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Ch 5-9 Mental Health
| Question | Answer |
|---|---|
| Abuse | physical, verbal, or emotional mistreatment of self or others; misuse of chemicals, food, or other substances |
| Culture | nonphysical traits, rituals, values, and traditions that are handed down to others from generation to generation |
| Ethnicity | the condition of identifying with an ethnic group |
| Ethnocentrism | when individuals believe that their particular ethnic or religious group has rights and benefits over those of others |
| Homeless | the state of being without a permanent place of residency or home |
| Parenting | raising children; referring to styles of raising children |
| Prejudice | prejudging people or situations before knowing all the facts |
| Religion | set of beliefs about one's spirituality, rituals, and worships |
| Stereotype | a general opinion or belief |
| Affect | the outward display or expression of a feeling or mood |
| Awareness | having a realization, perception, or knowledge |
| Data collection | gathering of information about a patient; part of nursing process |
| Evaluation | part of nursing process that summarizes nursing interventions and the outcomes |
| Formal Teaching | teaching that is planned and scheduled |
| Implementation | part of the nursing process that identifies specific actions a nurse will do to help a patient meet a goal; nursing intervention |
| Informal Teaching | teaching that is provided at unplanned or unscheduled times |
| Judgement | subjective assessment of a patient's ability to make appropriate decisions |
| Memory | mental function that enables a person to store and recall information |
| Mood | an individual's sustained emotional tone, which influences behavior, personality, and perception |
| NANDA-I | nursing organization that establishes and oversees standardized language for nurses to improve communication and outcomes |
| Nursing Diagnosis | nonmedical statement of an existing or potential problem |
| Nursing Interventions Classification (NIC) | a comprehensive standardized language of intervention labels and possible nursing actions |
| Nursing Outcomes Classification (NOC) | standardized language that provides outcome statements and a set of indicators that describe the specific patient, caregiver, family, or community states related to outcome |
| Nursing Process | established system of data collecting and care planning performed by nurses |
| Objective | step one in nursing process. It is data related to the patient that represents touch, sight, smell, and body language |
| Orientation | measurement of knowledge of person, place, and time in the mental health assessment |
| Patient Interview | interaction between the patient or client and the health-care provider in order to collect patient data |
| Patient Teaching | any set of planned education activities designed to improve patients' health behaviors and health status |
| Plan of Care | nursing process and medical orders that dictate a patient's daily care |
| Planning | systematic way for the patient to achieve their goals. Planning is two parts: short term goals and long term goals, both are measurable and realistic |
| Scope of Practice | terminology used by national and state/provincial licensing boards for various professions that defines the procedures, actions, and processes that are permitted for the license |
| Subjective | based on personal feelings or beliefs; often relates to patients reporting symptoms in their own words |
| Thinking/Cognition | the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses. |
| Adaptation | the effective coping to changes that are external and internal |
| Coping | the act of successfully adapting psychologically, physically, and behaviorally to problems or stressors |
| Defense Mechanisms | group of behaviors used to reduce or eliminate anxiety. Unconsciously falling into habits that give the illusion of coping but produce ineffective results |
| Effective Coping | skills that reduce tension and do not create more problems for an individual |
| Ineffective Coping | use of coping skills that do not reduce tension and/or that are hazardous to an individual |
| Akathisia | restlessness; an urgent need for movement |
| Antidepressants | classification of psychoactive medications used to treat depression |
| Antimanic Agents | classification of psychoactive medications used to treat manic behavior ex. bipolar disorder |
| Antiparkinson Agents | classification of medications used to treat the symptoms of both drug-induced and non-drug-induced parkinsonism |
| Antipsychotics | classification of psychoactive medications used to treat psychotic behavior found in disorders such as schizophrenia and organic brain disorders |
| Behavior Modification | form of treatment in which variables are manipulated to encourage and reinforce desired behavioral changes |
| Cognitive | pertaining to the thought process and the ability to think |
