Exam 1 Flashcards

1
Q

What is mental health?

A

A state of wellbeing in which individuals:

  • Reach their own potential
  • Cope with normal stresses of life
  • Work productively
  • Contribute to the community
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are traits of people with good mental health?

A

People who have the capacity for:

  • Rational thinking
  • Communication skills
  • Learning
  • Emotional growth
  • Resilience
  • Self-esteem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most important key for mental health?

A

Resilience

Self-esteem is important too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is another name for mental illness?

A

Mental disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a mental illness defined as?

A

All psychiatric disorders that have a definable diagnoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are mental illnesses related to?

A

Developmental, biological, or psychological disturbances in mental functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

An example of a mental illness where the ability to think being impaired

A

Altzheimer’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

An example of a mental illness where emotions are affected

A

Major depressive disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

An example of a mental illness where behavioral alterations are apparent

A

Schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Explain the mental health continuum

A

At one end: Health/well being
In the middle: emotional problems or concerns
At the other end: mental illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define resilience*

A

*Ability and capacity to secure resources needed to support well-being
(The single biggest protective factor for mental health)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is resilience characterized by?

A

Ability to secure needed resources

Capacity for regulating one’s own emotions and overcoming negative, self-defeating thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which individual attribute or behavior is essential for recovery?

A

Resilience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Examples of risk and protective factors involving social and economic circumstances

A

Family
Schools and peer groups
Socioeconomic status
Educational advancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk and protective factors involving environmental factors

A

Political climate and cultural considerations
Social and economic policies
(Marginalized populations = risk factor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is mental illness a physical illness?

A

The root of most mental disorders lies in intercellular abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define the diathesis-stress model?

A

Diathesis: biological predisposition
Stress: environmental stress/trauma
(Nature vs. Nurture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Explain what the diathesis-stress model is

A

The most accepted explanation for mental illness

The combination of genetic vulnerability and negative environmental stressors cause mental illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define parity

A

Equivalence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What was the Mental Health Parity Act (1996)?

A

Required insurance companies to provide equal treatment coverage for psychiatric disorders (but did not require them to cover it)

(But many insurance companies still place limits on mental health coverage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What was the Patient Protection and Affordable Care Act?

A
  • Provides coverage for most uninsured Americans through expanded Medicaid eligibility (for very poor)
  • Created health insurance exchanges to offer more choices
  • “Insurance mandate” for coverage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define epidemiology

A

The quantitative study of the distribution of mental disorders in human populations
(to identify high-risk groups and high-risk factors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define incidence

A

Number of new cases in a given time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define prevalence

A

Number of cases regardless of when they began

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define lifetime risk

A

Risk that one will develop a disease during a lifetime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Does the flu have a higher incidence or prevalence?

A

Higher incidence

Because we don’t get the flu and keep the flu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Does diabetes have a higher incidence or prevalence?

A

Prevalence because once you are diagnosed with it, you always have it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How are mental disorders diagnosed?

A
  • Use official medical guidelines of the American Psychiatric Association for diagnosing psychiatric disorders
  • Based on specific criteria influenced by multi professional clinical field trials
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How are mental disorders classified?

A

Using clinical descriptions of mental and behavior disorders which have two broad classifications and subclassifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is evidence based practice in psychiatric mental health nursing?

A

Use nursing, psychosocial, neurobiological theories, and research

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does psychiatric mental health nursing promote mental health?

A

Through assessment, diagnosis, and treatment of behavioral and mental disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Most important trend affecting the future

A

Advocacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

In what ways does a psychiatric nurse advocate for their patients?

A
  • Through direct and indirect care, nurses must:
  • report abuse, neglect,
  • uphold confidentiality,
  • support the patient’s right to make decisions regarding treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are trends that will affect the future of mental health?

A
Educational challenges
Demand for mental health professionals
Aging population
Cultural diversity
Science, technology, and electronic healthcare
Advocacy
Legislative involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Levels of Awareness in Freud’s psychoanalytic theory

A

Conscious
Preconscious
Unconscious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Define conscious according to Freud

A

Contains all the material a person is aware of at any one time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Define preconscious according to Freud

A

Contains material that can be retrieved rather easily through conscious effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Define unconscious according to Freud

A

Includes all repressed memories, passions, and unacceptable urges lying deep below the surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

The three distinct systems of the personality according to Freud’s theory

A

Id
Ego
Superego

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is id?

