Key Terms Exam 1 Flashcards
comorbidity
two co-occurring chronic illnesses
deinstitutionalization
legislation that resulted in mass movement of severely mentally ill persons from state hospitals to outpatient care
* put into community, medicated but did not have the skills to function independently in society *
diathesis-stress model
diathesis: biological predisposition
stress: env or trauma
most accepted explanation for mental illness –> combo of genes and env lead to mental illness
dual diagnosis
co-occurring mental illness and substance use disorder
med adherence vs compliance
adherence: sticking to the developed plan of care
mental health
state of wellbeing in which everyone can realize their own potential, cope with stressors, work productively, and contribute to the community
mental health parity
requires insurance companies to provide equal treatment coverage for psychiatric disorders
mental illness
health conditions involving changes in emotion, thinking or behavior (or combo)
- associated with distress and or problems functioning in social, work, family activities
NAMI
national alliance for mental illness –> ADVOCATE for proper term usage and treatment
- communicate that mental illness are brain disorders
- eliminate stigma and discrimination
- advocate for people with mental illness
- improve access to treatment services
- integrate mental illness into community life
revolving door treatment
patients weren’t given adequate resources to function in society after deinstitutionalization so they would frequent the ED for care and would have repeated admission to inpatient units
recovery
process of change through which individuals improve their health and wellness
- self directed life
- strive to reach full potential
resilience
ability and capacity to secure resources needed to support well being
- characterized by optimism, sense of mastery, competence
therapeutic milieu
the surroundings and physical env of the inpatient hospital unit providing sense of safety and security
- interactions with peers and staff
- engage to achieve social competence and self worth
- real life training and coping skills
- activities, rules, reality orientation
stigma
widespread fear and misunderstanding of mental illness
- heightened by focus on extraordinary sx in film and literature
acute care hospital
highly structured setting that optimizing safety and addresses crisis intervention
- avg 3-7 days
long term hospitalization
if patient needs more than 7 days of treatment
partial hospitalization programs
alternative for patients who need some supervision but are not appropriate for inpatient hospitalization
transference
patient’s past experiences impact how they react towards you, unconsciously associates nurse with someone
- you remind me of my granddaughter
counter transference
the nurse’s past may impact one’s perception and influence how one provides care, barrier created when nurse responds emotionally, negatively or positively
- you remind me of my grandma
interpersonal therapy
focus on interpersonal relationships by improving functioning and communication patters
- identification of emotion
- expression of emotion
- dealing with emotional baggage
group therapy
2+ people with a common goals/interest
- each has characteristics that influence its progress and outcomes
cognitive behavioral therapy
cognitive + behavioral
- thoughts cause feelings and behaviors not external things, like people, situations, or events
- brief, time limited and structured
- hw and self counseling
- goals identified by patient
- changing our thoughts can change feelings that result in better outcome
dialectic behavior therapy
treats chronically suicidal inds, actively participating to change problematic behaviors
- cognitive + behavioral + mindfulness
- emotional regulation, interpersonal effectiveness, distress tolerance, mindfulness, self management skills
challenging stinking thinkin
taking internal conversation and making it positive
cognitive distortions
- all or nothing thinking
- overgeneralization
- mental filter
- discounting the positive
- jumping to conclusions
- magnifications
- emotional reasoning
- “should” statements
- labeling
- personalization and blame
risk factors
characteristics that make it more likely an ind will consider, attempt, die by suicide
protective factor
characteristic that makes it less likely an ind will consider, attempt, die by suicide
warning sign
signs indicating an immediate risk of suicide
suicidal ideation
thinking about death
- wish to be dead
- consider methods
- formulate plans to carry out
suicidal behaviors
acts associated with suicidal intent
suicide attempt
engaging in potentially injurious behavior with the intentions of death
suicide attempt interruption by self or others
self: person takes steps to injure but stops prior to fatal injury
other: person takes steps to injure but stopped by someone else before fatal injury
suicide/ death by suicide
death caused by self directed injurious behavior with the INTENT to die as a result of behavior
cluster suicide or suicide contagion
environmental risk factor where multiple suicides occur closer together in time and space than would normally be expected
suicide survivors
the circle of survivors of a person
postvention
providing mental healthcare and support to survivors or family/friends
