Nurse-Patient Relationship Flashcards
Mental Status Exam (MSE)
Comprehensive exam of a persons mental status
Components:
- appearance
- behavior/attitude
- speech
- affect
- mood
- thought process
- thought content
- cognition
Echopraxia
Repeating movements that are observed
Waxy flexibility
Passive yielding of all movable parts of the body to any effort made at placing them in certain positions
Posturing
Voluntary assumption of inappropriate or bizarre postures
Pacing and rocking
Pacing back and forth and rocking the body
Neologisms
Made-up words that have meaning only to the person who invents them
Echolalia
Repeating of words or phrases spoken by someone else “echo”
Clang associations
Choice of words governed by sounds (often rhyming)
Word salad
Group of words put together in a random fashion
Circumstantiality
Delay in reaching the point of communication because of unnecessary and tedious details
Tangentiality
Unable to get to the point of communication due to the introduction of many new topics
Loose association
Shift of ideas from one unrelated topic to another. More severe than tangential.
Perseveration
Persistent repetition of the same word or idea in response to different questions
Mutism
Inability to speak
Perceptions
Interpretation of stimuli through senses
Illusions
Misperceptions of real external stimuli
Delusions
Fixed false beliefs that are irrational and that the individual maintains as true despite evidence to the contrary
Psychiatric assessment
Orientation to time
Orientation to place
Attention and immediate recall of 3 words
Abstract thinking
Recent memory 3 words again
Name objects
Ability to follow verbal command
Ability to follow written command
Ability to use language correctly
Ability to concentrate
Understanding spatial relationships: draw a clock
Case management
A health delivery process whose goals are to provide quality healthcare, decrease fragmentation, enhance the clients quality of life, and contain costs
Managed care
A concept designed to control the balance between cost and quality of care. Individuals receive care based on need, which is determined by coordinators of the providership
Case manager
The individual responsible for negotiating with multiple healthcare providers to obtain a variety of service for for the client
Critical pathways of care
CPC
The tools for provision of care in a case management system
Determine which categories of care will be provided and when
Milieu therapy
Therapeutic community
Scientific structuring of the environment to effect behaviors changes and to improve the psychological health and functioning of the individual
- adaptive coping
- interaction and relationship skills
- utilize these skills that can be generalized to other aspects of his or her life
Group
A collection of individuals whose association is founded on shared commonalities of interest, values, norms, or purpose
Can be:
- by chance
- by choice
- by circumstance
Socialization
The teaching of social norms occurs through group interaction
Support
Fellow group members are available in times of need
Camaraderie
Individuals receive joy and pleasure from interactions with significant others
Normative influence
Different groups enforce established norms in various ways
Empowerment
Change can be made by groups at times when individuals alone are ineffective
Task groups
Groups are formed to accomplish a specific outcome or task
Teaching groups
The focus is to convey knowledge and information to several individuals
Supportive and therapeutic groups
The primary concern is to prevent possible future upsets by teaching the participants effective ways of dealing with emotional stress arising from situational or developmental crises
Group therapy
Has a sound theoretical base and leaders generally have advanced degrees in psychology, social work, nursing, or medicine
Therapeutic groups
Are based on lesser extent on theory. The focus is on group relations, interactions amount group members, and consideration of a selected issue
Self-help groups
Composed of individuals with a similar problem
Serve to reduce the possibilities of further emotional distress leading to pathology and necessary treatment
May or may not have professional leader; run by members; leadership often rotates person to person;
Seating in group dynamics
Best when there is no barrier between the members
Size of group dynamics
Size makes a difference in the interaction amount members; 7 or 8 members provide a favorable climate for optimal group interaction
Open ended groups
Members leave and others join at any time during the existence of the group
Closed ended groups
All members join at the time the group is organized and terminate membership at the end of a designated period
Groups installation of hope
By observing the progress of others in the group with similar problems, a group member garners hope that his/her problems can also be resolved
Universality
Individuals come to realize that they are not alone in the problems, thoughts, and feelings they are experiencing
Imparting of information
Group members share their knowledge with each other. Leaders also provide information
Group Altruism
Individuals provide assistance and support to each other, thereby helping to create a positive self-image and promote self growth
Corrective recapitulation of the primary family group
Group members re experience early family conflicts that remain unresolved
Catharsis
Within the group, members are able to express both positive and negative feeling
Phases of group development
Phase I: Orientation
- establish rules and goals
- promotes trust
Phase II: Working
- work toward completion of task
- leader role diminishes
- trust established
Phase III: Termination
- sense of loss and grief to the end of the group
- grief from previous losses can be triggered
Autocratic leadership
Focus is on the leader, on whom the members are dependent for problem solving, decision making, and permission to perform
Production is high, morale is low
Democratic leadership
- focus is on members, who are encouraged to participate fully in problem-solving of group issues, including taking action to effect change
Production is somewhat lower, but morale is much higher
Laissez-faire leadership
There is no focus in this type of leadership
Goals are undefined and members do as they please
Productivity and morale are low
Psychodrama
Group therapy that employs a dramatic approach
Clients become actors in life-situation scenarios
An identified client is selected to portray a life situation
Other members play roles of people with whom the client has unresolved issues with
Basically role playing
Family therapy
Family is viewed as a system in which the members are interdependent
Goal is to facilitate a system change rather than focus on any one individual as the one in need of treatment
Crisis
A sudden event in ones life, during which usual coping mechanisms cannot resolve the problem
the crisis disturbs homeostasis
Characteristics of crisis
- not necessarily equated with psychopathology
- crises are precipitated by specific, identifiable events
- personal
- acute, not chronic, and resolved in one way or another
- contains the potential for growth or deterioration
Phases of a crisis
Individual is exposed to a precepitating stressor
When previous problem solving techniques do not relieve the stressor, anxiety increases further
All possible resources, both internal and external, are called on to resolve the problem and relieve the discomfort
Whether or not a stressful event results in a crisis depends on
The individuals perception of the event
The availability of situational supports
The availability of adequate coping mechanisms
Dispositional crisis
An acute response to an external. Situational stressor
Crisis of anticipated life transitions
Normal life-cycle transition that may be anticipated but over which the individual may feel a lack of control
Crisis from traumatic stress
Precipitated by an unexpected, external stressor over which the individual has little or no control, and from which he or she feels emotionally overwhelmed and defeated
Maturational/developmental crisis
Occurs in response to a situation that triggers emotions related to unresolved conflicts in ones life
Crisis reflecting psychopathology
An emotional crisis in which preexisting psychopathology has been instrumental in precipitating the crisis or in which psychopathology significantly impairs or complicates adaptive resolution
- personality disorders, anxiety, bipolar, schizophrenia
Psychiatric emergency
A crisis in which general functioning has been severely impaired and the individual is rendered incompetent or unable to assume personal responsibility
- suicide, OD, acute psychoses, uncontrollable anger, alcohol intoxication
Crisis intervention
The minimum therapeutic goal of crisis intervention os psychological resolution of the individuals immediate crisis and restoration to at least the level of functioning that existed before the crisis period
Disaster nursing
A common feature of disasters is that they overwhelm local resources and threaten the function and safety of the community
Disasters leave victims with a damaged sense of safety and well-being and varying amounts of emotional trauma
Grieving is normal
