SP22 Final Exam Flashcards
What is the most important therapeutic factor when providing in providing nursing care to clients with mental illness?
Positive, unconditional regard; nonjudgmental attitude
What should a nurse do if a patient asks about personal information (e.g., dating interests)?
Set limits and maintain boundaries
Token economy
Environments where there are clear rewards (and the removal of rewards) for desired behavior
What is the ego defense mechanism (e.g., rationalization, denial, suppression, displacement, etc.)? Can you recognize them?
Ego is the balancing or mediating force between ID and superego
Ego defense mechanism: Rationalization
Excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-respect
Ego defense mechanism: Denial
Failure to acknowledge an unbearable condition; failure to admit the reality of a situation
Ego defense mechanism: Suppression
Conscious exclusion of unacceptable thoughts and feelings from conscious awareness
Ego defense mechanism: Displacement
Ventilation of intense feelings toward persons less threatening than the one who aroused those feelings
What is milieu therapy?
Clients interaction with one another, including practicing interpersonal relationship skills, giving one another feedback about behavior, and working cooperatively as a group to solve day-to-day problems
What is the purpose/benefit of partial hospitalization programs?
Build communication and social skills, problem solving, monitoring medications, learning coping strategies and skills for daily living
Why are multidisciplinary teams important in mental healthcare?
Different members of the team have expertise in specific areas; by collaborating, they can meet patients needs more effectively
What are examples of advocating for a patient?
- ensuring privacy and dignity
- promoting informed consent
- preventing unnecessary exams and procedures
- accessing needed services and benefits
- ensuring safety from abuse and exploitation
What is boundary blurring? Examples?
Losing the nurse-patient relationship; crossing boundaries
-Ex. forming an intimate relationship with a patient
What is the first priority in the “orientation” phase of the nurse-patient relationship?
Form good rapport
What is assertiveness training? Examples?
The ability to express positive and negative ideas and feelings in an open, honest, and direct way
-Ex: “No I can not work for you”
“I do not like when you do that”
What is the best way to communicate with a patient during severe anxiety?
Use concrete messages-use words that are as clear as possible, need no interpretations
What is resilience?
having healthy responses to stressful circumstances or risky situations
What is culturally competent care?
Being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, etc
What should a nurse do when attempting to provide culturally competent care to a patient from a different racial or cultural group?
Learn about other cultures and become skilled at providing care to people with cultural backgrounds that are different from their own. Ask patient how nurse can promote spiritual, religious and health practices, recognize own feelings and possible prejudices
Affect
Outward expression of patients emotional state
Blunted affect
Showing little or slow-to-respond facial expressions
Flight of ideas
Excessive amount and rate of speech composed of fragmented or unrelated ideas
Judgment
Ability to interpret one’s environment and situation correctly and to adapt to one’s behaviors and decisions accordingly
Insight
Ability to understand the true nature of one’s situation and accept some personal responsibility for that situation
Suppose a nurse learns a client hasn’t been taking their medications. What should be the nurse’s initial response?
Inquire about the why
What might be a sign that a patient is hallucinating?
They say they hear voices, see things that are not there
If a client makes a credible threat to harm another person, can a nurse breach confidentiality?
Yes-safety to others and self is the first priority. Duty to warn
Suppose a client is involuntarily hospitalized because they are a danger to others. What rights (if any) does the client lose?
Right to freedom (the ability to leave the hospital when he or she wishes)
What is the ethical principle called autonomy? What is an example of a nurse advocating for it?
Refers to a person’s right to self-determination and independence.
-Ex: Encourage patients to make choices about his or her own health
What are the Kübler-Ross’s stages of grieving?
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
What is disenfranchised grief? How might a nurse experience it?
Grief over a loss that is not or cannot be acknowledged openly, mourned publicly or supported socially
-A nurse might experience it if she works in organ donation or is involved intimately with the death of patients who may donate organs to another person
What are behavior limits and when are they needed?
Limits placed on behavior, they are needed when patients are crossing boundaries, becoming physically aggressive, etc
What should a nurse do if a verbally aggressive client refuses to take a time out? What’s the next step?
Ensure a show of strength- gather more staff
What are examples of therapeutic statements to a rape victim?
- “You have a right to be safe and respected”
- “The rape is not your fault”
What should a nurse do if child abuse is suspected?
The nurse is mandated to report it; thorough documentation of assessment data
When might a nurse recommend a women’s shelter?
When her abuser violates an OP and they feel unsafe
What are the key symptoms of PTSD?
reexperiencing trauma through dreams or recurrent and intrusive thoughts; showing emotional numbing such as feeling detached from others; and being on guard, irritable, or experiencing hyperarousal
-experiences dreams, flashbacks, reactions to external cues about events
What childhood experiences sometimes are present in clients who have dissociative identity disorder?
Sexual and physical abuse
What is the priority when caring for a client recently sexually abused?
Continually assess the patient’s potential for self-harm or suicide and take action accordingly
Who can develop PTSD?
Anyone who has experienced a traumatic event