Chapter 1: Foundations of Psychiatric - Mental Health Nursing Flashcards
WHO definition of health
State of complete physical, mental, and social wellness, not merely the absence of disease or infirmity
Mental Health definition?
State of emotion, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior, and coping
What can factors that influence a persons mental health be categorized as?
Individual, Interpersonal, and Social/Cultural
Individual or Personal Mental Health factors include
a person’s biologic makeup, autonomy, and independence, self-esteem capacity for growth, ability to find life meaning, emotional resilience, sense of belonging, and coping or stress management
Interpersonal Mental Health Factors include
effective communication, ability to help others, intimacy, and balance of separateness and contentedness
Social/Cultural Mental Health Factors include
sense of community, access to adequate resources, intolerance of violence, support of diversity amount people, mastery of environment, and positive, realistic view of ones world
Mental illness includes disorders that affect
mood, behavior, and thinking such as depression, schizophrenia, anxiety and addictive disorders
Individual factors that contribute to mental illness include
biologic makeup, intolerable or unrealistic worries or fears, inability to distinguish reality from fantasy, intolerance of life uncertainties, a sense of disharmony in life
Interpersonal factors that contribute to mental illness include
ineffective communication, excessive dependence on or withdrawal from relationships, no sense of belonging, inadequate social support, and loss of emotional control
Social/Cultural factors that contribute to mental illness include
lack of resources, violence, homelessness, poverty, and discrimination
What is the Diagnostic and Statistical Manual of MEntal Disorders (DSM-5)?
Taxonomy published by the American Psychiatric Associated and revised as needed. Described all mental disorders, showing detailed criteria for each
DSM-5 has what three purposes?
Provide standardized nomenclature and language for all mental health professionals
Present defining characteristics or symptoms that differentiate specific diagnoses
To assist in identifying the underlying causes of disorders
What was the ancient therory about how emotions were controlled?
That amount of blood, water, and yellow and black bile controlled emotions. Corresponded with happiness, calmness, anger, and sadness
During Christian times, what severe and brutal measures were performed?
Incarceration in dungeons, flogging and starving
Who developed the idea of an asylum?
Philippe Pinel in France and William Tuke in England
What was the concept of asylum?
A safe refuge or haven offering protection at institutions where people had been whipped, beaten and starved because of being ill
What did Dorothea Dix do?
Began a crusade to reform the treatment of mental illness after a visit to Tukesinstitution in England. 32 state hospitals openeded
What were the first psychotropic drugs used?
Chlorpromazine (Thorazine , an antipsychotic drug) and Lithium (an antimanic agent)
10 years after the first drugs were introduced, what other drugs were introduced?
Monoamine Oxidase Inhibitors Antidepressnats
Haloperidol (Haldol), an antipsychotic
Tricyclic Antidepressants
Anxianxiety Agents called Benzodiazepines
What movement caused the enactment of the Community Mental Health Centers Construction act?
Movement toward treating those with mental illness in less restrictive environments . Lead to Deinstitutionalization
What was Deinstitutionaliztion?
Deliberate shift from institutional are in state hospitals to community facilities. Closer to patients home and provided emergency care, inpatient care, and education.
How many people have a mental illness in the US?
44.7 million
How many poeple in the US actually seek treatment?
19.2 million
What age group has the highest prevalence of mental illness and lowest percentage to seek treatment?
Those 18-25
What are some consequences that can happen from not being treated?
Homelessness, Psychiatric Boarding, Arrest, Incarceration, Victimization
What is managed care?
Concept designed to purposely control the balance between the quality of care provided and the cost of the care . Care received is based on need rather than on request
What did Utilization review firms or managed care organizations develop?
Control the expenditure of insurance funds by requiring providers to seek approval before the delivery of care
What is case management?
This is an effort to provide necessary care while containing cost. Person assigned case manager who coordinates all care
Who manages mental health care?
Privately owned behavioral health cre firms that manage their costs
What must a person do if they do not have insurance?
Rely on their counties of residence to provide funding through tax dollars
What is Medicare?
COvers people 65 years and older, those with kidney failure, and poeple with certain disabilities
What is Medicaid?
Jointly funded by federal and state governments and covers low-income individuals and families
Medicaid expires when?
When you turn 65 who are receiving SSI or SSDI
What is the Mental Health Parity Act?
This eliminated annual and lifetime dollar amounts for mental health care . Substance abuse was not covered however
Who is Linda Richards?
The first American Psychiatric nurse. She improved nursing care in psychiatric hospitals and organized educational programs in state mental hospitals
What are some early therapies that were tested?
Insulin shock therapy, psychosurgery, and electroconvulsive therapy
Who were the two nursing theorists that shaped psychiatric nursing practice?
Hildegard Peplau and June Mellow
What did June Mellows book focus on?
Described her approach of focusing on client’s psychosocial needs and strengths focusing on the here and now
What did Peplau describe?
Desvribed the therapeutic nurse-client relationship with its phases and taks and wrote about anxiety
What are the standards of care?
Are authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable
What is the Phenomena of concern?
Describes the 13 areas of concern that mental health nurses focus on when caring for clients
What is self-awareness?
Process by which the nurse gains recognition of his or her own feelings, beliefs and attitudes
A significant advance in treating persosn with mental illness was the development of
psychotropic drugs in the 50’s
A shift of institutional care to care in the community began when7
1960s
One result of deinstitutionalization is what?
The revolving door of repetitive hospital admission without adequate community follow-up
Treatment rates for children and adults?
68% and 57%
How many homeless have mental illness?
1/3
How many homeless have abuse problems?
1/2
Treatment rates for homeless and those with dual diagnosis of mental illness and substance abuse?
37% and 3%
Psychiatric nursing was recognized when?
Late 1800s
When was psychiatric nursing required in nursign education?
1950s
Psychiatric nursing practice has been influced by who?
Hildegard Peplau and June Mellow
What did June Mellow write?
About nurse-client relationship, anxiety, nurse therapy, and interpersonal nursing theory
What has the ANA published?
Standards of care that guide psychiatric-mental health nursing clinical practice
What is the goal of self-awareness?
To know oneself so that one’es values, attitudes, and beliefs are not projected onto the client, interfering with nursing care
