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Behavioral Health > Quiz #2 Chapters 7, 8, 9, 10 > Flashcards

Quiz #2 Chapters 7, 8, 9, 10 Flashcards

1
Q

Nursing process

A
  1. Assessment
  2. Nursing diagnosis
  3. Outcome
  4. Planning
  5. Implementation
  6. Evaluation
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2
Q

Types of assessment

A

Review of systems
Laboratory data
Mental status examination (MSE)
Psychosocial assessment
Spiritual assessment
Self awareness assessment
Validating assessment

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3
Q

Review of systems

A

Ex: physical exam taken by the primary care doctor
Obtaining vital signs, historical review of body systems

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4
Q

Laboratory Data

A

Blood tests to differentiate between a mood disorder and that of an illness
Ex: hyperthyroidism can appear to be magic phase of bipolar disorder. So blood test can rule this out.

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5
Q

Mental Status Examination (MSE)

A

Differentiating between systemic condition and psychiatric disorders
Example: delirium and dementia

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6
Q

Psychosocial assessment

A

Obtains the following about the patient
ex:
Central or chief complaint
History of violent behavior
Alcohol and or substance abuse
Family psychiatry history
Current stressors and coping methods

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7
Q

Spiritual assessment

A

Religious beliefs can have an influence on how ppl understand the meaning and purpose in their lives. And how they use their judgment to solve problems

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8
Q

Self-awareness assessment

A

Positive trait
Being consciously aware of our personal biases
Examine how you are feeling at the moment before an interview
Our feelings can affect the way we feel about a pts response

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9
Q

Validating assessment

A

Asking a patient why they were admitted to get validation

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10
Q

Nursing Diagnosis

A

Actual
Risk
Health promotion (for patients who are ready to go home)

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11
Q

Outcome identification

A

Use SMART goals
Specific, measurable, achievable, realistic, and timely

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12
Q

Step 4: Planning

A

This is where we will plan on what to do

Example:
Planning to have a one to one sitter for a patient who is planning to suicide.
This always depends on priority.

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13
Q

Step 5: implementation

A

Implements the plan using evidence-based interventions whenever possible.
Mileu therapy should be done for every patient (structuring the environment to affect behavioral changes improve psychological health and functioning) it also includes orienting patients to their rights and responsibilities
- ex: lowering the lights to lower stimuli (they should always be maintained in the least restrictive environment.
Therapeutic relationship/counseling

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14
Q

Step 6: Evaluation

A

Is the treatment working?
Ongoing assessment of data allows for revisions of nursing diagnoses, or changes to more realistic outcomes

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15
Q

Documentation

A

Use the term “NONADHERENCE” Instead of “NONCOMPLIANT”
NONCOMPLIANT has negative connotations while nonadherent makes us want to figure out what is wrong with the clients ability to take the medication

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16
Q

Factors that affect communication

A

Personal factors
Environmental factors
Relationship factors

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17
Q

Personal factors

A

Emotional factors : mood, responses to stress
Social factors : previous experience, cultural differences, language differences
Cognitive factors : problem solving ability, knowledge level

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18
Q

Environmental factors

A

Physical factors : background noise, lack of privacy
Societal determinants : economic factors, presence of others, expectations of others

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19
Q

Relationship Factors

A

Being comfortable talking to strangers.
Naturally we have prejudices. Our duty is to guard against negative feelings towards others who seem different from us.

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20
Q

Nonverbal communication

A

Is the bulk of our communication
Ex: facial expressions, body posture, hand movements
Tone and pitch

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21
Q

Congruent Message

A

If the verbal and nonverbal messages are matching
Ex: a student says that they need to get good grades (content) and if the student skims through nursing textbook (process, the message is congruent

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22
Q

Noncongruent messages

A

When verbal and nonverbal messages do not align
(Words do not match the actions)

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23
Q

Use of Silence

A

Is not the absence of communication it is a channel for transmitting and receiving messages.
Used for listening
Provide meaningful moments

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24
Q

Active listening

A

Includes the following:
Observing the patients nonverbal behaviors
Listening and understanding
Listening for “false notes” (inconsistencies with what the pt says
Providing the patient with feedback

25
Q

Clarifying techniques

A

Verifying the patients messages

Ex:
“I’m not quite sure what you were saying. Did you say you are not going to group tonight”

Helps identify and correct misperceptions

26
Q

Closed ended questions

A

Questions that have yes or no answer

Example: “did you sleep well today?”

