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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
Q

Proxemics - Intrusion of personal space (4 levels)

A

Public- greater than 12 feet awaySocial - up to 12 feet awayCasual - 4 feet awayIntimate - 1.5 feet away

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26
Q

Therapeutic Communication is

A

the single most important tool of psychiatric nurse- Here and now- Feelings-Effective (mindful) listening

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27
Q

Therapeutic Communication Techniques (9)

A

NAME?

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28
Q

Ineffective Communication Techniques (9)

A

-SHARING PERSONAL INFORMATION-DOUBLE OR MULTIPLE QUESTIONS (INTERROGATING)-Parroting-Changing the subject-False reassurance-Belittling-Probing-Advising-Imposing values

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29
Q

Types of relationships (2)

A

Therapeutic - professional, helping relationshipSocial (Friends) - can’t CO-EXIST

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30
Q

Phases of Therapeutic Relationships (3)

A

Phase I - OrientationPhase II - WorkingPhase III - Termination

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31
Q

Phase I - Orientation

A

“Getting to know you” phaseTrust buildingSTART to develop mutually acceptable goals

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32
Q

Phase II - Working

A

PROMOTES CHANGE-Goals finalized

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33
Q

Phase II - Termination

A

NO NEW TOPICS-Summarize and evaluate progress

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34
Q

Transference

A

Client - nurse-Feelings stirred up in PATIENT based on past experiences

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35
Q

Counter-Transference

A

Nurse - client-Feelings stirred up in NURSE/THERAPIST based on past experiences

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36
Q

In MH nursing stigma is

A

A barrier that discourages them from seeking help

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37
Q

It’s important to verify

A

The information the patient has given you

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38
Q

If suicidal plan/intent is discovered -

A

deal with this before going on - Suicidal assessment is a MUST!

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39
Q

Orientation

A

PersonPlaceTimeSituation

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40
Q

Memory - Be alert for

A

Confabulation - Spontaneous narrative report that never happenedConfusion of imagination & memory

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41
Q

Guidelines for Group Members (6)

A

-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

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42
Q

Therapeutic Milieu (6)

A

-SAFETY FIRSTStructure - daily scheduleNorms - expectations- limit setting- balance between independent and dependent- environmental modification-LIMIT SETTING WITH LEAST RESTRICTIVE METHODUse of Seclustion-**ALWAYS LAST RESORT-NEVER USED AS PUNIS

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43
Q

Somatic treatments are used to

A

Effect behavioral change

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44
Q

Types of Somatic Treatments

A

NAME?

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45
Q

After Electroconvulsive therapy (ECT) -

A

Patient CAN NOT EAT until gag-reflex is back

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46
Q

PsychoTropic Drug is

A

A substance taken for the TREATMENT of Mental Illness

47
Q

PsychoActive Drug is

A

Any substance which ALTERS the functioning of the brain

48
Q

Goal of Psychopharmacology (4 select all that apply)

A

NAME?

49
Q

1 reason for readmission to the hospital

A

NON-COMPLIANCE

50
Q

1 reason for Non-Compliance

A

LACK OF EDUCATION about prescribed treatment

51
Q

Nurses role in Psychopharmacology (4)

A

-FOLLOW 5 Rights-know interactions-know side effects-EDUCATE client *If client refuses med - find out WHY!

52
Q

Goal of case management

A

To prevent unnecessary hospitalization

53
Q

Upon admission assess (3)

A

-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
Q

Defusion Strategies

A

-Look confident-Display calmness-Create some space-Speak slowly, gently and clearly- LOWER YOUR VOICE!!!- Avoid staring

55
Q

If not trained in PMCS (all SN’s) - 3

A

NAME?

56
Q

IC - Freud’s Basic Assumptions

A

-ANXIETY is the motivator for all behavior-ALL BEHAVIOR HAS A MEANING-Present behavior is influenced by PAST experiences

57
Q

Most significant factor is personality development

A

Internal emotional life

58
Q

The only way to truly forget something is to

A

First fully remember it

59
Q

Freund believed the human mind -

A

Never truly forgets

60
Q

ID is -

A

Devil on the shoulder”I WANT CHOCOLATE!”

61
Q

SuperEgo is -

A

Angel on the shoulder”YOU’RE ON A DIET!”

62
Q

Ego is -

A

Compromise between ID and SuperEgo”Maybe a small piece of chocolate”

63
Q

Coping mechanisms are

A

things we are aware we are doing:-exercise-read-listen to music

64
Q

Defense Mechanisms are

A

psychological processes that help us cope with reality

65
Q

Major defense mechanisms (13)

A

-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
Q

Suppression

A

Conscious exclusion of unacceptable desires, thoughts, or memories from the mind.

