PsychiaPrelim 2 Flashcards

1
Q

The center for coordination and integration of all information needed to interpret and respond to environment

A

Cerebrum

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2
Q

The center for coordination of movements and postural adjustments

A

Cerebellum

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3
Q

Four lobes of the brain

A

Frontal lobe
Parietal lobe
Temporal lobe
Occipital lobe

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4
Q

Contains centers that control cardiovascular and respiratory functions, sleep, consciousness, and impulses

A

Brain stem

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5
Q

Regulates body temperature, appetite, sensations, memory, and emotional arousal

A

Limbic system

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6
Q

The process of communicating information among neurons by sending electrochemical messages from neuron to neuron

A

Neurotransmission

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7
Q

(Excitatory) control of complex movements, motivation, cognition, and regulation of emotional responses

A

Dopamine

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8
Q

Implicated in schizophrenia and other psychoses, Parkinson’s disease

A

Dopamine

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9
Q

Chemical substances manufactured in the neuron that aid in the transmission of information throughout the body

A

Neurotransmitters

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10
Q

Two types of neurotransmitters

A

A. Excitatory
B. Inhibitory

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11
Q

Parts of the brain stem

A
  1. Midbrain
  2. Pons
  3. Medulla
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12
Q

The types of major neurotransmitters

A
  1. Dopamine
  2. Norepinephrine
  3. Epinephrine
  4. Serotonin
  5. Histamine
  6. Acetylcholine
  7. Neuropeptides
  8. Glutamate
  9. GABA ( Gamma Amino-butyric Acid )
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13
Q

Changes in attention , learning and memory, sleep and wakefulness, and mood regulation

A

Norepinephrine

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14
Q

Controls fight or flight response in the PNS

A

Epinephrine

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15
Q

Excess implicates anxiety disorders, deficits contribute to memory loss, social withdrawal, depression

A

Norepinephrine and Epinephrine

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16
Q

( inhibitory ) control of food intake, sleep and wakefulness, temperature regulation, pain control, sexual behavior, regulation of emotions

A

Serotonin

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17
Q

Associated in anxiety, mood disorders, schizophrenia (withdrawn behavior, delusions,hallucinations)

A

Serotonin

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18
Q

(neuromodulator) peripheral allergic responses, control of gastric secretions, cardiac stimulation, alertness

A

Histamine

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19
Q

(excitatory or inhibitory) affects the sleep/wake cycle and signals muscles to become active

A

Acetylcholine

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20
Q

(neuromodulator) enhance, prolong, inhibit, or limit the effects of principal neurotransmitters

A

Neuropeptides

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21
Q

(excitatory) high levels can cause neurotoxic effects

A

Glutamate

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22
Q

Implicated in the brain damage caused by stroke, hypoglycemia, sustained hypoxia or ischemia, Huntington’s and Alzheimer’s

A

Glutamate

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23
Q

(major inhibitory) modulates other neurotransmitter systems rather than to provide a direct stimulus

