PMHNP Expert Flashcards
Standard of practice
- think standard of care
- determined by the ANA
- Law requires NP to carry out car per criteria that other nurses would do in similar circumstances
- Way to judge the nature of care provided
- can be legally described
Scope of practice who sets the minimum requirements
- State and state board of nursing
- Questions stating to report to state board of nursing are usually correct, not reporting to supervisor or colleague
Standards of nursing practice examples
- assessment
- Diagnosis
- outcome identification
- planning
- Implementation -coordination of care, health teaching and health promotion, consultation, prescriptive authority
- evaluation
standards of professional performance
- quality of practice
- education
- professional practice evaluation
- collegiality
- collaboration
- ethics
- research
- resource utilization
- leadership
what could be done if person is uncomfortable in group setting although interpersonal learning could be advantagous
encourage attendance to group settings alongside individual therapy
Emeshment (simple definition)
- relationship involving 2 or more individuals with unclear boundaries
- may occur in countertransferance scenarios
Key function limbic system and where is it
- regulates and modulates emotions and memory
- takes shape of a closed fist in the middle of forebrain (largest region of brain)
- limbic means limbus = border. The components sit on the border above the brain stam and under the cerebral cortex
main structures of limbic system
- hypothalmus
- thalamus
- amygdala
- hyppocampus
- fornix
- cingulate gyrus
key roles of hypothalmus
WHAT HEC
* Water balance
* Hunger
* Appetite
* Temperature
* Hormones
* sEx/libido
* Circadian rhythm
Key roles of the amygdala
responsible for aggression, fear, ANXIETY, emotions and sense of smell (attach to memory)
hippocampus primary functions
involved in emotions, STRESS, learning, and memory (short term into long term)
Thalamus functions
major relay station between the senses and the cortex -processes sensory information (hearing, taste, sight, and touch) helps with memory, planning, and emotions
what is one of the first structures affected by Alzheimer’s disease
hippocampus
what does cyngulate gyrus do
plays a role in processing conscious emotional experience
what does the fornix do
an arch-like structure that connects the hippocampus to other parts of the limbic system
Cerebellum functions
- coordinates complex muscle movements (walking, hiking, playing ball) combines sensory information from eyes, ears, and muscles to help movement coordination
- balance and posture
- muscle tone
- issues with cerebellum loss of muscle coordination (ataxia)
anterior cingulate cortex
- part of cerebral cortex, found in medial portion of cerebral hemispheres
- Divided into anterior and posterior regions
- Anterior cingulate cortex (ACC) interconnected to limbic system and prefrontal cortex
- responsible for cognitive functions, decision making, empathy, impulse control, and emotions
- posterior cingulate (PCC) default mode network (DMN). regulates balance between internally and externally focused attention
corpus collusum and is the largest area of what in the brain
thick bundle of nerve fibers that connects the left and right hemispheres of the brain (largest white matter of the brain)
gray matter versus white matter of brain
- gray matter is found on the surface white matter is deeper
- gray matter is made up of cell bodies, processes information, controls movement, memory and emotions. It gets its gray color from cell bodies of neurons.
- white mater is made up of nerve fibers connects different regions of brain, which help with focus, learning, and problem solving and balance. Gets its white color from myelin sheaths that surround the nerve fibers, which helps protect them and transfer signals faster
what causes an elevates erythrocyte sedimentation rate (ESR)
- infections that affect blood, bone, heartm skin or lungs (TB, rheumatic fever and severe skin infections)
- Autoimmune disease like Lupus and RA
- cancer - leukemia, lymphoma and myeloma
- Other inflammatory conditions - temporal arteritis, polymyalgia rheumatica, inflammatory bowel disease
what can cause elevated cytokines
- they are signaling proteines that help control inflammation
- allow immune system to mount a response
- in excess lead to excessive inflammation and autoimmune dsease
can be caused by
any autoimmune disease, viral infection
Iatrogenic effect
another term for side effect
FDA issues sever warning for med what do you do
If patient is stable on med, assess risk versus benefits. Discuss with patient and document. Do not stop medication unless risk outweighs benefit.