| Cognitive Behavioral Therapy (CBT) | psychotherapeutic approach that combines behavior therapy with cognitive psychology; it is a problem-focused and action-oriented short-term therapy |
| Counseling | one of several forms of therapy |
| Crisis | a state of psychological disequilibrium |
| Dystonia | a disorder in which the symptoms manifest as bizarre distortions or involuntary movements of any muscle group |
| Electroconvulsive Therapy (ECT) | reserved for types of depression or schizophrenia not responding to other forms of treatment. A current is passed through the patient, resulting in mild seizure and temporary amnesia |
| Hypnosis | form of therapy that is meant to produce a state of increased relaxation and increases openness to suggestions for behavior modification |
| Milieu | environment for treating patients |
| MAOI | group of antidepressant medications that work by blocking the enzyme monoamine oxidase |
| Person-Centered Therapy | humanistic theory of unconditional positive regard for the person, involving treatment of the whole person rather than just the illness |
| Psychoanalysis | method of psychotherapy based in Freudian theory; uses free association and dream interpretation as part of the treatment. Usually long term |
| Psychopharmacology | medications as they are used and prescribed for mental illness |
| Rational-Emotive Therapy (RET) | form of therapy involving a rational balance between thinking and feeling |
| Stimulants | classification of medication that directly stimulates the CNS |
| Tardive Dyskinesia | involuntary movements due to side effects of some antipsychotic drugs |
| Alternative Medicine | modalities that replace those of conventional medicine |
| Aromatherapy | related to herbal therapy; provides treatment by both direct pharmacological effects of the aromatic plant substances and indirect effects of certain smells on mood and affect |
| Beliefs | concepts, opinions, and ideas that are accepted as true and are usually not exactly the same for each individual |
| Biofeedback | method of teaching patients to recognize tension within the body and to respond with relaxation |
| Complementary Medicine | a wide variety of alternative practices such as acupuncture and hypnosis that are recognized and accepted by mainstream medicine; done in conjunction with traditional medicine |
| Holistic | viewing a person as a whole |
| Hypnotherapy | means for entering an altered state of consciousness, and in this state, the use of visualization and suggestion to bring about desired changes in behavior and thinking |
| Integrative Medicine | the combination of conventional and less traditional treatment methods |
| Mind-body connection | an interconnection of the mind and body in which the mind influences the body's responses |
| Models | pictures or ideas that we form in our minds to explain how things work. They help us understand and interact with other people and our environment, and help us to formulate beliefs. |
| Placebo | a neutral, inactive agent given in place of medication that produces symptom relief or other desired effects based upon the patient's expectations and beliefs |
| Presupposition | assumptions we make when forming communication |
| Rapport | the matching of speech patterns using auditory, kinesthetic, and visual references, which provide a starting point for meaningful communication |
| Reflexology | massage and manipulation of the feet that acts upon energy pathways in the body, unblocking and renewing the energy flow |
| Reiki | a form of energy work incorporating touch that manipulate the client's energy along body meridians or pathways |
| Trance | state of altered awareness of a client's surroundings that brings the individual's focus of attention to an internal experience, such as a memory or an imagined event |
| Yoga | mind-body method of healing that uses body positions to facilitate balance and flexibility |
| What techniques doe nurses need to help patients who may be homeless and physically or mentally compromised? | 1. treat the whole person, not the homelessness 2. treat the person as any other patient 3. maintain all patient rights |
| Authoritarian Parenting | -parent sets strict rules, child has little or no voice in family decisions -"because I said so" "because I'm dad/mom" -can lead to rebellious, hostile children - enter adulthood angry/violent/unable to make consistent decisions |
| Authoritative Parenting | -firm, consistent rules/limits, but allows discussion and flexibility when needed -children allowed some freedom (with limits), and a voice in some decisions -preferred style of parenting, balance of rules & responsibility |
| Permissive Parenting | -provides little structure and few guidelines/boundaries -parent acts as friend rather than parent -child is unsure of what is okay and what is not |
| The concepts of space, time, and waiting are: | cultural |
| Phenomenon of homelessness can be blamed, in part, on: | access to community services |
| How much of the homeless population are mentally ill? | approximately one-third |
