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Mental health- 405 > Study Guide 1 > Flashcards

Study Guide 1 Flashcards

1
Q

“The successful adaptation to stressors from the internal and external environment, evidenced by thoughts feelings and behaviors that are age appropriate and congruent with local and cultural norms”

A

Mental health

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2
Q

“Maladaptive responses to stressors from the internal or external environment evidenced by thoughts behaviors and feelings that are incongruent with the ind. social, occupational and or physical functioning”

-includes dysfunctional NT and behaviors

A

Mental illness

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3
Q

Mental health nursing assessment #1 Priority?

A

Safety
Suicide risk/assessment
Self harm/violence

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4
Q

What is Maslows level of highest achievement for mental health patients?

A

Self actualization-fulfillment of ones highest potential

-psychologically healthy, fully human, highly evolved, and fully mature

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5
Q

What are the 8 stages of Eriksons Theory of Development?

  • ineffective passage through one stage =impaired future development
  • TX is to go back for successful developmental passage
A
  1. Trust vs mistrust
  2. Autonomy vs shame and doubt
  3. Initiative vs guilt
  4. Industry vs inferiority
  5. Identity vs role confusion
  6. Intamacy vs isolation.
  7. Generativity vs stagnation
  8. Ego integrity vs despair
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6
Q
  1. Trust vs mistrust

Birth-18mo

A

Develop a basic trust in the no they fugue and learn to generalize it to others.

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7
Q
  1. Autonomy vs shame and doubt

18mo-3years

A

Gain some self control and independence within the environment

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8
Q
  1. Initiative vs guilt

3-6 years

A

Develop a sense of purpose and the ability to initiate and direct own activities

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9
Q
  1. Industry vs inferiority

6-12 years

A

Achieve a sense of self confidence by learning, competing, performing successfully and receiving recognition from others.

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10
Q
  1. Identity vs role confusion

12-20 years

A

Goal is to integrate the tasks mastered in previous stages into a secure sense of self

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11
Q
  1. Intimacy vs isolation

20-30 years

A

To form an intense lasting relationship or a commitment to another person, a cause or institution or a causative effort.

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12
Q
  1. Generativity vs stagnation or self absorbtion

30-65 years

A

Achieve the Life goals established for oneself while also considering the welfare of future generations

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13
Q
  1. Ego integrity vs despair

65- death

A

Review ones life And derive meaning from both positive and negative events, while achieving a positive sense of self.

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14
Q

“The combination of character, behavioral, temperament, emotional and mental traits tags are unique to each specific individual”

A

Personality Definition

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15
Q

“Respect for persons”

  • Person as a autonomous moral agent whose right to determine their destinies should always be respected
  • individuals are always capable of making decisions for them self
A

Autonomy

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16
Q

Ethical principles

A

Fundamental guidelines that influence decision making. The ethical principles are used frequently by health care worked to assist with ethical decision making.

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17
Q

What are the ethical principles?

A

Autonomy- respect for persons
Beneficence- duty to “do good to others”
Non maleficece- do no harm
Justice- right of individuals to be treated equally and treated with fairness
Veracity- ones duty to be truthful, tell the truth

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18
Q

Cognitive behavioral therapy (CBT) -Beck

A 
Teaches client new thinking 
Problem=distorted thinking=distorted behavior =trouble 
Tx is based on interrupting distorted thinking 
-deal with negative train of thoughts 
-focus on self control 
-coping process acquired by learning 
-short term, issue specific 
-measurable outcomes
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19
Q

CBT

A

Thought-behavior-emotion

  • tears distorted beliefs and changed way of thinking-reduces symptoms
  • “talk therapy”
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20
Q

CBT

A

1- build new skills that allow client to be aware of thoughts
2- teach skills provide alternative view points
3- goal is to improve feelings, thoughts and improve behavior changes towards positive self thinking
4- nurse utilized structural psychoeducational talk to assist client with problem solving

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21
Q

Prochaska and diclements stages of change

A 
Precontemplation 
Contemplation
Prepetation/determination 
Action 
Maintenance
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22
Q

Precontemplation

A

Client will discover and admit that they have a problem

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23
Q

Contemplation

A

Client will think and devise a plan that works for them

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24
Q

Preparation:determination

A

True commitment to change poor coping methods.

