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3920: Mental Health > Midterm Review > Flashcards

Midterm Review Flashcards

1
Q

What is Mental Health

A
  • State of well being
  • Able to realize own potential, cope with stress, work productively
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2
Q

Mental Illness

A
  • Alterations of cognition, mood, behavior
  • Significant distress & impaired functioning
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3
Q

What is Recovery

A
  • Living a satisfying & hopeful life with mental health challenges/illness
  • NOT clinical recovery or cure
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4
Q

Psychosocial Rehabilitation Model (PSR)

A
  • Help individuals living with mental illness move towards recovery
  • Implemented at inpatient & outpatient settings
  • HPC’s see capacity for recovery
  • Client-centered care through strength based lens
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5
Q

Public Hospitals Act

A
  • Determine what care is given
  • All hospitals in ontario
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6
Q

Health Care Consent Act

A
  • Regulation for consent to treatment
  • Anything done for health purpose
  • Includes course of treatment, plan, community treatment plan
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7
Q

Form 33

A
  • Provided to patient if deemed incapable
  • Outline their rights
  • Can review with a patient’s rights advocate
  • Opportunities to appeal the decision
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8
Q

SDM Act

A
  • Grant substitute decision maker to act on their behalf for personal care
  • Also during period of capacity
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9
Q

Mental Health Act

A
  • Sets conditions & time limits to admit & treat personals experiencing mental health disorders
  • Permits certain infringements on person’s rights & freedoms to ensure necessary treatment
  • Have right to patient advocate support & advice
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10
Q

Form 1 Hold

A
  • Authorizes assessment by psychiatrist
  • 72 hours max
  • Completed by physician
  • Admission for immediate safety concern
  • Notify client with form 42
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11
Q

Form 3

A
  • 14 days
  • Completed by psychiatrist
  • Admission as involuntary patient
  • Notify client with form 30
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12
Q

Form 4

A
  • 1-3 months per renewal
  • Completed by psychiatrist
  • Ongoing admission as involuntary patient
  • Notify client with form 30
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13
Q

Community Treatment Order (CTO)

A
  • Mandatory outpatient treatment plan under MHA
  • Close monitoring to be carried out in community to support patient transition
  • Violation can result in apprehension & presentation to facility for assessment
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14
Q

MSE Purpose

A

Systematic focused assessment of mental status

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15
Q

What is Self-Harm

A

Self-inflicted behavior causing harm to one’s own body

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16
Q

Suicidal Ideation

A
  • Thoughts, feelings person experiences about wanting to die
  • Wishing to relieve oneself of severe emotional pain
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17
Q

Suicidal Behaivors

A

Self-inflicted behaviors with intention to die

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18
Q

Suicidal Attempt

A
  • Behavior that did not result in death
  • Despite expectation/intention of death
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19
Q

Suicidal Death

A
  • Fatal self-inflicted act
  • Some evidence intent was to die
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20
Q

Active Thoughts of Suicide

A
  • Thoughts about taking action to end one’s life
  • Method, plan, intention
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21
Q

Passive Thoughts of Suicide

A
  • Thoughts about death/dying
  • No plan or intent
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22
Q

Primary Prevention

A
  • Intervention before health effects occur
  • Suicide screening
  • Informational campaigns
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23
Q

Secondary Prevention

A
  • Early identification & treatment of those at risk/living with a health effect
  • Ongoing suicide screening & risk formulation
  • Treating suicidality with evidence-based practices
  • Crisis counselling
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24
Q