A

Totally unconscious and impulsive

Drives instincts and reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the ego?

A

Problem solver and reality tester

Attempts to navigate the outside world

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the superego?

A

Moral component of personality

Induces guilt and pride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is classical psychoanalysis?

A

Freud’s premise that early intra psychic conflict is the cause for all mental illness
This theory is no longer thought to be valid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Define *transference

A

Unconscious feeling that the patient has toward you that was originally felt during childhood
EX: an older patient says “you remind me so much of my granddaughter”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Define *countertransference

A

*this is what we (as the nurse) feel toward the patient. This comes into play with how we treat patients (justice and fairness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the psychodynamic theory?

A
  • Newer psychoanalytic model that focuses more on here and now
  • Uses tools of psychoanalysis
  • Best candidates are the “worried well”
  • Increased back and forth between therapist and patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Define *interpersonal theory

A

The purpose of all behavior is to get needs met through interpersonal interactions and to reduce or avoid anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Define anxiety according to Sullivan

A

Any painful feeling or emotion that arises from social insecurity or prevents biological needs from being satisfied

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Define security operations according to Sullivan

A

Measures the individual uses to reduce anxiety and enhance security

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Define self-system according to Sullivan

A

All of the security operations an individual uses to defend against anxiety and ensure self-esteem collectively make up the self-system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is interpersonal therapy most effective in treating?

A

Grief and loss
Interpersonal disputes (relationship conflicts)
Role transition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Who established the foundations for interpersonal theory implications for nursing?

A

Hildegard Peplau

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How did Peplau apply the Interpersonal Theory to nursing?

A
  • Nurses are both participants and observers in therapeutic conversations
  • Self-awareness helps keep focus on patient
  • Lowering patients’ anxiety improves ability to think and function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are behavioral theories?

A

Use conditioning to respond to a specific stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How are behavioral theories applied to nursing?

A

Modifying or replacing behaviors

Behavior management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is behavioral therapy?

A

Assumes that changes in maladaptive behavior can occur without insight into the underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is behavioral therapy best used to treat?

A

Phobias
Alcohol use disorder
Schizophrenia
And many other conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

5 types of behavioral therapy

A
Modeling
Operant conditioning
Exposure therapy
Aversion therapy
Biofeedback
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is modeling behavioral therapy?

A

The therapist provides a role model for specific identified behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is operant conditioning behavioral therapy?

A

Basis for behavior modification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is exposure therapy behavioral therapy?

A

Patients are encourages to face their fears to eliminate them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is aversion therapy behavioral therapy?

A

Pairs a target behavior with a negative stimulus to extinguish the undesirable behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is biofeedback behavioral therapy?

A

Used to control the body’s physiological response to stress and anxiety (like relaxing certain muscles) to reduce/eliminate pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What do cognitive theorists believe?

A
  • There is a dynamic interplay between individuals and the environment
  • *thoughts come before feelings and actions
  • Thoughts about the world and our place in it are based on our own unique perspectives, which may or may not be based on reality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Two of the most influential cognitive theories:

A

Rational-emotive behavior therapy

Cognitive-behavioral therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How does rational-emotive behavior therapy work?

A

Aims to eradicate irrational beliefs by helping patients recognize thoughts that are not accurate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How does cognitive-behavioral therapy work?

A

Teaches pts to challenge distorted beliefs and change their way of thinking
In order to reduce symptoms of depression and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Which group does trauma-focused cognitive behavioral therapy focus on?

A

First developed to address sexual abuse trauma in children
Expanded for all ages
Still focuses more on children and adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

How does trauma-focused cognitive behavioral therapy work?

A

For trauma that is very difficult to get past,
Is short-term, and incoorporates cargivers and family therapy
Helps identify feelings and how to manage them (and replace negative thoughts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are dialectical strategies?

A

Integration of opposites (help the patient and therapist give up extreme positions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Which type of patients was dialectical behavioral therapy developed for?

A

Individuals with intractable behavioral disorders involving emotional dysregulation (ex: women with borderline personality disorder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

How does dialectical behavioral therapy work?

A

Employs CBT elements:

  • mindfulness
  • distress tolerance
  • interpersonal effectiveness
  • emotional regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is CBT mindfulness?

A

Being aware and present in the moment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is CBT distress tolerance?

A

Tolerating pain instead of frantically trying to transform it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is CBT interpersonal effectiveness?

A

Asking for what you want and being able to say no when needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is CBT emotional regulation?

