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1
Q

Lobotomy severs

A

Frontal Cortex

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2
Q

Frontal Cortex Effects

A

Impulse, Reasoning and Executive Thinking

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3
Q

Psychotropic Medication 1st Introduced in 1950s

A

Thorazine

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4
Q

Thorazine had a huge impact because it…

A

Changed our ability to care for individuals with mental illness

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5
Q

Things that can make Mental Health worse (2)

A

Genetic PredispositionStress

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6
Q

Definition of “Mental HEALTH” and AEB factors (4)

A

Mental Health is a state of emotional, psychological and social wellness evidenced by:-satisfying interpersonal relationships-effective behavior and coping-positive self-concept-emotional stability

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7
Q

Definition of Mental ILLNESS (AMA)

A

“A disturbance in thoughts or mood that causes maladaptive behavior, inability to cope with normal stresses and/or impaired functioning”

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8
Q

Resilience is

A

Being able to adapt to life’s misfortunes and setbacks”The quality that allows someone to be knocked down by life and come back stronger than ever”

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9
Q

Healthy People 2020 Goal and Objectives (3)

A

Goal of HP2020 is to improved mental health through prevention and by ensuring access to appropraite, quality mental health services. Objectives –Reduce suicide rate-Reduce suicide attempts by adolescents-Reduce proportion of adolescents who engage in disordered eating behaviors

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10
Q

Axis I

A

Clinical Psychiatric Diagnosis/Diagnoses

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11
Q

Axis II

A

Personality Disorders & Mental Retardation

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12
Q

Axis III

A

Medical Diagnosis/Diagnoses

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13
Q

Axis Iv

A

Psychosocial Stressors (i.e. Homeless, recently divorced, kicked out of school, fired from job, etc.)

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14
Q

Axis V

A

GAF - Global Assessment of Functioning

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15
Q

Voluntary Discharge (3 aspects)

A

-Request in writing (date, time, initial and put in chart)-Agency must respond within 72 hours-Not guaranteed to be d/c’d

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16
Q

Informal Discharge (3 aspects)

A

NAME?

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17
Q

Kendra’s Law

A

Mandated case management upon discharge - Patient must have a case manager with outpatient treatment and possible substance abuse treatment:-Come in for meds-Come in for AA meeting

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18
Q

Tarasoff definition

A

“When the public has a right to know”-To report suspected incidents of child abuse or maltreatment/neglect while acting in a professional manner (i.e. “I’m going to kill Kristin with a gun and I have a plan ** example)

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19
Q

Guidelines regarding “duty to warn” state that a therapist should consider taking action to warn a third party when his or her client -

A

NAME?

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20
Q

Mentally Ill Act 1984 / Right to Treatment states:

A

“A person hospitalized for mental illness shall,during his hospitalization, be entitled to medical and psychiatric care.”

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21
Q

Need MD Order For :

A

Seclusion

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22
Q

Timothy’s Law

A

Prevents discrimination by prohibiting insurance companies from limiting coverage for mental illness

