Mental health final examination Flashcards
(Maslow’s hierarchy of needs): Basic fundamental needs include food, water, air, sleep, exercise, elimination, shelter, and sexual expression.
Physiological needs
(Maslow’s hierarchy of needs): The individual possesses a feeling of self fulfillment and the realization of their highest potential.
Self actualization
(Maslow’s hierarchy of needs): Needs at this level are for avoiding harm, maintaining comfort, order, structure, physical safety, freedom from fear and protection.
Safety and security
(Maslow’s hierarchy of needs): The individual seeks self respect and respect from others, works to achieve success and recognition in work, and desires prestige from accomplishments.
Self esteem
esteem of others
(Maslow’s hierarchy of needs): Needs are for giving and receiving of affection, companionship, satisfactory interpersonal relationships, and identification with a group.
Love and belonging
During this stage, the responses of the fight or flight syndrome are initiated.
Alarm reaction stage
This stage occurs when there is a prolonged exposure to the stressor to which the body has become adjusted. The adaptive energy is depleted, and the individual can no longer draw from the resources for adaptation. without intervention for reversal death can occur.
Stage of exhaustion
The individual uses the physiological response of the first stage as a defense in the attempt to adapt to the stressor. if adaptation occurs, the third stage is prevented or delayed.
Stage of resistance
This level of anxiety prepares people for action. it sharpens the senses, increases motivation for productivity, increases the perceptual field, and results in a heightened awareness of the environment. The individual is able to function at their optimal level.
Mild anxiety
Anxious individual is less alert to events occurring within the environment. The individual’s attention span and ability to concentrate decrease. assistance with problem solving may be required. increased muscular tension and restlessness are evident.
Moderate anxiety
Anxious individual is so greatly diminished that concentration centers on one particular detail only or on many extraneous detail. attention span is extremely limited, and the individual has difficulty completing the simplest task. physical symptoms (e.g., HA, palpitations, insomnia). and emotional symptoms (e.g., confusion, dread, horror) may be evident.
Severe anxiety
Individual is unable to focus on even one detail. misperceptions are common, and a loss of contact with reality may occur. The individual experience hallucinations or delusions. behavior is characterized as wild and desperate actions or extreme withdrawal. feeling of terror, and individuals may be convinced that they have a life threatening illness or fear that they are going crazy, are losing control, or are emotionally weak.
Panic anxiety
Sleeping, eating, physical exercise, smoking, crying, yawning, drinking, daydreaming, laughing, cursing, pacing, foot swinging, fidgeting, nail biting, finger tapping and talking to someone with whom one feels comfortable.
Mild anxiety coping behaviors
Covering up a real or perceived weakness by emphasizing a trait one considers more desirable.
Compensation
EX: a physically handicapped boy is unable to participate in football, so he compensates by becoming a great scholar.
Refusing to acknowledge the existence of a real situation or the feelings associated with it.
Denial
EX: a woman drinks alcohol every day and cannot stop, failing to acknowledge that she has a problem.
The transfer of feelings from one target to another that is considered less threatening or that is neutral.
Displacement
EX: a client is angry at his doctor, does not express it, but becomes verbally abusive with the nurse.
Attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors.
Rationalization
EX: john tells the rehab nurse i drink because its the only way i can deal with my bad marriage and my worse job.
Preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors.
Reaction formation
EX: jane hates nursing. she attended nursing school to please her parents. during career fay she speaks to prospective students about the excellence of nursing as a career.
Responding to stress by retreating to an earlier level of development and the comfort measures associated with that level of functioning.
Regression
EX: when 2 year old jay is hospitalized for tonsillitis he will drink only from a bottle although his mother states he has been drinking from a cup for 6 months.
An attempt to increase self worth by acquiring certain attributes and characteristics of an individual one admires.
identification
EX: a teenaged boy who required lengthy rehabilitation after an accident decides to become a physical therapist as a result of his experience.
An attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning and analysis.
Intellectualization
EX: susans husband is being transferred with his job to a city far away from her parents. she hides anxiety by explaining to her parents the advantages associated with the move.
Integrating the beliefs and values of another individual into one’s own ego struture.
Introjection
EX: children integrate their parents’ value system not the process of conscience formulation. a child says to friend don’t cheat its wrong.
Separating a thought or memory from the feeling tone or emotion associated with it
Isolation
EX: without showing any emotion, a young woman describes being attacked and raped.
Attributing feelings or impulses unacceptable to one’s self to another person.
Projection
EX: sue feels a strong sexual attraction to her track coach and tells her friend he’s coming on to me.
Involuntarily blocking unpleasant feelings and experiences from one’s awareness.
Regression
EX: an accident victim can remember nothing about the accident
Rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive.
Sublimation
EX: a mother whose son was killed by a drunk driver channels her anger and energy into being the president of the local chapter of mothers against drunk drivers.
The voluntary blocking of unpleasant feelings and experiences form one’s awareness.
Suppression
EX: Scarlett O’hara says i don’t want to think about that now ill think about that tomorrow.
Symbolically negating or canceling out an experience that one finds intolerable.
Undoing
EX: joe is nervous about his new job and yells at his wife. on his way home he stops and buys her some flowers.
Psychiatric disturbances characterized by excessive anxiety that is expressed directly or altered through defense mechanisms. it appears as a symptom such as an obsession, a compulsion, a phobia or a sexual dysfunction.
Neuroses
defined as a severe mental disorder characterized by gross impairment in reality testing, typically manifested by delusion, hallucinations, disorganized speech, or disorganized or catatonic behavior.
psychosis
- Exhibit minimal distress
- unaware that their behavior is maladaptive
- unaware of any psychological problems
- exhibiting a flight from reality into a less stressful world or into one in which they are attempting to adapt.
common characteristics of people with psychoses.
- Aware that they are experiencing distress
- aware that their behaviors are maladaptive
- unaware of any possible psychological cause of the distress.
- feel helpless to change their situation
- experience no loss of contact with reality.
Common characteristics of people with neuroses.
A subjective state of emotional, physical and social responses to the loss of a valued entity.
Grief
the loss, or anticipated loss, of anything of value to an individual can trigger the grief response. this period of characteristics emotions and behaviors is known as?
Mourning
This is a stage of shock and disbelief. the response may be one of No! it can’t be true. protective mechanism that allows the individual to cope within an immediate time frame while organizing more effective defense strategies.
Denial
Why me? and its not fair! envy and resentment toward individual not affected by the loss are common. may be directed at the self or displaced on loved ones, caregivers and even God.
Anger
If God will help me through this I promise I will go to church every Sunday and volunteer my time to help others. sometimes the promise is associated with feelings of guilt for not having performed satisfactorily, appropriately or sufficiently.
Bargaining
During this stage the full impact of the loss is experienced. this is a time of quiet desperation and disengagement form all associations with the lost entity. it represents advancement toward resolution rather than the fixation in an earlier stage of the grief process.
Depression
The final stage brings a feeling of peace regarding the loss that has occurred. the focus is on the reality of the loss and its meaning for the individuals.
Acceptance
Individuals often begin the work of grieving before the actual loss occurs.
Anticipatory grief
Resolution fact
Length of the grieving process is also affected by the number of recent losses experienced by an individual and whether they are able to complete one grieving process before another loss occurs.
is characterized by an intense preoccupation with memories of the lost entity for many years after the loss has occurred. behaviors associated with the stages of denial or anger are manifested, and disorganization of functioning and intense emotional pain related to the lost entity are evidenced.
the prolonged response
The individual becomes fixed in the denial stage of the grieving process. the emotional pain associated with the loss is not experienced, but anxiety disorders (e.g., phobias, somatic symptom disorders) or sleeping and eating disorders (e.g., insomnia, anorexia) may be evident. may remain in denial for many years until the grief response is triggered by a reminder of the loss.
