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mental phase II

mental health

ID basic innate drive for survival and pleasure, demands constant gratification
ID goals are to reduce tension, to increase pleasure, and to keep discomfort to a minimum
EGO reality factor, perceives conditions accurately, decides how and when to act
EGO stand for reason and good sense, whereas the id stands for untamed passion
SUPEREGO parental or societal value system, perfection and morality, judge and censor over thought/activities of the ego.
personality the relatively consistent set of attitudes and behaviors particular to an individual
personality consist of unique patterns of mental,emotional, and behavioral traits, woven together. influenced by genetic and interactions with the environment
preconsciousness thoughts, feelings, drives and ideas that are outside our awareness but we easily recall to consciousness
preconsciousness helps to screen certain thoughts and repress unpleasant thoughts and desires.
unconsciousness holds memories, feelings, and thoughts that are not available to the conscious mind.
self complex concept comprising four distinct parts that influence behavior .
self personal identity, body image, role, self esteem
manifestation of body image include stance, posture, clothing and jewelry
role performance expected behavior of an individual in a social position.
ascribed roles no personal choice (male/female)
assumed role selected by an individual (occupation)
self esteem comprises the thoughts and feelings each of us holds about ourselves
self concept more than the total of the four parts of self
self concept all perceptions and values each of us holds and our behaviors and interaction
disturbances in self concept arise in those of us with mental illness or emotional problems.
stress nonspecific response of the body to any demand made on it.
our response to a stressful situation or event often a result of learned or conditioned behavior.
stressor a situation, activity, or event that produces stress.
stress highly subjective, uniquely perceived by the person experiencing it
anxiety vague feeling of apprehension that results from a perceived threat to the self. produces fight/flight
anxiety a universal emotion and is a response to a stressful event. assess the vital signs to assess the level of anxiety
anxiety an internal process we experience when there is a real or perceived threat to our physical body or self concept.
mild anxiety increased vital signs and an awareness of danger,ready for action, increased motivation, think-make connections, alert
moderate anxiety tension, decreased perception, alert to specific info, argue-teasing-complaining,
moderate anxiety headache, diarrhea, nausea, vomiting, low back pain, increased vital signs
severe anxiety feels impending danger, tunnel/ distorted vision, communication distorted/difficult to understand
severe anxiety feels fatigue, changes in vital signs evident on assessment
panic extreme terror, immobilized, reality distorted,personality disintegrates,can cause harm to self and others
anxiety major component of all mental health disturbances.
mild anxiety readies the body for action and reaction to danger
motivation gathering of personal resources or inner drive to complete a task or reach a goal.
frustration anything that interferes with goal directed activity.
compensation a boy who is small in stature places emphasis on academics rather than attempting sports
conversion the individual who witnesses a murder then experiences sudden blindness with no organic cause
denial the patient who suffered a heart attack is told to restrict physical activity is found doing push-ups and sit-ups
displacement the person has an argument at work at work and comes home and yells at his family
dissociation person who has been victimized retells the situation laughing and joking
identification person dresses like their hero
introjection person that follows commands without the authority figure present
projection a student who does poorly on an examination and states, "the test was unfair. the teacher did not present the material correctly."
rationalization dad was in a hurry this morning so I did do what I was told so that I could catch a ride to school
reaction formation a person who is excessively polite to an individual who is disliked
regression an 8 year old who reverts to bed-wetting and thumb-sucking while hospitalized
repression a patient who is incontinent after surgery dismisses the event due to embarrassment.
sublimation teenager who engages in many competitive sports
suppression a student who fails to keep an appointment for academic counseling
mind body link positive thinking to heal the body within
placebo effect positive response to treatment
illness homeostatic imbalance
recovery and rehabilitation the last stage of an illness event
denial refusal to admit being ill.
short term denial useful in mobilizing internal resources
long term denial results in maladaptive behavior patterns
shock emotion that paralyzes the individual's ability ability to process information. incapable of decision making
anger response to emotional/physical injury directed either inward or outward toward others, or both.
anger irrational response to minor events of the day and/or interrupts the person's social functioning
withdrawal removes self from interaction with others and the environment.
withdrawal often a sign of depression
social isolation in the older adult frequently a result of physical or financial limitations
losses in the older adult results in anxiety, fear, or depression
relocation to or within the hospital potential to cause stress in the older person that manifests as behavioral change
often causes the loss of the will to live hopelessness and helplessness
hopelessness and helplessness sometimes causes suicide
secondary gain sometimes a ploy to manipulate and cope with various emotional conflicts.
