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Psych final nw

What therapeutic verbal communication technique gives a person time to collect thoughts or think through a point? Using silence
How do you give minimal cues? A therapeutic technique Encourage pt. To continue smile,nod,lean forward
What are some examples of a general lead Go on. And then? Tell me about. Uh huh.
What is "clarification" as a therapeutic comm. Technique Attempting to put into words vague ideas or unclear thoughts of the patient to enhance the nurses understanding or asking the patient to explain what he means "what would you say is is the main point of what you just said?"
What is "accepting" as a therapeutic technique Indicates that the person has been understood, does not necessarily mean that the nurse agrees. Nurse should not imply understanding when they do not understand. Needs to remain non judgmental "yes,i follow what you say"
Offering self means to what? Therapeutic technique. Offers the nurses presence and interest in interaction. "I would like to spend time with you"
Restating means to what Repeats the main idea expressed. Gives the patient the idea of what has been communicated. Patient can clarify the message, if it has been misunderstood.
A broad opening does what? Allows the patient to take the intiative in introducing the topic, emphasizes the importance of the patients role in interaction.
What type of communication technique is "making observations", and what does it do? It is therapeutic by verbalizing what is observed or perceived encourages the patient to recognize specific behaviors and compare perceptions with the nurse ex. " you seem tense"
"exploring" is what? A thera peutic technique. Delving further into a topic, experience, feeling, a relationship; especially helpful with patients who tend to communicate on a superficial level; ex. Please tell me more about that in detail.
What is "reflection" in therapeutic communication? Directs feelings,questions and ideas back to the patient. Encourages the patient to accept his own feelings and thought. Encourages person to think of self as a capable person. Ex. What do you think you should do?
Focusing is what in therapeutic communication? Taking notice of a single idea or even a word, works especially with a patient who is moving rapidly from one subject or thought to another. Not therapeutic with anxious client. Ex. This point see,s worth looking at more closely.
A therapeutic technique, encouraging description of perception is done how, and what does it do? Ex. Tell me what is happening now? Tell me when you feel anxious. Increases the nurses understanding of the patients perceptions. Talking aout feeling and difficulties can lessen the need to act them out inappropriately.
Describe "giving recognition" Therapeutic technique, acknowledging and indicating awareness; better than complimenting, which reflects the nurses judgement. Ex. " hello mr. R I notice that you walked two laps around the unit"
Describe placing event in time or sequence Clarifies the relationships of events in time so that the nurse and patient can view them in perspective. Ex. Was this before or after your surgery
Describe presenting reality Therapeutic technique, when the patient has a misperception of the environment, the nurse define reality or indicates his or her perception of the situation to the pt. Ex. "there is no one else in the room but you and me Mrs. S.
Describe attempting to translate words into feelings When feelings are expressed indirectly the nurse tries to decode what has been said and to find clues to the underlying true feelings or meaning. Ex. Patient-" I am dead inside" nurse-" are you saying you feel lifeless or does life seem meaningless to you
Describe voicing doubt. Is it therapeutic Therapeutic technique, expressing uncertainty to the reality of the patients perceptions; often helpful with a delusional patient; undermines the patients belief by not reinforcing exaggerated perceptions. Ex. Isn't that unusual? Really?
Describe paraphrasing Therapeutic technique, checks whiter the nurses translation of the patients words is an accurate interpretation of the message.
Describe encouraging a formulation of a plan of action Allowing patient to identify alternative actions for situations they may find stressful, it may serve to prevent anger or anxiety from escalating to an unmanageable level
Describe summarization Therapeutic technique, brings together points of discussion to enhance understanding. Also allows the opportunity to clarify communications so that both nurse and patient leave the interaction with the same ideas in mind
Describe touch as a therapeutic tool for communication Providing therapeutic and appropriate use of touch, especially during uncomfortable or stressful situations for the patient. Ex gently rubbing the patients arms during a painful procedure
Describe suggesting collaboration as a therapeutic tool Emphasizes working with the patient, nit doing things for the patient. Encouragers the view that change is possible through collaboration.
Describe verbalizing the implied as a therapeutic tool Putting into words that the patient has only implied or said indirectly; can also be used with the patient who has impaired communication
Describe validating as a therapeutic tool A form of feedback used to ensure that both patient and nurse have the same basic understanding of the message.