67
Q

Maladaptive use of defense mechanisms

A

Problem if overused or over relied upon-Never going to move forward if overused

68
Q

Portion of the mind that has no ability to delay gratification of needs is

A

ID (Lymbic system)

69
Q

Sullivan - Interpersonal Theory

A

Behavior and personality are the direct results of interpersonal relationships

70
Q

According to Sullivan - Therapeutic relationship serves as a -

A

Model of adaptive interpersonal relationships

71
Q

PEPLAU —- Nursing is

A

AN INTERPERSONAL PROCESS

72
Q

Therapeutic relationships are

A

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
Q

The nurse knows that which of these concepts are shared by Sullivan and Peplau

A

NAME?

74
Q

The nurse knows that which of the following is most imporatant according to both Sullivan and Peplau

A

Quality of therapist-client relationship

75
Q

Behavior therapy -

A

Techniques used to modify behavior

76
Q

Reinforced behavior is

A

LEARNED

77
Q

Behavioral techniques used to weaken connetions between troublesome situations and a habitual response to them

A

NAME?

78
Q

Cognitive Behavioral Therapy (CBT) is

A

NAME?

79
Q

Focus of CBT

A

To achieve beneficial change

80
Q

Cognitive and Behavioral therapies work because of Neuroplasticity is

A

The ability of the nervous system to change in it’s structure and function

81
Q

An intervention used by therapists using Sullivan’s theory is:

A

Discuss current interpersonal relationships

82
Q

Psychobiology

A

Study of biochemical foundations of thought, mood, emotion and behavior

83
Q

Limbic System

A

EMOTIONAL BRAIN-ID Type Behavior

84
Q

The executive functions of the brain are regulated by

A

The Frontal Lobe

85
Q

Synapse

A

Microscopic space between two neurons

86
Q

Neuro Transmission

A

Electrical impulse goes from Axon to DendriteReceptors-SeratoninNorepinephrineDopamineGABA

87
Q

Agonists

A

ACTIVATE receptors - initiate a response

88
Q

Antagonists

A

BLOCK receptors - blocks the response

89
Q

Major Neurotransmitters implicated in psychiatric disorders (3 classes - 6 meds)

A

Monoamines-Dopamine-Norepinephrine-Serotonin-HistamineAmino Acids-GABAAcetylcholine-Ach

90
Q

What neurotransmitter is not excritory?

A

GABA

91
Q

Psychotropic Medications

A

DO NOT CURE MENTAL ILLNESS

92
Q

Psychoimmunology

A

The Nervous system and immune system interact directly!

93
Q

Prochaska & DeClemente’s Theory of Change

A
  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
Q

Mental Illness Assumptions (select all that apply)

A

-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
Q

Cultural Competency

A

1-D

96
Q

Not all members of a culture SHARE

A

Identical Beliefs

97
Q

Which of the following question should be included in a cultural assessment? (4)

A

NAME?

98
Q

To keep communication lines open - ALWAYS

A

Request an interpreter!!!

99
Q

African Americans View of Mental illness

A

Lack of spiritual balancepunishment for sinChurch is important for support - pray for healing

100
Q

Greeting African Americans

A

Direct eye contact shows interestSilence indicated lack of trust

101
Q

When caring for an african american - a culturally competent nurse would know …

A

Silence may indicate a lack of trust of the caregiver of situation

102
Q

When caring for Cambodians - It is EXTREMELY inappropriate to

A

TOUCH the HEAD without permission (never touch their HEAD PERIOD)

103
Q

Acupuncture in the Asian (Chinese) culture

A

restores balance of energy

104
Q

In the Chinese culture - avoid

A

eye contact with authority figures asking questions = sign of dispect- Silence is a sign of respect

105
Q

In the Chinese culture the eldest male is

A

the decision maker/spokesperson

106
Q

In the Chinese culture - the nursing priority is to

A

Restore the feeling of balance and harmony

107
Q

In the Filipino culture mental illness is due to

A

NAME?

108
Q

Effects of medication on Japanese Americans -

A

Metabolize some psychiatric medications more slowly - Lower dose on an Asian client will likely achieve same effect

109
Q

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?

A

Include the patient’s son (eldest male) in the formulation of her plan of care.

110
Q

Formal greetings for Russians

A

NAME?

111
Q

In the Russian culture, mental illness is related to

A

NAME?

112
Q

In the Filipino culture the would do what to greet someone?

A

Smile instead of shaking someone’s hand

113
Q

Culture Bound Syndrome

A

NAME?

114
Q

Why develop a care plan to include the client’s cultural background? (3)

A

NAME?

Psych - Test 2 (4 decks)

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