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Mental Health Lecture > Exam 1 Terms > Flashcards

Exam 1 Terms Flashcards

1
Q

Define resilience

A

Ability and capacity to:
- secure resources needed to support well-being
- regulate one’s own emotions
- overcome negative, self-defeating thoughts

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2
Q

Most accepted explanation for mental illness

A

Diathesis-stress model

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3
Q

What is Diathesis?
What is stress?

A

Biological predisposition (nature)
Environmental stress or trauma (nurture)

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4
Q

Act that required insurance companies to provide equal treatment coverage for psychiatric disorders

A

Mental health parity act

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5
Q

Act that allowed coverage for most uninsured Americans, health insurance exchanges, and insurance mandate

A

Patient protection and affordable care act

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6
Q

Study of the distribution of mental disorders

A

Epidemiology of mental disorders

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7
Q

What does epidemiology of mental disorders identify?

A

High-risk groups and high-risk factors

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8
Q

Number of new cases of a disease in a given time

A

Incidence

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9
Q

Number of new cases regardless of when they began

A

Prevalence

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10
Q

Example of high incidence

A

The flu because we don’t get the flu and keep it

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11
Q

Example of high prevalence

A

Diabetes because once someone is diagnosed with it, they will always have it

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12
Q

Official medical guidelines of the American Psychiatric Association for diagnosing psychiatric disorders

A

DSM5

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13
Q

What is the DSM5 based on?

A

Scientific criteria influenced by multi professional clinical field trials

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14
Q

Which type of theories and research does psychiatric mental health nursing use?

A

Nursing, psychosocial, neurological theories
Evidence based practice

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15
Q

How will mental health nursing be affected in the future?

A

Educational challenges
Demand for mental health professionals
Aging population
Cultural diversity
*Advocacy through direct and indirect care
Legislative involvement

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16
Q

List Freud’s Levels of Awareness

A

Conscious - all material person is aware of
Preconscious - Material that can be retrieved rather easily through conscious effort
Unconscious - repressed memories, passions, & unacceptable urges

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17
Q

Important terms from classical psychoanalysis still used today

A

Transference
Countertransference

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18
Q

Unconscious feeling that the patient has toward you

A

Transference

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19
Q

Unconscious feeling the nurse has toward the patient

A

Countertransference

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20
Q

Psychoanalytic model that focuses on here and now

A

Psychodynamic theory

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21
Q

Best candidates for this therapy are “worried well”

A

Psychodynamic therapy

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22
Q

Therapy with increased back and forth between therapist and patient

A

Psychodynamic Therapy

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23
Q

Theory that believes all behavior is to get needs met through interpersonal interactions and to reduce or avoid anxiety

A

Interpersonal theory (Sullivan)

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24
Q

Parts of Sullivan’s Interpersonal theory

A

Anxiety
Security operations
Self-system

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25
Q

What are security operations?

A

What we do to get our needs met

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26
Q

What is the self-system?

A

Made up of all the security operations an individual uses to defend against anxiety and ensure self-esteem

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27
Q

Therapy that is most effective in treating grief and loss

A

Interpersonal therapy

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28
Q

Therapy that is most effective in treating interpersonal disputes

A

Interpersonal therapy

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29
Q

Therapy that is most effective for treating role transition

A

Interpersonal therapy

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30
Q

Implications for nursing for interpersonal therapy

A

Patient is both a participant and observer (Hildegard Peplau)
Must use self awareness to keep focus on patient (know your triggers)

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31
Q

Theories that use conditioning to respond to a specific stimuli

A

Behavioral theories

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32
Q

Implications in nursing regarding behavioral theories

A

Used to modify or replace behaviors

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33
Q

Techniques used in behavioral therapy

A

Modeling
Operant conditioning
Exposure therapy
Aversion therapy
Biofeedback

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34
Q

Therapist provides role model for specific behaviors

A

Modeling

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35
Q

Uses positive reinforcement to increase desired behaviors

A

Operant conditioning

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36
Q

Patient is encouraged to face their fears

A

Exposure therapy

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37
Q

Therapy that pairs target behavior with negative stimulus

A

Aversion therapy

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38
Q

Therapy used to control body’s physiological response to stress and anxiety

A

Biofeedback

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39
Q

Theories that believe thoughts come before feelings and actions

A

Cognitive theories

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40
Q

Theories that believe 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

A

Cognitive theories

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41
Q

Two of the most influential cognitive theories

A

Rational-emotive behavior therapy (Ellis)
Cognitive-behavioral therapy (beck)

