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nursing 233 > P1 Mental Health Act/Assessments- notes and pp > Flashcards

P1 Mental Health Act/Assessments- notes and pp Flashcards

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1
Q

what are the 4 domains?

A

biologic, psychological, spiritual, and social

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2
Q

Which domain is the focus of pharmacological agents and electroconvulsive therapy under?

A

Biologic Domain

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3
Q

The psychological domain contains the theoretical basis of what processes?

A

thoughts, feelings, and behaviour.

Also influences ones emotion, cognition, and behaviour.

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4
Q

Cognitive approaches, behaviour therapy and client education are all based under theories of this domain ______.

A

Psychological domain

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5
Q

Spiritual activity involves what? (spiritual domain)

A

introspection, reflection, and a sense of connectedness to others or the universe

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6
Q

Is spiritual just religion?

A

No. may be spiritual but not religious. spirituality is relational in nature.

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7
Q

what does standard one: Provides competent professional care through the development of a therapeutic relationship encompass?

A

The development of the relationship is the foundation where the nurse can enter into partnerships with clients and through the use of human sciences, and the acrt of caring, develop helping relationships

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8
Q

what does Standard 2: Performs, refines client assessments through the diagnostic and monitoring function encompass?

A

1nurse explains the assessment process and provides feedback. Knowledge is integrated with the nurses conceptual model of nursing practice, which provides a framework of processing client data and for developing client focused plans of care.

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9
Q

what does standard 4: effectively manages rapidly changing situations include?

A

risk factors for self harm, aggressive behaviour and rapidly changing meant and physical health status

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10
Q

which standard does this go under: Nurse has a responsibility to advocate for clients right to, to receive the least restrictive form of care and to respect and affirm clients right to self-determination in a safe and equitable manner?

A

Standard 5: Monitors and ensures the quality of health care practices

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11
Q

what are some added standards in mental health nursing in comparison to the standards of nursing? (what are the mental health standards)

A

S1: provide competent profession care through the development of a therapetuic relationship (kind of like client focused care)

S2: performs, refines client assessments through the dx and monitoring fx (maybe like evidence based?)

S2: adminsters and monitors therapeutic interventions (evidenced base kinda?)

S4:Effectively manages rapidly changing situations

S5: intervenes through the teaching-coaching function

S6: monitors and ensures the quality of health care practices (client focused- advocate for pt)

S7: practices effectively within organization and work-role structire

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12
Q

what are critical pathways used for?

A

ensures quality level of care in a cost effective way

used for clients with typical symptoms and follow an expected course of treatment

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13
Q

what is the most prevelant misconception about mental illness?

A

that the patient is dangerous or violent

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14
Q

T or F:
prejudice is the differential treatment of others bc they are members of a particular group or identified as being negatively differnent?

A

F.

that is the defn for DISCRIMINATION

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15
Q

what is the definition of prejudice?

what can nurses do about this?

A

hostile attitude towards others bc they belong to a particular group that is considered to have objectionable characteristics

must acknowledge and examine their biases in preparation of care.

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16
Q

what is stigma?

what is a barrier to?

A
  • Stigma is a form of prejudice that spreads fear and misinformation, labels individuals and perpetutates stereotypes
  • It can be a barrier to all aspects of life; it limits access to employment, housing, education and health care.
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17
Q

what are the two types of assessments?

A

comprehensive assessment and focused assessment

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18
Q

what are some assessment techniques ?

A

observation (verbal and nonverbal, hygiene)

examination (biological stuff-hormone cycles, meds, MSE)

Interview

Collaboration

Domains

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19
Q

what is included in the psychological domain

A

manifestations of pMH problems, mental status, stress and coping and risk assessment

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20
Q

what exam can you do in the psychological domain??

A

MSE - • Systematic assessment of an individuals appearance, affect, behavior, and cognitive processes

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21
Q

what might you look for in general observations?

A

appearance (dress, hygiene, tattoos, skin piercings)

psychomotor behaviour (posture, gait, facial expression)

attitude toward interview (accommodating, cooperative)

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22
Q

whats the difference between emotion and mood?

A

emotion is an individuals experience of a feeling or state

mood is pervasive and sustained emotion that colours the persons perception of the world. so…
mood is what they report about their emotional state

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23
Q

what is euthymic?

A

normal mood

24
Q

what is euphoric

A

elated mood

25
Q

what is dysphoric mood?

A

depressed, disquieted restless

26
Q

what kind of affect does an individual have if they seek out a recent tragic death in a monotone voice?

A

constricted affect

27
Q

stability of affect can be described as what?

