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Mental Health sum#1
Note cards for first test
| Question | Answer |
|---|---|
| 1 The 5 A’s | Ask a question, Acquire literature, Appraise the literature, Apply the evidence, Assess the performance |
| 1 attending | refers to an intensity of presence, being there for and in tune with the patient |
| 1 Caring | is the most natural and most fundamental aspect of human existence |
| 1 Clinical algorithms | are step by step guidelines prepared in a flowchart format |
| 1 Clinical pathways | are usually specific to the institution using them, they serve as a map for specified treatments and interventions |
| 1 Clinical practice guidelines | are systematically developed statements that identify, appraise, and summarize the best evidence about prevention, diagnosis, prognosis, and therapy |
| 1 Evidence based practice | the method for using treatment approaches to medical and mental health illness that are scientifically grounded |
| 1 Patient advocate | the person who speaks up for the patient |
| 1 Psychiatric-mental health nursing | employs a purposeful use of self as its art and a wide range of nursing, psychosocial, and neurobiological theories and research evidence as its science. |
| 1 Recovery model | is seen as the social model of disability rather than the medical model |
| 1 Hildegard Peplau | mother of psychiatric nursing |
| 1 Three areas inherent in the art of nursing | caring, attending, and patient advocacy |
| 2 mental health | successful performance of mental functions resulting in the ability to engage in productive activities, and cope |
| 2 mental illness | is considered a clinically significant behavioral or psychological syndrome experienced by a person and marked by distress, or disability |
| 2 mental disorders | are medical diseases |
| 2 DSM-IV-TR | manual that classifies mental disorders |
| 2 Psychiatry’s definition of normal mental health | changes over time and reflects changes in cultural norms, society’s expectations, professional biases, individual differences, and political climate |
| 2 resiliency | the ability to recover from or adjust to misfortune and change |
| 2 seven aspects of mental health | happiness, control over behavior, appraisal of reality, effectiveness in work, healthy self-concept, satisfying relationships, and coping strategies |
| 2 epidemiology | is the quantitative study of the distribution of mental disorders in human populations |
| 2 prevalence rate | is the proportion of a population with a mental disorder at a given time |
| 2 factors that affect mental health | support system, family, developmental events, cultural beliefs, health practices, negative influences |
| 2 biologically based mental illness | a mental disorder caused by a neurotransmitter dysfunction, abnormal brain structure, or inherited genetic factors |
| 2 types of biologically based | schizophrenia, bipolar, major depressive, OCD, panic, PTSD, autism |
| 2 In disorders- | There is much physical in mental disorders, and much mental in physical disorders |
| 2 The three things that affect mental illness the most are | family, religion, and sex |
| 2 intrinsic factors are | inherited factors |
| 2 extrinsic factors are | environmental factors |
| 2 5 Axis | I. clinical disorder II. personality disorders and mental retardation III. General medical condition IV. Environmental problems V. Gaf |
| 2 NANDA describes a nursing diagnosis as | a clinical judgment or response to health problems and life processes |
| 2 Gaf | Global assessment of functioning the higher the gaf the better functioning |
| 3 psychotherapy | talk therapy, focusing on the inner workings of the mind |
| 3 freuds three layers of mental activity | conscious, preconscious, and unconscious |
| 3 conscious | current awareness |
| 3 preconscious | lying below the surface, but accessible |
| 3 Unconscious | where our primitive feeling drives and memories reside |
| 3 id | primitive pleasure seeking part of our personality that resides in unconscious mind |
| 3 ego | sense of self, balances id and superego by using defense mechanisms, rational mind |
| 3 superego | our conscience, influenced by our morals |
| 3 psychoanalytic therapy | knowing the unconscious mind to uncover the truth, long and expensive |
| 3 transference | patient projects intense feelings onto the therapist related to previous relationships |
