Mental Health - Final Blueprint Flashcards
What is classified under each Axis of the DSM IV
Axis I - Clinical Ds (Primary Dx, ex: mood ds)
Axis II - Personality Ds & Mental retardation
Axis III - Medical Conditions (HTN, DM)
Axis IV - Psychological & environmental stressors
Axis V - GAF correspondent to pt level of funct.
Non-Therapeutic
.
Therapeutic Techniques
Using Silence
Active listening [active listening, listen w/empathy]
Clarifying [paraphrasing, reflecting, restating, exploring]
Therapeutic Communication
Goal-directed professional communication, directed towards the needs of the patient
Therapeutic use of self
Most important part of N/Pt relationship
The conscious use of self to establish rapport, a relationship and to formulate interventions.
Common Countertransference Reactions
Boredom (indifference) Rescue Overinvolvement Overidentificaiton Misuse of Honesty Anger Helplessness or Hopelessness
Peplau’s model of the Nurse-Patient relationship
Pre-orientation Phase
Orientation Phase
Working Phase
Termination Phase
Pre-orientation Phase
“Planning Phase”
Establish goals for encounter
Orientation Phase
Primary to build Trust Rapport confidentiality termination pt needs & goals est. contract
Working Phase
maintain relationship
promote pt prob-solve skills
overcome resistent behaviors
Promote practice
Termination Phase
Saying goodbye
Summarize pt achievements
Pt share feelings
Factors that promote growth in patients
Genuineness
Empathy
Positive regard (attending actions, suspending value jugements, help develop resources)
Empathy
Understand pt’s feelings
Sympathy
objectivity is lost and ability to help pt in solving personal problems ceases.
“feeling sorry for pt”
Social Relationship
Purpose is friendship, socialization, enjoyment.
-Mutual needs are met
Therapeutic Relationship
- the nurse maximizes her communicaitons skills, understanding of human behaviors, and personal strengths to enhance the patients growth.
- focus is on pt’s ideas, experiences & feelings
Id
- At Birth/newborns
- source of instinct reflexes, needs, genetic inheritance
- CANNOT problem solve
- NOT logical
- Operates on pleasure principle
Ex: hungry crying infant
Ego
- Emerges at 4-5 months old
- Problem solver
- REALITY TESTING
Superego
- Last to develop
- Moral component of personality
Sigmund Freud
“Father of Psychiatry”
- Believed mental disorders are unresolved childhood conflicts
- Personality Structure (id, ego, superego)
- 3 levels of awareness
- Psychosocial development
- Defense Mechanisms
- Psychoanalytic therapy
Psychoanalysis
Freud
Patient talks freely
ONLY for emotionally healthy pt (strong ego)
Psychodynamic Therapy
Freud
follows psychoanalytic model though is more interactive and oriented to present
ONLY for emotionally healthy pt (strong ego)
Erik Erikson
Personality develops over lifespan
Harry Stack Sullivan
“Relationships”
- interpersonal psychotherapy
- Security Operation
- Participant observer
Hidegard Peplau
- Nurse/Patient relationship
- 1st theorhetical framework
- Implemented IPRs
- 4 levels of anxiety
Pavlov
Classic Conditioning
Dog & Bell
Skinner
Operant Conditioning
Behavior Therapy
- Modeling
- Operant Conditioning
- Systematic Desensitization
- Aversion Therapy
- Biofeedback
Rational Emotive Behavior Therapy
Albert Ellis
Eradicate irrational beliefs
“stinkin thinkin”, be an optimist`
Cognitive Behavioral Therapy
-Aaron Beck
Dilectcal Behavioral Therapy
.
Milieu Therapy
.
Inpatient Admission Criteria
- Danger to self
- Danger to others
- Unable to meet basic (survival) needs
RN Roles
- Admission
- Assess Safety
- identify education needs
- Est. therapeutic relationship
- Assess physical and emotional health status
- Milieu
- Medication Admin.
- Crisis prevention & management
- Facilitate groups (not psychotherapy)
- Discharge planning
- Collaborate w/TX team
- Documentation
Neurotransmitter(s) associated with Schizophrenia
Dopamine & Glutamate
Neurotransmitter(s) associated with Mood disorders
Norepinephrine
Neurotransmitter(s) associated with Depression
Serotonin
Neurotransmitter(s) associated with Anxiety
GABA
CRH (corticotropin-releasing hormone)
Neurotransmitter(s) associated with Alzheimers
Acetylcholine
Neurotransmitter(s) associated with Bipolar
Norepinephrine, serotonin and dopamine
Neurotransmitter(s) associated with ADHD
Norepinephrine & Dopamine
Pervasive Developmental DS (PDD)
Autism
Aspergers
Retts
Childhood disintegration
Autism
Behavior syndrome
May exhibit Savant syndrome (exceptional talent in one area)
Emerges before 3yrs old
IQ may be affected
Asperger’s
Later onset than autism
Cognitive and language development are not affected
Idiosyncratic behavior
Retts
ONLY in females
Profound mental retardation
Onset prior to 4yr old
associated with seizures
