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NUR 185 Test 1

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Which defense mechanism is known as covering up a real or perceived weakness by emphasizing a trait one considers more desirable? Compensation
Which defense mechanism is refusing to acknowledge the existence of a real situation or the feelings associated with it? Denial
Which defense mechanism is the transfer of feelings from one target to another that is considered less threatening or that is neutral? Displacement
Which defense mechanism is an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires? Identification
Which defense mechanism is an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis? Intellectualization
Which defense mechanism integrates the beliefs and values of another individual into one's own ego structure? Introjection
Which defense mechanism separates a thought or memory from the feeling, tone, or emotion associated with it? Isolation
Which defense mechanism attributes feelings or impulses unacceptable to one's self to another person? Projection
Which defense mechanism attempts to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors? Rationalization
Which defense mechanism prevents unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors? Reaction Formation
Which defense mechanism is a form of retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning? Regression
Which defense mechanism involuntarily blocks unpleasant feelings and experiences from one's awareness? Repression
Which defense mechanism re-channels drives or impulses that are personally or socially unacceptable into activities that are constructive? Sublimation
Which defense mechanism in the voluntary blocking of unpleasant feelings and experiences from one's awareness? Suppression
Which defense mechanism symbolically negates or cancels out an experiences that one finds intolerable? Undoing
Why does mental illness seem to occur? Because of a failure to adapt to a stressful situation
What is GAS and who developed it? GAS- General Adaptation Syndrome. Developed by Hans Selye
What is the basic principle behind the General Adaptation Syndrome? You either fight and fix the stressful situation to get back to where you were or you don't and exhaustion takes over, disease develops and, at times, the body can die as an extreme
What is the RLCQ? The Recent Life Changes Questionnaire where a high score means a person could be at greater susceptibility to physical or psychological illness
What is considered a high score in the RLCQ for a six month period? 300 LCU's (Life Change Units)
What is considered a high score in the RLCQ for a 12 month period? 500 LCU's (Life Changes Units)
With the transaction theory, what is considered a primary appraisal? How a client perceives a stressor, whether it's positive or negative
With the transaction theory, what is considered a secondary appraisal? Basically what a client knows what they can do and what their resources are
What is considered a MILD level of anxiety? The client is focus enhanced
What is considered a MODERATE level of anxiety? The client's focus is impaired but they are still able to follow directions
What is considered a SEVERE level of anxiety? The client's focus is very limited, they are fixated on a single detail
What is considered a PANIC level of anxiety? The client has zero focus because they have shut down. They aren't thinking and judgement is impaired
What is our goal with psych patients? To see if they have used a positive coping strategy in the past or to help them acquire new coping strategies
What was the name of the person during the Civil War Era that began to care for the mentally ill? Dorothea Dix
Who was the first American psychiatric nurse? Linda Richards
Name Maslow's Hierarchy of Needs from bottom to top Physiological Needs, Safety & Security, Love & Belonging, Self-Esteem & Esteem of Others, Self-Actualization
What are the six indicators of Jahoda? 1. A positive attitude toward self 2. Growth, development, and the ability to achieve self-actualization 3. Integration 4. Autonomy 5. Perception of reality 6. Environmental mastery
Who came up that mental health is defined as relative to the situation and that mental illness is never absolute or fixed? The APA
What is the DSM-IV-TR and who uses it? Diagnostic & Statistical Manual of Mental Disorders, 4th Ed. Text Revision and it's used my doctors
What is Axis I of the DSM-IV-TR? What the pt is being treated for; their focus of care
What is the Axis II of the DSM-IV-TR? Personality disorders and mental retardations
What is the Axis III of the DSM-IV-TR? General medical conditions
What is the Axis IV of the DSM-IV-TR? Problems that pt are having difficulty with such as family functioning, support groups, etc.
