foundations for mental health nursing
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| what is mental health | successful adaptation/harmony & balace in the individual, family & friends and community evidenced by thoughts, feelings & behaviors
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| to be sane (legal definition) | take responsibility for self and behavior
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| "normality" of behavior determined by... | the culture
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| what is mental illness? | a sense of disharmony w/aspects of living that are distressing t the individual, family, friends and community. evident in thoughts, feelings and behaviors
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| mental illness interferes with functioning of | social, occupational and physical
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| how can a person be committed to a hospital | if there a dangerous to themselves or others
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| DSM-IV-TR | multiaxial evaluation system
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| Axis I | all mental health disorders except those on Axis II (peronality disorders & mental retardation)
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| Axis II | personality disorders and mental retardation
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| Axis III | general medical conditions (after surgery)
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| Axis IV | psychosocial and environmental problems (divorce,flooding, 9-11)
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| Axis V | Individual's psychological, social, & occupational functioning on th global assessment of functioning (GAF) scale--level of functioning before then now ex-50/100,30/100,70/100
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| anxiety | primary psychological response patterns to stress
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| affect of anxiety | thoughts, feelings, and behaviors-can interfere with functioning
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| psychological responses to anxiety | diffuse apprehension--vague feelings of uncertainty & hopelessness
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| 4 levels of anxiety was created by | Hildegard Pepleu (mother of anxiety)
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| 4 levels of anxiety | mild (seldom a problem), moderate-perceptual field diminishes, severe-perceptul field-so diminished, panic-the most intense state
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| psychological responses behaviorly for mild level of anxiety | use coping mechanisms to deal with stress (eating, drinking, sleeping, physical exercise, smoking, crying, laughing, talking to persons w/whom they feel comfortable)
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| denial | #1 defense mechanism
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| displacement | when your angry/upset w/someone you take it out on someone else
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| introjection | take quality of someone else and take that as your own
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| projection | feeling something but using someone else as they feel that way when they don really feel that way
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| reaction formation | act oppostie of how you feel
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| 1990 was the year of | the brain
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| moderate to severe level of anxiety has | a number of physiological disorders
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| neurobiological theory principles | brain dysfunction & behavior, genetic influences on behavior, social and developmental factors & gene expression, learning and neuron function
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| the neurobiological theory includes | genomics(genes-susceptibility), diathesis(stress model), gender, neurotransmission(concern with levels), biological rhythms
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| older theories of mental disorders were based on | intrapersonal, gender bias, crisis, behavioral, cognitive
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| Id | no inhibition, immediate gratification
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| intrapersonal theories according to Sigmund-Freud | psychoanalytic approach, organized the structure of personality into 3 components, psychosexual development(oral,anal,phallic,latency,and genital)
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| 3 components that Sigmund-Freud organized the structure of personality | id, ego, superego
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| ego | rational self
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| superego | perfection, OCD
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| Theory of psychosocial developemt according to Erikson is based on | the influence of social processes on the development of the personality
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| Erikson had how may stages of development | 8 and the major development tests
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| Eriksons stages of development | trust vs mistrust, autonomy vs shame and doubt, initiative vs guilt, industry vs inferiority, identity vs role confusion, intimacy vs isolation, gerativity vs stagnation, ego integrity
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| trust vs mistrust | birth-18 months
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| autonomy vs shame and doubt | 18 months-3 yrs
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| initiative vs guilt | 3-6 yrs
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| Theory of psychosocial developemt according to Erikson is based on | the influence of social processes on the development of the personality
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| Erikson had how may stages of development | 8 and the major development tests
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| Eriksons stages of development | trust vs mistrust, autonomy vs shame and doubt, initiative vs guilt, industry vs inferiority, identity vs role confusion, intimacy vs isolation, gerativity vs stagnation, ego integrity
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| Intimacy vs isolation | 20-30 yrs
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| trust vs mistrust | birth-18 months
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| autonomy vs shame and doubt | 18 months-3 yrs
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| initiative vs guilt | 3-6 yrs
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| ego integrity | 65 yrs-death
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| idustry vs inferiority | 6-12 yrs
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| identity vs isolation | 12-20 yrs
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| harry stack sullivan | focus:relationship
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| Intimacy vs isolation | 20-30 yrs
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| hildegard peplau | mother of psych
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| a nursing model by peplau applies | interpersonal theory to nurse-client relationship development
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| gernerativity vs stagnation | 30-65 yrs
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| ego integrity | 65 yrs-death
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| abraham maslow | physiologic or growth related needs--to be met vefore h/she can fulfill full potential
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| peplau sees interpersonal experiences as | learning experiences for nurses to facilitate forward movement/improvement of pt's personality
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| harry stack sullivan | focus:relationship
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| hildegard peplau | mother of psych
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| a nursing model by peplau applies | interpersonal theory to nurse-client relationship development
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| peplau sees interpersonal experiences as | learning experiences for nurses to facilitate forward movement/improvement of pt's personality
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| crisis theory | usual resources and coping skills are ineffective
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| four stages of personality development by peplau? | stape 1-learning to count on others, stage 2-learning to delay satisfaction, stage 3-identifiying oneself, stage 4-developing skills in participation
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| crisis theory | usual resources and coping skills are ineffective
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| balancing factors of crisis theory | perceptions, coping skills, support systems
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| behavioral theory was by | B.F. Skinner
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| behavioral theory focus' on | a person's actions
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| behavioral theory believes that behaviors are | learned & can be modified
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| behavioral theory | operant reinforcement (system of reward and punishment)
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| cognitive theory was developed by | Aaron Beck
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| cognitive theory according to Aaron Beck believes that | emotional and behavioral dysfunction is r/t cognitive distortion-can be changes
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| standards of psychiatric-mental health nursing practice | standard I-assessment, standard II-diagnosis, standard III-outcome identification, standard IV-planning, standard V-implementation, standard VI-evaluation
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| assessment | interview, observation, psychosocial assessment, neuropsychiatric assessment, physical assessment
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| Outcome Identification & planning | NANDA nursing diagnosis, Nursing Outcome Classification (NOC), planning nursing priorities
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| Implementation | Roles of the Psychiatric Nurse(acc. to Peplau)
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| Roles of the Psychiatric Nurse(acc. to Peplau) | socializing agent, teacher, model, advocate, counselor, role player, milieu manager
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| Evaluation | eval and document client progress toward outcome (formative & summative), self evaluation
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| conditions essential for developing therapeutic relationship | rapport, trust, respect, genuine, empathy
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| Pre interaction phase of nurse client relationship | obtain information, self assessment of feeling, fears, anxieties, etc.
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| Introductory/Orientation Phase of nurse client relationship | introductions, roles & purpose; establish contract for intervention, confidentiality, gather assessment, set mutually acceptable goals, diagnosis & outcomes
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| working phase of nursse client relationship | ongoing use of nursing process, therapeutic alliance/maintain trust & rapport, implementation focus-promote insight, work towards established goals, transference, coutnertransference
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| termination phase of nurse client relationship | reminiscence, eval of progress, plans for future, coping w/feelings
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jbittner
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