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23
Q

IB - Congruent

A

The non-verbals match the verbal

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24
Q

Incongruent

A

The non-verbals don’t match what the patient is saying

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25
Proxemics - Intrusion of personal space (4 levels)
Public- greater than 12 feet awaySocial - up to 12 feet awayCasual - 4 feet awayIntimate - 1.5 feet away
26
Therapeutic Communication is
the single most important tool of psychiatric nurse- Here and now- Feelings-Effective (mindful) listening
27
Therapeutic Communication Techniques (9)
#NAME?
28
Ineffective Communication Techniques (9)
-SHARING PERSONAL INFORMATION-DOUBLE OR MULTIPLE QUESTIONS (INTERROGATING)-Parroting-Changing the subject-False reassurance-Belittling-Probing-Advising-Imposing values
29
Types of relationships (2)
Therapeutic - professional, helping relationshipSocial (Friends) - can't CO-EXIST
30
Phases of Therapeutic Relationships (3)
Phase I - OrientationPhase II - WorkingPhase III - Termination
31
Phase I - Orientation
"Getting to know you" phaseTrust buildingSTART to develop mutually acceptable goals
32
Phase II - Working
PROMOTES CHANGE-Goals finalized
33
Phase II - Termination
NO NEW TOPICS-Summarize and evaluate progress
34
Transference
Client - nurse-Feelings stirred up in PATIENT based on past experiences
35
Counter-Transference
Nurse - client-Feelings stirred up in NURSE/THERAPIST based on past experiences
36
In MH nursing stigma is
A barrier that discourages them from seeking help
37
It's important to verify
The information the patient has given you
38
If suicidal plan/intent is discovered -
deal with this before going on - Suicidal assessment is a MUST!
39
Orientation
PersonPlaceTimeSituation
40
Memory - Be alert for
Confabulation - *Spontaneous narrative report that never happened*Confusion of imagination & memory
41
Guidelines for Group Members (6)
-Consider needs of all members-Treat members with respect and attention-Maintain confidentiality-Allow all members to speak-Contribute to group by sharing opinions, experiences, feelings whenever you are comfortable doing so-**Can talk about BUT NOT ACT O
42
Therapeutic Milieu (6)
-**SAFETY FIRST**Structure - daily scheduleNorms - expectations- limit setting- balance between independent and dependent- environmental modification-**LIMIT SETTING WITH LEAST RESTRICTIVE METHOD**Use of Seclustion-**ALWAYS LAST RESORT-NEVER USED AS PUNIS
43
Somatic treatments are used to
Effect behavioral change
44
Types of Somatic Treatments
#NAME?
45
After Electroconvulsive therapy (ECT) -
Patient CAN NOT EAT until gag-reflex is back
46
Psycho*T*ropic Drug is
A substance taken for the TREATMENT of Mental Illness
47
Psycho*A*ctive Drug is
Any substance which ALTERS the functioning of the brain
48
Goal of Psychopharmacology (4 select all that apply)
#NAME?
49
#1 reason for readmission to the hospital
NON-COMPLIANCE
50
#1 reason for Non-Compliance
LACK OF EDUCATION about prescribed treatment
51
Nurses role in Psychopharmacology (4)
-FOLLOW 5 Rights-know interactions-know side effects-EDUCATE client *If client refuses med - find out WHY!
52
Goal of case management
To prevent unnecessary hospitalization
53
Upon admission assess (3)
-aggressive behavior risks-what has helped client in the past if/when he has become angry-**Ask client what he would like us to know that will help him control aggressive thoughts/behaviors
54
Defusion Strategies
-Look confident-Display calmness-Create some space-Speak slowly, gently and clearly- **LOWER YOUR VOICE!!!**- Avoid staring
55
If not trained in PMCS (all SN's) - 3
#NAME?
56
IC - Freud's Basic Assumptions
-*ANXIETY* is the motivator for all behavior-**ALL BEHAVIOR HAS A MEANING**-Present behavior is influenced by PAST experiences
57
Most significant factor is personality development
Internal emotional life
58
The only way to truly forget something is to
First fully remember it
59
Freund believed the human mind -
Never truly forgets
60
ID is -
Devil on the shoulder"I WANT CHOCOLATE!"
61
SuperEgo is -
Angel on the shoulder"YOU'RE ON A DIET!"
62
Ego is -
Compromise between ID and SuperEgo"Maybe a small piece of chocolate"
63
Coping mechanisms are
things we are aware we are doing:-exercise-read-listen to music
64
Defense Mechanisms are
psychological processes that help us cope with reality
65
Major defense mechanisms (13)
-Conversion (converts psych to physical energy)-Denial (denies there is any problem)-Displacement (express anger on someone else less threatening)-Dissociation (out of body experience)-Identification (Identify with someone)-Intellectualization (Going to w
66
**Suppression**
Conscious exclusion of unacceptable desires, thoughts, or memories from the mind.
67
Maladaptive use of defense mechanisms
**Problem if overused or over relied upon**-Never going to move forward if overused
68