A

GABA

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24
Q

Types of Brain Imaging Techniques

A
  • Computed tomography (CT scan) or Computed axial tomography (CAT scan)
  • Magnetic Resonance Imaging (MRI)
  • Positron Emission Tomography (PET)
  • Single Photon Emission Computed Tomography (SPECT)
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25
Types of Brain Imaging Techniques LIMITATIONS:
1. The use of radioactive substances in PET and SPECT 2. Imaging equipment is expensive to purchase and maintain 3. Some persons cannot tolerate due to claustrophobia 4. Some changes in disorders cannot be detected with current imaging techniques
26
- Serial x-rays of brain - Structural image - 20-40 minutes
Computed tomography (CT)
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- Radio waves from brain detected from magnet - structural image - 45 minutes
Magnetic Resonance Imaging (MRI)
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- radioactive tracer injected into bloodstream and monitored as client performs activities - functional - 2-3 hours
Positron emission tomography (PET)
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- radioactive tracer injected into bloodstream and monitored as client performs activities - functional - 1-2 hours
Single proton emission computed tomography (SPECT)
30
Neurobiologic causes of mental illness
1. Genetics and Heredity 2. Stress and Immune System (Psychoimmunology) 3. Infection
31
Studies commonly conducted to investigate the genetic basis of mental illness: Twin studies Adoption Family studies
Genetics and Heredity
32
A compromised immune system could contribute to the development of a variety of illnesses
Stress and Immune System (Psychoimmunology)
33
Existence to a virus during critical fetal development of the nervous system
Infection
34
Medication management is a crucial issue that greatly influences the outcomes of treatment for many clients with mental disorders
Psychopharmacology
35
Several categories of drugs used to treat mental disorders (psychotropic drugs)
- antipsychotics - antidepressants - mood stabilizers - anxiolytics - stimulants
36
Refers to the maximal therapeutic effect that a drug can achieve
Efficacy
37
Describes the amount of the drug needed to achieve that maximum effect; low-potency drugs require higher dosages to achieve efficacy, while high-potency drugs achieve efficacy at lower dosages
Potency
38
It is the time it takes for half of the drug to be removed from the bloodstream
Half-life
39
Responsible for supervising the testing and marketing of medications for public safety
US Food and Drug Administration (FDA)
40
A drug will prove effective for a disease that differs from the one involved in original testing and FDA approval
Off-label use
41
This means that package inserts must have a highlighted box, separate from the text, which contains a warning about the serious or life-threatening side effects
Black box warning
42
Formerly known as Neuroleptics
Antipsychotic drugs
43
Used to treat the symptoms of psychosis, such as the delusions and hallucinations seen in schizophrenia, schizoaffective disorder, and the manic phase of bipolar disorder
Antipsychotic drugs
44
Who is the author of Psychoanalytic / Psychodynamic Theories
Sigmund Freud
45
Sigmund Freud’s Psychoanalytic / Psychodynamic Theories
- Instincts (drives) produce energy. - There are genetically determined drives for sex and aggression. - Human behavior is determined by past experiences and responses. - All behavior has meaning and can be understood. - Emotionally painful experiences/ anxiety motivate behavior. - Client can change behavior and responses when made aware of the reasons for them.
46
Freud’s Developmental Stages
- Oral - Anal - Phallic - Latency - Genital
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Freud’s Theory of Personality
ID Ego Superego
48
Freud’s Theory of Personality - present at birth - instinctual drive for pleasure and immediate gratification - Libido - operates on pleasure principle - uses primary process thinking
ID
49
Freud’s Theory of Personality: - develops as sense of self that is distinct from world of reality - conscious, preconscious and unconscious - operates on reality principle - uses secondary process thinking by judging reality and solving problems
Ego
50
Functions of the Ego
- Controls and regulate instinctual drives - Mediates between ID drives and demands of reality; ID drives vs. Super ego restrictions - Reality testing - Stores up experiences in “memory” - Directs motor activity and actions - Solves problems - Uses defense mechanisms to protect self
51
Levels of Awareness
- Preconscious - Unconscious - Conscious
52
Levels of Awareness: Knowledge not readily available to conscious awareness but can be brought to awareness with effort
Preconscious
53
Levels of Awareness: Knowledge that cannot be brought into conscious awareness without interventions; the largest part
Unconscious
54
Levels of Awareness: Aware of own thoughts and perceptions of reality
Conscious
55
Freud’s Theory of Personality: Conscious awareness of acceptable/unacceptable thoughts, feelings and actions is “conscious”
Superego
56
The author of Behavioral Model
Ivan Pavlov and B.F Skinner
57
Ivan Pavlov: Classical Conditioning
