Inpatient Flashcards
List BHT responsibility in an inpatient ward.
Admitting patients Discharging patients Assessing patients Co-facilitating groups Conducting recreational activities Administration requirement Role model
What task do you need to do when a patient is first admitted?
The task involved in admitting are: checking and recording vital signs admission paperwork orienting patient to the unit briefing the patient on the policies and procedures of the unit checking patients belongings
What are you checking for when you are checking the patients belongings?
Items that could potentially be harmful to themselves or others
Keep an inventory of the items you take from the patient
Give patients pjs to change into
These items; prescription medicine, scissors, alcohol, shoe laces, Aspirin are an example of what?
Items that could potentially be harmful to themselves, to other patients, or to staff members.
True or False
You must keep an inventory of the items you must take from the patient.
True
True or False
The inventory of the patient’s items doesn’t have to be done in front of them.
False
What is the goal of inpatient hospital?
The most obvious goal for inpatient hospital care is to discharge the patient to outpatient care.
True or False
Discharge planning doesn’t start until after the patient starts treatment.
False
Discharge planning must begin on admission and be a focused nursing activity throughout patients day
What are the 4 steps of the Discharge Procedure?
- Inform patient of impending discharge
- Assist patient in packing personal effects
- Assist the patient as need in out processing the hospital
- Complete the patient’s discharge
What list does the patient’s name need to be on before they are discharged?
Verify the patient’s name is placed on the Nursing Unit 24 hour Report or other form
What are the different Psychiatric Classifications?
1A Severe psychiatric patients that require medications and MUST be place in restraints.
2B Psychiatric patients who may require restraints and medications
3C Psychiatric patients who are generally cooperative, reliable, and compliant under supervision.
What are some elopement clues?
Verbal Behaviors
No-Verbal Behaviors (ACTIONS)
True or False
A BHT or doctor can write an order to place a patient on elopement precautions
False.
Doctor must write the order to place a patient on elopement precautions
What are the procedures for an attempted elopement?
Attempt to verbally stop the patient, Notify the nursing staff
When an elopement is suspected, thoroughly search the unit first.
What are the procedures for an actual elopement?
Notify security forces and the patient’s doctor & Complete the Patient Absence Report
What are the procedures for when a patients return to the unit after elopement?
Ask the patient why the eloped, Place patient on elopement precautions, thoroughly search the patient and his/her baggage, & do not punish them
What is therapy?
To improve functional abilities, enhance well-being and increase independence.
What is leisure education?
to teach recreation skills and attitudes that can be used throughout life
What is recreation participation?
to promote health and growth through rewarding leisure and recreation experiences
What is the purpose of a workshop?
Supports the rehabilitation process by teaching the patient and family about the mental illness and the coping skills that well help with successful community living
Strengthen interpersonal skills by encouraging individuals to join in activities
What is the purpose of physical activities?
Build confidence and self-esteem by focusing on strengths and by developing and enhancing skills.
Improve physical abilities
Manage stress
Express feelings in positive and effective ways
What is the purpose of an outing?
Learn new approaches to old skills, so they can continue to enjoy leisure and live as independently as possible.
What is the purpose of arts and crafts?
Providing opportunities for creativity and self-expression
Set goals that challenge them to do their best
What is the purpose of relaxation?
Manage stress through activities that relax both mind and body.
What is the purpose of cooking?
Promote greater self-reliance
Enrich the quality of life by providing opportunities for creativity and self expression.
What is the purpose of occupational activities?
Assist patient in selecting and starting projects
Allow patient appropriate autonomy
Assist in the evaluation of patient progress
What are the 4 steps of the Therapeutic Recreation Therapist?
- Conduct an assessment of the person’s abilities, interests, needs and desires
- Set goals
- Design a written plan to achieve goals
- Evaluate progress
True or False
Adult learners require a group approach to education.
False
Adult learners require an individualized approach to education that focuses on their self-identified needs and engages them as active participants in the teaching-learning progress
True or False
An adult education that focuses on their self-identified needs and engages them as active participants
True
True or False
The interest of the patient should also be considered when coming up with an education plan.
True
What are 3 things that may affect a patients ability to learn?
- Behavior
- Memory
- Attention span
What are some things you may want to include in a general education plan for coping with psychiatric illness?
Describe the role of stress in contributing to psychiatric disorders
Enhance social and living skills to enable full participation in vocational and recreational activities.
Playing cards with your patient can help them in what way?
Playing cards with patients with cognitive impairment, allows staff to assess memory, concentration, orientation and abstract thinking
The body of your workshop should be a minimum of how long?
30 min
True or False
You need to ask your patient’s for feedback at the end of each workshop.
False
Do not ask the patients for feedback or how you can improve your class.
What is the definition of relaxation?
Relaxation is a positively perceive state or response in which a person feels relief of tension or strain
What are 4 elements needed to produce relaxation or alleviate stress?
Quiet environment
Focused attention
Passive attitude
Quiet posture
What are some objectives of relaxation therapy?
Go from the SYMPATHETIC MODE (flight or fight) - to the PARASYMPATHETIC MODE, relaxation
What are some relaxation techniques?
Benson's Relaxation Technique Meditation Guided Imagery Breathing Exercises Biofeedback
What relaxation technique requires special training?
