Crisis Intervention / Ethical / Sexual Assault
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| Sudden event in one's life which disturbs homeostasis, in which one's usual coping skills are compromised | crisis
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| 3 types of crisis | maturational / situational / adventitious
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| loss of job, death of loved one, abortion, severe mental/physical illness is example of? | situational crisis (usually anticipated)
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| overwhelming perception of event; usually resolved in 4-6wks; strugg for equalibirium | crisis
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| unplanned, crisis of disaster, accidental(flood, rape, fire, assault, murder) | adventitious crisis
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| interruption in stage of growth/development(midlife crisis) | maturational crisis
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| 3 short term meds used for crisis | antidepressants, sedatives/hypnotics, benzodiazepines (antianxiety)
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| 4 Phases of crisis | Phase 1 = exposure to stressor, Phase 2 = trial & error, Phase 3 = fight/fligt (anxiety increases to severe/panic level) Phase 4 = Breaking point (depression, suicide, confusion, personality disorganization)
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| 3 Counseling Strategies | Primary (client education), Secondary (crisis intervention), Tertiary (rehab)
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| 2 main goals of crisis intervention | client safety & decrease anxiety
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| True/False ? = Person in crisis, assumed to be mentally health & has functioned well in past, just presently in state of disequalibirum | TRUE
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| 4 important factors in assessment of client | safety, perception of event, support system, coping skills
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| Provide safety, assess problem, crisis intervention is what type of counseling strategy | Secondary
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| teach coping skills, assist client in making life changes, educate client is what type of counseling strategy | primary
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| CISD, Rehab, shelters, promoting optimal level of functioning is what type of crisis intervention? | tertiary
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| Used to debrief staff, schoolchildren, rescue/healthcare workers after tragic event | CISD (critical incident stress debriefing)
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| Consists of 7 phase group meeting in safe controlled environment | Critical incident stress debriefing (CISD)
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| Crisis can lead to what 3 things? | Personality disorder, Dissociative disorder, depression
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| Any type of sexual activity that victim doesnt want/agree to | Sexual Assault
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| Ex: RAPE, but can be over phone/internet, Can be inappropriate touching / intercourse | Sexual assault
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| CRIME of violence, aggression, anger & power. Weapon used is SEX. Nonconsensual. Person usually KNOWN (69%) | Rape
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| Occurs in 1 in 6 women.Most people suffer: LONG TERM & SEVERE emotional TRAUMA | Rape
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| 4 date rape drugs | GSB, Rohypnol, Ketamine, Burundanga
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| Most common/least common rapes? What do each experience? | Most common = marital/date rape - EXPERIENCE: depression & sexual distressLease Common = stranger - EXPERIENCE: depression, fear & anxiety
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| Similiar to PTSD. Contains an: Acute phase & Long-term reorganization phase | Rape-Trauma Syndrome
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| Occurs immediately & LASTS up to 2wks after rape. Emotions are EXPRESSED (crying, laughing) or CONTROLLED (confusion, numb) | ACUTE phase of Rape-Trauma Syndrome
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| What phase of crisis does feelings of helplessness occur (since coping skills failed)? Also experience confusion & disorganization | Phase 2 (Trial & Error)
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| Deals w/persons present problem & resolution of IMMEDIATE crisis only; Nurse takes ACTIVE, DIRECT role | Crisis intervention
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| lessens time person is mentally disabled DURING a crisis: (counseling strat) | Secondary Care
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| promotes mental health & reduces mental illness (counseling) | primary care
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| support 4 those RECOVERING from disabling mental state | tertiary care
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| Occurs 2 or more wks after RapeConsists of: Intrusive thoughts, increased motor activity, increase motional liability, fear & phobias | Long-Term Reorganizational phase of Rape-Trauma syndrome
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| Increased motor activity is ? (Long-Term Reorganization) | moving, changing phone#'s, contacting old friends
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| Increased motional liability would be? | crying, mood swings, depression, intense anxiety
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| intrusive thoughts are? | nightmares, flashbacks, insomnia, re-experiencing event
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| fears & phobias associated w/long-term reorganization is: | fear of outside/inside, fear of being alone/in crowds, fear of males, avoidance of significant others, fear of sexual encounters
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| True/False : Rape is usually NOT impulsive act, most are PLANNED & over 50% involve a weapon | True
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| situation that requires choice between morally conflicting alternatives | Ethical Dilemma
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| known to every society & most members of society comform to these norms | Social Norm
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| 3 Methods of changing human behavior | Behavior Modification Tech / psychotherapy / psychotropic drugs
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| values related to human conduct; Right/wrong of actions or Good/Bad of motives | Ethics
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| Ethical conecpts w/in scope of nursing, medicine & allied health | Bioethics
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| 5 principles of Bioethics | Autonomy / Beneficence / Fidelity / Justice / Veracity
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| Principles of Bioethics: 1. Treat everyone the same(fair & equal)2. (Nonmaleficence) Do NOT harm (loyal)3. Always tell the TRUTH | 1. Justice2. Fidelity3. Veracity
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| Bioethic Principles: 1. Act on others BEHALF2. RESPECT client decisions | 1. Beneficence2. Autonomy
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| PERSONAL beliefs | Values
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| process of SELF discovery where PERSONAL values & value ranking are identified | Values Clarification
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| what a person is entitled to have, do or recieve from others w/in limits of the law | Rights
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| Nice to know, but do NOT override lawCan influence lawsApproved by ANA | Code of Ethics
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| 2 TYPES of Law | Statutory & Common
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| Type of law enacted by legislative body (Nurse Practice Act) | Statutory
