midterm Flashcards
important legislation
- BCMHA
- freedom of information & protection of privacy act (FOIPPA)
- adult guardianship act (AGA)
- criminal code of canada (assault/sexual)
psychiatric nursing definition
- promotion, maintenance, and restoration of health, focus psychosocial, mental, emotional health
- prevention, treatment, and palliation of illness and injury, focus psychosocial, mental or emotional disorders, & associated comorbid physiological conditions primarily assessing health status, planning, implementing, and evaluating interventions and coordinating services
what guides your practice
- prof standards
- practice standards
- scope of practice
- code of ethics
prof standards
- TR
- competent, evidence-informed
- professional responsibility & accountability
- leadership and collaboration in quality
- professional ethical practice
code of ethics values
- safe competent & ethical practice ensure to protection of public
- respect for the inherent worth, right choice, and dignity of persons
- health, mental health, and well-being
4 levels of control
- regulation & legislation
- BCCNM standards, limits & conditions
- organizational policies
- individual nurse competence
scope of practice
activities that a group of professional are educated and authorized to perform rather than what any individual can do
autonomous scope of practice
non-restricted activities and restricted activities (does not require order)
activities that aren’t restricted
don’t need orders, daily responsibilities
restricted activities that don’t require order
- wound care
- nursing diagnosis
- inhalation
- IV
- assessing clients and treating conditions
restricted activities with order
require order!!
rpns be sure restricted activities fall within scope even with order from listed health professional
listed professionals are
regulated bodies with authorization to give rpn order
physician, dentist, midwife, naturopath, pharmacist, RN, NP
activities that require orders
- procedures below body surface
- administering a substance
- putting items into body openings
- putting substancecs in ear
- medications
rpns have authority to diagnose conditions only t/f
true
cultural safety principals
- self reflective practice
- building knowledge through education
- anti-racist practice
- cerating safe health care experiences
- person-led care (relational care)
- strengths based and trauma informed practice
foippa
- personal & private information required to be kept confidential
- some conditions when personal and private information can be accessed or shared
- people ahve right to access their personal and private information
stress
normal response to situational pressures especially if perceived as threatening
repsonse to a changing environmental conditions
limitations of the recent life changes questionnaire
- perception = could be good or bad thing
- coping
- implications of chronic or re-occurring event
stress symptoms
- physical (headache, fatigue)
- emotional (crying, upset, nervous, overwhelmed)
- cognitive (memory loss, difficulty making decision)
- behavioural (isolation, compulsive eating)
emotional response
situation = something happens
thought = situation is interpreted
emotion = feeling occurs as a result of thought
behaviour = action in response to emotion
primary appraisal
evaluates whether in danger or threat
- demands, role expectations, what to do, goals
if answer is NOT feeling a threat then…
stress will resolve
if answer is YES feeling a threat then….
secondary appraisal
secondary appraisal
considers options for dealing with situation
look into toolbox & try strategies (coping, medication, deep breathing)
allostasis
mechanisms that change the controlled variable by predicting what level will be needed and overriding local feedback to meet anticipated demand
fight, flight, fawn
- anger, range
- fear, anxiety
- passive, pleasing, clinging
vulnerable individuals are…
ppl traumatized & victimized & more suspectible
- youth, women, first nations, elderly, LGBTQ+, refuges
resolution of crisis
depends on realisitic perception of events, strategies available and support system
coping
individual’s constantly changing cognitive and behavioural efforts to manage specific external or internal demands that are appraised as taxing or exceeding their resources
positive coping
leads to adaption (well-being & max social functioning)
inability to cope
leads to maladaption = illness, poor self-concept, reduced social functioning
problem focused coping (2)
inner-directed strategies
outer-directed strategies
inner directed strategies
= altering one’s own beliefs, attitudes, responses
outer directed strategies
attempt to eliminate or alter a situation or another’s behaviour
emotion focused coping
seek to manage own emotional distress (exercise, meditation, talking to friends)
nursing interventions = stress, panic, and crisis
- establish or re-establish routine (self care, exercise, sleep)
- observe, assess, explore, discuss (changes in behaviour & mental status, social supports, appraisal of significant life events & stressors)
small stress can be good thing, give you push you need, motivating to do best (t/f)
TRUE
crisis
coping and defensive mechanism that has been used to solve problems and adapt to change is no longer effective
situational crisis
sudden & unexpected (accidents, natural disasters)
developmental crisis
occur as part of the process of growing and developing through various periods of life
sometimes predictable part of life cycle
(leaving home, having baby)
existential crisis
inner conflicts related to things such as life purpose, direction, and spirituality
(person questions if life has meaning, purpose, value)
phases of crisis response
- problem arise, increase anxiety, stimulates usual problem-solving techniques
- usual problem-solving techniques are ineffective, anxiety continue to rise, trial & error attempts made to restore balance
- trial & error fail, anxiety escalates to severe/panic, person adopts automatic relief behaviours
- doesn’t work, anxiety overwhelms person = serious personality disorganization which signals person in crisis
seven stage crisis intervention model
- conduct crisis & biopsychosocial assessment (lethality measures)
- establish rapport & relationship
- identify dimensions of presenting problems (“last straw of crisis precipitants)
- explore feelings and emotions (including active listening and validation)
- generate and explore alternatives (untapped resources and coping skills)
- develop and formulate plan
- follow up plan and agreement
crisis intervention
provision of emergency psychological care to assist victims in returning to an adaptive level of functioning and to prevent or moderate the potentially negative effects of psychological trauma
5 principles of crisis intervention
- early intervention
- stabilization
- facilitating understanding
- focusing on problem solving
- encouraging self reliance (empowerment)
benzo for anxiety
- short term use, quick relief (30 mins)
- dependence & withdrawal (2 week use)
- s/e: interactions, resp depression, drowsiness, poor memory, confusion
paradoxical effect benzo
increased anxiety, irritability, agitation, aggression, mania, impulsive behaviour, hallucinations
withdrawal sx benzo
increased anxiety, insomnia, depression, pounding heart
