Mental Health Framework Flashcards
where does the action of psych drugs occur
neural synapse
what causes cognitive or motional symptoms
excessive or deficient activity of neuotransmitters
what is the synapse
primary site for psychotropic drugs
what is neuroendocrinaology
study of the interaction btwn the nervous system and the endocrine system and the effects of various hormone on cognitive, emotional, and behavioral functioning
what cuases circadian rhythms to be disrupted
hormone imbalance
what is a resault of altered secretion of ADH from pain or emotional stress
water intoxication in severe mental illness resulting from electrolyte imbalance (hyponatremia) can result in death
what are the s/s of h20 intoxication
polydipsia
what is psychoneuroimmunology
study of the relationship btwn the immune system,nervous system and the psychological process
what are cytokines active in
inflammatory response-infections
mood disorders- depression and bipolar
research looking at prolonged activation of cytokines
what do antidepressant block
reuptake od serotonin and norepinephrine
how do antipsychotics work
blocking specific neurotransmitter receptors
what do benzodiazepines do
facilitate transmission of GABA
what do psychostimulants do
increase release of norepinephrine, serotonin, and dopamine
bottom of maslows
physiological needs
2nd in maslows
safety needs
3rd in maslows
love and belonging
4th in maslows
esteem
top of maslows
self-actualization
what is fight or flight syndrome
individuals experience both physical and psychological responses to stress
general adaptation syndrome
what is cure
ritualistic exorcism consists of beatings, starvation, harsh treatment to purge the body of supernatural forces
nsg assessment of spirituality
what gives you hope
what gives you meaning in life
what gives you purpose in life
what was freuds perspective
psychoanalytical
start @ childhood
what is skinners psychological perspective
behaviorist
what is eriksons psychological perspective
developmental
what is becks psychological perspective
cognitive
what is sullivans psychological perspective
interpersonal
what is stage 1 of eriksons
trust vs mistrust (1st yr of life) …. hope
what is stage 2 of eriksons
autonomy vs shame (toddler)….. will
what is stage 3 of eriksons
initiative vs guilt (toddler)……purpose
what is stage 4 of eriksons
industry vs inferiority (school/job) (“i cant do this”)…. competency
what is stage 5 of eriksons
ego identitiy vs role confusion (adolescents)….. fidelity
what is stage 6 of eriksons
intimacy vs isolation….. love
what is stage 7 of eriksons
generativity vs stagnation…. care
what is stage 8 of eriksons
ego integrity vs despair (looking back)…. wisdom
what is freud’s psychoanalytical theory
conscious level…..subconscious level…..unconscious level
what is conscious level
thoughts and perceptions that can transform experiences into unconscious states
what is subconscious level
memories, stored knowlowledge that is readily available
what is unconscious level
fears, violent motives, unaaceptable sexual desires, irrational wishes, immoral urges, shameful experiences, selfish needs, traumatic memories, painful emotions
what is freuds ego defense mechanisms
compensation
denial
displacement
identification
intellectualization
introjection
isolation
projection
rationalization
reaction formulation
regression
repression
sublimation
suppression
undoing
what is compensation
covering up a real or perceived weakness by emphasizing a trait one considers more desireable
what is denial
1st stage of grief
refusing to acknowledge the existence of a real life situation or the feelings associated w/ it
what is displacement
the transfer of feelings from one target to another that is considered less threatening or that is neutral
what is identification
an attempt to increase self-worth by acquirnig certain attributes and characteristics of an individual one admires
what is intellectualization
an attempt to avoid expressing actual emotions associated w/ a stressful situation by using intellectual process of logic, reasoning, and analysis
what is introjection
integrating the beliefs and values or another individual into ones own ego structure
what is isolation
separating a thiught or memory from the feeling tone or emotion associated with it
what is projection
attributing feelings or impulses unacceptable to ones self to another pereson
what is rationalization
attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behavior
what is reaction formation
preventing unacceptable or undesireable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
what is regression
responding to stress by retreating to an earlier level of development and the comfort measures associated w/ the level or functioning
what is repression
involuntarily blocking unpleasant feelings and experiences from one’s awareness
what is sublimation
rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive
what is suppression
the voluntary blocking of unpleasant feelings and experiences from one’s awareness
what is undoing
symbolically negating or canceling out an experience that one finds intolerable
what is the DSM-5
diagnostic and statistical manual of mental disorders
emphasizes role of neurobiology and genetics over theories of personality
all diagnoses require that symptoms cause dysfunction
severe and persistent mental illness…
is characterozed by functional impairment that interferes with vocational capacity
creates serious interpersonal difficulties
may be associated w/ a suicide plan or attempt
what is milieu therapy
french for middle
eng- enviornment
used in inpatient and outpatient
goal to produce behavioral change
adaptive coping skills learned
relationship skills strengthened
what 5 things are important in the milieu
containment- safety and security
structure- needs structure to promote goals of treatment (activities, schedule)
involvement- develops sense of scoail community
support- must be supportive rather than rigid or punitive
validation- must support and affirm needs of the individual inside and outside of the group
what percent of the homeless population suffer from mental illness
30
what is autonomy
patient has the right to make their own health decisions
what is beneficence
do good
what is nonmaleficence
do no harm
what is justice
treat patients equally and fairly
what is veracity
always be truthful
what are the 3 rights patients have
right to treatment
right to refuse treatment
right to the leat restrictive/least invasive treatment alt.