A

Choosing and changing emotions that are problematic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are implications for nursing regarding cognitive theories?

A

Recognizing the interplay between events, negative thinking and negative responses

Helping the patient identify negative thought patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What do humanistic theories focus on?

A

Human potential and free will to choose life patterns supportive of personal growth

Emphasize a person’s capacity for self-actualization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Main points of the theory of human motivation

A
  • Psychology must go beyond negative experiences to include love, compassion, happiness, etc.
  • Humans are active participants in life, striving for self-actualization
  • When lower needs are met, higher needs can emerge
80
Q

What is Maslow’s Hierarchy of Needs?

A

Humans are motivated my unmet needs
Humans are striving for self-actualization
When lower needs are met, higher needs can emerge

81
Q

What are the implications for nursing regarding humanistic theories?

A

Key to successful nurse-patient relationships: emphasis on human potential and the patient’s strengths

Prioritizing: establishes what is most important in the sequencing of nursing actions

82
Q

What does the biological model say?

A

**Recognizes that psychiatric illnesses are as physical in origin as physical illness, so it can take the blame off of the person

83
Q

What type of treatments does the biological focus on?

A

Neurological
Chemical
Biological
Genetic

84
Q

What does the biological model seek to understand?

A

How the body and brain interact to create:
Emotions
Memories
Perceptual experiences

85
Q

How does biological model treatment work?

A

Targets the site of the illness using physical interventions such as drugs, diet, or surgery

86
Q

Types of biological therapies:

A

Psychopharmacology therapy

Brain stimulation therapies

87
Q

Types of brain stimulation therapies

A

Electroconvulsive therapy
Transcranial magnetic stimulation - repetitive (rTMS)
Vagus nerve stimulation (VNS)
Deep brain stimulation (DBS)

88
Q

What is electroconvulsive therapy (ECT)?

A

Used to induce a seizure to reset brain chemicals

89
Q

Implications of biological theories for nursing

A
  • Physical needs and physical care in nursing are part of a holistic approach to healthcare
  • Focusing on the qualities of a therapeutic relationship
  • Understanding the patient’s perspective
  • Communicating in a way that facilitates the patient’s recovery
    (All takes place alongside physical care)
90
Q

What does the cognitive development theory say?

A

Our mental representations of the world (schemata) depend on the cognitive stage we have reached

91
Q

What are the cognitive development stages?

A

Sensorimotor stage
Preoperational stage
Concrete operational stage
Formal operational stage

(Operations = thinking about objects)

92
Q

What happens during the sensorimotor stage?

A

Birth to 2 yrs
Begins with basic reflexes
Continues to purposeful movement, spatial skills, hand-eye coordination

93
Q

What occurs during the preoperational stage?

A

2-7 yrs

Cannot think abstractly

94
Q

What occurs during the concrete operational stage?

A

7-11 yrs

Logical thought appears

95
Q

What occurs during the formal operational stage?

A

11 yrs - adulthood
Conceptual reasoning
Can think abstractly and problem solve

96
Q

What is the theory of psychosocial development?

A

Belief that personality continues to develop through old age

And that development occurs in 8 predetermined and consecutive live stages, resulting in a positive or negative outcome

97
Q

Which stage of psychosocial development occurs between age 12-20?

A

Identity vs. role confusion

98
Q

Which stage of psychosocial development occurs during age 20-35?

A

Intimacy vs. isolation

99
Q

Which stage of psychosocial development occurs between age 35-65?

A

Generativity vs. self-absorption

100
Q

Which stage of psychosocial development occurs during age 65+?

A

Integrity vs. despair

101
Q

What is the theory of object relations?

A

Object = significant person

Past relationships influence sense of self and present relationships

102
Q

What does the theory of object relations believe that psychological problems stem from?

A

The result of a disruption of early separation

103
Q

What are two important theories of moral development?

A

Stages of moral development

Ethics of care theory

104
Q

What is the stages of moral development theory?

A

The framework for understanding the progression from black and white thinking about right and wrong to a complex decision making process

105
Q

What are the three main categories of the stages of moral development?

A

Preconventional level
Conventional level
Postconventional level

106
Q

Which stages are in the preconventional level?

A

Stage 1: obedience & punishment

Stage 2: individualism & exchange

107
Q

Which two stages are in the conventional level?

A

Stage 3: good interpersonal relationships

Stage 4: maintaining social order

108
Q

Which two stages are in the postconventional level?