- Behavior can be changed through conditioning with external or environmental conditions or stimuli - His experiment with dogs involved his observation that dogs naturally began to salivate (response) when they saw or smelled food (stimulus)
58
B.F. (Burrhus Frederic) Skinner: Operant Conditioning
- People learn from their history or past experiences, particularly those experiences that were repeatedly reinforced. - All behavior is learned. - Consequences result from behavior.
59
B.F. (Burrhus Frederic) Skinner: Operant Conditioning
- Behavior that is rewarded with reinforcers tend to recur. - Positive reinforcers that the behavior will recur. - Negative reinforcers that are removed after a behavior increase the likelihood that the behavior will recur.
60
The author of Interpersonal Theory
Harry Stack Sullivan
61
Harry Stack Sullivan’s Interpersonal Theory
- Infancy - Toddlerhood/Early Childhood - Pre-School - Young Adulthood - Later adulthood - Senescence
62
- Need for security - Learns to rely on others to gratify needs and satisfy wishes, develops a sense of basic trust, security and self worth when this occurs
Infancy
63
Child learns to communicate needs through use of words and acceptance of delayed gratification and interference of wish fulfillment
Toddlerhood/Early Childhood
64
- Development of body image and self-perception - Organizes and uses experiences in terms of approval and disapproval received - Begins using selective inattention and disassociates those experiences that cause physical or emotional discomfort and pain
Pre-School
65
Becomes economically, intellectually and emotionally self sufficient
Young Adulthood
66
Learns to be interdependent and assumes responsibility for others
Later Adulthood
67
Develops an acceptance of responsibility for what life is and was and of its place in the flow of history
Senescence
68
The author of Cognitive Theory
Jean Piaget
69
- 0-2 years - reflexes - imitative repetitive behavior - sense of object permanence and self separate from environment - trial and error results in problem solving
Sensorimotor
70
- 2-7 years - self-centered, egocentric - cannot conceptualize other’s view - animistic thinking - imaginary playmate - symbolic mental representation - creativity - 2-4 Pre-conceptual - 4-7 intuitive
Pre-Operational
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- 7-12 years - Logical concrete thought - Inductive reasoning - can relate, problem solving ability - reasoning and self-regulation
Concrete Operational
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- 12 years - above - abstract thinking - separation of fantasy and fact - reality oriented - deductive reasoning - apply scientific method
Formal Operational
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Humanistic Theory: The author of Human Motivation/Need Model
Abraham Maslow
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Hierarchy of needs in order of importance
1. Physiologic 2. Safety 3. Love and belonging 4. Esteem and recognition 5. Self-actualization
75
Human Motivation/Need Model (Maslow)
- Primary needs need to be met prior to dealing with higher-level needs - Focuses on provision of positive aspects
76
- Also known as EXISTENTIALISM - view of human beings as continually changing or becoming - Corey (2000) presents a summary of Six Major Existential Propositions
Existential Philosophy
77
Piaget’s four stages of Cognitive Development
1. Sensorimotor 2. Preoperational 3. Concrete operations 4. Formal operations
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The father of Psychoanalysis
Sigmund Freud
79
Roles of the Nurses in the Therapeutic Relationship
- Stranger - Resource person - Teacher - Leader - Surrogate - Counselor
80
Who wrote about the roles of the nurses in the therapeutic relationship?
Hildegard Peplau
81
Peplau also believed that the nurse could take on many other roles, including:
- consultant - tutor - safety agent - mediator - administrator - observer - researcher
82
Hildegard Peplau The phases of the nurse-client therapeutic relationship:
1. Orientation phase 2. Identification phase 3. Exploitation phase 4. Resolution phase
83
What phase is directed by the nurse and involves engaging the client in treatment, providing explanations and information, and answering questions?
Orientation Phase
84
What phase begins when the client works interdependently with the nurse, expresses feelings and begins to feel stronger?
Identification Phase
85
What phase the client no longer needs professional services and gives up dependent behavior. The relationship ends.
Resolution Phase
86
What phase the client makes full use of the services offered?
Exploitation Phase
87
- Patient’s problems and needs are clarified. - Patient asks questions. - Hospital routines and expectations are explained. - Patient harnesses energy toward meeting problems. - Patient’s full participation is elicited. - Patient responds to persons he or she perceives as helpful.
Orientation
88
- Patient feels stronger. - Patient expresses feelings. - Interdependent work with the nurse occurs. - Roles of both patient and nurse are clarified.
Identification
89
- Patient makes full use of available services. - Goals such as going home and returning to work emerge. - Patient’s behaviors fluctuate between dependence and independence.
Exploitation
90
