific issue—for instance, stress management, medication management, or assertiveness training Education group
Who developed client-centered therapy in which the therapist plays a supportive role, demonstrating unconditional positive regard, genuineness, and empathetic understanding to the client Carl Rodgers
a humanistic American psychologist who focused on the therapeutic relationship and developed a new method of client centered therapy. This person was one of the first to use the term client rather than patient. Carl Rodgers
This focuses on the role of the client, rather than the therapist, as the key to the healing process. Client-centered therapy - developed by Carl Rodgers
What person focused on social and psychological development in the life stages. This was an extension off of Fruad's work of personality development across the life span but focused on social and psychological development in the life stages Erik Erikson
In Erikson's theory a person must complete a life task that is essential to his or her well-being and mental health. These tasks allow the person to achieve life’s virtues. What are the virtues? hope, purpose, fidelity, love, caring, and wisdom.
What stage of Eriksons stages of psychosocial development - Viewing the world as safe and reliable; relationships as nurturing, stable, and dependable Trust vs mistrust
What stage of Eriksons stages of psychosocial development - Achieving a sense of control and free will Autonomy vs shame and doubt
What stage of Eriksons stages of psychosocial development - Beginning development of a conscience; learning to manage conflictand anxiety Initiative vs. guilt
What stage of Eriksons stages of psychosocial development - Emerging confidence in own abilities; taking pleasure in accomplishments Industry vs inferiority
What stage of Eriksons stages of psychosocial development - Formulating a sense of self and belonging Identity vs. role confusion
What stage of Eriksons stages of psychosocial development - Forming adult, loving relationships and meaningful attachments to others Intimacy vs. isolation
What stage of Eriksons stages of psychosocial development - Being creative and productive; establishing the next generation Generativity vs. stagnation
What stage of Eriksons stages of psychosocial development -Accepting responsibility for one’s self and life Ego integrity vs. despair
Laboratory experiments with dogs provided the basis for the development of _____ __________ theory of classical conditioning. Ivan Pavlov’s
What is Ivan Pavlov’s classical conditioning? positive behavior
______________theorists believe that behavioral deviations result when a person is out of touch with himself or herself or the environment Existential
What is Logotherapy? A therapy designed to help individuals assume personal responsibility (the search for meaning (logos) in life is a central theme)
Counselors and therapists who work with clients in spirituality and grief counseling often use the concepts that ______developed Frankl
Give an example of a primary prevention. stress management education
Give an example of a secondary prevention early identification of potential mental health problems
Give an example of a tertiary prevention monitoring and coordinating rehabilitation services for the mentally ill.
___________ __________ may practice therapy and often have the primary responsibility for working with families, community support, and referral. Social workers
___________ ________ focuses on the functional abilities of the client and ways to improve client functioning, such as working with arts and crafts and focusing on psychomotor skills. Occupational therapy
The primary function of the psychiatrist is what? diagnosis of mental disorders and prescription of medical treatments
______ ______ includes determining clients’ interests and abilities and matching them with vocational choices. Clients are also assisted in job-seeking and job-retention skills as well as in pursuit of further education, if that is needed and desired. Vocational rehabilitation
What are the signs of Lithium Toxicity? - sever diarrhea - vomiting - drowsiness - muscle weakness - lack of coordination
What can happen if lithium is continued with signs of lithium toxicity? Untreated, the symptoms worsen and can lead to renal failure, coma, and death
controls complex movements, motivation, cognition, regulation of emotional response Dopamine
changes in attention, learning, memory, sleep, wakefulness, mood regulation Norepinephrine
causes flight-or-fight response Epinephrine