A

Stage 5: social contract & individual rights

Stage 6: universal ethical principles

109
Q

Why is the ethics of care theory so important for nurses?

A

So we can target interventions

110
Q

What does the ethics of care theory emphasize?

A
  • Criticized the theories of moral development as favoring males
  • Suggests that a “morality of care” should replace Kohlberg’s “justice view” of morality
  • Relationships banding together
  • Putting the needs of those we care for above the needs of strangers
  • Ties progress to personal development and sense of self more than cognition
111
Q

Implications of development theories for nursing

A

Developmental model is important part of nursing assessment

Helps determine what types of interventions are most likely to be effective

112
Q

Qualifications for psychiatric home care

A

Homebound
Having a mental health diagnosis
May experience coexisting medical problems
Can safely be managed in the home setting
Has identified treatment needs

113
Q

Examples of why a patient may be homebound for psychiatric home care

A

Circumstances that impair their functioning such as:
Anxiety
Paranoid thoughts
Medical conditions
Impairment in ability to complete self-care
Impairment in thoughts
Memory impairment

114
Q

Important considerations for the plan of care of a patient in psychiatric home care

A
  • Plan must be completed upon admission and reviewed ever 60 days
  • RN must include specific outcomes that are measurable
  • Must include frequency and duration of visits
115
Q

What is the difference between Intensive Outpatient Programs (IOP) and partial hospitalization Programs (PHP)?

A

IOP: patient is kept for 3-4 hours. For pts who need a little extra help that can’t be met by a counseling session

PHP: from 9-3 Mon-Fri. For pts who can still take care of themselves during the rest of the time

116
Q

Example of a patient who would benefit from a PHP

A

** A patient who has a substance use disorder who just went through treatment but doesn’t trust themself to be at home while spouse is at work

117
Q

What is ACT?

A

Assertive community care

24 hour care for people out in community with persistent psychiatric symptoms that are unable to come into treatment

118
Q

Benefits of patient-centered health/medical homes

A

Has all types of care in one building

Allows for patient to feel more comfortable because others won’t know what they are seeking care for

119
Q

What is a comprehensive emergency service model?

A

Used for emergency psychiatric care
Dedicated psychiatric space and staff
Often affiliated with a full-service emergency department in a hospital or medical center

120
Q

What is a hospital-based consultant model?

A

Has no dedicated space or separate staffing

But has psychiatric staff on site for emergency psychiatric care

121
Q

What is a mobile crisis team model?

A

Stabilization in the field to assess and de-escalate during psychiatric emergencies

122
Q

Levels of prevention strategies for psychiatric emergencies:

A

Primary prevention
Secondary prevention
Tertiary prevention

123
Q

Explain primary prevention strategies of psychiatric emergencies

A

Trying to stop something before it starts

Teaching coping strategies to young people

124
Q

Explain secondary prevention strategies to prevent psychiatric emergencies

A

Screenings to try to catch it early

May not stop the disorder from beginning but can catch it before it progresses

125
Q

Explain tertiary prevention strategies to prevent psychiatric emergencies

A

What happens once someone has a disorder (there is a diagnosis, event, or hospitalization)
Want to prevent it from getting worse, or from other problems occurring due to the disorder

126
Q

Characteristics of the nurse in outpatient settings:

A

Strong problem-solving and clinical skills
Cultural sensitivity
Flexibility
Knowledge of community resources
*Autonomy
Promoting recovery and continuation of treatment

127
Q

Problems that may affect the success of treatment for a patient who is being discharged from inpatient services into outpatient community services

A
  • medication administration
  • pt may not follow up with care (needs transportation)
  • support system
  • substance use history or current use
128
Q

Settings for inpatient care

A

Crisis stabilization/observational units
General hospital and private hospitals
State psychiatric hospitals (most restrictive)

129
Q

Ways a patient gets into inpatient care?

A
  • Direct admission on referral
  • Emergency department or crisis service
  • Voluntary or involuntary
130
Q

What are clinical pathways used for?

A

Used by inpatient units for standardization in treatment and to improve outcomes

131
Q

What is milieu?

A

Surroundings and physical environment

132
Q

What are the goals of unit design for therapeutic milieu?

A

Promote and environment of safety and empower patients to partner with clinical staff and take ownership of their own mental health and safety

133
Q

Define ethics

A

The study of philosophical beliefs about what is considered right or wrong in a society

134
Q

Define bioethics

A

Used in relation to ethical dilemmas surrounding healthcare

135
Q

What is an ethical dilemma?

