Introduction to MH Flashcards
Significant disturbances of an individual’s:
Thoughts
Emotions
Behavior
Which is true about Mental Health
Does have underlying biological pathology
Does not have underlying biological pathology
No underlying biological pathology
What are the three major stigma barriers of MH
Public
Self
Label Avoidance
What are the four recovery dimension?
Health
Home
Purpose
Community
What is use to diagnose Mental Illness in standardizing diagnostic criterias?
DSM-5
What the abbrievation DSM-5
Diagnostic and Statistical Manual
What are the two key principles for Self determinism?
Autonomy
Independence
With Mental Health treatment what the big S word
Self (Self Determinism)
Legal Issues
Self determinism: They have the right to refuse, unless ?
acute
What do pt have te right to refuse with which treatments?
Hospitalization
Medication Administration
Physical R
Least restrictive environment
he right to refuse unnecessary restriction when less restrictive appropriate interventions are available except when?
Harm to self or others
Acute esposide
Any physical or chemical means or device that restricts free movement in the
environment and cannot be self removed/eliminated by patient?
Restraints
Types of Restraints
Physical
Chemical
Seclusion
Any mechanical or physical device, material, or equipment attached to or
adjacent to a person’s body to restrict movement or access to one’s body (e.g., soft
padded wrist, mittens, arm-leg straps, vest, manual holds)
Physical
Any drug (e.g., Haldol + Ativan + Benadryl) utilized for discipline,
convenience, or with purpose of removing patients’ direct control over actions
Chemical
Involuntary confinement of a patient alone in a room or area from which
the patient is physically prevented from leaving (e.g. locking a door)
Seclusion
Human consequences of Restraint
Death
Psychological harm
Physical injury
Compliance consequences restraints are highly regulated by ?
The Joint Commission and CMS
Conditions to use Restraints
There is ? risk of harm to self or other.
imminent
Which of the following are preventative or least restrictive aproaches before using Restraints?
Reducing stimuli
Changing environment
Redirection
De-escalation
PRN medication
Nurses can initiate without order, but must obtain order within ?
an hour (1 hr)
Restraints
Orders are for up to ? hours in adults
4h
Orders are for up to ? hour in ages 9-17y
2h
Orders are for up to ? hour for <8y
1h
At end of time new order is needed with another ?
physical assessment
Attending provider* must conduct physical assessment of pt within ? hour
1h
In children – must notify legal guardian within ? hour of initiation
1h
Monitoring 5
- 1:1 continuous observation by
designee who records q15 minute: - Respirations
- Circulation
- Signs of injury
- Behavior/psychological status
Nursing assessment ? hour:
q1
What should nurses check for with q1 hour with MH pt
Range of motion
Elimination
Nutrition
Fluids
Discontinuation
Debrief with patient (and staff) after restraint
d/c
Vital Signs obtained as soon as possibl
What are the process for nurses with pt MH with Restraints
Montoring
Nursing assessment q1 hour
Discontinuation
Competency evaluation is conducted by ?
psychiatrists or psychologists
competency can be a ? status
temporary
An individual willingly seeks and agrees to receive mental health services?
Voluntary treatment
an individual is deemed unable or unwilling to provide informed consent for mental health care?
Involuntary treatment
Involuntary treatment why? 2
Risk of self harm or harm to others
Severe impairment in the ability to care for oneself.
What treatment should or should not be provided?
Living Will
A written document authorizing another person to make health care decisions
Power of Attorney
Treatment plan made in advance of a mental health crisis
Patient self determination act (Psychiatric advanced care directives)
You can Breach of confidentiality of pt only when?
Duty to warn (Harm Others)
What are the 7 Ethical Principles in Psychiatric Nursing?
Autonomy
Beneficence
Fidelity
Justice
Non-Maleficence
Veracity
Paternalism
The right of adults with capacity to make informed decisions about their own medical care.
Autonomy
The ethical duty of physicians to act in the patient’s best interest.
Beneficence
loyalty to patients
Fidelity
All persons (patients) should be treated equitably
Justice
The principle of “do no harm
Non-Maleficence
The principle of being honest and telling the truth to patients
Veracity
When a healthcare provider makes decisions for a patient without the patient’s consent, or without fully considering the patient’s wishes.
Paternalism
What are the 3 domains afpart of the Biopsychosocial framework for nursing practice
Biological
Psychological
Sociological
What is the most important tool of psychiatric nursing practice
Self, Self Awareness
