psych exam 1 Flashcards
family/party files form with local magistrate describing patient’s symptoms and behavior. judge signs warrant and deputies take patient to jps for evaluation. person may be discharged, admitted voluntarily or have a CME filed.
magistrate’s warrant
is filed with the court and if the presiding judge signs, an order of proective custody is issued
CME
any creditable person that has knowledge of the person’s behavior
applicant
issued by judge after pt. is evaluated by a dr and a CME for menal illness is filled out and given to clerk
order of protective custody
involuntary admission
pts. 18 and younger
if thought to be danger to self, others or unable to perform self-care
must be converted to an order of protective custody or a voluntary admission or a pt. must be discharged after evaluation
application for detention
can be obtained by any peace officer
application for detention
treatment will be up to ___ days
90
person can be discharge before the 90 day commitment on a _______
furlough status
pt. can be returned to the hospital if…?
person decompensates before the end of the commitment
evaluated by a dr. and either return to jail or are admitted. admission must be voluntary. officer or deputy remain w/ pt. until a disposition is made
county hold
voluntary patient may….
be discharged by treatment team
request to be discharged
if discharge is requested
pt. must be evaluated within 4 hours
if dr. thinks pt. could be a danger to self or others or unable to perform self care
dr. can initiate paperwork for involuntary admission
persons with mental illness are guaranteed the same rights under
federal and state law as any other citizen
Rights of citizen/patients
vote enter into contractual agreement religious freedom legal counsel informed of research and refusal to participate send and recieve mail be present for inspection of mail partic. in planning treatment
protected under HIPAA
receive treatment and have medical records kept confidential
pt.’s permission must be obtained to share info with
persons who are not directly involved in care
exceptions to confidentiality rule
duty to warn and protect 3rd parties
notify secret service of threats
report child and elder abuse
cannot administer psychotropic drugs w/o
patient’s informed consent
informed consent
nature of problem purpose of medication risks/benefits of med alternative treatment options probability of success risks if not consenting treatment
don’t need informed consent in which 2 instances
pt. behavior out of control
judge issues an order to administer med w/o consent after a med. commitment hearing
last resorts in behavioral interventions
seclusion and restraint
levels of seclusion and restraint
talking to pt. moving pt. to less stimulating setting prn med seclusion restraint
use of seclusion or restraint
requires a writen order
restraint order must be
for a limited time period
specify seclusion or type of restraint
nurse can ptu a pt in seclsion/restraint
emergency conditions
obtain an oder as soon as possible post incident
everytihbng in regard to incidnet
must be fully documented
pt. must be told why
the seclusion/restraint was initiated
what behavior need to be changed to be released
contraindication to seclusion or restraint
unstable delirium or dementia suicidal overdoses convenience of staff to punish a patient
threat to use force, no contact
assault
offensive touching of another person
battery
inappropriate seclusion, confining a person to a speific area
false imprisonment
act or omission to act that results in injury to the pt
negligence
capacity of nure to assume safe care of pt
duty
conduct that exposed pt to risk of harm
breach of duty
except for what the nurse did or didn’t do, would this injury have occurred
cause in fact
were there any intervening actions or persons taht were in fact causes of harm to the patient?
proximate cause
loss of earnings, medical expenses
damages
5 elements required to prove negligence
duty breach of duty cause in fact proximate cause damages
3 precautions r/t pt. safety
suicide
elopement/AWOL
assault
check w/ staff before you
hand out anything
3 staff safety precaustions
training
least restrictive means
working as a team
student safety
stay in day area don't go in a pt. room psotiion around exit no long cord wearing stud earrings
dopamine
fine muscle movemen
integration of emotions/thoughts
decision making
hormonal release by hypothalamus
NE
mood
fight or flight
5-HT
sleep regulation hunger mood pain perception aggression sexual behavior
GABA
inhibition reduces aggression/excitation/anxiety pain perception anticonvulsant properties muscle relaxant properties
Ach
assists in learning, memory
regulates mood: mania, sexual aggression
stimulates PNS
order of brainstem
midbrain
pons
medulla oblongata
emotions
learning
memory
basic drives
amygdala
hippocampus
regulates basic drives
links higher brain activities and internal organs
hormonal secretions
hypothalamus
4 A’s of schizo
affec
associative looseness
autism
ambivalence
assessment for ____ is crucial in those with schizo
why?
depression - impending relapse, increases suicide risk
3 nursing diagnosis for positive symptoms
disturbed sensory perception
risk for self-directd or other directed violence
disturbed thought processes
2 nursing diagnosis for negative symptoms
social isolation
chronic low self-esteem
patient safety and medical stabilization
acute phase
adhere to treatment
stabilize meds
control or cope with symptoms
stabilization phase
maintain achievement
prevent relapse
achieve independence, satisfactory quality of life
maintenance phase
shared beliefs, values and practices that guide a group’s members in patterned ways
culture
culture helps develop what is ___ and ____
normal
abnormal
more related to economic and social standing
minority
used to categorize people in social and political ways rather in biological mode
race
for mental health nurses, it is better to focus on ___ rather than on ____
ethnicity rather than on race
members of a cultural group are introduced to cultural worldview, beliefs, values and practices
enculturation
degree wo which a person fulfills the expectations of the culture
mental health
belief that one’s own group is superior
ethnocentrism
key to mental health care
communication
lifetime commitment to self-evaluation and criique of one’s level of culural awareness
3 cultural intersections during an encounter with a patient
ability to perform a cultural assessment in a sensitive way
cultural skill
genuine concern for pt. welfare and a willingness to listen to each pt’s viewpoint
cultural desire