A

Conflict between two or more courses of action, each with favorable and unfavorable consequences

136
Q

Principles of bioethics:

A
Autonomy
Beneficence
Nonmalificence
Justice
Fidelity
Veracity
137
Q

What is autonomy?

A

Respecting the rights of others to make their own decisions

138
Q

Example of autonomy

A

Patients have the right to refuse medication

139
Q

What is beneficence?

A

The duty to promote good

140
Q

Example of beneficence

A

Helping someone in their time of need (if a car accident just happened, helping the victims)

141
Q

What is nonmaleficence?

A

Doing no harm to patient

142
Q

Example of nonmaleficence

A

Protecting confidential info about a patient

143
Q

What is justice?

A

Distribute resources or care equally

144
Q

Example of justice

A

Spending equal time with patients that you like and don’t like

145
Q

What is fidelity?

A

Maintaining loyalty and commitment; doing no wrong to a patient

146
Q

Example of fidelity

A

Maintaining your competence (not working on a unit you haven’t been trained on)

147
Q

What is veracity?

A

One’s duty to always communicate truthfully

148
Q

Example of veracity

A

Telling a patient you don’t know if their going to die, but you will stay with them and take care of them

149
Q

When is it ok for a patient to be commited involuntarily?

A

Mentally ill
*Danger to self or others
Gravely disabled
In need of treatment and illness prevents voluntary help seeking

150
Q

What is emergency commitment used for?

A

Temporary admission if a person is confused or demented

Used for observation, diagnosis and treatment

151
Q

How long is emergency commitment, generally?

A

24-96 hours

This time is used to determine if someone should be admitted involuntarily

152
Q

What is a Writ of habeas corpus?

A

Used when patient’s believe they have been held without just cause.
A letter explaining why they shouldn’t be involuntarily committed that challenges unlawful detention

153
Q

What does Least Restrictive Alternative Doctrine mean?

A

ALWAYS taking the least drastic or restrictive action

If a pt can be treated in out patient setting, they should not be treated in inpatient

154
Q

Discharge procedures from inpatient care

A
  • Unconditional release (pt can just leave)
  • Termination of the legal patient-institution relationship
  • Release against medical advice (pt signs themselves out)
  • Conditional release
155
Q

Factors of conditional release

A
  • usually requires outpatient treatment for a specified period of time with follow-through eval
  • assisted outpatient treatment
  • similar to conditional release but court-ordered
156
Q

Patients’ rights under the law:

A
Right to treatment
Right to refuse treatment
Right to informed consent
Rights regarding psychiatric advance directives
Rights regarding restraint and seclusion
Rights regarding confidentiality
157
Q

Which rights do patients have regarding informed consent?

A
  • Patient must be informed of risks, benefits, and alternatives
  • Person must voluntarily accept treatment (gone over with pt by the *physician, not the RN)
  • Implied consent
  • Capacity & competency must be considered
158
Q

Example of implied consent

A

If you approach a pt with medication and the pt indicates a willingness to take the medication

159
Q

Difference between capacity and competency

A

Capacity can fluctuate depending on someone’s mental state (ex: under the influence of drugs)

Competency is decided by a court to determine if someone can take care of their own needs

160
Q

What rights do patients have regarding restraint and seclusion?

A
  • Must have orders and documentation
  • In an emergency, a nurse may place a pt in seclusion or restraint, but obtains written or verbal order as soon as possible thereafter
  • Orders for restraint or seclusion are never written as an as needed or as a standing order
161
Q

What are the two exceptions to patient confidentiality?

A
  • Duty to warn and protect third parties (if a patient is a danger to themselves or others)
  • Child and elder abuse reporting
162
Q

What is Tort?

A

Any wrongful act, intentional or accidental, that results in an injury to another

163
Q

What is intentional tort?

A

Willful or intentional acts that violate another person’s rights or property

164
Q

Examples of intentional tort

A

Assault
Battery
False imprisonment (ex: restraining someone)
Invasion of privacy
Defamation of character (slander or libel)

165
Q

What is unintentional tort?

A

Unintended acts against another that produce injury or harm

166
Q

Examples of unintentional tort in nursing

A

Negligence

Malpractice (most common)

167
Q

5 elements to prove negligence

A

1 - Duty
2 - Breach of duty - Didn’t meet the standards of care
3 - Cause in fact - If it wasn’t up to what the nurse did or didn’t do, would this still have happened?
4 - Proximate cause - Could you have foreseen this?
5 - Damages - There must be damages to the patient

168
Q

Legal standards nurses have to follow

A

State board of nursing
Professional organizations
Institutional policies and procedures

169
Q

How must nurses act on questionable practice?

