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developmental stages

developmental stage

name freud stages: Oral(B-18mo) anal(18-36mo) phallic/oedipal(3-5y) latency(5-11/13y) genital(11-13y)
describe (B-18mo) stage Oral- major site of tension/gratification is mouth, lips, tongue; ie: biting/sucking. Id present @ birth, Ego develops from rudimentary structure present @birth
describe (18-36mo) stage Anal-anus & surrounding area are major source of interest -voluntary sphincter control acquired
describe (3-5y) stage Phallic/oedipal-genitals focus of intrest, stimulation, & excitment -penis is organ of interest for both sexes -penis envy for girls -masturation common -oedipus complex in boys & girls
describe (5-11y) stage Latency- resolution of oedipus complex -sex drive channelled into school activites -formation of superego** -final stage of psychosexual development
describe (11-13y) stage Gential- begins w/puberty & biologic capacity for orgasm; involves capacity for true intimacy
name Erikson's stages (psychosocial) first 4: trust vs. mistrust (infant) autonomy Vs. shame/doubt (toddler) intitiative Vs. guilt (preschool) industry vs. inferiority (schoolage)
name Erikson's stages last 4 identity vs. role confusion (adolescense) intimacy v isolation (young adult) generativity v stagnation (middle adult) ego integrity v despair (maturity)
explain Eriksons trust v mistrust Hope(infant)- viewing world as safe & reliable; relationships nurturing, dependable, & stable
explain Eriksons autonomy v shame/doubt Will(toddler)- acheiving a sense of control & free will
explain eriksons initiative v guilt Purpose(preschool)-beginning of conscience; learning to manage conflict & anxiety
explzin eriksons industry v inferiority competance(schoolage)-emerging confidence in abilities; taking pleasure in accomplishments
explain eriksons identity v role confusion Fidelity(adolescence)-formulating a sense of self & belonging
explain eriksons intimacy v isolation Love(young adult)-forming adult, loving relationships & meaningful attachments to others
explain eriksons generativity v stagnation Care(middle adult)-being creative/productive; establishing next generation
explain eriksons ego integrity v despair Wisdom(maturity)-accepting responsibility for 1 self & life
who is Hildeard Peplau? nursing theorist who developed the concept of the Therapeutic Nurse-Patient Relationship.
4 phases of the nurse-pt relationship orientation identification exploitation resolution
phase 1 orientation directed by nurse, engages client in tx, giving explainations & info, & answering questions.
phase 2 identification client works independantly w/nurse, expresses feelings & begins to feel stronger
phase 3 exploitation client makes full use of the services offered
phase 4 resolution pt no longer needs pro. services & gives up dependant behavior. relationship ends
6 roles of nurse in the therapeutic relationship stranger-offering pt same courtesy as stranger resource person-giving specific answers to questions in larger context teacher-helping client learn formally or informally
6 roles of nurse in relationship cont'd leader-offering direction to pt or group surrogate-being substitute for other like parent/sibling counsler-promoting experiences leading to health for pt like expressing feelings.
mild anxiety sharpened senses inc. motivation alert enlarged percetual feild can solve prob effective learning restless butterflies sleepless irritable hypersensitive to noise
moderate anxiety selectivelt attentive perceptual feild limited to task can be redirected cant connect thoughts muscle tension diaphoresis pounding pulse headache dry mouth higher voice pitch
moderate anxiety cont'd inc rate of speech GI upset frequent urination inc automatisms
severe anxiety perceptual feild on 1 detail or scattered details cant complete tasks cant solve prob or learn behavior of anxiety relief but ineffective feels awe,dread,horror not redirected
severe anxiety cont'd severe headache N/V, diarrhea trembling rigid stance vertigo pale tachycardia chest pain crying ritualistic behavior
panic anxiety perceptual field only on self cant process environmental stimuli distorted perceptions loss of rational thought personality disorganization doent recognize danger possibly suicidal
panic anxiety cont'd delusions or hallucination possible cont communicate verbally either cannot sit or totally mute & immobile mat bolt & run
psychoanalysis takes months or years to complete (rich mans therapy)
ID innate desires pleasure seeking aggression sexual impulse
Super ego moral ethical values parental
Ego mature adaptive the balance between the two behavior
deinstitutionalization Tx for pts in the least restrictive environments possoble. shift from state hospitals to community facilities. Lead to the revolving door effect
revolving door effect shorter hospital stays, but the pts return back to hospitals more frequently.
define mental disorder clinically significant behavioral or psychological syndrome or pattern that pccurs in an individual & is associated w/present distress or disability or w/inc risk of suffering death, pain, disability, or imp loss of freedom
mental health multifaceted & has many infuential factors. catagorized as individual, interpersonal, & social/cultural
what is the DSM-IV-TR outlines specific Dxs. provides standerdized nomenclature & language for all mental health pros. differentiates Dxs & defining charectaristics. assists in IDing underlying c/o disorders
Axis I IDs all major psyc disorders EXCEPT mental retardation & personality disorders ie:depresison, schizo, anxiety,substance-related disorders
AxisII reporting mental retardation & personality disord. & prominant maladap[tive personality features & defense mechanisms
AxisIII current med conditions are potentially relevant to understanding or managing persons mental disor. & med conditions that may contribute to understanding pt
AxisIV psycsocial & environmental problems that amy affect Dx, Tx, & porg. of Dx. ie:problems w/support goups, social environment, occupation, housing, economics, access to HC, & legal system
AxisV Global Assessment of Functioning. scale of 0-100 on CURRENT level of functioning. Dr may give score out of last 6mo or Year. Pt must leave hiigher w/what they came in with
managed care control balance b/t quality & cost of care. ppl recieve care based on need rather than request
case management case-by-case basis to provide necessary services while containing cost. Manager coordinates all needs for pt
standard of practice: Assessment psyc nurse collects comprehensive health data that is pertinant to pts health of situation
standard of practice: Dx psyc nurse analyzes assess data to determine Dx of problems, including level of risk
standard of practice: outcome ID psyc nurse IDs expected outcomes for a plan individualized to pt or situation
standard of practice: planning psyc RN develops plan that prescribes strategies & alternatives to attain expected outcomes
standard of practice: implementation psyc RN impliments the ID plan
standard of practice: 5a coordination of care psyc RN coordintes care delivery.
Linda Richards first psyc nurse (1940)
Milieu Therapy community of therapy where clients interact with one another. Ex: practicing interpersonal skills, giving feedback abt behavior to each other,& working together as a group to solve everyday problems
psychosocial interventions nursing activites that enhance clitent's social & psyc functioning & improve social skills, interpersonal relationships, & communication
Created by: 1225581002