what are the 2 exceptions to HIPPA
duty to warn
suspected child or elder abuse
what is a 201
voluntary admission
2/3 of admissions
72-hours notice/letter of intent to withdraw from the program
age 14 and over
what is a 302
involuntary commitments
emergency commitments
what is the criteria for 302
danger to self
danger to others
unable to care for basic personal needs
what is a crisis
sudden event in one’s life during which usual coping mechanisms cannot resolve the problem
crisis disturbs homeostasis
exposure to stressor….. increased anxiety…..try new solution…..breaking point
what are some things to know about crises
occur in all individuals
precipitated by specific identifiable events
personal in nature
acute and are resolved within a brief period
contains potential for psychological growth or deterioration
what is a dispositional crisis
acute response to an external situational stressor or trigger
ex domestic violence d/t losing job
what is a crisis of anticipated life transitions
normal life cycle transitions that may be anticipated but over which the individual may feel a lack of control
ex. new college student cant handle stress of moving away
what is a crisis resulting from tramatic stress
crisis precipitated by an unexpected external stressor over which the individual has little to no control and as a result of which he/she feels emotionally overwhelmed and defeated
ex seeking MH care after experiencing a natural disaster
what is crisis reflecting psychopathy
crisis influcenced or triggered by preexisting psychopathology (personality disorders, anxiety, bipolar, and schizophrenia)
ex pt w/ schizo unable to fill meds and becomes increasingly paranoid and delusional to the point that she is found hiding in the brush alongside a road for fear that the gov. will find her and expose the truth about her identity
what is maturational crisis
associated w/ various stages of growth and development
eriksons 8 stages
what are the stages of life that have an increased risk of crissi
adolesence
marriage
parenthood
midlife
retirement
what is a situational crisis
acute responses to external stressors
real or only in the perception of the individual
countless numbers of situational crises
crises put individual at risk for mental illness
what are examples of situational crises
poverty- inadquate, crowded living, nutritional deficits, medical neglect, unemployment, homeless
high rateof life change events- death of loved one, divorce, job loss, change in living conditions, etc
environmental conditions- tornados, floods, hurricanes, etc.
trauma- rape, war, physical attack, torture etc
what are psychiatric emergencies
crisis situations where general functioning has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility for his/her behavior
ex. acutely suicidal individuals, drug overdoses, reactions to hallucinogenic drugs, etc
characteristics of anger
frowning
glaring
clenched fists/jaw
low-pitched voice
yelling and shouting
turning back on/abrupt walking away
characteristics of aggression
pacing/restlessness
verbal/physical threats (slamming or banging on doors, objects, fists, shadowboxing, loud voice, argumentative, forceful accusations, profanity)
tense facial expression and hostile body lang- expanded area of personal space
3 factors to identify extent of crisis
past hx of violence
pt diagnosis
current behaviors
what is the primary therapeutic goal of crisis intervention
psychological resolution of the individuals immediate crisis and restoration to at least the level of functioning that existed b4 the crisis period
what is trauma informed care
a philosophical approach that values awareness and understanding of trauma when assessing, planning and implementing care
what causes retramatization
seclusion and restraints
what are the core concepts of TIC
empowerment
trauma
respect
collaboration
hope
connection
recovery
what is transference
this person reminds me of….
what is self-awareness of trauma hx in healthcare providers
may impact effectiveness in providing care to pts
may trigger emotions
may impact interventions and identifications of outcomes
what are resources for healthcare providers
EAP-employee assistant programs, counseling, coporate health coaching
debrief difficult pts w/ coworkers
private MH counseling
physical activity resources through employer
what are aces
adverse childhood experiences
what is therapeutic use of self
ability to use one’s personality consciously and in full awareness in an attempt to establish relatedness and to structure nsg interventions
nurse uses aspects of his or her personality, experience, expertise, values, feelings, intelligence, needs, coping skills, and perceptions to establish relationships w/ pts that are beneficial to pts
conditions essential to developing a therapeutic nurse-pt relationship
autonomy
rapport
trust
respect
genuineness
empathy
biophyschosocial assessment priorities
current mental and pmh
current health physical status/meds and med hx
current and past relationship/family dynamics
current and past substance use (alc/drugs)
nonpharmacological treatment
therapy
complementary treatment and practices
support groups
what is psychoanalysis
freud- to resolve internal conflicts which he believed came from early childhood experiences
classical psychoanalysis is a therapeutic process of assessing unconscious thoughts and feelings and resolving conflict by talking to a psychoanalyst
attend many sessions over months to years
what is psychotherapy
involves verbal therapist to pt interaction than classic psychoanalysis
pt and therapist develop a trusting relationship to explore the pt’s current problems
what is CBT
focuses on individual thoughts, feelings, and behaviors to solve current problems
pts learn how to use evidence to challenge their distorted thoughts ab themselves, others, and the future
what is behavior therapy
based of skinners theory of operant conditioning that behavior is learned and has consequences
uses tools like reinforcement and punishment to change behaviors
what is motivational interviewing
pt centered style of communication that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior
often used to addressbehavioral management of illness such as addiction, diabetes, heart disease and asthma
what is ECT
when meds not effective
procedure done under general anesthesia where small electric currents are passed through the brain, intentionally triggering a brief seizure
causes changes in brain chem that can quickly reverse symptoms of certain MH conditions