Describe informing as a therapeutic tool The skill of information giving especially helpful in health teaching and patient education ex. "let me explain how your medication works"
Describe the non therapeutic tool of giving advice Telling the patient what to do or how to behave implies that the nurse knows what is best, and that the patient is incapable of any self-direction ; discourages independent thinking
Describe the non therapeutic tool of saying you know how the person feels You may be hoping to empathize, but most likely you will be talking about yourself, also may be making a false clain
Describe the non therapeutic tool of changing the subject May invalidate the patients feelings and needs can leave he patient feeling alienated and isolated
Describe the non therapeutic tool of making value judgments May make Patient feel misunderstood, not supported, angry, anxious, prevents problem solving ex. How come you still smoke when your wife has lung cancer
Describe the non therapeutic tool of giving approval or agreeing Indicating accord with the patients ideas or opinions implies that the nurse has the right to pass judgement on whether the patients idea are right; may lead the patient to focusing on pleasing the nurse ex. That's right, I agree
Describe the non therapeutic tool of disapproving or disagreeing Can make a person defensive. Ex. That's wrong I disagree you shouldn't have done that
Describe the non therapeutic tool of giving false reassurance Underrates a patients feelings and belittles a patients concerns. May make patient stop sharing feelings and disconnect with the nurse
Describe the non therapeutic tool of rejecting Refusing to consider or showing contempt for the patients ideas or behavior, may cause patient to discontinue interaction with nurse for fear or rejection. Ex. Let's not discus.... I don't want to hear about that....
Describe the non therapeutic tool of probing Persistent questioning of the patient, pushing for answers the patient doesn't want to discuss, cause patient to feel used and may feel defensive
Describe the non therapeutic tool of requesting an explanation ( why questions) Asking the patient to provide reasons for thoughts, feeling behaviors and events, asking why a patient did something or feels a certain way is intimidating and may make them defensive
Describe the non therapeutic tool of asking excessive questions Results in patient not knowing which question to answer and possibly being confused about what is being asked
Describe the non therapeutic tool of belittling feelings When the nurse misjudged the degree of the patients discomfort a lack of empathy understanding may be conveyed. Causes patient to feel insignificant
Describe the non therapeutic tool of using denial When the nurse denies that a problem exists they block discussion with the patient and avoids helping the patient identify and explore areas of difficulty
Describe the non therapeutic tool of interpreting The nurse seeks to make conscious that which is unconscious, to tell the patient the meaning of his experience
Describe the non therapeutic tool of making stereotyped comments Cliches and trite expressions are meaningless in a nurse-patient relationship when the nurse makes empty conversation it encourages a like response from the patient
Describe the non therapeutic tool of indicating the existence of and external source of power Attributing source of thoughts, feelings and behaviors to others or to outside influences ex. What makes you say that?
Describe the non therapeutic tool of defending Attempting to protect someone or something from verbal attend may cause the patient to think the nurse is taking sides against the patient
Define the defense mechanism compensation Used to make up for perceived deficiencies and cover up shortcomings related to these deficiencies to protect the conscious mind from recognizing them
Define the defense mechanism conversion The unconscious transformations of anxiety into a physical symptom with no organic cause. Often the symptom functions to gain attention or as an excuse.
Define the defense mechanism denial Involves escaping unpleasant anxiety causing thoughts feeling wishes or needs by ignoring their existence
Define the defense mechanism displacement Is th e transference of emotions associated with a particular person object or situation to another nonthreatening person object or situation
Define the defense mechanism dissociation Is a disruption in the usually integrated functions of consciousness, memory , identity or perception of the environment. It may result in a separation between feeling and thought. May manifest in compartmentalizing uncomfortable aspects of ones self
Define the defense mechanism identification Is attributing to oneself the characteristics of another person or group. This may be done unconsciously
Define the defense mechanism intellectualization Is a process in which events are analyzed based on remote cold facts without passion, rather than incorporating feeling and emotion into the processing
Define the defense mechanism introjection The process by which the outside world is incorporated or absorbed into a persons view of self
Define the defense mechanism projection Refers to the unconscious rejection of emotionally unacceptable feature and attributing them to other people, objects or situations. You can remember this defense through the childhood retort or what you say is what you are
Define the defense mechanism rationalization Consists of justifying illogical or unreasonable ideas actions or feelings by developing acceptable explanations that satisfy the teller as well as the listener
Define the defense mechanism reaction formation When unacceptable feelings or behaviors are controlled and kept out of awareness by developing the opposite behavior or emotions
Define the defense mechanism regression Reverting to an earlier more primitive and childlike pattern of behavior that may nit have been previously exhibited
Define the defense mechanism repression A first line psychological defense against anxiety. It is the temporary or long term exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness. This happens at an unconscious level
Define the defense mechanism splitting The inability to integrate the positive and negative qualities of oneself or others into a cohesive image. Aspects of the self and of others tend to alternate between opposite poles, for example either good loving nurturing or bad hateful destructive
Define the defense mechanism sublimation An unconscious process of substituting mature constructive and socially acceptable activities for immature destructive and unacceptable impulses. Often impulses are sexual or aggressive
Define the defense mechanism suppression The conscious denial of a disturbing situation or feeling.