Delayed or inhibited response
Fixed in the anger stage of grieving. All the normal behaviors associated with driving such as helplessness, hopelessness, sadness, anger and guilt are exaggerated out of proportion to the situation. the individual turns the anger inward on the self, is consumed with overwhelming despair and is unable to function in normal activities of daily living.
Distorted response
The combination of character, behavioral, temperamental, emotional and mental traits that are unique to each specific individual
personality
Meeting basic needs. locus of instinctual drives-the pleasure principle. Present at birth, it endows the infant with instinctual drives that seek to satisfy needs and achieve immediate gratification. behaviors are impulsive and may be irrational.
ID
also called the rational self or the reality principle begins to develop between the ages of 4 to 6 months. a primary function is one of mediator that is to maintain harmony among the external world.
EGO
Referred to as the perfection principle. develops between ages 3 and 6 years, internalizes the values and morals set forth by primary caregivers. composed of two major components the ego ideal and the conscience
superego
Includes all memories that remain within an individuals awareness. events and experiences that are easily remembered or retrieved are considered to be within one’s conscious awareness. EX: telephone numbers, birthdays of self and significant others, dates of special holidays, and what one had for lunch today.
Conscious
includes all memories that may have been forgotten or are not in present awareness but, with attention, can readily be recalled into consciousness. examples: telephone numbers or addresses once known but little used and feelings associated with significant life events that may have occurred at some time in the past. helps to suppress unpleasant or nonessential memories from consciousness. under control of the superego which helps to suppress unacceptable thought and behaviors.
preconscious
includes all memories that one is unable to bring to conscious awareness. it is the largest of the three topographical level. consists of unpleasant or nonessential memories that have been repressed and can be retrieved only through therapy, hypnosis, and with certain substances that later the awareness, and have the capacity to restructure repressed memories. may emerge in dreams.
preconscious
psychic energy (or the drive to fulfill basic physiological needs such as hunger, thirst, and sex).
libido
the process by which the id invests energy into an object in an attempt to achieve gratification. EX: instinctively turns to alcohol to relieve stress.
Cathexis
the use of psychic energy by the ego and the superego to control id impulses. EX: i already have ulcers from drinking too much. i will call my AA sponsor for support. i will not drink
Anticathexis
Freud’s stages
relief from anxiety through oral gratification of needs
Oral ages birth-18months
Freud’s stages
Learning independence and control, with focus on the excretory function.
Anal ages 18 months-3 years
Freud’s stages
Identification with parent of same gender; development of sexual identity; focus on genital organs
Phallic ages 3-6 years
Freud’s stages
Sexuality repressed; focus on relationships with same gender peers
Latency ages 6-12 years
Freud’s stages
Libido reawakened as genital organs mature; focus on relationships with members of the opposite gender.
Genital ages 13- 20 years
is a feeling of emotional discomfort, toward the relief or prevention of which all behavior is aimed. is the chief disruptive force in interpersonal relations and the main factor in the development of serious difficulties in living. it arises out of one’s inability to satisfy needs or achieve interpersonal security.
Anxiety
the fulfillment of all requirements associated with an individual’s physiochemical environment. ex: oxygen, food, water, warmth, tenderness, rest, activity, sexual expression
satisfaction of needs
the feeling associated with relief from anxiety. when all needs have been met, one experiences a sense of total well being.
interpersonal security
is a collection of experiences or security measures, adopted by the individual to protect against anxiety.
self system
Components of the self system:
the ____ ____ is the part of the personality that develops in response to positive feedback from the primary caregiver. feelings of pleasure, contentment, and gratification. the child learns which behaviors elicit this positive response as ti becomes incorporated into the self system.
the good me
Components of the self system:
the ___ ___ is the part of the personality that develops in response to negative feedback from the primary caregiver. anxiety is experienced, eliciting feelings of discomfort, displeasure, and distress. the child learns to avoid these negative feelings by altering certain behaviors.
the bad me
Components of the self system:
The __ ___ is the part of the personality that develops in response to situations that produce intense anxiety in the child. feelings of horror, awe, dread and loathing are experience in response to these situations, leading the child to deny these feelings in an effort to relieve anxiety. these feelings have been denied becoming __ __ but someone else. this withdrawal from emotions has serious implications for mental disorders in adult life.
