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NUR 3015 exam 1 > lecture 1- mental health and mental illness > Flashcards

lecture 1- mental health and mental illness Flashcards

1
Q

what is mental health

A

able to recognize own potential
cope with normal stress
work productively (occupation)
make contribution to community (varies per person)

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2
Q

what are traits of mental health (7)

A

think rationally
communicate appropriately
learn
grow emotionally
be resilient
have a healthy self-esteem
realistic goals and reasonable function within the individual’s role

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3
Q

what is mental illness

A

disorders with definable diagnosis
significant dysfunction in mental functioning related to: developmental, biological, physiological disturbances
culturally defined

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4
Q

describe resilience

A

ability and capacity to secure resources needed to support well-being
ex: “strength” to recover, ability to bounce back
essential to recovery!

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5
Q

what is resilience characterized by

A

optimism
sense of mastery
competence

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6
Q

what are the risk and protective factors of mental health

A

individual attributes and behaviors
social and economic circumstances
environmental factors

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7
Q

describe the diathesis stress model

A

-biological predisposition of mental illness due to environmental stress or trauma
- combination of genetic vulnerability and negative environmental stressors (ex: someone develops major depression d/t inherited and biological vulnerability that alters brain chemistry or through stressful environment

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8
Q

what is assertion in relation to diathesis stress model

A

describes how most psychiatric disorders result from a combination of genetic vulnerability and negative environmental stressors

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9
Q

describe the mental health parity act (1996)

A

parity = equivalence
- required insurance companies to provide EQUAL treatment coverage for psychiatric disorders

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10
Q

describe patient protection and affordable care act

A
  • coverage for most uninsured Americans through expanded medicaid eligibility (for very poor)
  • created health insurance exchanges to offer more choices
  • “insurance mandate” for coverage
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11
Q

what is epidemiology of mental disorders

A

quantitative study of the distribution of mental disorders in human population
- identifies high risk groups
- identifies high risk factors

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12
Q

what is incidence in relation to epidemiology

A

number of new cases in a given time

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13
Q

what is prevalence in relation to epidemiology

A

number of cases regardless of when they began
- total number of cases

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14
Q

what is lifetime risk in relation to epidemiology

A

risk that one will develop a disease in the course of a lifetime

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15
Q

what are examples of prevalence

A
  • major depressive disorder: 6.7% prevalence
  • schizophrenia: 1.1% prevalence
  • panic disorder: 2.7% prevalence
  • generalized anxiety: 3.1% prevalence
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16
Q

what is clinical epidemiology

A

examines health and illness at population level
groups treated for specific mental disorders are studied for:
- natural history of illness
- diagnostic screening tests
- interventions

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17
Q

clinical epidemiology results used to describe frequency of (2)

A

mental disorders + symptoms appearing together (physical)

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18
Q

what is the DSM-V

A

the diagnostic and statistical manual of mental disorders
- official medical guidelines of the american psychiatric association for diagnosing psychiatric disorders
- based on specific criteria influenced by multi professional clinical field trials

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19
Q

what is the ICD-10-CM

A

international classification of diseases
- clinical descriptions of mental and behavior disorders
- 2 broad classifications & subclassifications

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20
Q

what is the role of psychiatric mental health nurses

A
  • main: promoting mental health through assessment, diagnosis, and treatment of behavioral and mental disorders
  • use nursing, psychosocial, neurobiological theories and research
  • work with people throughout the life span
  • employed in a variety of settings and among varied population
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21
Q

what is within NANDA-I

A

standardized nursing diagnoses

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22
Q

what is within NOC (nursing outcomes classification)

A

standardized outcomes, definitions of these outcomes, and measuring scales

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23
Q

what is within NIC (nursing interventions classification)

A

seven domains of nursing interventions

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24
Q

describe the basic level of psychiatric nursing practice

A
  • psychiatric mental health registered nurse (PMH-RN)
  • 2 years full time, 2000 clinical hours, 30 hours continuing education, followed by certification exam to add “BC” to RN title (RN-BC)
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25
Q

describe the advanced practice of psychiatric nursing practice

A
  • psychiatric mental health advanced practice registered nurse (PMH-APRN)
  • master of science or doctorate
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26
Q

what are some future challenges and roles of the mental health domain

A

education - less availability
aging population - increasing prevalence in alzheimers + dementias
cultural diversity - adjust practices to meet needs of cultures
science, technology, and electronic health care - telepsychiatry
patient advocacy
legislative involvement - nurses aren’t given a seat in policy making

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27
Q

what is the psychoanalytic theory focused on?