Define the defense mechanism undoing Most commonly seen in children, it is when a person makes up for an act or communication
What type of anxiety occurs in the normal experience of everyday living. This person sees, hears, and grasps more info. Mild anxiety
What type of anxiety is a person experiencing if they see hear and grasp less information and may demonstrate selective inattention. Voice tremors and shaking may be noticed Moderate anxietY
What type of anxiety is a person experiencing when their perceptual field is greatly reduced, learning and problem solving are not possible at this level person may be dazed and confused Severe anxiety
The most extreme level of anxiety, person loses touch with reality and may have markedly disturbed behavior Panic
Define panic attack The sudden onset of extreme apprehension or fear usually associated with feelings of impending doom
Define agoraphobia An intense excessive anxiety or fear about being in places or situations from which escape may not be available if panic attack occurred
Define panic disorder Recurrent episodes of panic attack, 1 month or more of a. Persistent concern about having attack b. Worry about consequences c. Significant change in behavior
Define phobia Irrational fear of an object or situation that persists although the person may recognize it as unreasonable
Define social phobia Fear of situations where one might be seen and embarrassed or criticized
Define specific phobia Fear of a single object activity or situation
Define OCD Either obsessions or compulsions, person knows they are excessive and unreasonable, they can. Cause increased distress and are time consuming
Define obsessions Preoccupation with persistent, intrusive, thoughts impulses or images
Define compulsions Repetitive behaviors or mental acts that the person feels driven to perform in order to reduce distress or prevent a dreaded even or situation
Define GAD or generalized anxiety disorder Excessive anxiety more days than not over 6 month period, inability to control worrying, anxiety and worry associated with three or more of following: restless, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance.
Define post traumatic stress disorder (PTSD) look over dsm Characterized by persistent reexperiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others, to which the individual responded with intense fear,helplessness or horror
Define acute stress disorder look at dsm Occurs within 1 month after exposure to a highly traumatic event
Define substance induced anxiety Characterized by symptoms of anxiety,panic attacks obsessions, and compulsions that develop with the use of a substance or within a month of stopping use of a substance
Define major depressive disorder Look at DSM criteria
Differentiate MDD and dysthymic disorder DD is characterized by a chronic depressive state for more than 2 years
Define anhedonia The inability to experience pleasure
Define anergia Fatigue or loss of energy
Define MDD subtypes (6) Psychotic feature, melancholic,atypical,catatonic,postpartum onset,seasonal affective disorder
Define psychotic features Delusional thinking, Disorganized thinking, hallucinations
Define melancholic features Severe for of endogenous depression
Define atypical features Dominant vegetative symptoms- overseeing oversleeping
Define catatonic features Non responsiveness, extreme motor retardation
List and define 3 stages of depression treatment Acute phase- 6-12 weeks reduction of symptoms Continuation 4-9 months prevent relapse Maintenance 1 year or more prevention of further episdodes
Define Bipolar I disorder At least one episode of mania alternates with major depression. Psychosis may accompany the manic episode
Define Bipolar II disorder Hypomanic episodes alternate with major depression. Psychosis is not present with major depression. Psychosis is not present in bipolar II. The hypomania of bipolar II tends to be euphoric and increases functioning, depression puts at ski for suicide
Define cyclothymia Hypomanic episodes alternate with minor depressive episodes. Hypomanic episodesmtend to be very irritable
Define rapid cycling Four or morenmood episodes in a 12 month period
Distinguish Btwn mania and hypomania Mania is more severe
Define flight of ideas Nearly continuous flow of accelerated speech with abruptnchanges from topic to topic
Define clang association Are the stringing together of words because of their rhyming sounds without regard to their meaning
Define associative loosness Disorganized thinking, manifested as jumbled and illogical speech and impaired reasoning
Define autism Thinking is not bound to reality but reflects the private perceptual world of the individual examples include neologisms, hallucinations, and delusions
Define ambivalence Simultaneously holding two opposing emotions, attitudes, ideas, or wishes toward the same person situation or object.
