Chapter 13 Flashcards
Stress and Mental Health
this is going to be review from the last lecture but de Marco is explaining it
typically before you start a patient on psychosocial you want to rule out what?
medical
tumors and endocrines are the two most famous things that cause what?
psychotic episodes, so treat those two first before you give them psychotics
a huge judgment call is based on some general observations ?
their appearance
- simply like winter clothes in the summer??
- summer clothes in the winter?
mood is what?
affect is what?
patient saying sad
how you think the patient feels
mood and affect can be what?
and means what?
congruent and incongruent
match or not match
what 3 words apply for mood?
euthymic
euphoric
dysphoric
what does these words mean ?
euthymic
euphoric
dysphoric
describe someone who is in normal mood, not too happy not too sad, appropriately acting
overall happy, manic, happy for no reason, smile, dancing
(not eating or sleeping)
sad, depressed
what are the 4 words for affect?
board
restricted
blunt
flat
what does these words mean?
board
restricted
blunt
flat
showing an emotionally board, when happy they are happy
showing emotions little less
even less than restricted
not expressing any emotion, saying you’re happy but not moving or smiling, just not expressing anything
what are the 4 terms that apply to speech?
pressured
hyperverbal
poverty of speech
cadence
what do these term mean?
pressured
hyperverbal
poverty of speech
cadence
quick, very fast, no periods, nonstop, dont even get a breathe. all the words are pushed together and no spaces, all one word
saying a lot of words at once! very talkative
( mania, super euphoric )
lack of speech, their not talking to you
rate and the rhythm! they speak, singly, and up and down in pitch!!
illusion
hallucination
delusion
meaning
something is actually there, but youre perceiving it different
- shadow in your room, but you think its a person
5 senses, there is nothing, you’re just hearing your voices in your head
belief or thought that you have that is incorrect!!!
you believe youre seeing angels that is ?
saying youre seeing angels that is ?
delusions ( belief )
hallucinations
what is ideas of reference mean?
give the 2 ways this can happen
patient thinks that the outside world is about them
- larger picture, reason why the president wore purple, is because he knows it my favorite color
- someone walks into the room, and people stare at you, you think they all hate you
circumstantial?
tangential?
flight of ideas?
loose of association ?
every piece of information around that point and answer
(staying on topic, but giving also un-needed information)
they never get to the point, all these facts about the question but never answer the actual question
jumping from idea to idea ( they all match, logical connection )
jumping from idea to another idea but they dont make sense
( literally jumping everywhere and nothing makes sense )
lets practice
which is which?
circumstantial
tangential
flight of ideas
loose association
im asking a questions
about your family disease?
my grandpa has a history of prostate cancer, he was in the military, and his favorite color was blue !
my grandpa use to be in the military, he went to the hospital, and was going to die soon, and he hated the nurses !
my grandpa loves the rain, oh its raining outside, the bugs are in the trees,, the cicadas are coming out next year!
my grandpa loves games! dude I love the color red, my dog is so kind, I love chips!
circumstantial
tangential
flight of ideas
Loose association
what is thought blocking mean ?
mainly associated with what ?
when the patient is trying to communicate with you and then stop mid sentence
appropriate speech, but just stop
psychosis cause they lose tract or get distracted
what is word salad?
the words in the sentence make zero sense
fly water peach orange paper peach dog
no connection to each other
what are the 4 things in memory?
recall
short term
recent
remote
recall
short term
recent
remote/long term
definition and how we test it ! (2 for each )
instant recall, I say a list of objects/numbers, then you say it right after!!
ill give you a list, recall it, then 8mins later, I ask you what that list is again, can you remember a few mins later
(MINTUES!)
what happens recently in the world, what was the weather like yesterday, anything in the past few days or maybe a week
(DAYS TO WEEKS)
months to years to decades, family history, child history, 1975 memories?
now onto the real chapter study : stress!
stress is a normal part of life!
there are two types of experiences of stress
what is positive and negative experience?
positive
- helps develops successful coping skills
negative
- can result in negative mental and physical health consequences
( can’t change usually )
how is stress defined as?
an environmental pressure or force that puts strain on a persons system
you can have acute and chronic stress, define it each ?
acute
- normal acute stress to get things done, like school but goes away when school is done
chronic
- stress out 24/7 regardless of what’s going on
what is the nursing goal for stress?
resolve stressful issues in the environment, reduce stress response, and develop positive coping skills
acute stress can lead to ______, which in turn can have negative impact on a persons what?
physiologic overload
health, well being, social functioning
chronic stress is associated with _____ that can lead to negative health outcomes
allostatic load (al)
what is homeostasis vs allostatis ?
bodys tendency to resist physiologic change and hold boldly functions relatively consistent, well coordinated and usually stable
dynamic regulatory process that maintains homeostasis through a process of adaptation
what is the order of how stress affects the body?
4!
appraisal
stress
coping
adaptation
( maldapation )
appraisal
stress
coping
adaptation
( maldapation )
explain each term and how it goes with the stress and mental health
primary challenge,harm
physiologic response, emotional response,
problem focused, emotional focuses
- innate action
health and wellness, social functioning
maladaptive is when youre coping is not working so young up getting sick, decreased self esteem, social dysfunction
your body does change when youre under stress, just know youre body will go into what state?
examples
beta blockers
- their anxiety goes away
- cause it decreases heart rate
fight and flight
what are the 2 types of coping ?
problem focused coping
emotion focused coping
what does problem focused coping ?
focus on the problem, so doing the project to assignment
spouse leaves her husband because she realizes that the abuse will not stop
what is emotion focused coping ?
focusing on the emotion, how do we deal with this
how to not be sad or depressed
there are 4 types of personality
a
b
c
d
can you describe each ?
competitive, aggressive, ambitious, impatient, alert, tense, restless
relaxed, easygoing, easily satisfied
introverted, respectful, conforming, complaint and eager to please
increased negative emotions, pessimism, non-sharing of emotions
many personal factors, such as personality patterns, beliefs, values, and commitment to an outcome, interact with environmental demands and constraints that produce a person-envrioment relationship
a patient can have 4 emotional response to stress which are?
negative
positive
borderline
nonemotions
negative
positive
borderline
nonemotions
means what?
anger, fright
happiness, love
hope, compassion
awe, confusion
what are some nursing interventions we are going to do for a patient who is under stress?
exercise
improve coping skills
spiritually
problem solving
family interventions
You are working at the mental health crisis center when a young male comes in a very distressed state and tells the nurse, “I just can’t get over being fired last week. I’ve asked for help. I’ve talked to friends. I’ve tried everything to get through this, but nothing is working. Help me!” Which initial crisis intervention strategy should the nurse use?
A. referral for counseling
B. support system assessment
C. emotion management
D. unemployment assistance
C. emotion management
because they already talked to the family, they need to be able to control their emotions, you need to calm down the patient
It is your first shift after orientation at the crisis shelter when an anxious young female is brought to the interviewing room; she is sobbing and tells you that she thinks she is pregnant following a rape and does not know what to do. Which nursing intervention is most appropriate at this time?
A. Ask the client about the type of things that she had thought of doing.
B. Recommend a pregnancy test after acknowledging the client’s distress.
C. Give the client some ideas about what to expect to happen next.
D. Question the client about her feelings and possible parental reactions.
B. Recommend a pregnancy test after acknowledging the client’s distress.