| What are the most common reasons for homelessness? | -economic setbacks -major health expenses -mental health |
| Mental Health Status Examination includes assessing: | -appearance -behavior -level of awareness -orientation -thinking/cognition -memory -speech/ability to communicate -mood/affect -judgment/abstract thinking |
| Intake/admission Interview | -typically closed-ended format -up to nurse to rephrase questions for patients to answer openly |
| Helping Interview | -determine/isolate particular concern of patient & help patient learn to help themselves |
| What are the guidelines for Nurse-Patient healing interviews? | -be honest -be assertive -be sensitive -use empathy -use open-ended questions |
| Principles of Teaching | -know the patient -know the material -have a teaching plan (APIE) -be flexible -be able to evaluate the learning -plan to allow a few minutes after the class for questions |
| What are the typical methods used in health teaching? | -lecture -demonstration |
| Lecture | -information giving/unilateral. Nurse talks, patient listens -only interactive if patient asks questions -good method of introducing topic to patients and giving them the significant information |
| Demonstration | -great to follow an introductory lecture -preferred method for visual and tactile learners |
| The nursing process is a method for: | -systemic organization and implementation of patient care |
| Denial | -usually 1st defense learned/used -unconscious refusal to see reality |
| Denial Example | -alcoholic states "I can quit any time I want to." -is not consciously lying |
| Repression | -unconscious burying of "forgetting" mechanism -excludes or withholds from people's consciousness events or situations that are unbearable -a step deeper than "denial" |
| Repression Example | -demonstrating emotions toward a person, but unable to identify the specific reason |
| Dissociation | -painful events or situations are separated or dissociated from the conscious mind -could be described as an out-of-body experience |
| Dissociate Example | -patient who had been sexually abused as child described the situation as if it happened to a friend/sibling |
| Rationalization | -substituting acceptable reasons for the true causes for personal behavior because admitting the truth is too threatening |
| Rationalization Example | -"I failed the test because the teacher wrote bad questions" -"the patient kept interrupting me, so I got distracted and he caused me to make a mistake" |
| Compensation | -making up for something a person perceives as an inadequacy by developing some other desirable trait |
| Compensation Example | -small boy who wants to be a basketball center; instead becomes honor roll student -physically unattractive person who wants to model instead becomes a famous designer |
| Reaction Formation (Overcompensation) | -similar to compensation, except the person usually develops the opposite trait |
| Reaction Formation (Overcompensation) Example | -small boy who wants to be basketball center becomes political voice to decrease the emphasis of sports in elementary grades -physically unattractive person who wants to be a model speaks out for eliminating beauty pageants |
| Regression | -emotionally returning to an earlier time in life with far less stress -commonly seen in patients while hospitalized NOTE: people do not regress to the same developmental age, it is highly individualized |
| Regression Example | -children who are toilet trained beginning to wet themselves -during serious illness, a patient exhibits behavior more appropriate for a younger developmental age, such as excessive dependency |
| Sublimation | -unacceptable traits or characteristics are diverted into acceptable traits or characteristics |
| Sublimation Example | -burglar teaches home safety classes -person who is potentially physically abusive becomes professional sports figure -people who choose not to have children run a day-care center |
| Projection | -attributing feelings or impulses unacceptable to oneself to others |
| Projection Example | -wife tells patient's nurse "my husband is worried about going home" (Wife is who is worried) -young soldier is fearful of upcoming deployment "those other guys are a bunch of cowards" |
| Displacement | -"kick the dog syndrome" -transferring anger and hostility to another person or object that is perceived to be less powerful |
| Displacement Example | -parent loses job without notice, goes home and verbally abuses spouse, who unjustly punishes child, who slaps the dog |
| Restitution (Undoing) | -makes amends for a behavior one thinks is unacceptable -makes an attempt at reducing guilt |
| Restitution (Undoing) Example | -giving a treat to a child who is being punished for a wrong-doing -person who finds lost wallet with lots of cash, does not return wallet, but puts extra in collection plate at next church service |
| Isolation | -emotion that is separated from the original feeling |
| Isolation Example | -"I wasn't really angry, just a little upset" |