secondary gain important for you to recognize this in order to plan appropriate interventions to meet emotional/psychological needs of patients playing up the sick role
in order to facilitate healthy adaptation understand the relationship of stressors, anxiety, and culture to a behavior
in learning, growth, and movement toward self actualization recognize constructive aspects of mild or moderate anxiety
with the context of perceptions of what is actually happening analyze current expectations, goals, beliefs, and values
positive thinking= healing power
crisis intervention goals decrease emtional stress and protect victim
crisis intervention goals assist the victim to organize and mobilize resources
crisis intervention goals return to precrisis status or a higher functional level
crisis intervention step assess the situation and individual
crisis intervention step determine possible interventions with input from clergy, family, friends, and health care provider
crisis intervention step implement the intervention plan
crisis intervention step crisis resolve and/or anticipatory plan emerges from the solution to the problem
initial phase of crisis confusion, disbelief, high anxiety that leads into a denial phase
once reality of crisis is evident anger and remorse, sadness and crying and acknowledges that what once was will never be
the final phase of reconciliation life will continue but will be different than it was and adaptation occurs
ways to help address the family crises constructively active listening, restating the facts, and therapeutic communication techniques
with or without crises they resolve in 4-6 weeks
result of crises development of coping skills and roles in life
short term active support focus on problem solving that facilitates a positive resolution to the crises
assessment of the emotional status: general appearance describe dress, make up, and hygiene
assessment of the emotional status: general behavior describe general activity level, posture, gait, and response to examination
assessment of the emotional status: speech pattern describe rate, tone, loudness, and quantity content of speech
assessment of the emotional status: speech pattern (response to questions too detailed; extreme distractibility; unable to complete answer; uses rhyming
assessment of the emotional status: content of thought describe thinking: reality oriented, delusional, evidence of hallucinations, or evidence of ideas or reference or other non-reality-based thinking
assessment of the emotional status: mood and affect describe overall feeling state and affect
assessment of the emotional status: sensorial function describe orientation, memory, attention, ability to think abstractly
assessment of the emotional status: insight and judgement does the individual understand the present situation? what is the individual willing to do about it?
assessment of the emotional status: potential for danger assess the individual's potential for violence or self esteem, degree of impulse control, previous history of violence or aggression toward others
frustration important to understand the patients by questions family and friends
self-reflection tool used when establishing a relationship with a patient with a psychiatric disorder
crisis person suffers a stressor and responds with ineffective coping efforts
neurosis ineffective coping with stress that causes mild interpersonal disorganization.
psychosis out of tough with reality, severe personality, perception, judgement impairment.
multiaxial system (DSM-IV-TR) classifies mental disorders and outlines various disorders and descriptive references
DSM-IV-TR facilitate medical diagnosis and to provide a guide to clinical practice
organic psychiatric disorders dementia, delirium
thought process disorders bizarre non reality-based thinking, defined by reality/communication distortion, withdrawal schizophrenia
affective (mood) disorders major depression, bipolar affective disorder
anxiety disorders generalized anxiety, panic disorder, phobias, obsessive-compulsive disorders,
types of delusions grandeur, ideas of reference, somatic delusions, thought broadcasting,thought insertions, thought withdrawal
grandeur I am God
ideas of reference the lady on tv is telling me to buy soap
persecution they put a transmitter in my tooth to monitor my every word
somatic delusions I have leprosy
thought broadcasting you all know the thoughts I have been having today
thought insertion janie put these thoughts in my head for her own pleasure
thought withdrawal you have been stealing my thoughts
organic mental disorders identifiable brain disease or dysfunction is the basis for the behavior
predominant characteristic of this disorder is disorientation organic mental disorder
axis 1 ID all major psychiatric disorders except developmentally delayed and personality disorderss,depression,schizophrenia, anxiety and substance-related disorders
axis 2 personality and developmental disorders, as well as prominent maladaptive personality features and defense mechanisms
axis 3 general medical conditions that are potentially relevant to the understanding or management of the person's mental disorder
axis 4 psychosocial and environmental disorders that have potential to affect the diagnosis, treatment, and prognosis of mental disorders
axis 5 global assessment of functioning that rates the overall psychological functioning of the person on a scale of 0 to 100
dementia treatment and prognosis treatment depends on the cause. prognosis is poor; essential feature of this condition is the slow deterioration rate of mental functioning
delirium treatment and prognosis treatment depends on the cause prognosis is guarded
organic nursing interventions orientate, decrease stimuli, safe environment, adequate nutrition, self care support
schizophrenia treatment and prognosis treatment is milieu therapy, psychotherapy, antipsychotic drug therapy, and long-term social support
schizophrenia treatment and prognosis prognosis is variable and depends on the extent of the symptoms and responses to treatments.