| 3 countertransference | when therapist projects feelings from past experiences onto the patient |
| 3 interpersonal theory | focuses on what goes on between people |
| 3 anxiety interpersonal | is transmitted empathetically from parent to child, also from approval or disapproval felt by child |
| 3 according to Sullivan | all behavior is aimed at avoiding anxiety and threats to self-esteem |
| 3 good me | focusing on positive attributes |
| 3 bad me | hiding the negative aspects from others and possibly ourselves |
| 3 not me | most drastic, things we find so objectionable that we can not even imagine them being part of us. |
| 3 interpersonal therapy | therapists guide and challenge maladaptive behaviors and distorted views, with focus on life |
| 3 behavior therapy | attempts to eliminate maladaptive behavior |
| 3 Ivan Pavlov | famous for classical conditioning, response to stimuli |
| 3 Systematic desensitization | learned responses can be reversed through facing your fear |
| 3 Aversion therapy | antabuse, eradicate unwanted habits by associating unpleasant consequences with them |
| 3 Biofeedback | people learn to control body reactions through relaxation |
| 3 cognitive therapy | seeks to modify negative thoughts that lead to dysfunctional emotions and actions |
| 3 schema | assumptions about ourselves or the world |
| 3 automatic thoughts | unthinking responses based on schemas |
| 3 cognitive development | dynamic progression from primitive awareness and simple reflexes to complex thought and responses |
| 3 piaget stages | sensorimotor- 0-2 yrs, preoperational 2-7 years, concrete operations 7-11 yrs., formal operations 11-adulthood |
| 3 Object permanence | when child can conceptualize objects that are no longer visible |
| 3 operations | term for thinking about objects |
| 3 conservation | when child can see from another’s point of view and can see a variety of solutions to a problem. |
| 3 Kohlberg’s 3 stages of moral thinking | pre-conventional, conventional, post-conventional |
| 3 biological model | current, dominant model, mental disorders are believed to have physical causes, will respond to physical treatment |
| 3 biological therapy | psychopharmacology is primary treatment for mental disorders |
| 3 major classifications of meds | antidepressants, antipsychotics, antianxiety, mood stabilizers, and psychostimulants |
| 3 Hildegard Peplau | name most commonly associated with psychiatric nursing |
| 3 Peplau four stages of anxiety | mild, moderate, severe, panic |
| 3 mild anxiety | day to day, stimuli are perceived and understood |
| 3 moderate anxiety | heightened sense of awareness, perceptual field narrowed, requires more direction |
| 3 severe anxiety | interferes with clear thinking, perceptual field greatly diminished, behavior directed at reducing anxiety |
| 3 panic anxiety | overwhelming, dangerous, cannot follow directions, panic attacks |
| 3 Peplaus four phases of therapeutic relationship | preinteraction, orientation, working, termination |
| 3 preinteraction | before meeting, report, read chart |
| 3 orientation | meets patient, set up times for meetings, anxiety, formulates nursing diagnosis, sets goals |
| 3 working | trust is built, patient identifies and works on problems, growth is evident |
| 3 termination | final, feelings of loss and anxiety, goals achieved, plans made |
| 5 Psychiatric Assessment | establish rapport, obtain chief complaint, review physical status, assess risk factors, preform MSE, assess psychosocial status, identify goals, formulate plan |
| 5 Mental Status Exam | objective data, behavior, nonverbal, appearance, speech, mood, thought content, perceptions, conative ability, judgment |
| 5 psychosocial assessment | subjective data, patients complaint, history, drug abuse, family, coping mechanisms, personal info, beliefs, patients goals |
| 5 nursing diagnosis | problem, etiology, supporting data |
| 5 outcomes | patient centered outcome hopes, wrote positively |
| 5 planning | pathways, or individual, use best interventions, must be safe- appropriate- individualized- and evidenced based |
| 5 EBP | nurses use of clinical skill with relevant research |
| 5 implementation | putting the plan into action |
| 5 evaluation | should be systematic, ongoing, and criterion based |
| 5 documentation | seventh step, must be focused, organized, and pertinent |
| 6 therapeutic communication | professional, goal directed, and scientifically based |