A

mobile (normal) or labile

28
Q

if someone displays a wide range of strong emotions they are considered what (in regards to affect?)

A

labile

29
Q

speech characteristiics are described in terms such as:

A

quantity, rate, and fluency of production and quality

30
Q

what are examples of different kinds of quantity’s of speech?

A

talkataive, verbose, subdued, reticent, or taciturn

31
Q

what is pressured speech?

A

rapi dna inc amount. difficult to understnad

32
Q

what are aphasic disturbances?

A

problems of speech output (may be neuralgic, cognitive or emotional)

33
Q

what are two disturbances associated with mental illness?

A

hallucinations and illusions

34
Q

what are hallucinations

A

false sensory perceptions not associated withe external stimuli. may be stimulated by auditory, visual, tactile, olfactory, or gustatory. auditory most common

35
Q

what are illusions

A

misperception of real sensory stimuli

36
Q

what does the MMSE evaluate?

A

orientation, memory, calculation, reading, visuospatial ability, language

37
Q

what will you assess in the “sensorium” aspect of the psychological assessment

A

GCS (LOC), MMSE, orientation, memory (immediate retention and recall, recent, short term or remote long term)

38
Q

what differentiates the questions you would ask for:
recent memory
short term
long term

A

o Recent memory: ask about about what they have done the past few hours
o Short term: what they have done past weeks/moths
o Long term: what they did a year ago

39
Q

what is insight/

A

understand the reality of a set of circumstances

40
Q

what is suicidal ideation?

A

thoughts about deliberate self-harm or self-inflicted death

41
Q

what are two ways someone can admit into the hospital

A

voluntary and involuntary

42
Q

when can voluntary patients discharge themselves?

A

anytime

43
Q

how long are involuntary patients detained for?

A

48 hours- one physician

one calendar month - 2 physicians (section two you- pink form)

44
Q

what is the criteria for involuntary admission?

A

suffering from mental disorder that impairs ability to act appropriately

requires psych treatment

requires care and supervision or for protection against self and others

not suitable as a voluntary patient

45
Q

who can intervene to get someone in the hospital?

A

physicians - sec 22 form 4
police sec 28
judges - sec 28, form 9

46
Q

does the pt have the right to refuse medications if they are in for psych treatment?

A

no

47
Q

is consent necessary for involuntary patients? can you refuse medications?

what do you have the right to?

A

no and no. you can refuse meds for anything else.

you have the right to know the risks, side effects and benefits of the treatment.

48
Q

what rights do involuntary patients have?

A

the right to receive info about their rights

second medical opinions

the right to review panel hearings

the right to apply to the courts

49
Q

what are the nurses responsibilities for psych treatment? **important

A

provide information to patients/parents of U16

assess understanding

provide an opportunity for questions

re-infrm when the patient is more able to understand

provide patients with Form 13 (their rights) and ask them to sign r provide reasons why the patient did not sign

50
Q

what might you assess in the biologic domain?

A 
meds, OTC, 
risky beahviour- sex, sti
other medical conditions ruled out (anemia, hypo/hyperthyroidism)
sleep
weight
vs
labs
malnutrition
hypothermia
dehydration
51
Q

how much you intervene in regards to the biological domain

A 
sleep-private quiet room
nutrition- reminding to eat, easier food (high energy food) 
water- bring it to them
treat hypothermia
limit stimuli that promote
agitation
watch side effects
medications
personal hygiene
52
Q

what assessments would you do for the psychological domain?

A 
coping- poor coping
what are their thought process/content
ability to manage stress
comprehension
judgment
conentration/attention span
defensive coping
risk for suicide
violence towards others
53
Q

how might you intervene in regards to the psychological domain?

A 
reintroduce yourself often
calm mannerism
dec env't triggers
inc monitoring
establish baseline
pharmacoloy
understanding pt thought process
maintain pt safety
understand what triggers them and stop that cascade
54
Q

what assessments might you do for the social domain?

A 
support systems
family structure
family might need support
emplyment
housing
sexual activity- changes?
expenditures
55
Q

how much you intervene in the social domain?

A

involve social work
family meetings
community or hospital support groups
rooming arrangements

56
Q

what assessments might you do in the spiritual domain?

A

start convo about spirituality
identify with certain faith/belief system
do you consider it important in your life
changes in b relief system?
do you feel hopeless, despair, change in mood?
any traumatic life event that lead you to a need of spiritual guidance?

57
Q

how might you intervene in the spiritual domain?

A

meditation
nature plan for managing recurrent symptoms
quieter env’t
encourage prayer, rituals

nursing 233 (4 decks)

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