an excitatory amino acid that can have major neurotoxic effects at high levels Glutamate
controls food intake, sleep, wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions Serotonin
affects sleep-and-wakefulness cycle; signals muscles to become alert Acetylcholine
modulation of other neurotransmitters GABA
neuromodulator that is involved in peripheral allergic responses such as gastric secretions, cardiac stimulation, and alertness. Histamine
Chemical substances to facilitate neurotransmission Neurotrasmitters
What type of drug and what is it used for? Blocks Dopamine receptors Antisychotic (neuroleptics)
What generation of antipsychotic? Chlorpromazine (Thorazine) Typical/First Generation/Conventional
What generation of antipsychotic? Fluphenazine (Trilafon Typical/First Generation/Conventional
What generation of antipsychotic? Thioridazine (Mellaril) Typical/First Generation/Conventional
What generation of antipsychotic? Haloperidol (Haldol) Typical/First Generation/Conventional
Classify the drug: Chlorpromazine (Thorazine) antipsychotic - Typical/First Generation/Conventional
Classify the drug: Fluphenazine (Trilafon antipsychotic - Typical/First Generation/Conventional
Classify the drug: Thioridazine (Mellaril) antipsychotic - Typical/First Generation/Conventional
Classify the drug: Haloperidol (Haldol) antipsychotic - Typical/First Generation/Conventional
What generation of antipsychotic: Clozapine (Clozaril) Atypical/Second Generation
What generation of antipsychotic: Risperidone (Risperdal) Atypical/Second Generation
What generation of antipsychotic: Olanzapine (Zyprexa) Atypical/Second Generation
Classify the drug: Clozapine (Clozaril) antipsychotic - Atypical/Second Generation
Classify the drug: Risperidone (Risperdal) antipsychotic - Atypical/Second Generation
Classify the drug: Olanzapine (Zyprexa) antipsychotic - Atypical/Second Generation
How do Atypical/Second Generation antipsychotics work? Work by blocking Serotonin receptors, and act on cholinergic and histamine receptors
Classify the drug: Aripiprazole (Abilify) antipsychotic - Third Generation
How do third generation antipsychotics work? partial dopamine system stabilizers - can act as an agonist or antagonist, depending on the concentration of a specific neurotransmitter.
_______________ are the chemical substances manufactured in the neuron that aid in the transmission of information throughout the body. Neurotransmitters
What are the client teaching for antisychotics? - Adherence to regimen - Manage SE --Thirst/dry mouth (sugar-free candy, liquids) --Constipation (dietary fiber, stool softeners) -Sedation (safety measures) - Missed dose ( w/in 4 hours of usual time) - Weekly bld draw - CBC, ANC W/ Chlozapine
What are antidepressants used for? major depressive illness, anxiety disorders, depressed phase of bipolar disorder, psychotic depression
Classify the drug: Tricyclic (TCAs) antidepressant
Classify the drug:Selective Serotonin Reuptake Inhibitors (SSRIs) antidepressant
Classify the drug: MAO inhibitors (MAOIs) antidepressant
Classify the drug:(Venlafaxine (Effexor), antidepressant
Classify the drug: Bupropion (Wellbutrin) antidepressant
Classify the drug: Duloxetine (Cymbalta antidepressant
Classify the drug: Trazodone (Desyrel) antidepressant
Classify the drug: Nefazodone (Serzone) antidepressant
How do antideprssants work? interact with monoamine neurotransmitter systems, especially norepinephrine and serotonin
What class of drug: interact with monoamine neurotransmitter systems, especially norepinephrine and serotonin antidpressants
What are the preferred drugs for clients at high risk for suicide, carries no risk of lethal overdose SSRI’s are preferred - antidepressant
What are the client teaching for Antidepressants? -Time of dosage - SSRI first thing in morning, TCAs at night -Actions for missed dose --SSRI up to 8 hours after missed dose --TCAs within 3 hours of missed dose -Safety measures -Dietary restrictions if taking MAOI
What are the dietary restrictions if taking MAOI antidepressants? give examples food with tyramine - red wine, cheese, aged meat, beer
Of particular concern with MAOIs is the potential for a life-threatening ___________ crisis if the client ingests food that contains tyramine or takes sympathomimetic drugs. hypertensive
What can be cause by taking MAOIs and SSRIs Serotonin Syndrome
What are the s/s of seratonin syndrome? Agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia
Classify the drug: Lithium Mood-Stabilizing
Classify the drug: Carbamazepine (Tegretol) Mood-Stabilizing