What are primary prevention services? Where the number of ppl who would get/have mental illness are reduced by helping to identify ppl at risk; try to help pts cope constructively
What are secondary prevention interventions? Trying to minimize symptoms of the pts mental illness by utilizing group therapy and medication
What are tertiary prevention services? Pts go to outpatient therapy; almost like a rehab
What is congruency of care? Taking care of pts while keeping in mind their cultural, spiritual and religious needs
Who developed the psychoanalytical theory and what did it entail? Sigmund Freud and he believed that a mental illness could occur when there was a malfunction between the id, ego and superego
Who developed the Interpersonal theory and what did it entail? Sullivan and it dealt with Stages of Personality Development
What was Erikson's type of theory called? Psychosocial theory
What type of theory did Piaget have and what did it deal with? Cognitive Development Theory and it has to do with concrete and abstract thinking
Who developed the Moral Development Theory? Kohlberg
What four aspects did Peplou point out in her Nursing Model? 1. Learning to count on others 2. Learning to delay personal satisfaction 3. Identifying oneself 4. Developing skills in participation
Define a therapeutic relationship? In interaction between two ppl; one is the caregiver and one is the client
What are some roles that a nurse takes on in a Nurse-Client relationship? Stranger, Resource, Teacher, Leader, Surrogate, Manager of care
What is the end goal of most therapeutic relationships? To get pt back to pre-illness state
What are the 7 characteristics of a therapeutic relationship? Caring, Rapport, Trust, Respect, Genuineness, Empathy, & Absolute Professionalism
What are the four phases of a therapeutic relationship? Pre-interaction, Orientation, Working, & Termination
What happens in the pre-interaction phase of the therapeutic relationship? Prepping- getting to know a little about your pt
What happens in the orientation phase of the therapeutic relationship? You work with the pt to establish a trusting relationship
What happens in the working phase of the therapeutic relationship? You work on coping strategies with the pt to help get them to a point where they can solve some problems
What is it called when a pt suddenly starts looking at you unconsciously and you remind them of someone and they start to treat you as if you are that person? Transference
What is it called when you believe you are the super nurse and that you can handle everything for a specific pt? Counter-transference
In which phase does transference and counter-transference occur? The working phase of the therapeutic relationship
What occurs in the termination phase of the therapeutic relationship? Pts become attached & dependent on you and that's why you need to explain that you will only be there for a short while so they know an end will come to the relationship.
What are three boundaries in the Nurse/Client relationship? Social, Personal, & Professional
What does SOLER stand for? Sit squarely, Open posture, Lean forward, Establish eye contact, Relax
What is one of the hardest parts of communication? Listening
What are five pre-existing conditions that occur with communication? Values, Attributes & Beliefs: Culture or Religion; Social Status: Gender: Age or Developmental Level ( I try to remember the beginning of each as VSCAG)
What are six forms of non-verbal communication? Physical Appearance & Dress: Body Movement & Posture: Touch: Facial Expressions: Eye Behavior: Vocal Cues or Paralanguage. ( VEPT BF)
What is waxy flexibility? A movement done by schizophrenic pts in which limbs stay in whatever position they are placed
What is paralanguage? A gestural component of the spoken word that consists of pitch, tone and loudness of spoken messages.
When someone is agitated what can you do with your hands to try to calm them down? Place them in prayer mode
What is considered milieu therapy? It is the therapeutic community
What did Skinner believe about basic assumptions? That in order for us to be able to have a better community for the pts, we should have 7 basic assumptions with three basic goals.
What are the three basic goals that Skinner believed in? 1) Get pts to learn coping skills (either something they have used in the pst or something new) 2) Show pts appropriate role models 3) Develop healthy relationship skills
What are the 7 basic assumptions that Skinner believed in? Identify strengths, Interpersonal interaction is inevitable, Autonomy & needs of the group, Responsibility for own behavior, Peer pressure & feedback, Inappropriate behaviors addressed, Restrictions & punishment are avoided
With Skinner's 7 basic assumptions, why is it important to identify strengths? So pts know there are some good things about them; it's important to give them positive feedback
With Skinner's 7 basic assumptions, why is interpersonal interaction inevitable? It's important to have conversations to build upon relationships
With Skinner's 7 basic assumptions, how do you get a pt to be responsible for their own behavior? Set limits and have them understand what is and isn't appropriate
When delivering punishments and reprimands, in what order do you want to go in as far as ending up in restraints? Talk a pt down, chemical restraints and lastly physical restraints
Why do we try to talk a pt down first? We want them to preserve their dignity
Define psychotherapy? It's a treatment for mental illness in which a mental health professional and a pt discuss problems and their feelings and work together to find solutions
What are the three phases of psychotherapy? Assessment (what brought pt here) Resolution (pt feel like their making headway; problem is closed to be resolved or thought of in a different way) Growth [Self-Actualization] (meet all your goals by Maslow)
What do you call a group a ppl that come together to share a common interest to learn to practice skills resolve conflict, etc? A therapeutic group
What's the number of ppl that you want in a therapeutic group? 7-10; anymore and you would have chaos with ppl vying for attention
What are three leadership styles? Autocratic, democratic, and laissez-faire
What is autocratic leadership? It's all about the leader, what he wants and how he wants to get it done, members of the group are unhappy; things get done
What is democratic leadership? Members have input and are the focus of the group; productivity is lower because the members are well-informed with knowledgeable opinions and resolutions to problems
What is laissez-faire leadership? The group doesn't get a lot done because they have a 'who cares' attitude
What is considered a crisis intervention? When a mental illness pt either loses to a battle in their life or with a battle currently going on in their life.
