Module 1 & 2: Introduction to Psychiatric Care
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| The ability to "cope with and adjust to the recurrent stresses of living in a acceptable way" | Mental health
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| Inherited characteristics, childhood nurturing, life circumstances | Factors that influence mental health
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| The severity of client's illness, the level of dysfunction, suitability of the setting for treatment, level of cooperation, client's ability to pay for services | Factors that determine inpatient care
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| Facility that provides services to people with mental problems within their home environments; clients are able to remain within their communities, associating with the real world | Outpatient care
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| Delivers foods to individuals in their homes | Meals on wheels
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| Food and clothing that is made available to women based on income eligibility | WIC - Women, Infants, and Children
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| Purpose is to stabilize the client and assist with crisis, refer to appropriate community resources | Emergency Department (ED)
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| Offers a protected, supervised environment within the community | Residential Programs (group homes)
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| Providing the client with the information to make certain decisions | Advocacy
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| How does advocate help client's? | Protects client's rights, helps clarify expectations, provides support, and acts on behalf of the client's best interest
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| Evaluates families; studies environmental and social causes of illness; conducts family therapy and admits new clients | Psychiatric social worker
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| Has an advanced degree, specialized training in art therapy; encourages members to analyze artwork, adjunct to the care team in diagnosis and treatment of children | Expressive therapist
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| Has an advanced degree, specialized training in recreational therapy; uses pet therapy, psychodrama, poetry and music therapy | Recreational therapist
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| What populations are at high risk for developing mental health problems? | Substance abuse, homeless, elderly, families, adolescence & children, rural residents, people with HIV, have suicidal thoughts, people with anxiety, depression or panic disorders
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| The right of people to act for themselves and make personal choices, including refusal of treatment | Autonomy
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| Obligation to keep your word; client relies on you and your credibility grows or diminishes depending on how well you keep your promises; Do what you say, or don't say it | Fidelity
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| Any act that threatens a client; no physical contact need occur, just a threatening action | Assault
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| When touching occurs without the client's permission; make sure the client understands what you are going to do before you do it | Battery
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| Taking photographs without consent of client | Invasion of privacy
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| Detaining a competent person against his or her will; both physical and verbal intimidation are included | False imprisonment
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| The omission (or commission) of an act that a reasonable and prudent person would (or would not) do | Negligence
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| Failure to exercise an accepted degree of professional skill that results in injury, loss, or damage | Malpractice
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| An agreement between the client and caregiver that documents knowledge of and agreement of treatment | Informed consent
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| When a client originates the request for mental health services | Voluntary admission
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| Process for institutionalization initiated by someone other than the client (physicians, police, and representatives of a county administrator may commit an individual for emergency treatment without a warrant) | Involuntary admission
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| What is the legal framework for practice in the state? | Professional Nurse practice act
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| Developed by specific health care discipline. Set of guidelines that provide measurable criteria for nurses, clients, and others to evaluate the quality & effectiveness of the nursing care provided | Standards of practice
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| In situations where serious harm or death may occur, mental health professionals have a specific duty to protect potential victims from possible harm; what is this duty? | Duty to warn
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| Learned pattern of behavior that shapes out thinking and serves as the basis for social, religious, and family structure | Culture
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| An oversimplified mental picture of a cultural group; may take negative, positive, or traditional form | Stereotype
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| Set of assumptions, values, beliefs, attitudes, and behaviors of a group. Members predict one another's actions and react accordingly | Shared
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| Although culture defines the dominant values; beliefs, and behaviors, it does not determine al the behaviors in any group | Individual behavior
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| Use of ______, how ________ is perceived and received; form of non-verbal communication | Touch
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| Area that surrounds the client - an invisible "bubble" that travels with a person | Space
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| Area the client needs to gain control over to claim for themselves | Territory
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| The concept of __________ is rooted in a cultures basic orientation; Problems with __________ may be based in the client's cultural orientation or psychiatric illness. | Time
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| Attempt to overcome feelings of inferiority or make up for deficiency | Compensation
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| Refusal to acknowledge conflict and thus escapes reality of situation | Denial
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| Putting of one's own unacceptable thoughts, wishes, emotions onto others | Projection
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| Use of a "good" (but not real) reason to explain behavior to make unacceptable motivation more acceptable | Rationalization
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| Coping with present conflict or stress by returning to earlier more secure stage of life | Regression
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| Unconscious channeling of unacceptable behaviors into constructive, more socially approved areas | Sublimation
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| Removal of conflict by removing anxiety from consciousness | Suppression
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| Sensorimotor, preoperational, concrete operations, and formal operations | Piaget's developmental stages
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| Trust/Mistrust | Infancy (Birth to 1 yr)
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| Autonomy/Shame & Doubt | Early childhood (1-3 yr)
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| Initiative/Guilt | Preschool (3-6 yr)
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| Industry/Inferiority | School age (6-12 yr)
