Chapter 11 - Diagnosis, Intervention, and Outcomes in Psychiatric and Mental Health Nursing

Question 1

What are PMH nursing interventions?

Answer 1

Nursing activities that promote mental health, prevent mental illness, assess dysfunction, assist clients to regain or improve their coping abilities, and/or prevent further disabilities

Question 2

The Canadian Collaborative Mental Health Care Charter principles

Answer 2

Health promotion and prevention of mental health problems
Holistic promotion
Collaboration
Partnership
Respect for diversity
Information exchange
Resources

Question 3

Best Practice Guidelines purpose

Answer 3

To deliver care that is effective and based on current evidence
To aid in seeking resolutions to clinical problems
To meet or exceed current quality standards in providing excellent care
To initiate use of innovations
To eliminate interventions that are not meeting best practice standards
To foster clinical excellence through supportive work environments

Question 4

Nursing diagnosis factors

Answer 4

Pathophysiologic, biologic, or psychological
Treatment related
Situational
Maturational

Question 5

What is a nursing diagnosis?

Answer 5

Clinical judgment about individual, family, or community responses to actual or potential problems/life processe

Question 6

Defining characteristics

Answer 6

Key sign and symptoms (clues) that relate to each other and that validate a nursing diagnosis

Question 7

Outcomes

Answer 7

Individual response to nursing care at a given point in time. They are concise, stated in few words, and in neutral terms

Question 8

Diagnosis specific outcomes

Answer 8

Show that the intervention resolved the problem or nursing diagnosis

Question 9

Indicators

Answer 9

Answer the question, “how close is the individual moving towards the outcome?”

Question 10

Initial outcomes

Answer 10

Those written after the initial interview and assessment

Question 11

Revised outcomes

Answer 11

Those written after each evaluation

Question 12

Discharge outcomes

Answer 12

Outcomes to be met before discharge

Question 13

How are outcomes expressed?

Answer 13

In terms of the individual’s actual responses or the status of a nursing diagnosis at a point in time after implementation of nursing interventions

Question 14

Primary purpose of developing individual outcomes

Answer 14

To ensure quality care and that the needs of the individual are being met

Question 15

Class or groups of interventions

Answer 15

Physiologic basic
Physiologic complex
Behavioural
Safety
Family
Health system
Community

Question 16

Biologic interventions

Answer 16

Focus on physical functioning
Directed towards the client’s self-care, activities and exercise, sleep, nutrition, relaxation, hydration, and thermoregulation, as well as pain management and medication management

Question 17

Self-care

Answer 17

Ability to perform activities of daily living successfully

Question 18

Counselling

Answer 18

Specific, time-limited interactions between a nurse and a client, family, or group experiencing immediate or ongoing difficulties related to their health or well-being

Question 19

Conflict resolution

Answer 19

Specific type of intervention through which the nurse helps clients resolve disagreements or disputes with family, friends, or other clients

Question 20

Steps of conflict resolution

Answer 20

1. Identify conflict issues
2. Know our own response to the conflict
3. Separate the problem from the people involved
4. Stay focused on the issue and the underlying motivations behind the position the other person took
5. Identify available options
6. Try to identify the established standards to guide the decision-making process

Question 21

Cultural brokering

Answer 21

Use of culturally appropriate strategies that aid in bridging or mediating between the client’s culture and the healthcare system

Question 22

Recovery orientation

Answer 22

A journey that is self-directed and person-centered. the individual takes responsibility for his or her part and is empowered in a process that focuses on strengths, peer support, and respect

Question 23

Tidal model

Answer 23

Emphasizes the importance of a collaborative relationship between the nurse and client

Question 24

Reminiscence

Answer 24

The thinking about or relating of past experiences, is used as a nursing intervention to enhance life review for older adults

Question 25

Behaviour therapy interventions focus

Answer 25

On reinforcing or promoting desirable behaviours or altering undesirable ones

Question 26

Behaviour modification

Answer 26

Specific, systematized behaviour therapy technique that can be applied to individuals, groups, or systems

Question 27

Token economy

Answer 27

Applies behaviour modification techniques to multiple behaviours. Clients are rewarded with tokens for demonstrating selected desired behaviours

Question 28

Aim of behaviour modification

Answer 28

To reinforce desired behaviours and extinguish undesired ones

Question 29

Cognitive intervention

Answer 29

Verbally structured interventions that reinforce and promote desirable, or alter undesirable, cognitive functioning

Question 30

Underlying belief of cognitive intervention

Answer 30

Thoughts guide emotional reactions, motivations, and behaviours

Question 31

Automatic thinking

Answer 31

Subject to errors or tangible distortions of reality that contradict object appraisals

Question 32

Illogical thinking

Answer 32

Another thinking error, occurs when a person draws a faulty conclusion

Question 33

Psychoeducation

Answer 33

Uses educational strategies to teach clients the skills they lack because of a psychiatric disorder

Question 34

Goal of psychoeducation

Answer 34

Change in knowledge and behaviour

Question 35

Health teaching

Answer 35

Involves collaborating with the client to determine learning needs and transmitting new information, “while considering the context of the client’s life experiences.”

Question 36

Milieu therapy/therapeutic environment

Answer 36

Provides a stable and coherent social organization to facilitate an individual’s treatment

Question 37

A therapeutic milieu facilitates

Answer 37

Client interactions and promotes personal growth

Question 38

Basic concepts of milieu therapy

Answer 38

Safety and security
Validation
Open communication
Structured interaction

Question 39

De-escalation

Answer 39

An interactive process of calming and redirecting a client who has an immediate potential for violence directed towards self or others

Question 40

De-escalation involves

Answer 40

Assessing the situation and preventing it from escalating to one in which injury occurs to the client or others

Question 41

Seclusion

Answer 41

Involuntary supervised isolation of a patient in a locked, nonstimulating room

Question 42

Chemical restraints

Answer 42

Use of medication to control clients or manage their behaviour

Question 43

Physical restraints

Answer 43

Any human or mechanical method that restricts the freedom of movement or normal access to one’s body, material, or equipment and cannot be easily removed