Mental Health Nursing, day 1

Question 1

what is Optimal mental health?

Answer 1

individual, group and environmental factors work together effectively: well-being, optimal development & use of mental abilities, achievement of goals, justice & equality

Question 2

what is Minimal mental health ?

Answer 2

I,G,E factors conflict producing subjective stress, impairment of mental abilities, failure to achieve goals, destructive behaviours; prevalent inequalities

Question 3

Recovery Model

Answer 3

1. Hopefulness, 2. recovery 3. reintegration 4. optimization of functioning in society

Question 4

Standards of Psychiatric-Mental Health Nursing (summary)

Answer 4

-Provision of competent, professional care through Therapeutic Relationship “Therapeutic Use of Self” -Ongoing, professional, systematic assessments -Evaluation: provision of and monitoring therapeutic interventions -Managing rapidly changing situations -Teaching & Coaching -Ensuring quality health practices – advocacy -Organization, interprofessional practice- partnerships

Question 5

what is cognitive therapy

Answer 5

Focus: - thoughts/cognitions - correcting cognitive distortions Therapist: active and directive …

Question 6

Psychodynamic/Psychoanalytic

Answer 6

Focus - internal experience - defense mechanisms - transference and past relationships Therapist more non-directive

Question 7

interpersonal therapy

Answer 7

Focus: learning more adaptive behaviour Applications: Operant conditioning Modeling Systematic desensitization Aversion therapy Relaxation Assertiveness Therapist: active & directive

Question 8

PHASES of the Therapeutic Relationship

Answer 8

1. Preinteraction 2. Introductory Orientation 3. Working 4. Termination

Question 9

Pre interaction phase

Answer 9

1. Self exploration 2. Self awareness – ONGOING - Professional Role - Own experiences - Biases, stigmatization, stereotyping - Communication style – strengths, weaknesses - Sense of hopefulness or lack of hope - Self analysis (see text)

Question 10

introductory/orientation phase

Answer 10

1. Why now? What brought patient to seek help?
   - Situational
   - Change in coping
   - Change in symptoms
   - Crisis
2. Goal for treatment – what are your goals for care?
3. Contract – trust and confidentiality
4. Exploring patient’s perspectives

Question 11

working phase

Answer 11

Question 12

Termination Phase

Answer 12

•VERY Important – especially at students
•Learning maximized for both parties
•Summarize
–What work was done
–Milestones reached
–Changes forthcoming or achieved
–Separation – expression of feelings
•Boundaries need to be well established to facilitate termination phase - Protection of client

Question 13

Dorothea Orem

Answer 13

Three foci: (promotes independence)

•Self Care
•Self Care deficit – lacking motivation, knowledge or skill in meeting self-care need
–Nurses help by: Acting or doing for
–Guiding
–Teaching supporting
–Enhancing milieu to meet current or future demands
•Nursing systems - series of actions to meet pt’s self-care needs

Question 14

General Adaptation Syndrome (GAS)

Answer 14

–Alarm reaction
–Resistance
–Exhaustion

Question 15

Psychoimmunology: possibilities

Answer 15

• Complex interworking and interdependence between the immune system, endocrine system, nervous system and the environment or emotional stress.
• Consider PANDAS: acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection, leading to OCD.

Question 16

Levels of intervention

Answer 16

1. Crisis: stabilization, inpatient hospitalization 24 hr. mobile unit intervention, telephone access and triage
2. Acute: remission, symptom relief, partial
   hospitalization, intensive out-pt Rx
3. Maintenance: recovery, improved functioning,
   rehab day treatment, supported independent living
4. Health Promotion: optimal level wellness, education, social

Question 17

Crisis, Maintenance, Health Promotion

Answer 17

• Crisis – acute , stabilization & safety
• Acute – goal to work toward recovery and remission
• Maintenance – complete recovery, functioning well in daily life (family, work, study, goal setting and attainment)
• Health Promotion – work toward OPTIMAL level of functioning, quality of life, inspiring and validating experiences

Question 18

cultural safety

Answer 18

•Recognition of historical context
–Various stressors
–Policy impact upon community / population health
–Status, social, political, psychosocial context
•Recognition of differences in perception, engagement, relationship understanding
– going in to hospital and nurses do FOR you
– feelings of shame or besmirch of family name
– Not engaging in therapy earlier than later
– understanding of mental illness as the brain as a physical entity that is changed rather than choice

Question 19

Primary, secondary, and tertirary nursing in mental health

Answer 19

…

Question 20

what is resilience

Answer 20

the personal characteristic that aids people to recognize stressors and decrease negative emotions, deal with them and learn from it

Question 21

Mental health Recovery

Answer 21

1. self directed
2. individual and person centered
3. empowering
4. holistic
5. nonlinear
6. strengh based
7. peer supported
8. respect
9. resonsibility
10. hope

Question 22

incidence

Answer 22

of new cases in a healthy population in a given time frame

Question 23

prevelance

Answer 23

total # of cases new and exsisting in a give pop during a time frame

Question 24

seven domains of mental health

Answer 24

1. functional health
2. physiological health
3. psychological health
4. health knowledge and behaviour
5. percieved health
6. family health
7. community health

Question 25

classes of the psychosocial domain

Answer 25

1. psychological well being
2. pscychosocial adaption
3. self control
4. social interaction

Question 26

nursing interventions

Answer 26

1. corrdination of care
2. health teaching and maintainance
3. milieu therapy
4. pharmacological, biological, and integrative therapies
5. medication and treatment
6. psychotherapy
7. consultation

Question 27

Social determinants of health

Answer 27

1. income and social status
2. social support networks
3. education
4. emploment and working conditions
5. social environments
6. physcial environments
7. personal health practices and coping skills
8. healthy childhood development
9. health services
10. biologic and genetic endownment

11 gender

12. culture

Question 28

standards of practice

Answer 28

1. provides competent and professional care through the development of a therapuetic relationship
2. performs/refines client assessment through diagnostic and monitoring function
3. administers and monitors therapeutic interventions
4. effectively manages rapidly changing situations
5. intervenes through the teaching- coaching function
6. montiors and ensures the quality of health care practices
7. practices within organizational and work role structure

Question 29

types of behavioural therapy

Answer 29

1. modelling
2. operant conditioning
3. systemic desensitization
4. aversion therapy
5. biofeedback

Question 30

Cognitive Behavioural Therapy (CBT)

Answer 30

• automatic thoughts or cognitive distortions, irrational thoughts/beliefs leading to false assumptions and misinterpretations
• patients are taught to challenge this thinking

* the idea that the way people feel is because of how they see the world