Can a crisis be major or minor? It can be either all dependent on the pts perception
With a crisis, what can in result in psychologically? disequilibrium and at times, so severe that the individual requires assistance to recover
How many phases of crisis development are there? 4
What is phase I of crisis development? Being exposed to the stressor
What is phase II of crisis development? Start working with coping mechanisms and they may begin to fail. If this happens, anxiety and helplessness starts to set in and the though processes are disorganized
What is phase III of crisis development? Pt tries to use all resources. They get into panic type situation trying everything in their power to get back to homeostasis
What is phase IV of crisis development? This is the possible breaking point. The pt almost disintegrates because tension has reach such a high point. It becomes an emotional roller coaster and behavior and thinking is very disorganized.
What is a dispositional crisis? It's unanticipated, could be chronic where the pt feels like they are out of control
What are anticipated life transitions? They are milestones you know are coming but they are still difficult such as the death of a parent
What is traumatic stress? It's stress that is very unexpected where the pt feels as if they have no control and are extremely vulnerable such as a rape
What are maturational/developmental crises? They are anticipated crises that make you feel helpless, rejected or depressed
What is crises reflecting psychopathology? It is when the pt already has a mental illness diagnosis but then they have a crisis in their life and it may become so distorted that the pt may feel abandoned or like they can't resolve the crisis due to their mental illness
What are considered psychiatric emergencies? The person's ability to function physically & psychologically are impaired and it becomes a question if the pt will be safe. They need someone to intervene on their behalf because they can't take responsibility for themselves
What is the essential goal of the Nurse Practice Act and what gives it, it's authority? To protect the public and it is given authority by the state legislature
Who's duties are delineated in the Nurse Practice Act? LPN's & RN's
The Nurse Practice Act is given authority by the state legislature, what type of law is this an example of? Statutory law
What are common laws? Laws that are based on decisions made in previous cases
What is civil law? Private and property rights of people and business (tort & contracts)
What is criminal law? Laws that offer protection from conduct that could injure the public
What are torts? A violation of civil law in which a person has been wronged
What are two examples of unintentional tort? Malpractice & negligence
What are two examples of intentional tort? Battery & assault
What is the BIGGEST issue that ppl get into so much trouble with as far as legal issues? Confidentiality & the Right to Privacy
What is HIPAA? An act that protects pts privacy and information
What is it considered when a pt tells you information? Privileged Communication
When do pts have the right to refuse treatment? When they are of mental status and awareness and are there by voluntary consent
When is it okay to challenge informed consent? When the pt is judged incompetent
When did the Mental Health Bill of Rights come about? In 1980 the bill came up stating that mental health pts have the right to have physiological needs met
What does JCAHO say about restraints? It has to be an emergent situation to put someone in restraints & seclusion; there are very specific timelines when using restraints & seclusion; different guidelines for different ages; tell you how to evaluate pt to make sure they are safe in restraints
What are voluntary admissions? Pts that sign themselves in
With an involuntary admission, how often may a pt must be re-evaluated to see if they stay on this status and be documented? 72 hours
What are three conditions of a pt of an involuntary admission? 1) Pt has to be dangerous to self or to others 2) They have to be observed as a mentally ill pt 3) They have to be gravely disabled
What type of procedure can a family start as well as a mental health official? Emergency commitment; person has to be obviously unsafe and the board decides if pt can stay or leave
What is involuntary outpatient commitment? The court orders a person to go for outpatient treatment
Created by: sdmarketto