The not me
To develop a basic trust in the mothering figure and learn to generalize it to others.
Erikson
Trust vs mistrust
infancy (birth-18months)
To gain some self control an independence within the environment
Erikson Autonomy vs shame and doubt early childhood (18months-3 years)
to develop a sense of purpose and the ability to initiate and direct own activities
Erikson
initiative vs guilt
late childhood 3-6 years
to achieve a sense of self confidence by learning, competing, performing successfully, and receiving recognition from significant others, peers and acquaintances.
Erikson
industry vs inferiority
school age 6-12 years
to integrate the tasks mastered in the previous stages into a secure sense of self
Erikson
identity vs role confusion
adolescence 12-20 years
to form an intense, lasting relationship or a commitment to another person, cause, institution or creative effort
Erikson
intimacy vs isolation
young adulthood 20-30
to achieve the life goals established for oneself while also considering the welfare of future generations.
Erikson
generatively vs stagnation
adulthood 30-65
to review one’s life and derive meaning from both positive and negative events while achieving a positive sense of self worth
Erikson
ego integrity vs despair
old age 65-death
being able to understand ones own behavior to help others identify felt difficulties and to apply principles of human relations to the problems that arise at all levels of experience
psychodynamic nursing
one who provides specific needed information that helps the client understand their problem and the new situation
resource person
one who listens as the client reviews feelings related to difficulties their experiencing in any aspect of life. interpersonal techniques have been identified to facilitate the nurse’s interaction in the process of helping the client solve problems and make decisions concerning these difficulties
a counselor
one who identifies learning needs and provides information to the client that may aid in improvement of the life situation
a teacher
one who directs the nurse-cleint interaction and ensures that appropriate actions are undertaken to facilitate achievement of the designated goals.
a leader
one who understands various professional devices and possesses the clinical skill necessary to perform the interventions that are in the best interest of the client
A technical expert
one who serves as a substitute figure for another
A surrogate
is the phase during which the client, nurse, and family work together to recognize, clarify and define the existing problem
orientation phase
is the phase after which the client’s initial impression has been clarified and during which they begin to respond selectively to persons who seem to offer the help that is needed.
The client can response in 3 ways:
1) on the basis of participation or interdependent relations with the nurse.
2) on the basis of independence or isolation from the nurse.
3) on the basis of helplessness or dependence on the nurse.
identification phase
is the phase during which the client proceeds to take full advantage of the services offered to them. Having learned which services are available, feeling comfortable within the setting, and serving as an active participant in their own health care, the client exploits the services available and explores all possibilities of the changing situation.
Exploitation phase
When the client is freed from identification with helping persons and gathers strength to assume independence. ____ is the direct result of successful completion of the other three phases.
Resolution phase
learning to communicate in various ways with the primary caregiver to have comfort needs fulfilled.
**clients with unmet dependency needs regress during illness and demonstrate behaviors that relate to this stage of development. other clients regress to this level because of physical disabilities associated with their illness.
Peplau’s interpersonal theory
age: infancy
Stage: learning to count on others
Learning the satisfaction of pleasing others by delaying self gratification in small ways
** First step in the development of interdependent social relations. the child feels powerless and fails to learn the satisfaction of pleasing others by delaying self gratification in small ways. they may also exhibit rebellious behavior by failing to comply with demands of the mothering figure in an effort to counter the feelings of powerlessness.