- Patient gives up dependent behavior. - Services are no longer needed by patient. - Patient assumes power to meet own needs, set new goals, and so forth.
Resolution
91
Roles of the Nurses in the Therapeutic Relationship: - Offering the client the same acceptance and courtesy that the nurse would to any stranger
Stranger
92
Roles of the Nurses in the Therapeutic Relationship: - Providing specific answers to questions within a larger context
Resource person
93
Roles of the Nurses in the Therapeutic Relationship: - Helping the client learn either formally or informally
Teacher
94
Roles of the Nurses in the Therapeutic Relationship: - Offering direction to the client or group
Leader
95
Roles of the Nurses in the Therapeutic Relationship: -Serving as a substitute for another, such as a parent or sibling
Surrogate
96
Roles of the Nurses in the Therapeutic Relationship: - Promoting experiences leading to health for the client, such as expression of feelings
Counselor
97
Who developed the concept of the therapeutic nurse–patient relationship, which includes four phases:
Hildegard Peplau
98
was an American psychiatrist who extended the theory of personality development to include the significance of Interpersonal relationships.
Harry Stack Sullivan (1892–1949)
99
100
five stages of psychosexual development
- oral (birth to 18 months) - anal (18–36 months) - phallic/oedipal (3–5 years) - latency (5–11 years or 13 years) - genital (11–13 years).
101
a primary technique used in psychoanalysis, involves discussing a client’s dreams to discover their true meaning and significance.
Dream analysis
102
is constantly expanding our knowledge in the field of psychiatry and is significantly affecting clinical practice.
Neurobiologic research
103
Several important Neurotransmitters
- dopamine - norepinephrine - serotonin - histamine - acetylcholine - GABA - glutamate
104
is based on the ability of medications to eliminate or minimize identified target symptoms
Pharmacologic treatment
105
The following factors must be considered in the selection of medications to treat mental disorders: the efficacy, potency, and half-life of the drug; the age and race of the client; other medications the client is taking; and the side effects of the drugs.
106
are the primary treatment for psychotic disorders such as schizophrenia, but they produce a host of side effects that may also require pharmacologic intervention. Neurologic side effects, which can be treated with anticholinergic medications, are called EPSs and include acute dystonia, akathisia, and pseudoparkinsonism. Some of the more serious neurologic side effects include TD (permanent involuntary movements) and NMS, which can be fatal.
Antipsychotic drugs
107
Because of the serious side effects of antipsychotic medications, clients must be well educated regarding their medications, medication compliance, and side effects. Health care professionals must closely supervise the regimen.
108
Antidepressant medications
include cyclic compounds, SSRIs, MAOIs, and a group of newer drugs.
109
The nurse must carefully instruct clients receiving MAOIs to avoid foods containing tyramine because the combination produces a hypertensive crisis that can become life-threatening.
110
Pharmacologic treatment is based on the ability of medications to eliminate or minimize identified target symptoms.
111
The following factors must be considered in the selection of medications to treat mental disorders: the efficacy, potency, and half-life of the drug; the age and race of the client; other medications the client is taking; and the side effects of the drugs.
112
The risk for suicide may increase as clients begin taking antidepressants. Although suicidal thoughts are still present, the medication may increase the client’s energy, which may allow the client to carry out a suicide plan.
113
are used to stabilize mood, particularly in bipolar affective disorder.
Lithium and selected anticonvulsants
114
The nurse must monitor serum lithium levels regularly to ensure the level is in the therapeutic range and to avoid lithium toxicity. Symptoms of toxicity include severe diarrhea and vomiting, drowsiness, muscle weakness, and loss of coordination. Untreated, lithium toxicity leads to coma and death.
115
are used to treat a wide variety of problems related to anxiety and insomnia.
Benzodiazepines - Clients taking them should avoid alcohol, which increases the effects of benzodiazepines.
116
The primary use of stimulants such as methylphenidate (Ritalin) is the treatment of children with ADHD. Methylphenidate - has proved successful in allowing these children to slow down their activity and focus on the tasks at hand and their school work. Its exact mechanism of action is unknown.
117
Clients from various cultures may metabolize medications at different rates and therefore require alterations in standard dosages. ► Assessing use of herbal preparations is essential for all clients.
118
was a humanistic American psychologist who focused on the therapeutic relationship and developed a new method of client-centered therapy.
Carl Rogers (1902–1987) - Carl Rogers: Client-Centered Therapy
119
focuses on the role of the client, rather than the therapist, as the key to the healing process.
Client-centered therapy
120
Four Levels of Anxiety
- Mild anxiety - Moderate anxiety - Severe anxiety - Panic anxiety
