Exam 1 Flashcards
1
Q
- Therapeutic communication (verbal and non-verbal) include what 4 things?
- What impedes communication in either the nurse or client
- What is transference?
- What is countertransference?
A
- appropriateness, efficiency, flexibility, and feedback
- anxiety
- Transference
Patient transfers unconsciously and inappropriately
displaces (transfers) onto the nurse feelings and
behaviors related to significant figures in patient’s past
Ex: Nurse reminds patient of their overbearing mother - Countertransference
Nurse counters unconsciously and inappropriately
displaces onto the patient feelings and behaviors related
to significant figures in the nurse’s past
Warning sign is if you over identify with your patient
Ex: Elderly patient reminds you of your grandma
Ex: Adolescent patient reminds you of your little brother
Ex: Your sibling was an alcoholic and now your patient is
alcoholic and you unconsciously treat the patient poorly
2
Q
How much distance between the following types of relationships?
- therapeutic communication between nurse/client?
- parent and small child, people who desire close contact, and people whispering?
- family and friends who are talking?
- communication in social work and business settings
A
- 3-6 feet
- 0-18 inches
- 2-3 feet
- 4 - 12 feet
3
Q
- What is a coping mechanism?
2. What is a defense mechanism?
A
- any effort to decrease anxiety, and protect oneself. Can be constructive or destructive. Can be task oriented or cognitvely oriented to neutralize the meaning of a problem.
- a coping mechanism used to decrease anxiety and protect the ego
4
Q
- What does the frontal lobe control?
- What do the temporal lobes control?
- What do the parietal lobes control?
- what does the occipital lobe control?
- what does the cerebellum control?
- what does the medulla control?
A
- decision making, impulse control, judgement, emotional control
- language, sexuality, emotion, hearing, memory
- sensory perception, movement
- vision
- coordination
- vital functions such as respirations, HR and BP (via vessel diameter).
5
Q
- What psychiatric condition are increases (and sometimes decreases) of dopamine associated with?
- What is decreased serotonin associated with?
- decreased norepinephrine?
- Decreased y-aminobutiric acid GABA?
- Decreased acetylcholine?
- Decreased glutamate?
A
- schizophrenia
- depression (and anxiety)
- depression (and anxiety)
- anxiety
- Alzheimers
- psychotic thinking
6
Q
- T or F, anxiety is a normal response to stress, a subjective experience?
- What are the 3 types of anxiety?
- What are the 4 levels of anxiety?
- Generally speaking, what actions should we take with anxious clients?
A
- T
- Normal: healthy type
Acute (state): percipitated by imminent loss or change
Chronic (trait): anxiety that persists over time.
- Mild (assoc. w/ tense experiences occurring in daily life. Heightens, enhances, motivates. Restless, irritable, mild tension).
Moderate: focus is on immediate concerns, narrowed perceptual fields, sight/sound diminish, but learning still occurs. Increased HR, perspiration, GI upset, headache, mild tremors.
Severe: feeling something bad is going to happen. Even more narrow perceptual fields. All behavior is aimed at relieving anxiety, no learning, Physical symptoms caused by sympathetic stimulation. Individual needs direction to focus.
Panic: inability to function or communicate effectively. Feelings of dread, doom, withdrawal, impulsive, erratic behavior, pacing, screaming, shouting. Patient can die if sustained panic.
- First recognize anxiety, establish trust, don’t criticize, watch for destructive behavior, offer creative outlets. Breathing, guided imagery, monitor vitals, anxiolytic meds, decrease stimuli
7
Q
- Nursing interventions specific to mild/moderate anxiety:
- Nursing interventions for severe to panic anxiety:
- What constitutes generalized anxiety disorder?
- In panic attacks, is it normal for client to not know where the anxiety is stemming from?
A
- find source of anxiety, encourage talking about feelings, help identify thoughts and feelings that occurred before the onset of anxiety, encourage problem solving, and encourage gross motor exercise
- use a calm manner, ALWAYS REMAIN WITH THE CLIENT, minimize environmental stimuli, provide clear, simple statements, use a low pitched voice, attend to the physical needs of the client, provide gross motor activity, administer antianxiety meds as prescribed, and ensure safety
- an unrealistic anxiety about everyday worries that persist more days than not, over at least 6 months and is not associated with another mental health problem.
- yes
8
Q
- Describe specific phobia:
- What defense mechanisms are commonly used in phobia?
- What are obsessions?
- What are compulsions?