Peplau’s interpersonal theory
age: toddlerhood
stage: learning to delay satisfaction
learning appropriate roles and behaviors by acquiring the ability to perceive the expectations of others.
** a concept of self develops as a product of interaction with adults. a child learns to structure self concept by observing how others interact with them.
Peplau’s interpersonal theory
age: early childhood
stage: learning to identifying oneself
learning the skills of compromise, competition, and cooperation with others; establishing a more realistic view of the world and a feeling of one’s place in it.
If a child tries to use the skill of an earlier level of development (crying, whining, or demanding), they may be rejected by peers of this juvenile stage. as this stage progresses, children begin to view themselves through the eyes of their peers.
preadolescents take on a more realistic view of the world and a feeling of their place in it. the capacity to love others develops at this time and is expressed in relation to one’s self acceptance. failure to develop appropriate skills at any point along the developmental progression results in an individual;s difficulty in confronting the recurring problems of life.
Peplau’s interpersonal theory
age: late childhood
stage: developing skills in participation
Peplau’s interpersonal theory fact:
potenital behaviors of individuals who have failed to complete the task of the second stage of development (learning to delay satisfaction):
- exploitation and manipulation of others to satisfy their own desires because they are unable to do so independently.
- suspiciousness and envy of others, directing hostility toward others in an effort to enhance their own self image.
- hoarding and withholding possessions form others; miserliness.
- inordinate neatness and punctuality.
- inability to relate to others through sharing of feelings, ideas or experiences.
- ability to vary the personality characteristics to those required to satisfy personal desires at any given time.
Theoretical perspectives:
is the greatest happiness principal. this principal holds that actions are right to the degree that they tend to promote happiness and wrong as they tend to produce the reverse of happiness. the doctrine that actions are right if they are useful or for the benefit of a majority.
action is taken based on the end results that produced the most good for the most people.
Utilitarianism theory
it is not the consequences or end results that make an action right or wrong; rather it is the principle or motivation on which the action is based that is the morally decisive factor.
this theory is also called deontology
this theory is made out of respect for moral law.
EX: i make this choice because it is morally right and my duty to do so.
Kantianism theory
this approach to ethical decision making is focused on the way of life and teachings of jesus christ. focus on the importance of virtues such as love, forgiveness, and honesty. the decisions about right and wrong should be centered in love for God and in treating others with the same respect and dignity with which we would expect to be treated.
the christian ethics
this theory advances the idea that decisions about right versus wrong are self evident and determined by human nature.
natural law theory
what is right and good is what is best for the individual making the decision. an individuals actions are determined by what is to their own advantage. the action may not be best for anyone else involved, but consideration is only for the individual making the decision.
ethical egoism
a situation that requires an individual to make a choice between two equally unfavorable alternatives.
ethical dilemma
this viewpoint emphasizes the status of persons as moral agents whose right to determine their destinies should always be respected. individuals are always capable of making independent choices.
autonomy
refers to one’s duty to benefit or promote the good of others.
beneficence
the requirement that healthcare providers do no harm to their clients
nonmaleficence
“fairness”. the right of individuals to be treated equally regardless of race, sex, marital status ect.
justice
refers to one’s duty to always be truthful. there are time when limitations much be placed on this principal, such aw when this principal will knowingly produce harm or interfere with recovery process
veracity
this act requires that healthcare facilities provide clear written information for every patient concerning their legal rights to make healthcare decisions, including the right to accept or refuse treatment.
the patient self determination act
this law has been enacted by a legislative body, such as a county or city council, state legislature, or the U.S congress.
statutory law
these law are derived from decisions made in previous cases. these laws apply to a body of principles that evolve from court decisions resolving various controversies. EX: might be how different states deal with a nurse’s refusal to provide care for a specific event.
common law
this law protects the private and property rights of individuals and businesses.
civil law
a ____ is a violation of a civil law in which an individual has been wronged. in a ___ action, one party asserts that wrongful conduct on the part of the other has caused harm and seeks compensation for hair suffered.
torts
malpractice and negligence actions is an example of an _____ tort
unintentional tort
touching of another person without that person’s consent. EX: medical treatment without the client’s consent can result in a charge of battery.
intentional tort.