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25
Q

Action

A

Working phase and client will make changes to their negative behaviors

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26
Q

Maintenance

A

Client will preserve to practice. Positive changes in there life and follow up with HC professional

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27
Q

Nervous System

A

Peripheral nervous system

  • somatic
  • autonomic
  • —-sympathetic
  • —–parasympathetic
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28
Q

Autonomous nervous system contains..

Acetylcholine works here

A

Sympathetic and parasympathetic

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29
Q

Somatic nervous system

A

Skeletal muscle
Voluntary control of body movements
Sensory neurons carry impulses to the brain and spinal cord

30
Q 
Stressful situations 
"Fight or flight" 
Increase HR RR 
Increase blood supply to organs and muscle to ensure O2 supply 
Decrease gastric secretions/peristalsis
A

Sympathetic division of ANS

31
Q 
Localized response 
Relaxed/non stressful 
"Rest and digest" 
HR and RR normal 
Sexretions and peristalsis increase for normal digestion
A

Parasympathetic division of ANS

32
Q

“The process of being stored for reuse”
Process of NT inactivation by which the NT is reabsorb bed into the pre synaptic neuron of which released it.
Allows for more NT available for transmission
*anti depressants block the reuptake of serotonin/NTs

A

Reuptake of NTs

33
Q

Produces activity at the sympathetic post synaptic nerve terminal in the ANS= flight or fight response
-regulation of mood, cognition, perception, locomotion, cardiac fxn, sleep and arousal

A

Norepinephrine

34
Q

Sleep, arousal, libido, appetite, mood, aggressive, pain, perception, coordination, judgement.
Too little= risk for depression

A

Serotonin

35
Q

Sleep, arousal, pain perception, movement, memory, assist with REM sleep, works in ANS, memory acquisition, nerves and muscles

A

Acetylcholine

36
Q

Slows down body activities, inhibitory NT, slows/calms CNS,
too little=anxiety
Too much= cns depression
Increase gaba=calming effect

A

GABA

37
Q

Inhibitory NT, movement, coordinating, emotions, voluntary judgement, release of Prolactin
Too much= potential schizophrenia
Too little= Parkinson’s disease

A

Dopamine

38
Q

Artistic, emotional, spatial portion of brain

A

Right hemisphere

39
Q

Usually dominant, logical portion of the brain

A

Left hemisphere

40
Q

Part of the brain that regulates muscle tone and coordination and maintains positive equilibrium

A

Cerebrum

41
Q

Regulates anterior and posterior lobes of pituitary gland, exerts control over the ANS, regulates appetite and temperature

A

Hypothalamus

42
Q

What is known as the emotional Brain?

A

The limbic system

Associated with feelings of fear, anxiety, anger, rage, aggression, love joy hope and with sexual and social behavior.

43
Q

What is HIPPA and its purpose?

A

Client confidentially
Patient has right to their medical records
Access to mail phone visitors
Be informed of the rights in a comprehensible language
Referral to other health care upon D/C

44
Q

Suicide risk assessment

Risk factors

A 
Previous attempts 
Mental disorders-mood disorder 
Substance abuse
Family history of suicide 
Social, work, family, financial loss
45
Q

Suicide risk assessment

Interventions

A 
Don't leave person alone 
Develop no suicide contract 
Ensure safe home environment 
Establishing rapport and promote a trusting relationship 
Accept feelings in a non judgmental way
Discuss methods of control
46
Q

Voluntary admission

A

Individual signs self in to treatment
Can stay as long as needed
May sign out unless dangerous to self or others
*most common type

47
Q

Involuntary admission

A

Used in emergency situations for observation
Picked up by police or MH team, borough to ER
Dangerous to self or others
Mentally ill need treatment
Unable to provide own basic needs

48
Q

Right to refuse medication

The right to the least restricted treatment in the least restrictive environment

A

Granted by the patients bill of rights to refuse treatment and medications to the extent permitted by law

The least restrictive chemical interventions, seclusion, mechanical restraints

  • individual treatment plan
  • explanations of treatment
  • freedom from restraint/seclusion
  • humane treatment, safe from harm
49
Q

When the patent unconsciously displaces (transfers) to the nurse feelings formed toward a person from the past.