A
- irrational fear of an object, activity, or situation that persists and that leads to avoidance, Associated with panic level anxiety or fear if the object, situation, or activity cannot be avoided.
- repression, displacement
- preoccupations with persistently intrusive thoughts, impulses, or images and ideas.
- the performance of rituals or repetitive behaviors an individual is driven to perform to prevent some event, divert unacceptable thoughts, and decrease anxiety.
9
Q
- T or F obsessions and compulsions happen together often?
- What happens if the client resists their obsessions or their rituals?
- What are the defense mechanisms of OCD?
- What are the nursing interventions for misc disorders such as hoarding, excoriation (skin picking), Substance or Medication induced disorder (due to another medical condition) and Trichotillomania (Hair pulling disorder)?
A
- T, the compulsive pattern behaviors are a way to neutralize the obsessive thoughts.
- anxiety.
- REPRESSION, DISPLACEMENT, UNDOING.
- ensure basic needs are met, identify what precipitates compulsive behavior, encourage client to talk about feelings, be empathetic, set limits on harmful behavior, implement a schedule, make a contract, positive reinforcement for non-ritualistic behavior. Don’t interrupt rituals unless safety issue
10
Q
- Decribe PTSD:
- How is PTSD diagnosed?
- Give examples of what can acuse PTSD:
- How might PTSD patients present?
- Interventions for PTSD:
- What is flooding?
A
- After experiencing a psychologically traumatic event, the individual is prone to re-experience the event and have recurrent and intrusive dreams or flashbacks.
- Symptoms last at least 1 month and can occur months to years after the traumatizing events.
- natural disaster, terrorist attack, combat experiences, accidents, rape, crime or violence, sexual, physical and emotional abuse
- avoidance, numbness, irritability, outbursts of anger, detachment, depression, suicidal thoughts, anxiety, sleep disturbances and nightmares, flashbacks of event, hypervigilance and exaggerated startle response, survival guilt, Poor concentration.
- Be non-judgmental and supportive, and assuring, Assist the client to recognize the association between feelings and trauma experience, Encourage expression of feelings, individual and group therapy, Monitor for suicide, Teach stress management coping mechanisms, relaxation techniques. Establish/re-establish relationships, Include family, hypnotherapy or systematic desensitization may be recommended possible forms of treatment. Flooding.
- a progressive review of the trauma experience
11
Q
- What is PTS?
- What are the purposes for the DSM5?
- Does the manual establish diagnostic criteria for various mental health problems?
- Does DSM5 take into account cultural health problems?
- Does DSM5 take into account mental health problems as well as substance addiction? What is this called?
A
- Posttraumatic stress. Happens in cancer patints. Can be during or after treatment. Similar to PTSD but not as severe.
- provides guidelines for health care personnel for identifying and categorizing mental health problems.
- yes
- yes
- yes. dual diagnosis
12
Q
- What is false imprisonment?
- Do involuntary patients retain their right to informed consent? Can they refuse treatment or meds?
- when do patients lose their right to refuse?
- Involuntary admissions have the right to ……….. …………… . However, they can be held for up to ….. hours for further evaluation.
- Clients are considered legally ………… until they are deemed legally ……….. .
- What constitutes assault?
- What constitutes battery?
A
- Retaining a voluntary client against their will. Or, if the reason for confining a client is for staff convenience.
- yes. yes, unless there is a separate treatment court order.
- When they pose an immediate threat to self and others.
- legal council. 72 hours
- competent, incompetent
- threatening a client
- touching a client in a harmful or offensive way
13
Q
- what is the difference between mental health and mental illness?
- What are maslow’s 5 levels?
- # 1 priority in mental healthcare?
A
- mental health refers to anyone’s state of mental, emotional well-being, mental illnesses are diagnosed conditions that affect thoughts and behaviors.
- physiological, safety, belongingness, esteem, self-actualization
- safety
14
Q
- What are extrapyramidal symptoms?
2. What causes EPS
A
- inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements
- dopamine blockade or depletion in the basal ganglia; usually form antipsychotic drugs.
15
Q
What are the following types of drugs used to treat?
- anticholinergics:
- antipsychotics
- antidepressants:
- mood stabilizers:
- anxiolytics, sedative hypnotics:
- psychostimulants:
- cognitive enhancers:
A
- used for side effects of most psychotropic meds
- psychosis, bipolar, aggression, tic disorders
- depression, pain , anxiety
- bipolar, aggression, mood disorders
- anxiety, sleep disorders, substance withdrawl
- ADHD, narcolepsy
- dementia