Tertiary Prevention

A
  • Lessen impact/progression of ongoing health issue
  • Inpatient care after attempt
  • Evidence based treatment after attempt
  • Suicide survivors support group
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25
Risk Mitigators - Protective Factors
- Reasons to live - Social support - Access to/benefits from health care/community supports - Skills in problem solving/conflict resolution & handling problems non-violently
26
Risk Factors
- Biological - Psychological - Social
27
Access to Lethal Means
- Many suicidal crises are short-lived - Help to survive periods of acute risk by restricting/reducing access to lethal means - Lethal means dependent on availability - discuss what patient has available - Strong relationship between availability, lethality, suicide death
28
C-SSRS
- Ideation: active & passive - Plan & intent - Behavior - Assess risk based on different time frames - Rating of low, moderate, high
29
Risk Formulation
- Understanding of how risk factors, warning signs, protective factors, access to lethal means, MSE, suicide screening results interact, exacerbate & fuel a heightened/lower risk - Collect assessment data - Formulate risk - Plan risk appropriate interventions
30
Suicide Intervention
- Includes suicide risk assessment & formulation - Safety planning - lethal means restriction - Postvention - Treat in least restrictive environment that will meet patient's safety needs - Re-assess & change environment as safety needs change
31
Recovery Goals
- Longer-term larger goals - Focused on recovery outcomes
32
Daily Goals
Behaviors/actions that help move towards recovery
33
Moment Goals
Next action that will create opportunity for recovery
34
Milieu Therapy
- Uses safe environment that is actively supporting client to achieve their goals - All client encounters have goal of being therapeutic
35
Milieu Therapy Goals
- Empower client to set & achieve goals - Develop purposeful relationships with team members to assist meeting these goals - Learn adaptive coping & interpersonal skills in controlled environment that can be generalized to other aspects of client's life - Build community
36
Psychotherapy
- Intense client-therapist relationship - Examine deeply emotional experiences, destructive behaviors patterns & serious mental health issues
37
Cognitive Behavioral Therapy
- Focused on relationship between cognition & behaviors - Often used in anxiety & depression
38
Interpersonal Therapy
- Focused on current challenges & relationships with others in client's life - Often used in depression
39
Dialectical Behavior Therapy
- Focused on acceptance - validating current thoughts & feelings - Change of thoughts & behaviors - Often used in BPD, depression, PTSD
40
Family Therapy
- Assist family members in identifying lived experience of one other - Define roles - Enhance relational capacity - Support family actions that have likelihood of support client in achieving goals
41
Group Therapy
- Initial, working, termination phases - Position of the leader in the group depends on group goals
42
Motivational Interviewing
- Patient led lasting behavior goal - Behavior change can occur from compliance or autonomy - Change motivated by autonomy likely lasts longer
43
Principles of Motivational Interviewing
- Express empathy - Develop discrepancy - Roll with resistance - Support self-efficacy - Assess confidence
44
Behavior Risk Assessment
- Recognizing risk for violent behaviors - Understand root cause - Planning intervention in context of violent behavior - Caring for ourselves & others when caring in context of aggression
45
What is Anger
Emotion that compels to act in a way that may harm/attack
46
What is Aggression
- Behavior that results in harm/injury to others - Physical or verbal
47
Risk Factors of Violence
- History of violence - Substance use - Trauma - Support system - Coping - Diagnosis
48
Planning your Approach
- Space - Attire - remove accessories that could be harmful - Behavior - none threatening body language, approach from side - Collaborate - Exit - maintain access to the exit
49
Anger & Aggression MSE Findings
- Fixation, frustration, anger - Clenched fists, pacing, increased muscle tone - Physical, self-harm - Changes to eyes, eye contact, lips pressed together - Sweating, flush, goosebumps, increased RR - Expressing anger/intent to harm
50
Responding to Risk
1. Stop 2. Think 3. Observe 4. Plan
51
Least Restraint
- All alternative interventions explored before use of restraint/seclusion - Must be under mental health act if used without permission
52
Antidepressant MOA
- Depression is caused by decreased monoamine neurotransmitters - Ie) serotonin, norep, dopamine - Increased neurotransmitters in brain by blocking reuptake
53
SSRI Action
- Inhibit reuptake of serotonin - Increasing serotonin in synapse
54
SSRI Nursing Considerations
- Psychotic & manic episodes - Interacts with MAOIs - Serotonin syndrome - Negatively interact with many meds - Liver & kidney - WBC - Do not stop abruptly
55
SNRI Action
Inhibit reuptake of serotonin & norepi
56
SNRI Nursing Considerations
- Psychotic & manic episodes - Interact with MAOIs - Risk for serotonin syndrome
57
TCA Action
Inhibit reuptake of norepi & some serotonin
58
TCA Nursing Consideration
- Anticholinergic effects - Kidney/liver
59
Anticholinergic Effects
- S/e of drug that block & inhibit activity of acetylcholine - Dry mouth - Difficulty voiding - Dilated pupils/blurred vision - Decreased gastric motility - Constipation
60
MAOI Action
- Inhibit monoamine oxidase breakdown -
61
MAOI Food Interactions
- Produce - Dairy - Meats - Bread - Avoid tyramine rich foods - hypertensive crisis risk
62
MAOI Hypertensive Crisis
- Break down food monoamines - When not broken down tyramine increase - Tyramine can increase BP
63
Antidepressant Timeline
- 4-6 weeks for effect (trial) - May increase anxiety first, reduces in time - Take med in morning to reduce insomnia - Alcohol interactions
64
Lithium Action
- Stabilize mood lability (bipolar & schizoaffective disorders) - Increases norepi re-uptake & serotonin sensitivity
65
Lithium Timeline
- 5-7 days for noticeable efficacy - 10-21 days for full efficacy
66
Lithium Nursing Considerations
- Narrow therapeutic window - Adherence to routine blood work - Hydration/salt intake teaching - Monitor for signs of diabetes (thirst, urination) - Increase hypothyroid risk - inhibits thyroid hormone - Lithium toxicity risk - Contraindicated with pregnancy
67
Benzodiazepines (asepam)
- Antianxiety - Stimulate effects of GABA
68
Benzos Nursing Considerations
- Pregnancy - Tolerance - Misuse - Dependence - Safety post dose (driving) - Alcohol - exacerbate sedative effects
69
Typical Antipsychotics
Non-selective (block all dopamine receptors) - cause more side effects
70
Atypical Antipsychotics
Selective (block selective receptors) - more normal
71
Extrapyramidal Side Effects (EPS)
- Akathisia - Rigidity - Bradykinesia - Tremor - Dystonia - Treat with anticholinergics
72
Akathisia
- Restless - Trouble standing still - Paces the floor - Feet in constant motion rocking back & forth
73
Tardive Dyskinesia
- Protrusion & rolling tongue - Sucking/smacking lips - Chewing motion - Involuntary movements
74
SSRI Suffix
pram
75
SNRI Suffix
axine
76
TCA Suffix
ipyline or ipramine

3920: Mental Health (7 decks)

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