Module 1: Introduction to Psychiatric/Mental Health Nursing

Question 1

What is Mental Health?

Answer 1

• A state of well-being in which individuals function within society and are generally satisfied with their lives.
• It includes more than their “emotional” state. (physiology, behaviors, thinking patterns, etc)

Question 2

What is Mental Illness?

Answer 2

-A disturbance(s) in a individual’s thinking, emotions, behaviors, and physiology.

Question 3

Diagnostic and Statistical Manual (DSM) Multiaxial System

Answer 3

Axis I: major diagnostic category (what brought the patient in for treatment?)
Axis II: Personality disorders
Axis III: Medical diagnoses (what other medical problems are going on with the patient that will impact their treatment?)
Axis IV: Psychosocial stressors (that are occurring at the particular time)
Axis V: Functional level (what is their present functional level and what has been their function level in the past year? 0-100 scale)

Question 4

Continuum of Care in Psychiatric-Mental Health

Answer 4

• Crisis intervention: the very beginning
• Crisis stabilization units: open unit where patient goes for 2-3 days until they can get situated
• Acute inpatient: usually a locked unit-provides structure and holding environment that’s one level up from crisis stabilization unit.
• Partial hospitalization: less restrictive treatment; provides groups, structure, one-on-one counseling; hospital during day, home at night.

Question 5

Acute Care Setting

Answer 5

• Therapeutic strategies (usually Milieu therapy)
• Milieu therapy (very important; usually run by RN; community of individuals, safe place for people to be)
• Crisis management strategies (involves crisis prevention intervention, verbal deescalation of patients)

Question 6

Legal and ethical issues in Psychiatric Care

Answer 6

• HIPPA
• Involuntary commitment
• Three day paper
• Guardianship

Question 7

HIPPA

Answer 7

Health Information Portability Act covers all of healthcare

Question 8

Involuntary Commitment

Answer 8

• may change by state
• if a person is a danger to themselves or others they may be involuntarily committed-involuntarily committed and transferred to a hospital for further evaluation for up to 3 days
• MA: pink paper

Question 9

Three day paper

Answer 9

• usually voluntary condition

- sign a three day paper: gives hospital 3 days to decide if they will go for commitment for the patient.

Question 10

Guardianship

Answer 10

• highest level of restriction

- appointment of an outside person other than patient to decide treatment options (usually involves medication)

Question 11

Biopsychosocial Approach

Answer 11

understanding the client in a holistic sense

• pathophysiology behind each d/o (genetics involved, neurotransmitters, brain pathology)
• psychological and emotional adaptation to stressors (how does the person adapt to social stressors in their life? What are their coping skills?)
• influence of social stressors

Question 12

Essence of Psychiatric Mental Health Nursing

Answer 12

1. self esteem is enhanced by the ability to interact with others in an ASSERTIVE manner (help pt to determine difference between assertiveness and aggressiveness)
2. some individuals may perceive TOUCH as a threatening gesture and respond in an aggressive manner.
3. TRUST is the basis for a therapeutic relationship.
4. UNREALISTIC GOALS set the pt up for failure and reinforce feelings of powerlessness. (goals need to be mutually met-mutually identified)
5. PRESENCE of a trusted individual provides feelings of safety and security.
6. Nurses INTERPERSONAL INTERACTIONS w/ clients form the basis of psychiatric nursing.
7. NEGATIVE self concept is a major factor impeding positive social interactions.
8. PHYSIOLOGICAL needs have highest priority in the area of psychiatric clients.
9. SAFETY needs are a priority of pt care.
10. Each person has CONTROL over own self only and cannot control or make another do anything.
11. LEARNING is enhanced when the individual is actively engaged in the process.