Classify the drug: Valproic Acid (Depakote) Mood-Stabilizing
Classify the drug: Gabapentin (Neurontin) Mood-Stabilizing
Classify the drug: Topiramate (Topamax), Mood-Stabilizing
Classify the drug: Oxcarbazepine (Trileptal) Mood-Stabilizing
Classify the drug: Lamotrigine (Lamictal)) Mood-Stabilizing
What mood stabilizer: Normalize reuptake of certain neurotransmitters Lithium
What mood stabilizers: Increase levels of GABA Valproic Acid (Depakote), Topiramate (Topamax))
What are the side effects of mood stabilizers Carbamazepine and Valproic Acid. -drowsiness - sedation - dry mouth - blurred vision
What are the client teaching for mood stabilizers? -Periodic monitoring of blood levels -12 hours after last dose taken (peak and trough) - Drug with meals - Safety measures
What type of drugs are Benzodiazepines, Buspirone (Buspar)? Antianxiety Drugs
How does the antianxiety drugs benzodiazepine work? Mediation of GABA
How does the antianxiety drugs buspirone work? Partial agonist activity at serotonin receptors
What are the client teaching for antianxiety drugs? - Safety measures - Avoidance of alcohol - Avoidance of abrupt discontinuation
What drug: treatment of ADHD in children and adolescents, residual attention-deficit disorder in adults, narcolepsy Stimulants
What type of drug: Amphetamines (methylphenidate amphetamine, dextroamphetamine) Stimulants
What are the client teaching for stimulants? - Dose after meals to avoid anorexia and nausea - Avoidance of caffeine, sugar, chocolate - Proper storage out of reach of children
What is the mechanism of action for stimulants? - Cause release of norepinephrine, dopamine, serotonin presynaptically - Direct agonist effects postsynaptically - Block reuptake of neurotransmitters
What type of drug is used for aversion therapy for alcoholism? Disulfiram (Antabuse)
What is the mechanism of action for Disulfiram (Antabuse) inhibition of enzyme involved with alcohol metabolism
What are the side effects of Disulfiram (Antabuse)? fatigue, drowsiness, halitosis, tremor, impotence
What are the client teaching for Disulfiram? -avoidance of alcohol, including common products that may contain it (Shaving cream, deodorant, OTC cough preparations)
sympathy or empathy - feelings of concern or compassion; focus shifting to nurse’s feelings Sympathy
What are the components of therapeutic relationships? - Trust - Genuine interest - Empathy - Acceptance - Positive regard
What are values? sense of right and wrong, code of conduct for living
What are beliefs? the ideas that one holds to be true
The use of aspects of personality, experience, values, feelings, intelligence, needs, coping skills, perceptions to establish relationships beneficial to clients. Who developed this concept H. Peplau (nurse-client relationships)
What are the 4 patterns of knowing? Empirical, Personal, Ethical, Aesthetic
Understanding where knowledge comes from and how it affects behavior helps the nurse become more __________”  self aware
ways one person expects another to behave or speak; a roadblock to authentic relationships Preconceptions
What type of relationship? Superficial communication; shifting roles; outcomes rarely assessed Social
What type of relationship: Emotional commitment of two persons Individual needs met; assistance with helping each other meet needs Intimate
What type of relationship? Focus on needs, experiences, feelings, ideas of client only Use of communication skills, personal strengths, understanding of human behavior by nurse Joint agreement on areas to work on; outcome evaluation Therapeutic
What are the phase of establishing a therapeutic relationship orientation working termination
In what phase of establishing a therapeutic relationship is it possible for transference or counter transference to occur? the working phase
transference vs countertransference transference (patient to nurse)/ countertransference (nurse to patient)
What are some behaviors that diminish therapeutic relationships -Inappropriate boundaries (relationship becomes social or intimate) -Feelings of sympathy, encouraging client dependency -Nonacceptance of client, avoidance
What are the therapeutic roles of a nurse?? - teacher - caregiver - advocate - surrogate
What are the goals of therapeutic communication? -Establish therapeutic relationship Identify patient’s most important concerns Facilitate patient’s expression of emotions Teach pt, family necessary self-care skills Recognize pt’s needs; Guide pt toward acceptable solutions
Created by: sbertelsen
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