True or false:
if a client confides in the nurse the potential for harm to an intended victim, is it the duty of the nurse to report this information?
true
the doctrine is the preservation and protection of individual autonomy in determining what will and will not happen to the person’s body.
informed consent
informed consent fact:
the client should receive information such as what treatment alternatives are available; why the physician believes this treatment is most appropriate; the possible outcome should the client select another treatment alternative; and the possible outcome should the chose to have no treatment.
there are some conditions under which treatment may be performed without obtaining informed consent. what 5 conditions are they?
1) . when a client is mentally incompetent to make a decision and treatment is necessary to preserve life or avoid serious harm.
2) . when refusing treatment endangers the life or health of another.
3) . during an emergency, in which a client is in no condition to exercise judgement.
4) . when a client is a child (consent is obtained form parent or surrogate).
5) . in a case of therapeutic privilege: information about a treatment may be withheld if the physician can show that full disclosure would: hinger or complicate treatment, cause severe psychological harm, or be so upsetting as to render a rational decision by the client impossible.
True or false:
if a psychiatric/mental health client in a health facility have severe psychiatric illness they are competent and capable of giving informed consent.
false
true or false:
if an individual has been legally determined to be mentally incompetent, consent is obtained from the legal guardian.
true
what is the nurse’s role in obtaining informed consent?
the nurse’s role in obtaining informed consent is that they act as the clients advocate to ensure that the following three major elements of informed consent have been addressed: knowledge (adequate information), competency (the individuals cognition is not impaired to an extent that would interfere with decision making), and free will (given consent voluntarily).
an individual makes direct application to the institution for services and may stay as long as treatment is deemed necessary
voluntary admissions
in which circumstances can involuntary commitments be made?
- in an emergency situation (client who is dangerous to self or others)
- for observation and treatment of mentally ill persons.
- when an individual is unable to take care of basic personal needs (the gravely disabled).
what are the 5 criteria to involuntary outpatient commitment?
1) a history of repeated decompensation requiring involuntary hospitalization.
2) the likelihood that without treatment the individual will deteriorate to the point of requiring inpatient commitment.
3) the presence of severe and persistent mental illness and limited awareness of the illness or need for treatment.
4) the presence of severe and persistent mental illness contributing to a risk of becoming homeless, incarcerated or violent, or of committing suicide.
5) the existence of an individual treatment plan likely to be effective and a service provider who has agreed to provide the treatment.
the failure to exercise the standard of care that a reasonably prudent person would have exercised in a similar situation; any conduct that falls below the legal standard established to protect others against unreasonable risk of harm, except for conduct that is intentionally, or willfully disregardful of others’ rights.
negligence
these are examples of what type of lawsuit:
- a duty to the patient existed, based on the recognized standard of care.
- a breach of duty occurred, meaning that the care rendered was not consistent with the recognized standard of care.
- the client was injured
- the injury was directly caused by the breach of a standard of care.
malpractice
when shared information is detrimental to the clients reputation, the person sharing the information may be liable for ______ of _____
defamation of character
when the information that is detrimental to the clients reputation is in writing…
libel
when the information that is detrimental to the clients reputation is oral defamation ….
slander
an act that results in a persons genuine fear that they will be touched without consent
assault
unconsented touching of another person.
battery
a therapeutic manner requires that the nurse have a great deal of self awareness and self understanding, having arrived at a philosophical belief about life, death and the overall human condition.
use of the self
what are some examples of nursing interventions that would promote trust in an individual who is thinking concretely (focuses their thought processes on specifics rather than generalities and immediate issues rather than eventual outcomes).