What are positive symptoms of schizophrenia Presence of something that is not normally present ex. Hallucinations, delusions
What are negative symptoms of schizophrenia The absence of something that should be present but is not ex. Apathy, lack of motivation, anhedonia
Define delusions False fixed beliefs that cannot be corrected by reasoning
Define concrete thinking Impaired ability to think abstractly
Define neologisms Made up words that have meaning to the pt. But a different or non existent meaning to others
Define echolalia The pathological repeating of smothers words and is often seen in catatonia
Define Echopraxia The mimicking of movements of another also seen in catatonic
Define word salad A jumble of words that is meaningless to the listener, and perhaps to the speaker as well, because of the extreme level of disorganization
Define Depersonalization A non specific feeling that a person has lost hue or her identity and that the self is different or unreal. Ex fingered as snakes or arms as rotting wood
Define derealization A falso perception that the environment has changed. Ex. Everything seems bigger or smaller or familiar surrounding have become somehow strange and unfamiliar,
What are two loss of ego boundaries in schizophrenia Derealization and depersonalization
Define hallucinations Involve perceiving a sensory experience for which no external stimulus exists
Define illusions Misperceptions or misinterpretations of real experience
Delusion: control Believing that another person group of people or external force controls thoughts feelings impulses or behaviors
Delusion: ideas of reference Giving personal significance to trivial events, perceiving events as relating to you when they are not
Delusion: grandeur Believing that one is a very powerful or important person
Delusion: somatic delusions Believing that the body is changing in an unusual way e.g. Rotting inside
Delusion: erotomanic Believing that another person desires you romantically
Delusion: jealousy Believing that ones mate is unfaithful
Define boundary impairment The impair ped ability to sense where ones body ends and the others bodies begins
Define stereotyped behaviors Repeated motor behaviors that do not presently serve a logical purpose
Define automatic obedience The performance by a catatonic patient of all simple commands in a robot like fashion
Define waxy flexibility The extended maintenance of posture usually seen in catatonic
Define negativism A kin to resistance but may not be intentional, active negativism patient does the opposite of what they are told to do, passive negativism, a failure to do what is requested
Define avolition Reduced motivation inability to initiate tasks
Define thought blocking A sudden interruption in thought process, usually due to internal stimuli
Define affective symptoms in schizophrenia Symptoms that involve emotions and their expression e.g. Dysphoria, suicidally, hopelessness
Define schizophreniform disorder Similar to schizophrenia except duration of illness lasts for less than one month, impaired social or occupational functioning may not be apparent
Define brief psychotic disorder A sudden onset of psychosis(delusions hallucinations, disorganized speech) or grossly disorganized or catatonic behavior for at least one day but less than one month
Define schizoaffective disorder Characterized by a major depressive manic or mixed mood episode presenting concurrently with symptoms of schizophrenia
Define delusional disorder Involves on bizarre delusions, e.g. Situations that could happen in reality such as being followed or deceived
Define shared psychotic disorder folie a deux A condition which one individual comes to share the delusional beliefs of another with whom there is a close sustained relationship
Define induced or secondary psychosis Psychosis may be induced by substance or caused by medical condition
Symptoms of metabolic disorder Weight gain dyslipidemia and altered glucose metabolism, a significant concern in most atypical antipsychotic drugs
What causes extrapyramidal side effects The blocking of d2 dopamine receptor site in the motor areas
What are some EPSs Akathisia, acute dystonias, psuedoparkinsonism, tar dive dyskinesia
Define acute dystonias Acute sustained contraction of muscles usually of the head and the neck
Define akathisia Psychomotor restlessness evident as pacing or fidgeting sometimes pronounced ver distressing to patients
Define pseudo Parkinsonism A medication induced constellation of symptoms associated with parkinsons disease:tremor, reduced accessory movements, impaired gait and stiffening or muscles
Define tar dive dyskinesia A persistent EPS that usually appears after prolog end treatment and persists even after the med has been discontinued. Consists of involuntary tonic muscle mocked that typically involve the tongue, fingers toes, neck trunk or pelvis
Define Neuroleptic malignant syndrome Reduced consciousness Increased muscle tone and autonomic dysfunction including hyperpyrexixa, Kabila hypertension, tacycardiatachyonea, diaphoresis and drooling
Define paranoia Any intense and strongly defended irrational suspicion
Define catatonic withdrawn Phase Abnormal levels of motor behavior, posturing, waxy flexibility, stereotyped jockeyed, muteness, extreme negativism, automatic obedience, echolalia, echopraxia
Define catatonic excited phase State of greatly increased motor activity
Define disorganized schizophrenia Dominant disorganized speech and behavior and inappropriately affect, delusions and hallucinations, grimacing, mannerisms other odd behavior
Define Unorganized schizophrenia Has active phase symptoms but no one clinical presentation dominates
Define residual No longer in active phase
Created by: Nwallace1965