| 6 communication can be 90% | nonverbal |
| 6 stimulus | one person has a need to talk to another |
| 6 sender | person sending the message |
| 6 message | information sent |
| 6 media | how the message is sent |
| 6 receiver | person receiving the message |
| 6 feedback | response to the sender |
| 6 Peplaus 2 principals that guide communication | clarity and continuity |
| 6 clarity | ensures the meaning of the message is understood by both parties |
| 6 continuity | promotes connections among ideas and feelings conveyed in those ideas |
| 6 factors that affect communication | personal, environmental, and relationship |
| 6 symmetrical | when two participants are equal |
| 6 complementary | one participant is superior to the other |
| 6 content | the verbal part of a message |
| 6 process | the nonverbal part of a message |
| 6 useful tools for nurses when communicating | silence, active listening, and clarifying |
| 6 silence | the absence of communication |
| 6 active listening | notes patients verbal and nonverbal responses as well as their own |
| 6 clarifying | corrects misunderstandings before they create problems |
| 6 paraphrasing | restating in different ways using shorter length |
| 6 restating | mirrors the patients message |
| 6 reflecting | statement that conveys the nurses observation of a patient when sensitive issues are discussed |
| 6 sharing observations | shows acceptance, makes pt aware of inner feelings and helps them own them |
| 6 exploring | enables the nurse to examine important information more fully |
| 6 excessive questioning | makes nurse look like interrogator |
| 6 giving approval or disapproval | may lead patient to try to please nurse, implies judgment |
| 6 giving advice | can foster dependency |
| 6 asking why questions | implies criticism |
| 7 basis of all psychiatric nursing treatment | therapeutic nurse patient relationship |
| 7 goals of therapeutic communication | facilitating, assisting, helping, promoting |
| 7 facilitating | helps communicate distressing thoughts and feelings |
| 7 assisting | helps problem solve to complete ADL’s |
| 7 helping | help patients to examine self-defeating behaviors and test alternatives |
| 7 promoting | promotes self-care and independence |
| 7 social relationship | primarily for friendship, enjoyment, or accomplishing a task |
| 7 in social relationships | roles may shift |
| 7 in therapeutic relationship | nurse assumes variety of roles, but relationship is constantly focused on patients problem |
| 7 accountability | nurses assume responsibility for their actions |
| 7 focus on patient needs | nurse focuses on best interest of patient |
| 7 clinical competence | nurse bases her conduct on knowledge |
| 7 delaying judgment | nurse refrains from judging patients |
| 7 supervision | nurse is supervised by a more experienced nurse |
| 7 during orientation phase | nurse forms a formal or informal contract with patient |
| 7 what helps a relationship | consistency, pacing, listening, impressions, comfort and control, and patient factors |
| 7 what hurts a relationship | inconsistency and unavailability, lack of self-awareness |
| 7 positive regard | ability to view another person as worthy of caring about |
| 7 space | interment 0-18”, personal 18-40”, social 4-12’, public 12+ feet |
| 7 communication can be facilitated by | offering leads (go on), statements of acceptance (uh-huh) |
| 17 crisis | acute, time limited occurrences experienced as emotional reactions |
| 17 crisis intervention | what nurses do to assist those in crisis to cope |
| 17 three types of crisis | maturational, situational, adventitious |
| 17 maturational crisis | each stage of Erickson is a maturational crisis |
| 17 situational crisis | from external source, (death, divorce) |
| 17 adventitious | crisis |
| 17 how many phases of crisis | four |
| 17 phase 1 | person is confronted with a problem, anxiety increases, defense mechanisims kick in |
| 17 phase 2 | if defense fails, anxiety continues to increase, functioning becomes disorganized, trial and error begin |
| 17 phase 3 | trial and error fails, anxiety increases to sever and panic, automatic relief behavior kicks in, resolution may be reached |
| 17 phase 4 | if problem not solved coping skills are ineffective, anxiety can overwhelm, serious personality disorganization, depression, violence, or suicide |
| 17 crisis assessment adverse affecters | unrealistic perception of problem, inadequate supports, inadequate coping mechanisms |
