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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

Created by: 100000602352444

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