A

If another nurse does any of these: negligence, irresponsibility, or impairment,
We have a duty to report

170
Q

How must a nurse report questionable practice?

A
Must document clearly and accurately first
Supervisor intervenes
(If unavailable, you must intervene to protect the patient)
171
Q

How must a nurse document care?

A

Accurate and complete
Means of interprofessional communication
Patient has a right to review record
The record belongs to the insitution

172
Q

What are retrospective record reviews used for?

A

Quality improvement
As evidence
Risk management purposes
To determine insurance reimbursements

173
Q

How are medical records used as evidence?

A

To determine:
The extent of pt’s damages and suffering in a suit
Nature and extent of injuries in abuse cases
Nature and extent of physical or mental disability in disability cases
Nature and extent of injury and rehabilitative potential in workers’ compensation cases

174
Q

Define minorities

A

Racially, ethnically, or culturally distinct groups that coexist, but are subordinate in some way to a dominant group

175
Q

Define minority status

A

Not always fewer in numbers, but lacking political and social power
May be treated differently and discriminated against

176
Q

Define race

A

Can be defined biologically, anthropologically, or genetically
Can be distinguished visually from one another based on physical characteristics

177
Q

Define ethnicity

A

Sharing a common heritage and history

Share worldview for thinking

178
Q

Define culture

A

Shared beliefs, values, and practices

179
Q

Which organization measures race and ethnicity in the United States?

A

U.S. Census Bureau

180
Q

What is the purpose for measuring race and ethnicity in the United States?

A

Help the government understand the needs of its citizens

Helps to identify disparities in health care along racial-ethnic lines

181
Q

Characteristics of western tradition

A

Identity found in individuality
Values: autonomy, independence, self-reliance
Mind and body = separate entities
Disease has a cause, treatment is aimed at cause
Time is linear
Success is obtained in prepping for the future

182
Q

Characteristics of eastern tradition

A
Family basis for identity
Body-mind-spirit = one entity
Time is circular and recurring
Born into fate; duty to comply
Disease caused by fluctuations in opposing forces
183
Q

Characteristics of indigenous culture

A

Places significance on place of humans in natural world
Basis of identity is the tribe
Person is an entity only in relation to others
Disease caused by lack of harmony between individual and environment

184
Q

What does ethnocentrism mean?

A

When you think your culture is the best

185
Q

What is cultural imposition?

A

When someone imposes their culture on someone else

186
Q

Things to keep in mind when using an interpreter for a patient

A
  • Must be a medical interpreter
  • Cannot be a family member or someone the patient knows
  • Should be as closely matched to a patient’s age and gender as possible
187
Q

Special at-risk populations for mental health and why?

A

Immigrants: discrimination
Refugees: reason they left their country
Cultural minorities: discrimination, disadvantaged, don’t have access

188
Q

Five constructs of (ways to provide) culturally effective care

A
Cultural awareness (most important)
Cultural knowledge
Cultural encounters
Cultural skill
Cultural desire
189
Q

How can someone be culturally aware?

A
  • Examine beliefs, values, and practices of own culture

- Recognize that during a cultural encounter, three cultures are intersecting (patient, nurse, setting)

190
Q

How can someone gain cultural knowledge?

A
  • Attend cultural events and programs
  • Forge friendships with diverse cultural groups
  • Studying
191
Q

How should nurses learn cultural differences?

A

Establish rapport
Ask culturally relevant questions
Identify cultural variables to be considered

192
Q

How do cultural encounters help nurses?

A

Deter nurses from stereotyping
Help them gain confidence in cross-cultural interactions
Helps them avoid or reduce cultural pain

193
Q

What is cultural skill?

A

Ability to perform a cultural assessment in a sensitive way

194
Q

What are ways a nurse can demonstrate cultural skill?

A

Use professional medical interpreter to ensure meaningful communication
Use culturally sensitive assessment tools

195
Q

What is the goal for a patient who is from a different culture?

A

A mutually agreeable therapeutic plan that is:

  • culturally acceptable
  • capable of producing positive outcomes
196
Q

What is cultural desire?

A

Genuine concern for patient’s welfare
Willingness to listen until patient’s viewpoint is understood
Having patience, consideration, and empathy