Biofeedback
What are some client criteria for relaxation?
Interpersonal conflict
Tendency to overwork
Reports of increased heart rate or blood pressure
overwhelming physical and/or psychological stressors
What are the 6 steps for teaching relaxation?
- Introduce the process
- Present Basic Technique
- The Consolidation of Muscles
- Teach Relaxation by Recall
- Teach recall with counting
- teach counting alone procedure
What does APR stand for?
Abbreviated Progressive Relaxation
How do you end an APR procedure?
Count down from 5 and have the client open their eyes
True or False
We do not obtain client feedback at the end of an APR procedure.
False
Obtain feedback from Client (How they feel, what took place during the exercise).
The client can master the basic relaxation techniques in how many sessions?
approximately 2 sessions
The 16 originals muscle groups are combined into how many?
The original 16 muscle group is combined in 7 muscle groups.
Once the 7 muscle groups relaxations is mastered, further training is conducted to focus on 4 major muscle groups.
How do you wake up a patient when doing relaxation by recall?
Once relaxation by recall is well developed, the client performs relaxation by recall, the counts slowly form 1 to 10.
What is the difference between an AD and a civilian who has eloped?
AD patients are AWOL
Civ. could result in their being discharged from the hospital
What are some development issues of late adulthood?
Physical Changes, Cognitive Changes, Psychosocial Changes
What is Erickson’s stage for late adulthood called?
integrity vs despair
What are the 5 intellectual aspects of mental functioning that starts to decrease in late adulthood?
Problem-solving ability, Reasoning, Judgment, Concentration and Memory
What are the 2 most common causes of cognitive impairment?
Depression and Dementia
What are the 2 psychosocial changes that occur in late adulthood?
Loss and Change
Why is a MSE a part of every geropsychiatric assessment?
This should be a part of any geropsychiatric assessment because of an increasing prevalence of dementia with age.
What are the 5 different types of losses experienced by geriatric patients?
Loss of self- care ability independence productive work financial security life purpose
Who has the highest rate of suicide?
white men in their 80s
What are 2 main disorders associated with late adulthood?
Dementia and Paranoid reactions
What is the most prevalent form of progressive dementia of old age?
Alzheimer’s
What are 2 somatic therapies used in older patients?
Electroconvulsive therapy (ECT), and psychotropic medications
What are some developmental/psychological changes in adolescence?
Physical changes, Influence of the peer group, redefining of the patient child relationship, developing and refining coping resources.
What is the Erickson stage for adolescences?
Identity vs. Role confusions
What adolescents disorder is characterized by an IQ of 70 or below?
Mental retardation
What 2 adolescent disorders are included under pervasive development?
Autism and Asperger’s
What 3 adolescent disorders are included under disruptive behavior disorder?
ADHD, ODD, and Conduct Disorder
What 4 adolescent disorders are included under Anxiety?
Separation anxiety disorder, Overanxious disorder, Avoidant disorder, and PTSD
Define Milieu Therapy.
Milieu Therapy is defined as a technique used to help the patient through the use of environment. A careful structuring of the social and physical environment of a psychiatric treatment program so that every interaction and activity is therapeutic for the patient
What are the 4 characteristics of Milieu Therapy?
- Democracy
- Commitment Engagement
- Communalism
- Humanitarianism
What are the 4 cornerstones of Milieu Therapy?
- Safety
- Structure
- Support
- Social skills
What are the 4 principles of Milieu Therapy?
- Behavior is a response to the environment
- Positive and negative reinforcement affect behavior
- Humans have a need for social contact
- Illness and therapy are both opportunities for learning about oneself, others, and relationships.
What are the 5 elements of Milieu Therapy?
- Physical
- Social
- Spiritual
- Emotional
- Education and learning
What is the overall goal of Milieu Therapy?
The overall goal of milieu therapy is the use of experience of daily living to correct dysfunctions in communication and interpersonal relationships.
What is the major tool used to foster collaborations between patients and staff?
Community Meeting
What are health and comfort searches?
Health and Comfort (H&C) inspections are proactive, precautionary measure, performed by staff to ensure the safety and integrity of the inpatient unit.
What are the Psychiatric Technician’s Responsibilities for Control of Hazardous Items?
Keep medication room locked at all times
Monitor patients while they are in the laundry room
Monitor patients while they have the gear locked opened with cleaning supplies.
True or False
Patients are to remain the common area while tech is searching their room.
False
Patients will be escorted to their rooms and a search will be conducted of all of their personal belongings.
How often do health & comfort searches happen?
at least 2 times per month on alternating shifts
they schedules but not routine
What are the 9 steps to the referral/ consultation process?
- Determine the need
- Determine the urgency
- Determine the type of services needed
- Explain the referral to the patient
- Privacy Act
- Contact agency
- referral instructions
- Document
- follow up
What is the purpose of goal setting?
Motivate, Educate, Evaluate
What are the elements that make up a good goal?
Goals describe the behavior to be changed
Are specific and measurable
Describe the conditions which the changed behavior will occur
Goals must be suitable and realistic
A goal should be accomplished in how many days?
1- 10 days
what treatment has been found to be effective in the treatment of depression in elderly patients?
ECT- Electroconvulsive therapy