- providing a blanket when cold
- providing food when hungry
- being honest
- simply and clearly providing reasons for certain policies, procedures and rules.
- providing written, structured schedule of activities.
- attending activités with the client if they are reluctant to go alone.
- being consistent in adhering to unit guidelines
- taking the client’s preferences, request, and opinions into consideration.
- ensuring confidentiality
what is the difference between empathy and sympathy?
empathy means that you remain emotionally separate from the other person, even though you can see the patient’s viewpoint clearly. sympathy implies taking on the others needs and problems as if they were your own and becoming emotionally involved to the point of losing your objectivity.
this phase of a therapeutic nurse-client relatioship involves preparation for the first encounter with the client. tasks include: obtaining information about the client from chart, significant others, or health team members. also examining feelings, fears, and anxieties about working with a particular client.
the goal in this phase involves exploring self perceptions.
preinteraction
during this phase of a therapeutic nurse-client relationship, the nurse and client become acquainted. tasks include: creating an environment for trust and rapport. establishing a contract for interventions. gathering assessment information. identifying the clients strengths and limitations. setting goals, developing a plan of action and exploring feelings.
the goal in this phase is establishing trust and formulating a contract for intervention
orientation (introductory) phase
the therapeutic work of the relationship is accomplished during this phase of a therapeutic nurse-client relationship. tasks include: maintaining the trust and rapport, promoting the clients insight and perception of reality, problem solving, overcoming resistance behaviors, and continuously evaluating progress.
the goal in this phase is to promote client change.
the working phase
occurs when the client unconsciously displaces to the nurse feelings formed toward a person from their past.
transference
what are some interventions for transference?
the relationship does not need to be terminated, except when the transference posses a serious barrier to therapy or safety. the nurse should assist the patient into identifying the transference and reassign a new and more appropriate meaning to the current nurse patient relationship.
refers to the nurse’s behavioral and emotional response to the client.
countertransference
what are some examples of a nurse’s behavior in countertransference ?
the nurse over identifies with the client’s feelings, the nurse and client develop a social or personal relationship, gives advice or attempts to rescue the client, encourages and promotes the clients dependence, feels anxious and uneasy in the presence of the client, the nurse is bored and apathetic in sessions with the client, the nurse has difficulty setting limits on the clients behavior, or the nurse defends the clients behavior to other staff members.
what are some interventions for countertransference?
the relationship should not be terminated. the nurse should be supportively assisted by other staff members to identify their feelings and behaviors.
the main task for this phase of a therapeutic nurse-client relationship involves bringing a therapeutic conclusion to the relationship.
the termination phase
intimate distance is how many inches
0-18
person distance is how many inches
18-40
social distance is how many feet away
4-12 feet
public distance is how many feet away
one that exceeds 12 feet.
this type of touch is impersonal and businesslike. it is used to accomplish a task.
functional-professional
a tailor measuring a customer for a suit or a physician examining a client.
social polite
a handshake. this type of touch at this level indicates a strong liking for the other person-a feeling that they are a friend
friendship-warmth
laying one’s hand on the shoulder of another. this type of touch conveys an emotional attachment or attraction for another person.
love-intamcy
engaging in a strong, mutual embrace. touching another in the genital region. this type of touch at this level is an expression of physical attraction only.
sexual arousal
this is the gestural component of the spoken word. it consists of pitch, tone, and loudness of spoken messages, the rate of speaking, expressively places pauses, and emphasis assigned to certain words.
paralanguage
what therapeutic communication technique is used when it gives the client the opportunity to collect and organize thoughts, and to think through a point.
using silence
what therapeutic communication technique is used when it conveys an attitude of reception and regard
Give an example.
accepting
EX: yes i understand what you said.
eye contact and nodding
what therapeutic communication technique is used when acknowledging and indicating awareness; better than complimenting, which reflects the nurse’s judgement
Give an example
giving recognition
EX: i see you made your bed.
