Exam 1 Flashcards
Describe aspects of mental health
- coping w/ normal stressors of life
- working productively
- contributing to the community
- thinking rationally
- effective communication
- grow emotionally
- good self esteem
- have resilience
Define the concept of resilience in mental health
- ability to maintain well-being in stressful circumstances
- awareness & acceptance of problems
- optimism
- good interpersonal skills
- use of social support
- sense of competence
Identify how the Diagnostic & Statistical Manual for Mental Disorders (DSM) is used to diagnose psychiatric conditions
- keeps things standardized
- gives criteria for mental disorders
- helps w/ planning, implementing, & evaluating care (3 dimensions)
- assessment of someone’s functioning in the day to day
What are the social influences of mental health care in the US
- consumer movement & “recovery”
- Decade of the Brain (1990’s)
-Human Genome Project (1990-2003) - Sugeon General’s Report on Mental Illness (1999)
- President’s New Freedom Commission on Mental Health (2003)
- Institute of Medicine
- Affordable Care Act (2010)
Describe goals of inpatient psychiatric hospitalization
- prevention of harm to self or others
- rapid stabilization
- re-entry into community
- use yourself yo develop a relationship w/ a pt
Describe consumer movement & “recovery”
- advocated for rights & fought stigma
- process of change through which individuals improve their health & wellness, live a self directed life & strive for full potential
Describe Decade of the Brain
- focused on dementia
- lots of new psych meds came out
- made public aware of advances in neuroscience
Describe Human Genome Project
- discovered psych disorders have genetic & environmental factors
Describe Surgeon’s General’s Report on Mental Illness
- 1st report on mental health
- there are effective treatments for MH
- MH is fundamental for overall health
Describe President’s New Freedom Commission on Mental Health
- improve access to treatment
- big focus was on screening in high risk populations
- focus on resilience & recovery as well
Describe Institute of Medicine
- big focus on QUALITY healthcare
- MH issues are treated differently than others
- find out what’s wrong w/ out system
Describe Affordable Care Act
- stated MH should be accessible & affordable
- MH should be valued & covered by insurance
- MH should not be integrated into primary care
Describe examples of culturally relevant care in psych nursing
- effectivley wrk within a pt’s cultural context
- adjust practice to meet pt’s unique beliefs, practices, needs & preferences
- awareness
- knowledge
- skill
- culturally desire
Describe biomedical model
- main model
- mental illness = brain disease
- mental illness has a physiological cause
- mental illness is pathological
- mental health problems are a deviation from normal
- no evidence of monoamine hypothesis
- tests & imaging are not used for diagnosis
- neuroscience is rapidly changing
Describe the 5 components of the therapeutic millieu
Component:
- basic needs
Support
- encouragement
- teach about illness & needs
- talking or listening to the pt
Structure
Involvement
- reliable & predictable
- interaction w/ environment
- unit jobs..eating in the dayroom
Validation
- person’s individuality
- given their rights as a pt
- their rights matter
Describe psychological model
- mental health symptoms arise from internal experiences & conflicts
- rooted in Freud’s work - psychoanalysis
- mental disorders due to unresolved childhood issues
- talk therapy
- levels of awareness
- defense mechanism
- significance of childhood experiences
- focuses on causes of suffering
Describe cultural model
- mental health issues can be understood from a cultural & spiritual perspective
- can affect core values & assumptions
- what is considered “normal”
- expression & experience of symptoms
Describe social model
- mental health problems are a response to social circumstances
- housing issues
- discrimnation
EX: COVID/pandemic
Describe consumer model
- reflects the experience of people who have received tx
- rejects the idea of normal (all a continuum)
- includes recovery model & neurodiversity concept
Which theoretical model is the predominant model we use
biomedical
Our 2nd brain is…
our gut
Mental illness = ?
brain disease
Someone having a brain disease means they have a ….
mental illness
Describe components of a psychiatric assessment including mental status examination
- current problem
- psychosocial assessment (who they live with, where they live, are they sleeping & eating?)
- physical exam
- mental status exam
How do you perform an appropriate mental status exam?