schizophrenia treatment and prognosis patient with paranoid type is often reluctant to seek treatment
schizophrenia nursing intervention establish therapeutic relationship,orientation,reduce anxiety, manage positive/negative behaviors, medication management
major depression treatment and prognosis includes antidepressant drug therapy, individual family or group psychotherapy, and ECT when drugs are ineffective or contraindicated
bipolar affective disorder treatment and prognosis treatment possibilities include psychotherapy; antimanic drugs (lithium); and family and individual support/education regarding drugs use
bipolar/major depression nursing interventions be kind but firm,expressive feelings, avoid activities that require attention, well balanced meals and snacks high fiber, avoid lithium toxicity
anxiety nursing interventions decrease stimuli, encourage the individual to share thoughts, remember what ever happens, I can deal with it, relaxation techniques, self care,
personality disorder interventions be firm and consistent, set limits on behaviors, encourage ventilation of feelings, know where the patient is at all times
personality disorder interventions establish consequences for limit violations, positive feedback, decision making and participation, always remain calm, watch for manipulating behaviors
Delirium Change in consciousness that occurs over a short period of time; Acute cognitive disorder that produces a marked change in mental status. It is reversible.
delirium reduced awareness and attention to surroundings,disorganized thinking, sensory misinterpretation and irrelevant speech.
delirium possible causes are physical treat the underlying cause. illnesses such as fever, heart failure, pneumonia, azotemia, or malnutrition
dementia Changes in mental status are caused by physical changes in the brain Loss of multiple abilities, including long and short memory loss, language, and the ability to understand (conceptualize).
dementia alzheimer's is the most common form of ________ in the U.S.
dementia vascular________is the second most common form in the U.S
orientation techniques and safe environment dementia key nursing interventions
Schizophrenia group of psychotic disorders characterized by gross distortion of reality, disturbance of language, and communication, withdrawal from social interaction, and the disorganization and fragmentation of thought, perception, and emotional reaction.
Schizophrenia Leading hypothesis regarding the neurobiology of schizophrenia; Excess of Dopamine in the center of the brain; Lowered Dopamine levels in the prefrontal cortex region.
Schizophrenia Hallucinations; Delusions; Formal thought disorder; Incoherence; Derailment; Illogical thinking; Repeated instances of bizarre or disorganized behavior.
schizophrenia subtypes Paranoid Type; Catatonic Type; Disorganized Type; Undifferentiated Type; Residual Type.
negative behavior patterns of schizophrenia apathy, social withdrawal, flat affect, anhedonia
positive behavior patterns of schizophrenia delusion, hallucination, disordered thinking, concreteness
stages of schizophrenia prodromal phase, acute phase, residual phase
mood disorders also known as affective disorders
mood disorders severe and inappropriate emotional responses, prolonged and persistent disturbances of mood and related thought distortions, and other symptoms associated with either depressed of manic states
mood prolonged emotion that affects a person's psyche. ranges from manic to depression
mood neurotransmitter insufficiency or excess of nor/epinephrine is sometimes the result of heredity or environmental factors such as prolonged stress or brain trauma
depression mood disturbance characterized by exaggerated feelings of sadness, despair, lowered self esteem, loss of interest and pessimistic thoughts
depression _____is so severe at times, it can cause you to contemplate or succeed at committing suicide
coping skills teaching _________ is essential to guard against suicide
incurable or painful illness diagnosis causing suicide in the hospital setting
unipolar depression major depressive disorder defined by repeating, severe, depressive episodes lasting more than 2 years
dysthymic disorder daily moderate depression that last more than 2 years. able to function but not enjoy life
bipolar disorder manic-depressive disorder
hypomanic episode early phase of a manic episode when symptoms are not severe
mania if untreated, delirium will possibly ensue, and death from exhaustion or accident is possible
cyclothymic disorder pattern that also involves repeated mood swings of hypomania and depression, though less intense
cyclothymic disorder no periods of normal function
seasonal affective disorders and postpartum depression connected to hormonal imbalances
seasonal affective disorder also known as winter depression is treated with phototherapy
further investigate if lasting more than two weeks postpartum depression
antidepressants, lithium, ECT, and psycho therapy treatment for mood disorders
antidepressants that take 2-4 weeks to work prozac, desyrel, elavil, effexor, meds ending in -ine
best taken in the a.m prozac
best taken at bedtime elavil
lithium used to treat bipolar disorder
signal anxiety learned response to an event such as test taking
free floating anxiety associated with feelings of dread that are not possible to identify
anxiety trait learned aspect of personality
generalized anxiety disorder (GAD) high degree of anxiety and/or avoidance behavior
GAD tend to worry or fret over many things and finds it difficult to concentrate on the task at hand
panic attack heart palp, tachycardia, sweating, trembling or shaking; feelings of dyspnea or choking, chest pain, nausea, chills or hot flashes
agoraphobia a type of panic disorder
agoraphobia high anxiety bought on by panic attack. tend to avoid people, places, or events. fears not getting help during an attack.
treatment for agoraphobia coping mechanisms, medication, emotional support and reassurance
obsessions recurrent, intrusive and senseless thoughts
compulsions behaviors that are performed in response to an obsessive thought.
Created by: SGT.MOSS