A

Transference

50
Q

What should a nurse do when a client is experiencing transference toward the nurse?

A

Assist the paying to sort out the past and the present and assign a new and appropriate meaning to the nurse-patient relationship.

51
Q

Nurses behavioral and emotion response to the client

A

Counter transference

52
Q

Assessment of mental health clients

A

A systematic dynamic process by which the RN through interaction with the patient and family collects and analyzes data.
-physical, psychological, spiritual, cognitive, functional, developmental and lifestyle.

53
Q

Nurse patient relationship stages

A

1-pre interaction: goal is to explore self perception
2- orientation/introductory: goal is to establish trust and formulate an intervention contract
3- working: promote client change
4- termination: evaluate goal achievement, ensure therapeutic closure

54
Q

Conditions to develop therapeutic nurse-patient relationship

A 
Rapport
Trust 
Respect 
Genuineness 
Empathy
55
Q

Introductory/orientation phase of the nurse-pt relationship

Opens the relationship
Develop rapport to
decrease patient anxiety

A 
Create trust rapport environment 
Contract for interventions 
Gather assessment data 
Identity pt strength and weakness
Formulate nursing dx
Identity/clarify problem 
Set mutually agreeable goals goals 
Develop realistic plan of action 
Explore feelings of pt and Nurse
56
Q

Working phase- patient nurse relationship

Nurse-patient work together to meet the patients goals
Phase won’t begin until trust and rapport are established

A

Maintain trust and rapport
Promote insight and perception of reality
Problem solving to work toward goals
Overcoming resistance
Continuously evaluate progress toward goal attainment

57
Q

What NT is associated with memory deficits and muscle weakness?

A

Acetylcholine

Increased levels- depression
Decreased levels- Alzheimer’s, PD, huntingtons disease

Myasthenia gravis is associated with muscle weakness
Damage to the cholinergic system in the brain has been shown with memory’s deficits and alz disease

58
Q

Unique patters of aberrant behavior and troubling experiences that occur in various parts of the world, whos clinical description do not readily fit into the western conventional nursing dx.

A

Cultural bound syndrome

59
Q

Interventions for cultural bound syndrome

A

Use interpreters
Allow family members to be around them
Ensure patients spiritual needs are met
Be aware of the differences among various cultures
Follow the practices that the patients view as essential
Be aware of stigma related to mental health

60
Q

What defines and influences cultures?

A

Beliefs practices values
Learned
Influenced
Acculturation

61
Q

The road to recovery is..

A

A stepwise process

62
Q

The recovery model

Steps

A 
Stage 1-moratorium
Stage 2- awareness 
Stage 3- preparation 
Stage 4- rebuilding
Stage 5- growth
63
Q

Components within each recovery stage

A

Hope: finding and maintains hope that recovery is possible
Responsibility: taking responsibility for ones life and well being
Self identify: renewing the sense of self and building a positive identity
Meaning and purpose: fining purpose and meaning in life

64
Q

What is the DSM V? What is its relationship with mental health?

A

The DSM V is a diagnostic tool that helps classify mental health disorders user by health professionals.
Using a multi-axial system

65
Q

DSM V Axis

A 
I- major clinical syndromes 
II- personality d/o, MR
III- general medical conditions
IV- psychosocial/environmental function 
V- global assessment function (GAF)
66
Q

*psychological and biological needs of the patient

The study of the biological foundations of cognitive, emotional and behavioral processes.

A

Psychobiology

67
Q

Goals of nurse patient relationship

A

Goals are mutually determined
Goals are defined in terms of the patients needs and are time limited and measurable
Select nursing interventions to move toward the goal

68
Q

Pre-interaction phase

Nurse-pt relationship

A

Before any interaction with the patient
Nurse examines own thoughts feelings and beliefs
Exploring support/needs
Includes these to facilitate nurse-or interactions

69
Q

Termination phase

Nurse-or relationship

A

Evaluate progress of goals
Review referral resources
Encourage expression of emotions
Ensure therapeutic closure

70
Q

Ability to use ones personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing interventions.

A

Therapeutic use of self

Mental health- 405 (4 decks)

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