A

sigmund freud
level of awareness
- conscious (perceptions, memories, thoughts, fantasies, feelings)
- preconscious (materials retrieved easily through conscious effort)
-unconscious (all repressed memories, passions, and unacceptable urges deep below surface)

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28
Q

what are the 3 personality structures in the psychoanalytic theory

A

Id
ego
superego

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29
Q

what is the ID

A

unconscious, impulsive
pleasure principle (source of drives, instincts, reflexes)
reflex action (cannot tolerate frustration)
primary process (illogical)

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30
Q

what is the ego

A

conscious, preconscious, unconscious
problem solver (can differentiate subjective experiences, memory images, objective reality)
reality tester (factors in reality to implement plan to decrease tension)

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31
Q

what is the superego

A

moral component (“should nots” “should”)
- perfectionist

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32
Q

what happens if the id>ego

A

impulse control issues

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33
Q

what happens if superego>ego,id

A

self critical, feelings of inferiority

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34
Q

describe defense mechanisms and anxiety relation

A
  • operate on unconscious level
  • deny, falsify, or distort reality to make it less threatening
    -ex: projection
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35
Q

what occurs during oral years (0-1 years)

A

teething, biting

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36
Q

what occurs during anal years (1-3 years)

A

toilet training

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37
Q

what occurs during phalliac/oedipal years (3-6 years)

A

identifies sexual identity (mom is female, dad is male)

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38
Q

what occurs during latency years (6-12 years)

A

growth of ego functions

39
Q

what occurs during genital years (12 years and beyond)

A

development of sexual and emotional relationships (planning life goals)

40
Q

what is classical psychoanalysis

A
  • intrapsychic conflict no longer considered to be the cause of all mental illness
  • valid tools and concepts
41
Q

what is transference

A

patient is transferring onto you
ex: “you look exactly like my sister”

42
Q

what is countertransference

A

you are transferring onto patient
ex: treating them differently if they remind you of someone you don’t like

43
Q

what is psychodynamic therapy

A

-newer psychoanalytic model
- focuses more on here and now
- uses many tools of psychoanalysis
- best candidates = “worried well” -> are intelligent and well motivated for change
- rapid back and forth between therapist and patient

44
Q

what is interpersonal theory

A
  • purpose of all behavior is to get needs met through interpersonal interactions and to reduce or avoid anxiety
  • 3 topics: anxiety, security operations, self-system
45
Q

describe anxiety from interpersonal theory

A

painful feeling or emotion that arises from social insecurity or prevent biological needs from being satisfied

46
Q

describe security operations from interpersonal theory

A

measures the individuals employs to reduce anxiety and enhance security

47
Q

describe self system from interpersonal theory

A

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

48
Q

what is interpersonal therapy most effective in training? (3)

A
  • grief and loss
  • interpersonal disputes
  • role transition
49
Q

describe sullivan’s theory and nursing

A

foundation for Hildegard peplau’s theory
- participant observer including: mutuality, respect for the patient, unconditional acceptance, empathy

50
Q

describe Hildegard Peplau’s theory of interpersonal relationships in nursing

A
  • influenced by Sullivan’s work
  • “the art of nursing”
  • “the science of nursing”
51
Q

describe “the art of nursing” described in Hildegard Peplau’s theory of interpersonal relationships in nursing

A
  • provide care, compassion, and advocacy
  • enhance comfort and well-being
52
Q

describe “the science of nursing” described in Hildegard Peplau’s theory of interpersonal relationships in nursing

A
  • application of knowledge to: understand a board range of human problems and psychosocial phenomena, intervene in receiving patients suffering and promote growth
53
Q

describe Peplau and the therapeutic relationship

A

4 levels of anxiety (mild, moderate, severe, panic)
- interventions to lower anxiety
- aim to improve patient’s ability to think and function

54
Q

what are the 3 behavior theories we learned in class

A

1) Pavlov’s classical conditioning theory: neutral stimulus + stimulus = conditioned response (involuntary)
2) Watson’s behaviorism theory: controlled environment = mold behavior and anyone can be trained
3) Skinner’s operant conditioning theory: learning through rewards + punishment = voluntary behavior

55
Q

what are the implications for nursing in behavior theories

A
  • modifying or replacing behaviors
  • behavior management
56
Q

what are the 5 types of behavioral therapy

A

modeling
operant conditioning
systematic desensitization
aversion therapy
biofeedback
Tip: MO SAD

57
Q

describe modeling in relation to behavior therapy

A

therapist is the role model for specific identified theories
- pt. learns through imitation/role playing

58
Q

describe operant conditioning in relation to behavior therapy

A

slowly exposed to something that is not triggering (positive reinforcement)

59
Q

describe systematic desensitization

A

development of behavior takes customized to patient’s specific fears, via learned relaxation techniques

60
Q

describe aversion therapy

A

treats behaviors like alcoholism, paraphilia disorder, shoplifting, violent & aggressive behavior, self mutilation
- pairing negative stimulus with specific target behavior, thereby suppressing behavior.
- ex: painting foul-tasting substances on fingernails of nail biters

61
Q

describe biofeedback in relation to behavior therapy

A

controlling body’s physiological response to stress and anxiety

62
Q

what is cognitive theory and therapies

A

dynamic interplay between individuals and the environment
- thoughts come before feelings and actions
- 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