121
is a positive state of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems. The person can take in all available stimuli (perceptual field).
Mild anxiety
122
involves a decreased perceptual field (focus on immediate task only); the person can learn new behavior or solve problems only with assistance. Another person can redirect the person to the task.
Moderate anxiety
123
involves feelings of dread or terror. The person cannot be redirected to a task; he or she focuses only on scattered details and has physiologic symptoms of tachycardia, diaphoresis, and chest pain. A person with severe anxiety may go to an emergency department, believing he or she is having a heart attack.
Severe anxiety
124
can involve loss of rational thought, delusions, hallucinations, and complete physical immobility and muteness. The person may bolt and run aimlessly, often exposing him or herself to injury.
Panic anxiety
125
focuses on a person’s positive qualities, his or her capacity to change (human potential), and the promotion of self-esteem. Humanists do consider the person’s past experiences, but they direct more attention toward the present and future.
Humanism
126
is a school of psychology that focuses on observable behaviors and what one can do externally to bring about behavior changes. It does not attempt to explain how the mind works.
Behaviorism
127
Rogers was one of the first to use the term client rather than patient.
128
The therapist takes a person-centered approach, a supportive role, rather than a directive or expert role, because Rogers viewed the client as the expert on his or her life. The therapist must promote the client’s self-esteem as much as possible through three central concepts:
1. Unconditional positive regard—a nonjudgmental caring for the client that is not dependent on the client’s behavior 2. Genuineness—realness or congruence between what the therapist feels and what he or she says to the client 3. Empathetic understanding—in which the therapist senses the feelings and personal meaning from the client and communicates this understanding to the client
129
involves removing a stimulus immediately after a behavior occurs so that the behavior is more likely to occur again. For example, if a client becomes anxious when waiting to talk in a group, he or she may volunteer to speak first to avoid the anxiety.
Negative reinforcement
130
can be used to help clients overcome irrational fears and anxiety associated with phobias.
Systematic desensitization
131
These behavioral principles of rewarding or reinforcing behaviors are used to help people change their behaviors in a therapy known as
Behavior modification
132
For example, if the desired behavior is assertiveness, whenever the client uses assertiveness skills in a communication group, the group leader provide
positive reinforcement - by giving the client attention and positive feedback.
133
believe that behavioral deviations result when a person is out of touch with him or herself or the environment. The person has self-imposed restrictions, criticizes him or herself harshly, and does not participate in satisfying interpersonal relationships.
Existential theorists
134
135
Founders of existentialism include:
- Albert Ellis (rational emotive therapy) - Viktor Frankl (logotherapy) - Frederick Perls (gestalt therapy) - William Glasser (reality therapy)
136
All existential therapies have the goal of returning the person to an authentic sense of self through emphasizing personal responsibility for oneself and one’s feelings, behavior, and choices.
137
- is a turning point in an individual’s life that produces an overwhelming response. Crises may be maturational, situational, or adventitious. Effective crisis intervention includes assessment of the person in crisis, promotion of problem-solving, and provision of empathetic understanding.
crisis
138
was a behaviorist who developed the theory of operant conditioning in which people are motivated to learn or change behavior with a system of rewards or reinforcement.
B.F. Skinner
139
help explain human behavior—both mental health and mental illness. There are several types of psychosocial theories, including psychoanalytic theories, interpersonal theories, humanistic theories, behavioral theories, and existential theories.
Psychosocial theories
140
believed that human behavior is motivated by repressed sexual impulses and desires and that childhood development is based on sexual energy (libido) as the driving force.
Freud
141
focused on both social and psychological developments across the life span. He proposed eight stages of psychosocial development; each stage includes a developmental task and a virtue to be achieved (hope, will, purpose, competence, fidelity, love, caring, and wisdom). Erikson’s theories remain in wide use today.
Erik Erikson’s theories
142
described four stages of cognitive development: sensorimotor, preoperational, concrete operations, and formal operations.
Jean Piaget
143
focused on development in terms of interpersonal relationships. He viewed the therapist’s role (termed participant observer) as key to the client’s treatment.
Harry Stack Sullivan’s theories
144
is a nursing theorist whose theories formed much of the foundation of modern nursing practice, including the therapeutic nurse– patient relationship, the role of the nurse in the relationship, and the four anxiety levels.