- evaluate pt’s CURRENT status
- objective info (nonjudgemental)
- assess communication
-content: WHAT
What are the 4 phases of the nurse-patient relationship
- pre orientation
- orientation
- working
- termination
Explain pre orientation phase
- self exploration
- gather info
- occurs before you meet the pt
Explain orientation phase
- develop rapport
- developing communication
- building trust & acceptance
Explain the working phase
- develop insight & change behavior
Explain termination phase
- evaluate progress
- check to see how the pt feels about the relationship ending
- review the goals (met & not met)
Identify differences between social & therapeutic relationships
SOCIAL:
- friendship
- mutual needs met
- superficial
- roles shift
- little evaluation
THERAPEUTIC:
- pt growth
- pt’s needs met
- focus on pt feelings & experiences
- clear boundaries
- evaluation of relationship
Describe clinical supervision as it is used in psychiatric nursing
- educational process
- regular meetings w/ more experienced practitioner
- wrk w/ pts
- increases knowledge & skills
Describe mindfulness & how it affects the nurse-patient relationship & nursing care
- when a person is mindful of their surroundings using all their senses
- when someone learns how to restructure negative thoughts
Provide examples of therapeutic techniques
- speak briefly
- use silence
- avoid advice
- pay attention to nonverbal cues
- focus on the pt
Define therapeutic communication
- knowing purpose of message
- saying what you mean
- understanding pt’s meaning
Discuss common blocks to therapeutic communication
- giving advice
- giving false reassurance
- offering personal opinions
- asking irrelevant personal questions
- offering value judgements
- excessive questioning
- giving approval or disapproval
- asking “why” questions
- changing the topic
Describe the criteria for voluntary admission to a psych facility
- pt agrees to receive tx
- signs consent for tx
- has right to request discharge (doctor decides in the end)
Describe the criteria for involuntary admission to a psych facility
- dangerous to self or others
- unable to meet basic needs
- pt has right to legal counsel & to take case before a judge
Describe the legal rights of pts in a psych facility
- humane treatment & care
- religous freedom
Describe the components of the right to informed consent
- diagnosis: what it is
- tx: purpose of it, how does it wrk
- consequences: of the tx, side effects
- alternatives: other options
prognosis: with or without tx
Define neurotransmitters
- play a role in symptoms & behavior
- can turn on & off receptors
- can have different effects in different parts of the brain
- can affect other brain chemicals
Define neurotransmission
- process by which neurons communicate w/ each other through electrical impulses & chemical messengers
- effect can be excitatory or inhibitory
Discuss the major functions of the the brain
- monitor changes in the external world
- monitor the composition of body fluids
- regulate contractions of skeletal muscles
- regulates internal organs
- store & retrieve memories
- regulate sleep cycle
- produce & interpret language
- process visual & auditory data
- regulate mood (affect) & emotions
Discuss the major functions of the amygdala
- responsible for aggressive responses
Discuss the major functions of the pre frontal cortex
- plays a role in aggressive behavior
- executive function
- consequences of actions
- distinguishing from good & bad
Functions of norepinephrine (NE)
- attention
- arousal
- mood
- fight or flight response
Functions of Dopamine (DA)
- muscle movement
- motivation
- cognition
- emotions
- pleasure & reward system
Describe Serotonin (5HT)
- most known
- mood
- sleep & arousal
- hunger
- pain perception
- agression
- sexual behavior
Describe Gamma-amino-butyric acid (GABA)
- inhibition (decreased aggression, excitation & anxiety)
- anticonvulsant
- muscle relaxant
Describe glutamate
- learning
- memory
- sensory perception
Describe acetylcholine
- learning
- memory
- mood
- sexual behavior
- aggressive behavior
Why are neuroimaging techniques used in psych
- used ti visualize brain structure, functions & metabolic activity
What are PET scans used for in psych
- identify chemical & physical changes in living tissue
What are MRIs used for in psych
- provide overall images of the brain & layers of the brain
What is SPECT used for
- reveals physiological activity in the brain
Describe empathy
- connect w/ another’s experience
- seeing it from the other person’s POV
- don’t have to fully understand
Describe genuiness
- being authentic
- don’t have to be perfect
- congruence: what you portray on the outside matches what’s on the inside
Describe positive regard/respect
- attending
- nonjudgemental
- encouraging independence