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42
Q

Therapy that helps patient recognize thoughts are not accurate and to eradicate irrational beliefs

A

Rational-emotive behavior therapy

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43
Q

Therapy that teaches patient to recognize negative thinking (depression & anxiety) and replace it with positive thoughts

A

Cognitive-behavioral therapy

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44
Q

Therapy that helps with very serious traumas. Helps identify feelings and how to manage them

A

Trauma-focused cognitive behavioral therapy

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45
Q

Therapy for people who think in extremes and have disorders involving emotional dysregulation

A

Dialectical behavioral therapy

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46
Q

Implications for nursing regarding cognitive therapies

A

Recognize the interplay between events, negative thinking, and negative responses
Help the patient identify negative thought patterns

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47
Q

Theory that believes psychology must go beyond experiences of hate, pain, misery, etc. and also include love, compassion, happiness, etc.

A

Theory of human motivation

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48
Q

Theory that believes humans are motivated by unmet needs

A

Maslow’s Hierarchy of Needs

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49
Q

Implications in nursing regarding Maslow’s hierarchy of needs

A

Helps establish sequence of nursing actions

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50
Q

Order (starting at the bottom) of Maslow’s hierarchy of needs

A

Physiological needs (food, water, oxygen)
Safety
Love and belonging
Esteem (self-esteem)
Self-actualization
Self-transcendence

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51
Q

Recognizes that psychiatric illnesses are as physical in origin as psychical illness

A

Biological model

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52
Q

Model that targets the site of illness using physical interventions (drugs, diet, surgery)

A

Biological model

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53
Q

Therapy that uses medication to treat psychiatric illness

A

Psychopharmacology therapy

54
Q

Brain stimulation therapy used to induce a seizure to reset brain chemicals

A

Electroconvulsive therapy (ECT)

55
Q

Stages of Cognitive development (Piaget)

A

Sensorimotor stage
Preoperational stage
Concrete operational stage
Formal operational stage

56
Q

Theory that believes personality continues to develop through old age

A

Theory of psychosocial development (Erickson)

57
Q

Eight stages of Erickson’s theory of psychosocial development

A

‣ Trust vs. Mistruct (0-1.5 yrs)
‣ Autonomy vs. Shame-doubt (1.5-3 yrs)
‣ Initiative vs. Guilt (3-6 yrs)
‣ Industry vs. Inferiority (6-12 yrs)
‣ Identity vs. Role confusion (12-20 yrs)
‣ Intimacy vs. Isolation (20-35 yrs)
‣ Generativity vs. Self-absorption (35-65 yrs)
‣ Integrity vs. Despair (65+ yrs)

58
Q

Theory that believes psychological problems were largely the result of a disruption of separation

A

Theory of object relations (Mahler)

59
Q

Theories that are an important part of nursing assessment

A

Theories of moral development

60
Q

Framework for understanding the progression from black and white thinking about right and wrong to more complex thinking

A

Stages of moral development

61
Q

List the 3 main stages of moral development

A

Preconventional level
Conventional level
Post conventional level

62
Q

What are the two stages in the preconventional level of moral development?

A

Stage 1: obedience and punishment (obedience is method to avoid punishment)
Stage 2: individualism and exchange (know not everyone thinks the way they do. If they or others choose to break rules, they risk punishment)

63
Q

What are the two stages of the conventional level of moral development?

A

Stage 3: good interpersonal relationships (believe people should get along and have similar values)
Stage 4: maintaining social order (“rules are rules” mindset returns, but this time bc individual has broader view of society)

64
Q

What are the two stages of the postconventional level of moral development?