- support, understanding, psychiatric referrals
nonsuicidal self injury
deliberate and direct attempt to inflict painful injuries to the surface of the body without intending to die
- attempt to alleviate psychic pain or numbness
blood alcohol level
amount of alcohol in blood
- inc tolerance might result in patient being able to tolerate a higher BAC while exhibiting less symptoms
- greater than 0.5 = death
substance addiction
pattern of problematic repeat use that is accompanied by
- cravings, persistent desire to cut down w/out success, impacts role obligations, inc social isolation, potentially hazardous, excessive amount attempting to get substance, withdrawal or tolerance
substance intoxication
symptoms are drug specific but recent overuse/excessive use of substance that results in reversible substance-specific syndrome
- judgement impaired impacting maladaptive behaviors and social/occupational functioning
substance withdrawal
symptoms developed with a substance is discontinued abruptly after frequent, heavy, prolonged use
non substance addiction- gambling, internet, sexual
behavioral addictions
wernicke’s encephalopathy
vit b1 (thamine) def that directly interferes with glucose production which is the brains main nutrient
- mental confusion, ataxia, dec recall/memories, ophthalmoplegia
reversible
korsakoff psychosis
non reversible persistent learning and memory problems
- ataxia, disorientation, delirium, psychosis, confabulation, neuropathy
tolerance
using inc amounts of substance over time to achieve the same effects and markedly diminished effects occurs with continued use
blackouts
function normally but do not remember
- one to several hours
relapse
recurrence of alc or drug dependent behavior in an ind who has previously achieved and maintain abstinence for a significant time beyond the period of detox
rehabilitation
- promote participation in outpatient support groups
- identify alt sources of satisfaction
- support and health promotion
recovery
specific lifelong commitment addressing
- agreed upon treatment plan, therapies support groups, self responsibility etc
drugs of abuse screening/ screening instruments
- detected/not detected (or below cut off)
- urine testing (2-3 days)
- blood
- hair (2/3 wk - 2/3 mo)
- saliva (24 hrs)
- sweat
cage aid
asking about drugs and alc
- can you cut down?
- annoyed w criticism?
- felt guilty?
- had eye-opener drunk?
crafft
adolescents alc use disorder id test
audit
adult alc use disorder id test
inhibitory NT
serotonin
GABA
excitatory NT
dopamine
glutamate
apraxia
difficulty controlling fine and gross motor movements despite having the strength
amygdala
processes emotions (anxiety, fear, pleasure), emotional connection between things
- damage results in rage
neuroplasticity
ability of the brain to change with learning
- functional changes in the brain that represent new knowledge and skills, recognizing new neural pathways
synaptic pruning
neurological process removes unnecessary/damaged neuronal structures
- improve network capacity by weaning out weak synapses
- simple replaced by complex
serotonin
inhibitory
- mood, emotion, sleep, pain, appetite, temp regulation, some cog function
- dec = depressive, anxiety
GABA
MAJOR inhibitory
- reduce anxiety/aggression/stress
- regulates norepinephrine, adrenaline, dopamine, serotonin
- dec = anxiety, mania, schizophrenia
dopamine
excitatory
- pleasurable, complex motor activities, role in hallucinations
- dec = depression, addiction
- inc = mania, + sx of schizophrenia
glutamate
excitatory
- seizure activity, neurodegeneration (alzheimers), dec psychosis, autism, OCD, depression, schizophrenia
acetylcholine
cognitive function
- sleep wake cycles
- dec = alzheimers, sleep disorders
- inc = depression
histamine
norepinephrine
stimulate sympathetic branch of ANS for fight or flight
- mood, attention, arousal
- dec = depression
- inc = mania, anxiety, schizophrenia
delirium tremens
medical emergency occurring from severe alcohol withdrawal
- prevent by assisting patient’s withdrawals
medically assisted withdrawal
wernicke-korsakoff syndrome
combination of the two that
- may require long term care
- low BP and temp, inc HR
- sx may mirror intoxication
SBIRT
screening, brief intervention, referral to treatment
- comprehensive approach to deliver early intervention and treatment services to ind with substance use disorders
- goal: prevent, reduce health related consequences
BNI algorithm
build rapport, ask permission, pt discusses pros and cons, nurse provides feedback, interpret scores from audit screens, determine pt motivation, negotiate plan
elicit, provide, elicit technique
nurse provided info and patient gives feedback
- ask permission to discuss
- we know that…
- what are your thoughts on that
range technique
range audit scores range from 0-40
ask what do you think the score was
normal are ppl low risk (0-15)
give score
elicit reaction what do you think of that
cluster a
odd, eccentric
cluster b
dramatic, emotional, erratic
cluster c
fearful, anxious
separation-individuation
psychoanalytic theory
- psychological birth of an infant which occurs over a period when the child separates from the mother and becomes ind
splitting
defense mechanism which ind is unable to integrate and accept both pos and neg feelins
- either all good or all bad
- ex: people are idealized, then get extremely disappointed
