Legal, Ethical, Substance abuse Flashcards
(39 cards)
What are important legal and ethical concepts?
Beneficence, autonomy, justice, fidelity, veracity.
A fundamental goal of psychiatric care is to strike a balance between the rights of the individual patient and the rights of society at large.
What is required for admission into a hospital in addition to having a psych problem that is based on DSM-5?
Patients with mental health illness are to be placed in less restrictive community settings rather than in institutions.
Illness must present an immediate crisis. Other, less restrictive alternatives are inadequate or unavailable.
The expectation exists that hospitalization and treatment will improve the immediate problem.
What is a BA-52?
52 is an emergency involuntary hospitalization, Baker act.
What is a 32?
Temporary involuntary. A specified number of physicians must certify that the person’s mental health status justifies detention and treatment;
a judicial review
Ex parte?
Family members legally have individual hospitalized
Allows client to challenge unlawful detention by requesting a judicial hearing.
Safe guards a voluntary client
Writ of habeas corpus
Right to Release
What are the patient rights? What is involved in each one?
Right to treatment: human environment, staff qualified and sufficient, individualized plan of care
Right to refuse treatment: withhold consent, withdraw consent
Right to informed consent
What are the four types of admissions?
Voluntary, involuntary (commitment), long-term formal commitment, involuntary outpatient commitment
This involves a surrogate decision maker. What else about it?
Advance psychiatric directive. Instructions about hospital choices, medications, treatment options, and emergency interventions. Identify individuals who are to be notified of hospitalization and who may visit.
What three things should nurses in the psychiatric setting understand? What do most state laws prohibit the use of?
Assault, battery, false imprisonment
Seclusion, restraint
When are behavioral restraint and seclusion authorized?
Behavior is physically harmful to the pt or another. Alternative measures are insufficient in protecting the pt and others. Decrease in sensory overstimulation is needed (seclusion only). Pt requests seclusion.
What are the requirements for restraint and seclusion?
Written order of a physician. Confined to specific, time-limited periods. Specify the type of restraint. In an emergency, the nurse may place the pt in seclusion and/or restraints and then obtain an order.
How often is a restrained or secluded pt’s condition reviewed and documented?
Very regularly, e.g. every 15-30 mins. Original order may be extended after a review and reauthorization.
What is documented about seclusion and restraints?
Behavior leading to the rest/seclu and alternatives already tried. Time pt is placed in and released from. All assessments and care.
What does the duty to warn and protect third parties include?
Tarasoff ruling
Assessing and predicting a pt’s danger of violence toward another. Identifying specific individuals being threatened. Identifying appropriate actions to protect victims.
How do drugs affect neurobiology, changing the structure of the brain and how it works?
It disturbs a person’s norma hierarchy of needs and desires and substitutes new priorities. Overrides ability to control impulses. Similar to other mental illnesses.
How much of an individuals vulnerability to addiction is attributable to genetics?
40-60%
What are the characteristics substance abuse?
Use of a substance occurs outside of a medical necessity, outside of social acceptance. Results in adverse effects to the abuser or others.
What are the characteristics of substance addiction?
Tolerance occurs when a person has to take more of the drug to “stay normal” and prevent withdrawal. Control over the substance is lost. Can be fatal.
What are the 4 C’s of addiction?
Compulsive behavior (finding and taking the substance), cravings, chronic relapsing brain disorder, cognitive impairment
Top ten classes of psychoactive substances in the DSM5?
Alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, tobacco, other or unknown.
Inflammatory, hemorrhagic, degenerative condition of the brain. Symptoms?
Wernicke’s encephalopathy
Double vision, nystagmus, lack of muscular coordination, mild or severely depressed mental function
Amnesia seen in chronic alcoholics
Korsakoff’s psychosis
Short term memory loss, inability to learn new skills, usually disoriented
How do drugs target the pleasure receptors of the brain?
Affect the limbic or reward system. First-time use releases a large amount of dopamine, resulting in pleasure. Neurons are unable to regulate dopamine. Dopamine is unable to stimulate the reward center. More of a drug is needed, causing a cycle of tolerance.