A

Stage 5: social contract and individual rights (social order is still important, but it must be good)
Stage 6: universal ethical principles (believe actions should create justice for all, and we are obliged to break unjust laws)

65
Q

Theory that emphasizes relationships and banding together, putting the needs of those we care about above those of strangers

A

Ethics of care theory

66
Q

Theory that ties progress to personal development and sense of self more than cognition

A

Ethics of care theory

67
Q

Qualifications for a patient seeking home healthcare

A

Homebound
Mental health diagnosis
May have coexisting medical problems
Can safely be managed in home
Has identified treatment needs

68
Q

Describe the continuum of care for outpatient and inpatient mental health settings

A

Primary care = least restrictive and most common
State hospital = most acute and most restrictive

69
Q

Type of outpatient psychiatric care for people with persistent psychiatric symptoms who can’t come in for treatment (provides 24 hour treatment)

A

ACT (assertive community care)

70
Q

What are intensive outpatient programs?

A

For patients who need a little extra help that can’t be met by a counseling session
(3-4 hours)

71
Q

What is partial hospitalization?

A

For patients who can still take care of themselves the rest of the time
(9-3 mon-fri)

72
Q

List the levels of prevention strategies

A

Primary: teaching young people coping sills
Secondary: screenings to catch disorders before they progress
Tertiary: after someone has diagnosis, try to prevent it from getting worse or from other problems occurring

73
Q

List the roles of a nurse in an outpatient setting

A

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

74
Q

Settings for inpatient care

A

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

75
Q

Type of plan inpatient units use to improve outcomes

A

Clinical pathways

76
Q

Patient surroundings and physical environment

A

Milieu

77
Q

Goal of milieu

A

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

78
Q

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

A

Minority

79
Q

Can be defined biologically, anthropologically, or genetically

A

Race

80
Q

Sharing a common heritage, history, and world view for thinking

A

Ethnicity

81
Q

Set of shared beliefs, values, and practices

A

Culture

82
Q

Beliefs of western tradition

A

Identity found in individuality
Values autonomy, independence, self-reliance
Disease has a cause, treatment aimed at cause

83
Q

Beliefs of eastern tradition

A

Family basis for identity
Born into fate
Disease cause by fluctuations in opposing forces

84
Q

Beliefs of indigenous culture

A

Basis of identity is the tribe
Person is an entity only in relation to others
Disease caused by lack of harmony with environment

85
Q

List some at-risk populations

A

Immigrants
Refugees
Cultural minorities

86
Q

List the 5 constructs of culturally effective care

A

Awareness
Knowledge
Encounters
Skill
Desire

87
Q

What is the difference between ethics and bioethics?

A

Ethics = beliefs about what is right or wrong in society
Bioethics = ethical dilemmas surrounding healthcare

88
Q

6 principles of bioethics

A

Autonomy
Beneficence
Nonmaleficence
Justice
Fidelity
Veracity

89
Q

Patients have rights over their own body

A

Autonomy

90
Q

Duty to promote good

A

Beneficence

91
Q

Doing no harm to a patient

A

Nonmaleficence

92
Q

Distribute resources and care equally

A

Justice

93
Q

Maintain loyalty and commitment

A

Fidelity

94
Q

One’s duty to always communicate truthfully

A

Veracity

95
Q

Types of hospital admissions

A

Voluntary
Involuntary
Emergency commitment

96
Q

Requirements for a patient to be admitted to the hospital involuntarily

A

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

97
Q

When is emergency commitment used?

A

Temporarily (24-96 hours) to observe patient and determine if they should be admitted involuntarily

98
Q

When a patient is released and they can just leave the hospital

A

Unconditional release

99
Q

Release that requires outpatient treatment with follow through evaluation

A

Conditional release

100
Q

Release that is court ordered and requires outpatient treatment with follow through evaluation

A

Assisted outpatient treatment

101
Q

Letter patient can write explaining why they don’t think they should be kept involuntarily

A

Writ of Habeas Corpus

102
Q

Law that states the least drastic restrictive action should always be taken

A

Least restrictive alternative doctrine

103
Q

Patient rights regarding restraint and seclusion

A
  • Must have orders and documentation
  • In emergency, nurse can place pt in seclusion or restraint and obtain order ASAP thereafter
  • Orders for restraints are never written as needed or standing order
104
Q

What are the exceptions to patient confidentiality?

