INTRO TO PSYCH Flashcards

Question

changes to multi-axial system

Answer 1

In 2013, the APA moved to a single axis system to avoid issues created with the multi-axial approach. The previous approach created an arbitrary hierarchy of mental disorders between the first two axes. It also implied a separation of mental disorders from physical disorders, when in fact mental disorders are physical disorders. This current approach still uses all of the same mental, physical and social considerations as the multi-axial system but does it in a more unified manner aimed at improving diagnosis and care, informing new research and allowing for global information sharing.

Answer 2

The first three axes are combined containing all mental and other medical diagnoses. This change removes artificial distinctions among conditions, benefiting both clinical practice and research use. The forth axis still represents contributing stressors, but now uses ICD codes which allows providers to better indicate other problems, such as relationship problems, which need clinical attention. The GAF of Axis V is no longer used due to lack of clarity and was replaced by the WHO’s Disability Assessment Schedule. This change brings the DSM tool into better alignment with other medical disciplines.

Answer 3

Measures disorders and their associated disabilities which are shown as conceptually distinct and are assessed separately.

Answer 4

Health promotion and illness prevention Attention to medically underserved populations Involvement of managed care in behavioral health Quality management, including client outcomes Expanded practice of advanced clinical providers PNP Community based primary care Influence of consumer and family advocacy Decreased benefits for Medicare, Medicaid, disability programs

Answer 5

Nearly 2/3rd of people with mental illness fail to seek treatment Leading to increase expenses r/t loss productivity, increase in criminal justice system and social service COST inpatient care, medications STIGMA misconceptions, discrimination, stereotyping REVOLVING DOOR TREATMENT decreasing length of stay, Managed Care mandates, deinstitutionalization, lack of community supports LACK OF PARITY inequality of coverage most effective vs. what received LIMITED ACCESS TO CARE inadequate, inappropriate, no care difficult for families to determine appropriate care

Answer 6

Increase the number of Mental Health Professionals caring for children and adolescents Expand Mental Health Services Cultural understanding Improve understanding Redesign rehabilitation services to meet client needs- social, physical, cultural needs Integration and collaboration in services

Answer 7

Reintegration into Society- family involvement, employment, continued education, social and recreational activities, community participation Legislation to improve coverage Culturally competent care Medication Adherence Self-Help and Advocacy National Alliance for the Mentally Ill Psychiatric Advanced Directives- treatment wishes

Answer 8

Education on medication is critical Compliance is a huge issue with this population Education around medication side effects is critical

Answer 9

Work with individuals and families who have psychiatric problems and disorders, such as depression, schizophrenia, bipolar disorder, psychosis or dementia. In this role you'll perform the following tasks: Assess mental health and physical needs and provide interventions based on individual needs Develop and evaluate nursing care plans to ensure positive outcomes Crisis intervention and counseling Help patients regain or improve their coping abilities Manage and work with a team to ensure and enhance the therapeutic environment Assist patients with self-care activities Administer and monitor treatment regimens

Answer 10

``` Participation in the interdisciplinary mental health team Advocacy Health promotion and maintenance Case management Screening Milieu therapy Health teaching Psychobiologic interventions ```

Answer 11

Therapeutic use of self Forms a trusting relationship that provides comfort, safety, and acceptance Genuineness and warmth Openness, realness, and lack of defenses Empathy Able to “walk a mile in the client’s shoes” Crucial to therapeutic relationship

Answer 12

Leadership Ability to empower, direct, and manage client care Acceptance Suggests neither approval nor disapproval but tolerance and appreciation of the client Maturity and self-awareness Major role in nurse’s ability to tolerate differences

Answer 13

Here are some general tips to ensure safety while working on a psychiatric unit: Never be alone with a patient in an isolated spot. Alert staff of your whereabouts at all times Always have an exit plan, do not put yourself in a position where your back is to a closed in area Avoid provocative clothing and avoid having too much skin exposed

Answer 14

Psychotic patients generally experience three delusional themes: 1.) Religious, 2.) Political, and 3.) Sexual. Avoid these topics unless you are experienced in managing them Avoid wearing necklaces or other items that can be used as a weapon to strangle. Do not wear loop earrings Always remember safety first. Always listen to your primary or gut instinct

Answer 15

The manner and focus of the nurse’s observations. Observations are extremely important The particulars of interviewing during data collection The types of interventions used for identified problems

Answer 16

Therapeutic nurse-client relationship Self awareness needed to reduce barriers to effective data collection and assessment Nurse’s personal feelings, values, beliefs, and perceptions that may interfere with accurate data collection Communication skills, developmental stage of client, culture, spirituality and religion

Answer 17

``` Physical examination Review of systems Diagnostic testing Vital signs Neurological status Changes in sleep patterns, appetite, libido, concentration Elimination Activity & exercise Hydration Self-care ```

Answer 18

``` *** psych nursing, nurse collects health data *** Mental status examination components: General appearance Orientation Mood and affect Quality of speech Thought process Cognitive Intellectual Performance Insight & Judgement ```

Answer 19

``` Psychosocial components Recent stressors Strengths Current medications History or psychiatric treatment Substance abuse history Quality of support systems Family definition of problem ```

Answer 20

``` Behavior Self-concept Body image Self- esteem Personal identity ```

Answer 21

``` Suicidal/homicidal ideation Coping patterns Spiritual and cultural needs Legal and occupational history Economic status Quality of life ```

Answer 22

``` Child and Adolescents - Growth and development - Family dynamics - Parenting styles Older adults - Avoid ageism - Determine how to address (e.g. surname) ```

Answer 23

Analyze assessment data to determine diagnoses | Develop according to NANDA classification system http://www.nanda.org

Answer 24

Psychiatric nurse identifies expected outcomes that are individualized to the client and measurable

Answer 25

Psychiatric nurse develops a plan of care that prescribes interventions to attain expected outcomes. Safety needs often a priority. Patient involvement is critical once they are well enough to be involved.

Answer 26

``` Psychiatric nurse implements the interventions identified in the plan of care. RN assumes many roles while assisting patient: Advocate Teacher Socializing agent Role model ```

Answer 27

biological psychological social

Answer 28

``` Promote self care Encourage physical activity Sleep intervention Encourage proper nutrition Relaxation techniques Medication management ```

Answer 29

``` Cognitive interventions Counseling Conflict resolution Bibliotherapy Reminiscence Behavior therapy Psychoeducation ```

Answer 30

``` Milieu therapy Containment Validation Structured interventions Open communication Patient Safety ```

Answer 31

Psychiatric nurse evaluates the client’s progress in attaining expected outcomes Dynamic process changes as client’s condition changes

Answer 32

It becomes part of the client’s permanent record Objective and subjective data are documented Written documentation should be clear and legible Nurses should avoid using inferences or judgments Nurses should use concrete and specific terms