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Mental Health > Crisis > Flashcards

Crisis Flashcards

1
Q

Define crisis

A

An overwhelming emotional response to a life, circumstance or stressor

-this usually lasts 4 to 6 weeks (if last longer than that, it can be an issue for the patient)

-

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2
Q

What are the three categories that you will see in crisis?

A
  • Maturation
    -Situational
    -Adventitious
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3
Q

Define Maturational crisis

A

Predicted or expected

  • major changes in one’s life
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4
Q

Define Situational crisis

A

UNEXPECTED or SUDDEN (loss, cancer)

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5
Q

Define aDVentitious crisis

A

(Social crisis)

*(D)isaster or (V)iolence

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6
Q

During a crisis event what is the first and most important factors that influence crisis

A

Patient’s perception of the event

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7
Q

For crisis intervention what is the primary intervention that the nurse should use

A

Directive intervention

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8
Q

What is the goal for directive intervention (crisis)

A
  • find out what the patient needs
  • raising self-awareness by providing feedback to patient
    -directing behavior by recommending suggestions for patients actions
    -
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9
Q

What is another intervention that the nurse can use for crisis

A

Supportive interventions

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10
Q

Define supportive interventions (crisis)

A

** to help empower the patient and not working on (fixing them)
-encourage recognition and expressing feelings
-serving as a sounding board

AFFIRMING SELF WORTH***

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11
Q

Define anger

A

This is “normal” when handled appropriately

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12
Q

Define hostility

A

Verbal aggression

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13
Q

Define physical aggression

A

Behavioral response

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14
Q

When a patient showing aggression what is the neuron background

A

Aggression shown in a patient can indicate a low serotonin level and can be fixed with admin of SSRI med

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15
Q

What screening tool can a nurse use to assess behavioral health in a patient

A

BROSET scale
- confusion
- irritable
- boisterous
-verbally threatening
- physically threatening
-attacking objects

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16
Q

What screening tool can the nurse use to assess aggression

A

ABRAT scale

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17
Q

Define the stages of aggression the nurse should assess

A

1) Preassaultive
-Triggering
-Escalation

2) Assaultive
-Crisis

3) Postassaultive
-Recovery
-Postcrisis

18
Q

What does the Preassaultive stage consist of

A

*Triggering- this is an event/ circumstance that initiates a response

*Escalation- patient shows hostility or anger that moves towards the (loss of patient control)

19
Q

Define the assaultive stage

A

*Crisis- this is the patients loss of control ( emotion and physical crisis)

20
Q

Define postassaultive stage

A

*Recovery
*Postcrisis- returning to base line

21
Q

During a Postcrisis stage, how long would the nurse expect to see the patient calm down and return to baseline

A

***10 min to calm down

22
Q

What is the BEST de-escalation technique the nurse can provide to the patient

A

Remaining CALM
Be empathetic
Provide NONJUDGMENTAL
Avoid taking things personal
Avoid overreacting
Use nonverbal communication

23
Q

When providing de-escalation to a patient what is the most important thing the nurse should focus on

A

Focus on patients feelings***
* Allow time for the patient to respond
* Allow silence for reflection

24
Q

If a patient is need of seclusion or violent restraints what must the nurse look for in the doctors order

A
  • the order CANNOT be a PRN order
25
Q

How long can a patient be in restraints

A

4 hours and if need for longer a NEW order must be prescribed

26
Q

When documenting the use of restraints what should the nurse document

A
  • clinical justification (description) of situation
    -Alternative attempts (what else did you try)***LEAST TO MOST RESTRICTIVE MEASURES FIRST
    -Notifications
    -Date and Time
    -Type of restraints used
27
Q

Define suicide

A

Intent act of killing self

28
Q

Define suicide ideation

A

The idea (thinking) of killing self

29
Q

Define suicide attempt

A

Acting on, either failed or incompetent

30
Q

When talking with patients about suicide what are some things the nurse should ask

A
  • how well thought out is the plan
  • what objects will be involved
  • how detailed is the plan
31
Q

What is the biggest risk factor for suicide patients

A

***sense of HOPELESSNESS (key indicator)

32
Q

What are some other risk factors seen in suicidal patients

A

Family Hx
* intense emotions
**history of trauma/ abuse
*lack of access to mental health care
* unemployment

33
Q

When assessing a patient for risk of suicide what are some conversational/actions the patient may say that can indicate a huge risk

A

***** giving away objects of value

  • saying things like:
    -“this will be over soon”
  • “ statements about giving up on life”
    -“ this is too hard”
34
Q

When providing suicide interventions what are the biggest things to provide to the patient

A

***safety precautions!!!
- Authoritative role = therapeutic communication = Directive (being clear and direct)

35
Q

What are the safety precautions the nurse must follow when providing care

A
  • 1 to 1 ratio
  • keeping self 3ft away
  • keep doors open
  • provide Q15 min rounding/ checks
  • room search to remove hazardous items
  • keep hands visible( not on hips or behind back)
  • no private rooms for suicide pts ( it allows pt to have someone to talk to and a second set of eyes in the room)
  • NO VISITORS IN PATIENTS ROOMS
  • strict MOUTH checks( pts can pocket pills = overdose)
36
Q

What is the goal out come for a patient who is a suicide risk

A

**Establish a no suicide contract
- safe from harming self or others
- establish realistic plans
- positive attributes

37
Q

Define work place hostility

A

Intimidating and disruptive behaviors

38
Q

In work place hostility there is a code of conduct, what does that outline

A
  • acceptable and unacceptable behavior
  • details on how unacceptable behavior should be handled
  • zero tolerance!!!!
39
Q

What type of patients would be of high risk for violence (vulnerable person)

A
  • low selfesteem person
  • feeling of HOPELESSNESS
    -protecting the perpetrator
  • accepts responsibility for the abuse (believing it is their fault)
40
Q

What patients are a high risk for violence

A

-female partner in a relationship
-vulnerable person
-pregnant women
-older adult females
-children

Mental Health (3 decks)

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