Mental Final - Exam 1 Flashcards
Suicidal patient interventions
Assess ideation, plan, and lethality. Contract and monitor closely or put on 1-to-1 if no contract.
Three things apparent in patients in a crisis state
Inadequate coping mechanisms, anxiety, and struggle for equilibrium
3 reasons for admission to psych unit
Harm to self, harm to others, self neglect
Patient rights
Communicate (phone) Keep personal items Habeus corpus Privacy Informed consent Refuse treatment
Preorientation phase
examine feelings, gather data
Orientation phase
Introduce, establish report, BEGIN termination, focus on pt needs
Working phase
Implement/evaluate care plan, assess safety, contract
Termination phase
Summarize, don’t make promises, be honest.
Patients feelings toward a nurse
Transference
Nurses feelings toward the patient
Countertransference
What does Dopamine effect? What does an increase/decrease cause?
Fine motor movement, emotions, reasoning
Increase: Mania, schizophrenia
Decrease: Parksinson’s, depression
What does Serotonin effect? What does an increase/decrease cause?
Sleep, hunger, mood, pain
Increase: Anxiety
Decrease: Depression
What does GABA effect? What does an increase/decrease cause?
Inhibitory; reduces aggression.
Increase: Reduced Anxiety
Decrease: Anxiety, Schizophrenia
What does Norepinephrine cause? What does an increase/decrease cause?
Mood, fight or flight
Increase: Mania, anxiety, schizophrenia
Decrease: Depression
Restraints steps
Verbally descalate Offer meds Offer to go to room - decrease stimuli Show of force Have patient stay in room Seclude - Lock door Restraints
Inappropriate affect
Laughs at death
Labile affect
Rapid mood changes
No connection between thoughts
Looseness of association.
Hallucinations
Positive. Auditory, Tactile, Gustatory, Olfactory, Visual
Anergia
Negative. Lack of energy
Erotomanic
Positive. Believing somebody desires you romantically
Avolition
Negative. Reduced motivation, lack of goals
Granduer
Positive. Believing you are very important or powerful.
Thought insertion
Positive. Believing that another person influences your thoughts or actions
Flat affect
Negative. Reduced expression
Jealousy
Positive. Believing that one’s mate is unfaithful
Anhedonia
Negative. Lack of pleasure and emotion
Ideas of reference
Positive. Perceiving events as relating to you when they are not.
Alogia
Negative. Poverty of speech; reduction.
Somatic
Positive. Believing that the body is changing in an unusual way.
Thought blocking
Negative. Sudden interruption in the thought process.
Persecution
Positive. Others are out to harm them.
Interventions for Poor boundary patients/Manipulative patients
Maintain firm boundaries, BE CONSISTENT. Give two firm choices (Must pick one) and change the subject if they persist.
Compensation
Covering up shortcomings
Conversion
Unconscious transformation of anxiety into a physical symptom
Denial
Escaping unpleasant thoughts by ignoring their existence
Displacement
Transference of emotions to another. Kicking the dog.
Disassociation
Separation of feeling and thought
Identification
Taking on the characteristics of another person or group
Intellectualization
Analysis of aspects based on cold facts and no passion
Introjection
Incorporating the outside world into the view of the self.
Projection
Rejecting unacceptable features and attributing it to other people. I hate you, you must hate me.
Rationalization
Justifying illogical or unreasonable ideas
Reaction formation
Reacting an exaggerated opposite to how you feel. A man who is gay has a number of conspicuous heterosexual affairs and openly criticizes gays.
Regression
Reverting to an earlier childlike pattern or behavior
Splitting
See people as all good or all bad.
Sublimation
Unconscious replacement of bad qualities for good qualities. Replacing immature with mature.
Suppression
Conscious denial of an event.
Repression
Unconscious denial of an event.
Undoing
When a person makes up for wrongdoing. I kicked your dog so I’ll buy you flowers.
Two healthy coping mechanisms
Altruism and sublimation
Axis definition
I: Clinical disorder (MDD, Substance abuse. Acute thing that needs treatment)
II: Personality disorder (OCD)
III: Medical Diagnosis (Diabetes)
IV: Environmental factors (Girlfriend broke up)
V: GAF score (50 = discharge).