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| Type of law that applies to body of principles that eveolve from court decisions made in previous cases | Common Law
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| 2 CLASSIFICATIONS of Law | Criminal & Civil
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| addresses PUBLIC WELFARE. Violations are punisahable by imprisonment, loss of license | Criminal Law
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| Injury to patient or Felonies such as: selling narcotics, abuse, theft are example of what classification of law? | Criminal Law
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| addresses reckless conduct of an individual/organization. Violations = monetary compensations | Civil Law
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| Civil wrong for which money damages may be collected by injured party(plaintiff) from wrongdoer(defendant) | Tort
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| Assault, battery, false imprisonment, slander(oral) & liable(written) are what kind of tort? | Intentional Tort
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| Negligence & Malpractice are what kinds of tort? | Unintential Torts
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| Less expensive than hospital & less restrictive threatment setting | Outpatient treatment
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| 6 Clients Rights | Consent, Communication, Confidentiality, Dignity/Respect, Freedom from Harm, Participation in Plan of Care
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| Required for specific therapies/treatment (Client Rights) | Consent
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| clients Right to communicate privately w/outside visitors, phone, mail | Communication
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| Clients right to unnecessary physical restraint; isolation, meds, abuse, neglect | Freedom from Harm
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| Clients right that is ethically important but also LEGALLY protected | Dignity/Respect
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| Clients right to share w/only those who have need & right to know | Confidentiality
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| Clients right to be involved in treatment plan | participation in Plan of Care
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| procedure used to challenge unlawful detention by gov; "Free the Person" | Writ of Habeas Corpus
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| Admission sought by client/guardian | Voluntary admission
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| Admission made without clients consent; Client is danger to self/others, client can NOT meed own basic needs | Involuntary Admission (Committment)
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| True/False: Client is NOT capable of consenting to treatment if he is INVOLUNTARLY Admitted | FALSE
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| True/False: With Involuntary admission, requires client retain freedom from unreasonable bodily restraints, rights to refuse meds(including psychotropic & antipsychotic meds) | TRUE
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| 3 types of involuntary admission (committment) | emergency / temporary / long-term
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| (Committment) 1-10 daysPrevent dangerous behavior to self/othersAuthorized by police, dr., mental health professional | EMERGENCY involuntary committment:
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| Admission that is longer than 1-10 daysObserve, diagnose, treat person w/mental illnessREQUIRES medical certification by 2 or more drs that person is mentally ill & in need of treatment | TEMPORARY (Observational) Involuntary Admission
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| Admission that lasts 60-180 days (extended care) Committed through court action or medical certification. Still considered competent | LONG-TERM (Formal) Involuntary Committment
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| Preventative measure, allowing court order before onset of a PSYC crisis that would RESULT in an inpatient committment | Involuntary OUTPATIENT Commitment
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| Tied to disability, welfare, housing that says must participate in treatment to avoid inpatient admission & to USE SERVICES | Involuntary Outpatient Committment
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| Requires outpatient treatment for a SPECIFIC time to determine compliance w/ MEDS, ADL"S, & ABILITY TO REINTEGRATE INTO COMMUNITY | Conditional Release
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| UNCONDITIONAL release / termination of client-institution relationship (may be court ordered) | Discharge
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| Requires that medical/pysc care & treatment be provided to ALL persons admitted to public hospital | RIGHT to TREATMENT
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| 3 Criterias for "Right To Treatment" | 1. Environment must be humane2. Staff must be qualified/sufficient to provide adequate treatment3. Plan of Care must be INDIVIDUALIZED
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| True/False: "Right to Refuse Treatment" allows client to withdraw consent @ any time & the right to refuse psychotropic drugs | TRUE
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| What client right is being informed of their condition, treatment, risks, benefits, alternatives | Right to Informed Consent
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| Based on persons "Right to Self Determination" | Right to Informed Consent
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| Intervention for the following:behavior is harmful to self/othersAlternative/less restrictive measures are insufficientDecrease in overstimulation is needClient anticipates that controlled environment would be best | Restraints / Seclusion
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| Requires drs written orders, with specific time periods, condition reviewed every 15min, | Restraints / Seclusion
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| When can a nurse use seclusion/restraints WITHOUT a drs orders | only in an EMERGENCY (risk of harm to self/others)
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| Legal duty to maintain patient confdentiality is acting to protect clients | Right to Privacy
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| Do not release info to clients employerDo not release even after persons deathHIV does not give reason to disclose info ALL are an example of | Patient Confidentiality
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| Voluntary act performed w/intent to bring about physical consequence | Intentional tort
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| Ex: Left suicidal client alone w/knife or open window | Intentional tort
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| No PHYSICAL contact, THREAT to use forceEx: Come here or I will give u this injection | Assault
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| Harmful/Offensive TOUCHING of another person"Injecting meds w/out consent" | Battery
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| Act w/intent to confine a person to a specific area | False Imprisonment
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| Recoverable by an injured party in an intentional tort action | Punitive damages
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| act that BREACHES DUTY of DUE CARE & results in or reponsible for persons injuries | Negligence
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| Conduct that EXPOSES client to UNREASONABLE risk of arm through acts of a nurse | Breach of Duty
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| Focus is to eleviate practice of its members by setting standards of excellence | Professional Standards of Practice
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