Instead ask
“How was ur sleep”

27
Q

Giving advice

A

This method is nontherapeutic
Ex: you should break up with your boyfriend

Instead say:
What are the pros and cons of your situation

28
Q

False reassurance

A

Saying “everything will be alright” this can belittle the patients feelings and give false hope

Instead say
“What do you think could go wrong” this is clarifying why the patient feels the way they feel

29
Q

Asking “Why?” Questions

A

“Why did you stop taking your medications” this statement implies blame and patient will feel defensive. Avoid “how” questions as well.

Instead ask “tell me some of the reasons that led you to not taking your medication” this is an example of giving broad openings

30
Q

Minimizing feelings

A

“I know what you mean” statements doesn’t allow the attention to focus on the patient

Instead empathize with the patient
“You must be feeling upset”

In cases you can say “I went through something similar” but then always follow up saying “it must have been hard”

31
Q

Making value judgements

A

“How come you are still smoking when your wife has lung cancer?”
Instead make observations by saying “I see you are still smoking even though your wife has lung cancer”

32
Q

Validating and exploring

A

If patient states “id like to die”
Say “this sounds serious, have you thought about harming yourself” it is important to always address what the patient states.

33
Q

Telehealth technologies

A

Electronic means of communication such as video conferencing
Allow for maintaining therapeutic relationships
Remote physical assessment and consults

34
Q

Facilitating

A

Communication of distressing thoughts and feelings

35
Q

Assisting

A

Patients with problem solving to help facilitate activities of daily living

36
Q

Helping

A

Patients examine self defeating behaviors and test alternatives

37
Q

Promoting

A

Self care and independence

38
Q

Social vs therapeutic relationship

A

Social relationship can be defined as a relationship that is primarily initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task.

Includes giving advice

39
Q

Boundaries

A

Patients needs are separated from the nurses needs
Blurring of boundaries can be caused by
-when the relationships slips into a social context
Ex: over helping: doing for patients what they are able to do themselves
controlling: asserting authority and assuming control of patients “for their own good”
narcissism”: needing to find weakness in patients to feel helpful

40
Q

Transference

A

A person unconsciously and inappropriately displaces patterns of behavior and emotional reactions toward another person

Ex: patient states “you remind me of my mom”

41
Q

Countertransference

A

Refers to the tendency of the nurse to displace onto patients feelings relate to ppl in her past.

Ex: if the nurse is struggling with an alcoholic family member, they may feel disinterested or disgusted towards an alcoholic patient. 

42
Q

Pre-orientation phase

A

Information regarding the first clinical phase

43
Q

Orientation phase

A

First time nurse and patients meet
Initial interview
- establishing rapport

44
Q

Working phase

A

Maintain the relationship
Gather further data
Promote the patients problem solving skills
Facilitate behavioral change

45
Q

Termination phase

A

Discuss ways to incorporate skills into life
May occur at discharge

46
Q

Consistency

A

Ensuring that a nurse is always assigned to same patient

47
Q

Pacing

A

Letting the patient set the pace and letting it fit the patients mood

48
Q

Listening

A

Letting the patient talk when needed

49
Q

Initial impressions

A

Positive attitude helps develop therapeutic alliance

50
Q

Comfort and control

A

Promoting patient comfort and balancing control
Not too strict and not too lenient

51
Q

Patient factors

A

Trust on the part of patient
Patients active participation in the relationship

52
Q

Factors that enhance growth

A

Genuineness
Empathy
Positive regard: viewing another person as being worthy of caring about

53
Q

Stress response

A

“Fight or flight” response
Immediately ready to meet a threat or stressor

54
Q

PTSD

A

Can occur in individual who has had trauma severe enough to be outside the range of normal human experience

55
Q

PTSD symptoms

A

TRAUMA
T = traumatic event
R =Re-experiencing trauma: flashbacks, nightmares
A = avoidance: attempting to avoid anything that might cause recall of the event
U = unable to function
M = month long symptoms
A = arousal increased : irritability, angry outbursts, self-destructive behavior, exaggerated startle response

56
Q

Risk factors

A

Age of traumatic event
Female
History of psychiatric illness
Lower educational level

57
Q

Acute stress disorder

A

Resolve within a month
Precipitating traumatic events are the same as PTSD

58
Q

Compassion fatigue

A

Aka secondary traumatic stress
Nurses and other health care workers become indirectly traumatized when trying to help someone who has experiences traumatic stress

59
Q

Symptoms of compassion fatigue

A

Inability to function
Difficulty separating work from personal life
Dread of working with certain individuals
Depression
Insomnia
Loss of hope
Images of another’s critical experience

Behavioral Health (8 decks)

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