| Conversion Reaction | -anxiety is channeled into physical symptoms NOTE: often, symptoms disappear soon after the threat is over |
| Conversion Reaction Example | -nausea develops the night before a major exam, causing person to miss exam -nausea may disappear soon after the scheduled test is finished |
| Avoidance | -unconsciously staying away from events or situations that might open feelings of aggression or anxiety |
| Avoidance Example | -"I can't go to the class reunion tonight. I'm just so tired, I have to sleep" |
| Scapegoating | -blaming others |
| Scapegoating Example | -"I didn't get the promotion because you don't like me" |
| Antipsychotics (Action, uses..) | Action - act on CNS, block dopamine receptors Use - treat behaviors in schizophrenia other potentially violent behaviors Side Effects - photosensitivity, dry mouth, EPS (akathisia, parkinsonism, dystonia, tardive dyskinesia) |
| Antipsychotics - Considerations | -antacids decrease absorption, take antacids 1-2 hours after the antipsychotics |
| Antipsychotics - common medications | Chlorpromazine (Thiazine) Haloperidol (Haldol) Clozapine (Clozaril) |
| Antiparkinson Agents (Actions, uses..) | Action - inhibits action of acetylcholine Use - decreases effect of drug-induced & non-drug-induced symptoms of parkinsonism Side Effects - blurred vision, dry mouth, dizziness, drowsiness, confusion, tachycardia, urine retention, constipation, BP chang |
| Antiparkinson - Considerations | -be avoided in children under 12/cautious with elderly -monitor BP carefully -hard, sugarless candy to combat dry mouth -increase dietary roughage for BM function -do not drive until response to medication is established |
| Antiparkinson - common medications | diphenhydramine (Benadryl) Biperiden (akineton) Benzotropine (Cogentin) |
| Antianxiety Agents (Actions, uses...) | Action - depress activities of cerebral cortex Use - decrease effect of stress/mild depression w/o sedation Side Effect - physical/psychological dependence, drowsiness, lethargy, fainting, postural hypotension, nausea, vomiting |
| Antianxiety Agents - Considerations | -administer IM doses deeply, slowly, into large muscle masses/ Z-track -Discontinue slowly -not safe to drive/cannot use alcohol -have patient change positions slowly |
| Antianxiety Agents - common medications | Alprazolam (Xanax) Buspirone (BuSpar) Diazepam (Valium) |
| Antidepressants (Actions, uses...) | Action - increase availability of serotonin Use - treatment of depression and some anxiety disorders Side Effects - drowsiness, dry mouth, agitation, postural hypotension, vertigo, constipation, urine retention, weight gain, blurred vision |
| Antidepressants - Considerations | -may take up to 3 weeks for change in mood -discontinue slowly, monitor for suicidal ideation -protect patient skin from sunburn/change positions slowly -diet restrictions with MAOIs |
| SSRIs (Bicyclic Antidepressants) | Action- increase availability of serotonin Uses- treatment of depression, anxiety, obsessive disorders, impulse control disorders |
| Tricyclic Antidepressants | Action- increase level of serotonin and norepinephrine, thereby increasing ability of nerve cells to pass information to each other. Uses- symptoms of depression, sleep disturbances, sexual function disturbances, changes in appetite, and cognitive chang |
| Tetracyclic Antidepressants | Actions & uses are similar to SSRIs |
| SSRIs - common medication | Citalopram (Celexa) Fluoxetine (Prozac) Sertraline (Zoloft) |
| Tricyclic antidepressants - common medications | Amitriptyline (Elavil) Nortriptyline (Pamelor, Aventyl) Amoxapine (Asendin) |
| Tetracyclic antidepressants - common medications | Maprotiline (Ludiomil) Buproprion (Wellbutrin) Mirtazapine (Remeron) |
| SNRIs | Action- increase the availability of serotonin and norepinephrine |
| SNRIs - common medications | Nefazodone (Serzone) Venlafaxine (Effexor) Duloxetine (Cymbalta) |
| MAOIs (action) | Action- prevent metabolism of neurotransmitters by monoamine oxidase |
| MAOIs - common medications | Phenelzine (Nardil) Tranycypromine (Parnate) Isocarboxazid (Marplan) |
| MAOIs - dietary restrictions | -avoid foods containing amino acid tyramine such as: aged cheese, avocados, yogurt, sour cream, chicken/beef livers, pickled herring, corned beef, bean pods, bananas, raisins, figs, smoked/processed meat, yeast supplements, chocolate, alcohol, caffeine |
| Antimanic Agents (Use..) | Use-stabilizes manic phase in bipolar disorder Side Effects- thirst, dry mouth, fatigue, nausea, abdominal pain, tremors, headache, drowsiness, confusion |
| Antimanic Agents - Considerations | -observe signs of toxicity: severe diarrhea, muscle weakness, persistent nausea, vomiting, seizures -dehydration/fever can cause toxicity |
| Antimanic Agents - Patient Teaching | -instruct patient to have periodic lab test for lithium blood levels -adequate fluid/sodium intake -teach patient signs of toxicity -pregnancy/breastfeeding not recommended for this medication |