A

Duty to warn and protect 3rd parties
Child and elder abuse

105
Q

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

A

Tort

106
Q

Examples of unintentional tort

A

Negligence
Malpractice (most common)

107
Q

When should you act on questionable practice by another nurse?

A

If they show negligence, irresponsibility, impairment, or criminal activity

108
Q

What is the process for reporting another nurse of negligence?

A

Document clearly and accurately first
Superior intervenes; if unavailable you must intervene

109
Q

How can a nurse protect themself from patient violence?

A

Always document patient’s potential for violence
Communicate observations to colleagues
New laws enhance criminal charges and penalties for striking nurses

110
Q

Publication that has basis for certification criteria

A

ANA publication: psychiatric-mental health nursing

111
Q

Publication that has legal definition of psychiatric mental health nursing

A

ANA publication: mental health nursing

112
Q

How should you assess children differently than adults?

A

Caregivers will provide a lot of info
Must consider development levels
Assessment will be a combo of interview and observation

113
Q

How should you assess adolescents differently than adults?

A

Special concern with confidentiality
Need to use best judgement
But always tell parents if patient is a danger to themself or others

114
Q

How should you assess older adults differently than adults?

A

Assess senses, motor function, and brain function
Do not assume they will be physically or mentally deficient

115
Q

What is the difference between interpreter and translator?

A

Interpreter = someone who interprets spoken foreign language
Translator = someone who translates written word

116
Q

What is a mental status exam?

A

Objective
Evaluation of individuals current cognitive processes

117
Q

What is a psychosocial assessment?

A

Subjective
Assessment to provide additional info from which to develop plan of care

118
Q

Difference between personal relationships and therapeutic relationships

A

Personal relationships are to meet mutual needs
Therapeutic relationships are focused on the patient’s needs, goals, and strengths

119
Q

How can you use therapeutic use of self?

A

Instrument for delivery of care
Use interpersonal communication techniques as tools of intervention

120
Q

List the phases of the nurse-patient relationship

A

Preorientation phase
Orientation phase
Working phase
Termination phase

121
Q

What happens during the Preorientation phase of nurse patient relationships?

A

Reviewing pt history
Recognizing your thoughts and feelings about meeting the pt
Anticipating ground rules

122
Q

What occurs during the orientation phase of the nurse patient relationship?

A

Establishing rapport and trust
Setting parameters of the relationship
Discussing confidentiality

123
Q

What occurs during the working phase of the nurse patient relationship?

A

Gather further data
Goal setting
Promote pt’s problem-solving skills
Build self-effect
Facilitate behavior change
Promote use of alternative adaptive behaviors

124
Q

What occurs during the termination phase of the nurse patient relationship?

A

Review goals achieved
Incorporate use of new coping strategies and application for future issues
Reflection and lessons learned
Express feelings of ending the therapeutic relationship

125
Q

Why is therapeutic communication imperative to nursing care?

A

Human interactions are an underlying cause of medical errors and preventable deaths
Human factors, leadership, and communication are top root causes of sentinel events

126
Q

What are communication skills vital for as a nurse?

A

Consistently demonstrate professionalism
Communicate care needs of pts to other staff
Communicate with patient
Effectively manage time and provide basic care needs

127
Q

List the therapeutic communication techniques

A

Using silence and listening
Presence - full attention
Clarifying techniques
Statements that let pt know you listened
Use of questions (mostly open ended)

128
Q

List the kinds of statements you can say to a patient to let them know you were listening

A

Reflections**
Restating
Paraphrasing
Summarizing
Acknowledging/affirming

129
Q

List non therapeutic communication techniques

A

Excessive questioning
Expressing approval or disapproval
Giving advice
Asking why

130
Q

List effective communication techniques

A
  • clear distractions from your mind and focus on the pt as a unique individual. Be present
  • gather info using open-ended questions and reflections
  • validate the patient (affirm and acknowledge)
  • listen, don’t tell
  • avoid aggressive verbal and nonverbal communication

Mental Health Lecture (5 decks)

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