Mental Health Flashcards
Mental disorders are:
biologically based brain disorders that variably affect aspects of cognition, emotion, and behavior
Therapeutic Milieu
safe, inviting environment for the patient; nurses role is to be the milieu manager
Enlightenment
asylum movement
Scientific Study
treatment: beginning of psych nursing; decade of the brain
Psychotropic Drugs
destigmatizing “least restrictive environment”
Community Mental Health
deinstitutionalization
Decade of the Brain
increased funding for brain research; new treatments; increased understanding of mental disorders
Continuum of Care
best fit for the patient for what is currently going on in their life; want to keep least restrictive
Axis I
Clinical Disorder (psych disorder); schizophrenia, major depression, bipolar
Axis II
Personality or Development Disorder; paranoid, borderline personality disorders, mental retardation
Axis III
General Medical Conditions (related to I or II); Neoplasms, endocrine disorders
Axis IV
Psychosocial Stressors; divorce, housing, educational issues
Axis V
Global Assessment Functioning (GAF); scale of 0-100; higher the number the better the persons functioning; score of 30+ pt behavior is highly influenced by delusions and hallucinations
Hildegard Peplau
mother of psychiatric nursing; focused on communication and problem solving skills of the nurse and expanded the role
Roles of Psychiatric Nurse
socializing agent, teacher, model, advocate, counselor, role player, milieu manager
Psycho-therapeutic Management
- therapeutic relationship (use of self) 2. psychopharmacology 3. milieu management (use of environment)
* *need to use all 3 components to have effective treatment
Therapeutic Nurse-Pt Relationship
must be consistent
Manage 6 Environmental Elements for Milieu
- Safety (keep pt free from danger or harm)
- Structure (environment, regulations, schedules)
- Norms (specific expectations of behavior)
- Limit-setting (clear and enforceable)
- Balance
- Environmental Modification
Inpatient Care
crisis intervention and safety
Traditional Outpatient
visit according to pt needs (per month/per week)
Partial Programs/ Day Treatment
need some supervision, structured activities
Psychiatric Home Care
combo of psych and medical illness
Community Outreach Programs
mobile crisis teams; will see more often in rural areas
Residential Services
need temporary or long term housing; group homes’ halfway house; apartment living
Self-help groups
conducted by members, not professionals
Intensive Outpatient
stabilize pt in communities
Assertive Community Treatment (ACT)
community based service delivery model; provide outreach to where pt lives
Primary Care
sometimes seeks PCP due to sigma, lack of knowledge, and or reduced access to care
Psychoanalytical Theory
Freud (id, ego, superego), consciousness (conscious, unconscious, precociousness); personality formed by early childhood (6), change is a process of insight
Developmental Theory (Erikson)
Biopsychosocial-environmental emphasis; lifespan personality development occurs in stages; growth entails mastery of critical tasks
Interpersonal Theory (Sullivan)
empathetic communication of anxiety (good me, bad me, not me), personality development focuses on behaviors needed to accomplish developmental tasks; goal is to develop mature, satisfactory, anxiety free relationships
Alarm Reaction (Stress Model)
+1 to +2; mobilization, activation of flight or fight response
Stage of Resistance (Stress Model)
+2 to +3; adaptation to stress within individuals capabilities
Stage of Exhaustion (Stress Model)
+3 to +4; loss of ability to resist stress; depletion of resources
M’Naghten Rule
not guilty by reason of insanity = “right vs wrong”
Tarasoff vs Regents
duty to warn
Voluntary Commitment
person requests hospitalization and voluntarily agrees to be admitted
Involuntary Commitment
person with legal capacity to consent, refuses to do so, and is treated against his or her will
Commitment of Incapacitated Persons
a person, who does not have the legal capacity to consent to treatment (incompetent), is admitted for treatment
Temporary Detention Order (TDO)
have to go before the judge; judge will either dismiss, pt will agree to voluntarily stay for a while, or they will be involuntarily committed
Emergency Custody Order (ECO)
usually occurs in the ED; is a short time frame looking for medical bed to evaluate pt further
Reasons for Involuntary Commitment
- harm to self (psych); retain rights
- harmful to others (psych); retain rights
- incompetent persons (medical); loose rights
Patient Rights
least restrictive environment; confidentiality of records; freedom from restraints/seclusion; to give consent or refuse treatment; provide advance directives
Frontal Lobes
controls voluntary motor activity; Broca’s area (speech)
Temporal Lobe
visual, auditory, olfactory; problems here may start to cause hallucinations; aphasia is result of damage to temporal lobe
Limbic System 4 F’s
feeding, fighting, fleeing, fornicating
Cerebrum
determines intelligence “thinking part of the brain”; personality, interpretation of sensory impulses, motor function, planning and organization, touch sensation
Schizophrenia
increase in dopamine
Depression
decrease in norepinephrine and serotonin
Alzheimer’s
decrease in acetylcholine
Anxiety
decrease in GABA