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| Identity/Diffusion | Adolescence (12-18 yr)
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| Intimacy/Isolation | Young Adult (18-25 yr)
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| Generativity/Stagnation | Middle Adulthood (25-65 yr)
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| Integrity/Despair | Maturity (65-death)
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| Established human needs into a hierarchy | Maslow
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| Breathing, food, water, sex, sleep, homeostasis, excretion | Physiological
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| Security of body, of employment, of resources, of morality, of the family, of health, of property | Safety
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| Friendship, family sexual intimacy | Love/Belonging
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| Self-esteem, confidence, achievement, respect of others, respect by others | Esteem
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| Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts | Self-actualization
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| Mainstream of health care practices in the modern world is based on methods of treatment; Practitioners use medical and surgical methods to treat disease and injury by finding what's wrong and fixing it. (includes medications) | Allopathic Medicine
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| Includes practices and treatments that agree or "work with" allopathic therapies | Complimentary Medicine
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| Practices and treatments that are used instead of conventional (allopathic) medicine | Alternative Medicine
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| Manipulation of muscles and connective tissue to relax the body and enhance well-being | Massage
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| Music and sound therapy have successfully been used to treat stress, depression, grief, schizophrenia and autism | Expressive therapy
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| Why are animal-assistive therapies used? | They are consistent and non-judgmental. They are always accepting and help ease loneliness. Work with animals has been found to promote socialization, increase empathy, encourage responsibility and commitment, and foster communication
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| What helps us to avoid the negative effects of stress? | Learning to control the body's flight or fight response
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| How do we control the body's flight or fight response? | Progressive relaxation, guided imagery and creative visualization; these can benefit the client as they don't interfere with other allopathic methods of treatment
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| Medications that act on the body's nervous system by altering the delicate chemical balances within that system | Psychotherapeutic drugs
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| Adrenergic - prepares body for fight or flight, HR & output increases, vessels in stomach constrict, pupils will dilate, bronchioles in lungs expand, increase in blood sugar & fatty acids for fuel, digestive & excretory processes are slowed | Sympathetic Nervous System
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| Cholinergic - used to conserve energy and provide balance; HR slows, decrease in circulating blood volume, sphincters relax, intestinal and glandular activity increases | Parasympathetic Nervous System
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| What are four classes of psychotherapeutic drugs? | Mood stabilizers, anxiety agents, antidepressants, antipsychotics
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| Common to all persons but if it interferes with out ability to function, it becomes a disorder | Anxiety
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| Another name for antianxiety agents | Anxiolytics or "minor tranquilizers"
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| Ativan, Valium, Librium | Benzodiazepines - oldest anxiolytic, fast acting but potential for dependency and withdrawal symptoms if stopped abruptly
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| Azaspirones | Used for anxiety (anxiolytic)
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| Can take typically 1-4 weeks before relief is noticed. However, side effects may be experienced soon after starting therapy. Any signs of toxicity (headaches, stiff neck, palpitations) should be reported to physician immediately | Antidepressants
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| Are often NOT used due to serious adverse reactions and interactions with food and drugs and strong dietary restrictions | MOAI's - Monoamine Oxidase Inhibitors
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| What medications do you avoid if you are taking a MOAI? | Other MOAIs and tricyclic antidepressants which may cause hyperpyrexia, severe convulsions, hypertensive crisis and death
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| Aged cheeses, avocados, bananas, beer, liver, red wine | Foods to avoid when taking MOAI's
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| Drug currently being used to treat anxiety disorders, seizures and neuropathic pain | Lyrica
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| Anti-cholinergic side effects of antidepressants | Dry mouth, nose, eyes, urinary retention, sedation, blurred vision, and excessive sweating
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| Lithium | Anti-manic; maintain balanced diet, liquid, and salt intake (DON'T use salt substitute) S/E: fine hand tremor, increased thirst & urination, nausea, anorexia, diarrhea/constipation
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| What can cause severe CNS depression when mixed with antipsychotics? | Alcohol, antianxiety, antihistamines, antidepressants, barbiturates (Demerol and Morphine)
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| When can antacids be given when taking antipsychotics? | 2 hours after taking medication
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| Vomiting, extreme hand tremor, sedation, muscle weakness, and dizziness | S/S of possible lithium toxicity
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| 0.6-1.2 mE/qL initially 0.8-1 mE/qL long term use | Therapeutic levels for lithium
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| Why does a patient taking lithium have to watch sodium intake? | Lithium and sodium compete for elimination from kidneys; increase in salt increases lithium elimination; decrease in salt decreases lithium elimination
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| What happens when lithium levels are too high? | Uncomfortable & possible life threatening toxicity
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| What happens when lithium levels are too low? | Manic behaviors return
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| How do you instruct a patient to take lithium? | Must take medication on regular basis at same time daily; if they miss a dose, they must wait until the next scheduled time to take medication
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| Thorazine, Haldol, Zyprexa, Seroquel, Risperdal | Antipsychotics; s/e: pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia, drowsiness, headache, blurred vision
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| Inability to sit still, pacing etc. | Akathisia
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| Irreversible side effect of long-term treatment that produces involuntary repeated muscle movements in the face, trunk, and extremities (arms and legs) | Tardive dyskinesia
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| Serious and potentially fatal side effect with unstable vital signs, fever, confusion, muscle rigidity, tremor, incontinence | Neuroleptic malignant syndrome (NMS)
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| Assess clients, coordinate care, administer medications, monitor & evaluate client responses, teach clients about their medications | Nurses responsibilities relating to psychotherapeutic drug administration
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