Portion of the mind that has no ability to delay gratification of needs is
ID (Lymbic system)
69
Sullivan - Interpersonal Theory
Behavior and personality are the direct results of interpersonal relationships
70
According to Sullivan - Therapeutic relationship serves as a -
Model of adaptive interpersonal relationships
71
PEPLAU ---- Nursing is
AN INTERPERSONAL PROCESS
72
Therapeutic relationships are
The foundation of nursing care-Close, helping relationship based on TRUST, which allows the nurse and client to work collaboratively to help the clients:-solve problems-cope more effectively-achieve developmental goals
73
The nurse knows that which of these concepts are shared by Sullivan and Peplau
#NAME?
74
The nurse knows that which of the following is most imporatant according to both Sullivan and Peplau
Quality of therapist-client relationship
75
Behavior therapy -
Techniques used to modify behavior
76
Reinforced behavior is
LEARNED
77
Behavioral techniques used to weaken connetions between troublesome situations and a habitual response to them
#NAME?
78
Cognitive Behavioral Therapy (CBT) is
#NAME?
79
Focus of CBT
To achieve beneficial change
80
Cognitive and Behavioral therapies work because of Neuroplasticity is
The ability of the nervous system to change in it's structure and function
81
An intervention used by therapists using Sullivan's theory is:
Discuss current interpersonal relationships
82
Psychobiology
Study of biochemical foundations of thought, mood, emotion and behavior
83
Limbic System
EMOTIONAL BRAIN-ID Type Behavior
84
The executive functions of the brain are regulated by
The Frontal Lobe
85
Synapse
Microscopic space between two neurons
86
Neuro Transmission
Electrical impulse goes from Axon to DendriteReceptors-SeratoninNorepinephrineDopamineGABA
87
Agonists
ACTIVATE receptors - initiate a response
88
Antagonists
BLOCK receptors - blocks the response
89
Major Neurotransmitters implicated in psychiatric disorders (3 classes - 6 meds)
Monoamines-Dopamine-Norepinephrine-Serotonin-HistamineAmino Acids-GABAAcetylcholine-Ach
90
What neurotransmitter is not excritory?
GABA
91
Psychotropic Medications
DO NOT CURE MENTAL ILLNESS
92
Psychoimmunology
The Nervous system and immune system interact directly!
93
Prochaska & DeClemente's Theory of Change
1. Pre-Contemplation - no intention of change (unaware)2. Contemplation - Aware problem exists (evaluation)3. Preparation - Intends to take action (small changes)4. Action - Dedicates considerable time and energy (Makes overt and viable changes)5. Adaptation & Maintenance - Works to adapt and adjust6. Evaluation - Assessment and feedback to continue change process
94
Mental Illness Assumptions (select all that apply)
-Change often takes a long time-The pace of change is variable-**Knowledge is usually NOT sufficient to motivate change**-Relapse is the norm
95
Cultural Competency
1-D
96
Not all members of a culture SHARE
Identical Beliefs
97
Which of the following question should be included in a cultural assessment? (4)
#NAME?
98
To keep communication lines open - ALWAYS
Request an interpreter!!!
99
African Americans View of Mental illness
Lack of spiritual balancepunishment for sinChurch is important for support - pray for healing
100
Greeting African Americans
Direct eye contact shows interestSilence indicated lack of trust
101
When caring for an african american - a culturally competent nurse would know ...
Silence may indicate a lack of trust of the caregiver of situation
102
When caring for Cambodians - It is EXTREMELY inappropriate to
TOUCH the HEAD without permission (never touch their HEAD PERIOD)
103
Acupuncture in the Asian (Chinese) culture
restores balance of energy
104
In the Chinese culture - avoid
**eye contact with authority figures** asking questions = sign of dispect- Silence is a sign of respect
105
In the Chinese culture the eldest male is
the decision maker/spokesperson
106
In the Chinese culture - the nursing priority is to
Restore the feeling of balance and harmony
107
In the Filipino culture mental illness is due to
#NAME?
108
Effects of medication on Japanese Americans -
Metabolize some psychiatric medications more slowly - Lower dose on an Asian client will likely achieve same effect
109
The nurse is caring for a female patient who is Chinese. The nurse notes that the patient is shy and avoids eye contact while her eldest son responds to the nursing intake assessment questions. What is the most appropriate nursing action?
Include the patient's son (eldest male) in the formulation of her plan of care.
110
Formal greetings for Russians
#NAME?
111
In the Russian culture, mental illness is related to
#NAME?
112
In the Filipino culture the would do what to greet someone?
Smile instead of shaking someone's hand
113
Culture Bound Syndrome
#NAME?
114
Why develop a care plan to include the client's cultural background? (3)
#NAME?

Psych Final (2 decks)

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