| 17 implementation has two basic goals | patient safety, and anxiety reduction |
| 17 primary care | promotes mental health and reduces mental illness to decrease the incidence of crisis |
| 17 secondary care | establishes intervention during an acute crisis to prevent prolonged anxiety, primary goal ensure safety |
| 17 tertiary care | provides support for those who have experienced a severe crisis and are noe recovering from a disabling mental state |
| 17 critical incident stress debriefing | seven phase group meeting that offers individuals the opportunity to share in a safe environment |
| 17 introductory phase CISD | purpose of meeting explained, participants motivated, confidentiality assured, guidelines explained, questions answered |
| 17 fact phase | discusses facts of incident, introductions and tell what happened from their perspective |
| 17 thought phase | participants discuss thought about the accident |
| 17 reaction phase | engage in discussion about whole event, talk about worst most painful part |
| 17 symptom phase | describe conative, emotional, and behavioral experiences since incident |
| 17 teaching phase | symptoms acknowledged and affirmed, talk about future symptoms, stress management techniques taught |
| 17 reentry phase | review old material, introduce new topics, bring closure |
| 17 Evaluation | usually occurs 4-8 weeks after initial interview, anxiety should be back to precrisis levels |
| 22 grief | reaction to loss |
| 22 acute grief | 4-8 weeks |
| 22 active symptoms of grief | 3-6 months |
| 22 work of mourning | 1-2 years |
| Bereavement | social experience of dealing with the death of a loved one |
| 22 mourning | culturally patterned expressions of bereavement and grief |
| 22 disenfranchised grief | when incurs a loss that can not be openly acknowledged or publicly mourned |
| 22 public tragedies | a loss whose effect is felt broadly across a community |
| 22 Kubler Ross | identified distinct phases of the human response to death and dying: denial, anger, bargaining, depression, and acceptance |
| 22 denial | a bereaved persons first response to death |
| 26 ethical dilemma | when there is a conflict between two courses of action |
| 26 ethics | the study about what is right and wrong in society |
| 26 bioethics | ethical questions that arise in healthcare |
| 26 beneficence | duty to act for the good of others |
| 26 autonomy | respecting the rights of others to make their own decisions |
| 26 justice | duty to distribute resources or care equally |
| 26 fidelity | maintaining loyalty and commitment to the patient |
| 26 veracity | ones duty to communicate truthfully |
| 26 law and ethics are closely related | because law tends to reflect the ethical values of society |
| 26 deinstitutionalization | in 1963 when care shifted from state care to community care |
| 26 civil rights | people with mental illness have the same civil rights |
| 26 writ of habeas corpus | where a patient can challenge commitments |
| 26 least restrictive alternative doctrine | most important concept applicable to civil commitment, least drastic means taken |
| 26 voluntary admissions | have the right to obtain and demand release |
| 26 involuntary admission | made without the patient consent |
| 26 hold for commitment | where they can hold you 1-10 days if you are a danger to yourself or others |
| 26 when voluntary demands release | hospital starts a 4 hr. letter that allows time for Dr to intervene |
| 26 conditional release | requires outpatient treatment for a specified time |
| 26 treatment must meet criteria | must be humane, staff must be qualified, plan must be individualized |
| 26 right to refuse treatment | patients can refuse treatment, judge can force them in some cases |
| 26 informed consent | patients right to know and self-determine, psych hospitals must get on all meds |
| 26 restraints | must have a dr order signed within 24 hrs, patient checked every 15 to 30 minutes |
| 26 tort | civil wrong in which money damages may be collected |
| 26 malpractice | act that breaches duty of care |
| 26 duty | measured by standard of care |
| 26 breech of duty | conduct that exposes the patient to an unreasonable risk of harm |
| 26 abandonment | when nurse fails to leave patient safely back in the hands of another healthcare provider |
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