63
Q

what are the 2 cognitive theories we learned in class

A

Rational-emotive behavior therapy (Ellis)
cognitive behavioral therapy (Beck)

64
Q

what is rational-emotive behavior therapy

A
  • aims to eradicate irrational beliefs (negative thinking)
  • recognize thoughts that are not accurate
    ex: ABC (activating event -> beliefs -> emotional consequence)
65
Q

what is cognitive behavioral therapy

A

test distorted beliefs and change way of thinking; reduce symptoms
- challenge negative thinking and substitute with positive, rational thoughts
- learn to recognize when thinking is based on distortions/misconceptions

66
Q

describe theory of human motivation

A
  • asserts that psychology must go beyond experiences of hate, pain, misery, guilt, and conflict to include love, compassion, happiness, exhilaration, and well-being
67
Q

describe Maslow’s hierarchy of needs

A
  • human beings are active participants in life, striving for self- actualization
  • when lower needs are met, higher needs are able to emerge
  • physiological, safety, belonging and love needs, esteem needs, self- actualization
68
Q

what does theory of human motivation emphasize and prioritize

A
  • emphasis on human potential and the patient’s strength
  • prioritizing nursing actions in the nurse-patient relationship
69
Q

describe the biological model

A

1) focuses on:
- neurological, chemical, biological, genetic
- qualities of a therapeutic relationship, understanding patient’s POV, communicating to facilitate recovery
2) how the body and brain interact to create:
- emotions, memories, perceptual experiences
3) consider other influences that play a role in the development and treatment of mental disorders
- social, environmental, cultural, economic

70
Q

describe the psychopharmacology therapy

A

use of medication to treat psychiatric illness

71
Q

what are 4 brain stimulation therapies

A

Electroconvulsive therapy (ECT): depression, mania, Catatonia (cortical)
Trans-cranial magnetic stimulation - repetitive (rTMS): depression (cortical)
Vagus nerve stimulation (VNS): depression (cervical cranial nerve)
Deep brain stimulation (DBS): depression, ocd (subcortical)
- similar to hard reset
- works sometimes, sometimes not

72
Q

what are the 4 developmental theories (cognitive development) by Piaget

A

sensorimotor stage
pre operational stage
concrete operational stage
formal operational stage

73
Q

describe the sensorimotor stage

A

birth -> 2 years
- basic reflexes, purposeful movements, spacial activities, hand-eye coordination

74
Q

describe the pre operational stage

A

2-7 years
- describe thinking about objects

75
Q

describe the concrete operational stage

A

7-11 years
- logical thoughts appears, abstract problem solving is possible

76
Q

describe the formal operational stage

A

11 - adulthood
- conceptual reasoning commences at approximately same time as puberty.
- abstract thinking and problem solving reflects those of an adult

77
Q

describe theory of psychosocial development (Erickson)

A

eight stages of development
- personality continues to develop through old age

78
Q

what age is trust vs. mistrust

A

0 - 1.5 years

79
Q

what age is autonomy vs. shame-doubt

A

1.5 - 3 years

80
Q

what age is initiative vs. guilt

A

3 - 6 years

81
Q

what age is industry vs. inferiority

A

6 - 12 years

82
Q

what age is identity vs. role confusion

A

12 - 20 years

83
Q

what age is intimacy vs. isolation

A

20 - 35 years

84
Q

what age is generativity vs. self-absorption

A

35 - 65 years

85
Q

what age is integrity vs. despair

A

65+ years

86
Q

describe the theory of object relations

A

past relationships influence sense of self and present relationships
- “object” = significant person
- disruption of early separation: psychosocial problems were the cause of this

87
Q

describe progression from black and white thinking to complex decision making (3 levels)

A

pre-conventional level
conventional level
post-conventional level

88
Q

describe pre conventional level

A

stage 1: obedience/punishment (rules, listening to authority)
stage 2: individualism/exchange (not everyone is the same)

89
Q

describe conventional level

A

stage 3: good interpersonal relationships (right/wrong r/t motivation, personality, good/bad in people)
stage 4: maintaining social order (rules are rules)

90
Q

describe post-conventional level

A

stage 5: social contract/individual rights (social justice for equality)
stage 6: universal ethics principles (actions should create justice for everyone involves. obliged to break unjust laws)

91
Q

describe ethics of care theory

A

Gilligan and Kohlberg
- morality of care vs. “justice view” of morality (we should do right no matter personal cost or cost to those we love)

92
Q

why is development theories in nursing important

A

they help determine what types of interventions are most likely to be effective

93
Q

schemata, automatic thoughts, and cognitive distortions are terms that relate to:
a) rational-emotive behavioral therapy
b) cognitive -behavioral therapy
c) operant conditioning therapy
d) biofeedback

A

B) cognitive behavioral therapy

NUR 3015 exam 1 (3 decks)

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