Hildegard Peplau
145
developed a hierarchy of needs stating that people are motivated by progressive levels of needs; each level must be satisfied before the person can progress to the next level. The levels begin with physiologic needs and then proceed to safety and security needs, belonging needs, esteem needs, and, finally, self-actualization needs.
Abraham Maslow
146
developed client-centered therapy in which the therapist plays a supportive role, demonstrating unconditional positive regard, genuineness, and empathetic understanding to the client.
Carl Rogers
147
Treatment of mental disorders and emotional problems can include one or more of the following: individual psychotherapy, group psychotherapy, family therapy, family education, psychiatric rehabilitation, self-help groups, support groups, education groups, and other psychosocial interventions such as setting limits or giving positive feedback.
148
An understanding of psychosocial theories and treatment modalities can help the nurse select appropriate and effective intervention strategies to use with clients.
149
The nurse–client relationship requires trust. Trust builds when the client is confident in the nurse and when the nurse’s presence conveys integrity and reliability. Trust develops when the client believes that the nurse will be consistent in his or her words and actions and can be relied on to do what he or she says. Some behaviors the nurse can exhibit to help build the client’s trust include caring, interest, understanding, consistency, honesty, keeping promises, and listening to the client. A caring therapeutic nurse–client relationship enables trust to develop, so the client can accept the assistance being offered.
Trust
150
Congruence occurs when words and actions match. For example, the nurse says to the client, “I have to leave now to go to a clinical conference, but I will be back at 2 PM,” and indeed returns at 2 PM to see the client. The nurse needs to exhibit congruent behaviors to build trust with the client.
Congruence
151
Trust is built in the nurse–client relationship when the nurse exhibits the following behaviors:
• Caring • Openness • Objectivity • Respect • Interest • Understanding • Consistency • Treating the client as a human being • Suggesting without telling • Approachability • Listening • Keeping promises • Honesty
152
When the nurse is comfortable with him or herself, aware of his or her strengths and limitations, and clearly focused, the client perceives a genuine person showing
genuine interest
153
is the ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client. It is considered one of the essential skills a nurse must develop to provide high-quality, compassionate care.
Empathy
154
Empathy versus sympathy
The nurse must understand the difference between empathy and sympathy (feelings of concern or compassion one shows for another). By expressing sympathy, the nurse may project his or her personal concerns onto the client, thus inhibiting the client’s expression of feelings. In the above example, the nurse using sympathy would have responded, “I know how confusing sons can be. My son confuses me too, and I know how bad that makes you feel.” The nurse’s feelings of sadness or even pity could influence the relationship and hinder the nurse’s abilities to focus on the client’s needs. Sympathy often shifts the emphasis to the nurse’s feelings, hindering the nurse’s ability to view the client’s needs objectively.
155
The nurse who does not become upset or responds negatively to a client’s outbursts, anger, or acting out conveys acceptance to the client.
Acceptance
156
The nurse who appreciates the client as a unique worthwhile human being can respect the client regardless of his or her behavior, background, or lifestyle. This unconditional nonjudgmental attitude is known as
positive regard
157
is the process of developing an understanding of one’s own values, beliefs, thoughts, feelings, attitudes, motivations, prejudices, strengths, and limitations and how these qualities affect others. It allows the nurse to observe, pay attention to, and understand the subtle responses and reactions of clients when interacting with them.
Self-awareness
158
are abstract standards that give a person a sense of right and wrong and establish a code of conduct for living. Sample values include hard work, honesty, sincerity, cleanliness, and orderliness. To gain insight into oneself and personal values, the values clarification process is helpful.
Values
159
The values clarification process has three steps:
choosing, prizing, and acting.
160
Choosing - is when the person considers a range of possibilities and freely chooses the value that feels right.
161
Prizing - is when the person considers the value, cherishes it, and publicly attaches it to him or herself.
162
Acting - is when the person puts the value into action.
163
are ideas that one holds to be true, for example, “All old people are hard of hearing, ” “If the sun is shining, it will be a good day, ” or “Peas should be planted on St. Patrick’s Day. ” Some beliefs have objective evidence to substantiate them. For example, people who believe in evolution have accepted the evidence that supports this explanation for the origins of life.
Beliefs
164