| Antimanic Agents - common medications | Lithium carbonate (Eskalith, Lithonate, Lithane, Lithobid) Valproic acid (Depakene) Divalproex sodium (Depakote) |
| Anticonvulsants (actions, uses...) | Action- not understood Use- stabilize manic episodes in bipolar disorders Side Effect- nausea, vomiting, indigestion, drowsiness, dizziness, prolonged bleeding, headache, confusion |
| Anticonvulsant - Considerations | -do not stop abruptly/taper -avoid alcohol -do not drive/operate heavy machinery/dangerous equipment |
| Anticonvulsant - common medication | -carbamazepine (Tegretol) Divalproex sodium (Depakote) Valrpoic acid (Depakene) |
| Stimulants (actions, use...) | Action- provide direct stimulation of CNS Use- promote alertness, decrease appetite, combats narcolepsy, treatment of ADHD Side Effects- rapid/irregular hr, hypertension, hyperactivity, hand tremor, rapid speech, confusion, depression, suicidal thoughts |
| Stimulants - Considerations | -tolerance/physical/psychological dependence can occur -amphetamines can cause changes in insulin requirements -monitor insulin carefully -use extreme caution when driving/operating machinery |
| What are the goals of psychotherapy? | 1. decrease patient's emotional discomfort 2. increase patient's social functioning 3. increase the patient's ability to behave/perform in a manner appropriate to the situation |
| Free Association | -patient says whatever comes to mind in response to a word given by therapist -therapist then looks for a theme or pattern |
| Dream Analysis | -patient keeps dream log -psychoanylists believe dreams are mirror to unconscious and it is possible to train patients to awaken long enough to record their dreams |
| Catharsis | -elimination of a complex (problem) by bringing it to consciousness and affording it expression |
| Behavior modification - (uses, outcomes) | Use- remove or greatly diminish behaviors that are inappropriate or unhealthy Desired Outcome- positive reinforcement for new behaviors, clearly stated expectations/appropriate behaviors, Consistently upholding patients care plan |
| Behavior Modification - patient teaching | -communication skills are important -ensure patient's understanding of the reasons for the changes in behavior |
| Negative Reinforcement | act of responding to the undesired behavior by taking away a privilege or adding an unwanted responsibility |
| RET | Use- mental health alteration that is consciously controlled Outcome- remain "undisturbed" as result of rethinking activating events, belief system, & consequences -patients will prob not be inpatients -patients perform "homework" -avoid must/should |
| RET A-B-C's | A- activating event - subject of faulty thinking B- belief system patient adopted about activating event C- consequence to continuing belief system |
| RET, emotional disturbance, D-E | D- disputing against beliefs appearing irrational E- effective emotions and behaviors about the activating event |
| Person-centered Humanistic Therapy | Use-all aspects patient care Outcome- patient feel accepted as human, allow patient to be self aware/self-accepting -maintain 3 qualities of Rogerian theory (empath, unconditional positive regard, genuineness) -centered in present -accepting self |
| What are the 5 phases of crises? | Pre-crisis, Impact, Crisis, Adaptive, Post-crisis |
| Pre-Crisis | person feels "fine". Will often deny stress level, and state a feeling of well-being |
| Impact | person feels anxiety and confusion. May have trouble organizing personal life, high stress level. Person will acknowledge stress buy may minimize severity |
| Crisis | person denies problem is out of control, withdraws/rationalizes behaviors/stress. Uses defense mechanism of projection frequently. |
| Adaptive | crisis perceived in positive way. Anxiety decreases, person attempts to regain self-esteem, able to start socializing again. Some positive problem solving |
| Post-Crisis | both positive and negative functioning may be seen. person may develop more positive, effective way of coping or may show ineffective adaptation such as hostile, depressed, substance abuse. |
| What are the nursing responsibilities in regards to crisis? | 1. ensure safety 2. diffuse the situation 3. determine the problem 4. decrease the anxiety levels 5. return the patient to pre-crisis (or better) level of functioning |
| Contraindications of Ginkgo Biloba | -pregnant/breastfeeding -caution for patient taking anticoagulants -caution for patient taking MAOI, Ginkgo can act as MAOI |
| Contraindications of Kava Kava | -pregnancy/breastfeeding -skin yellowing from accumulation of plant pigment can occur in chronic use -liver disease |
| Contraindications of St. John's Wort | -pregnant/breastfeeding -caution for patient taking anticoagulants & MAOIs |
| Contraindications of Omega 3 Fatty Acid supplement | -caution for patients taking anticoagulants |
| Contraindications of Sam-E | -can cause mania in patients with bipolar disorder -rule out before treatment |
Created by:
ahoyyitbeaddi
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