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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
Action
Working phase and client will make changes to their negative behaviors
26
Maintenance
Client will preserve to practice. Positive changes in there life and follow up with HC professional
27
Nervous System
Peripheral nervous system - somatic - autonomic - ----sympathetic - -----parasympathetic
28
Autonomous nervous system contains.. | Acetylcholine works here
Sympathetic and parasympathetic
29
Somatic nervous system
Skeletal muscle Voluntary control of body movements Sensory neurons carry impulses to the brain and spinal cord
30
``` Stressful situations "Fight or flight" Increase HR RR Increase blood supply to organs and muscle to ensure O2 supply Decrease gastric secretions/peristalsis ```
Sympathetic division of ANS
31
``` Localized response Relaxed/non stressful "Rest and digest" HR and RR normal Sexretions and peristalsis increase for normal digestion ```
Parasympathetic division of ANS
32
"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
Reuptake of NTs
33
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
Norepinephrine
34
Sleep, arousal, libido, appetite, mood, aggressive, pain, perception, coordination, judgement. Too little= risk for depression
Serotonin
35
Sleep, arousal, pain perception, movement, memory, assist with REM sleep, works in ANS, memory acquisition, nerves and muscles
Acetylcholine
36
Slows down body activities, inhibitory NT, slows/calms CNS, too little=anxiety Too much= cns depression Increase gaba=calming effect
GABA
37
Inhibitory NT, movement, coordinating, emotions, voluntary judgement, release of Prolactin Too much= potential schizophrenia Too little= Parkinson's disease
Dopamine
38
Artistic, emotional, spatial portion of brain
Right hemisphere
39
Usually dominant, logical portion of the brain
Left hemisphere
40
Part of the brain that regulates muscle tone and coordination and maintains positive equilibrium
Cerebrum
41
Regulates anterior and posterior lobes of pituitary gland, exerts control over the ANS, regulates appetite and temperature
Hypothalamus
42
What is known as the emotional Brain?
The limbic system | Associated with feelings of fear, anxiety, anger, rage, aggression, love joy hope and with sexual and social behavior.
43
What is HIPPA and its purpose?
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
Suicide risk assessment | Risk factors
``` Previous attempts Mental disorders-mood disorder Substance abuse Family history of suicide Social, work, family, financial loss ```
45
Suicide risk assessment | Interventions
``` 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
Voluntary admission
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
Involuntary admission
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
Right to refuse medication The right to the least restricted treatment in the least restrictive environment
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
When the patent unconsciously displaces (transfers) to the nurse feelings formed toward a person from the past.
Transference
50
What should a nurse do when a client is experiencing transference toward the nurse?
Assist the paying to sort out the past and the present and assign a new and appropriate meaning to the nurse-patient relationship.
51
Nurses behavioral and emotion response to the client
Counter transference
52
Assessment of mental health clients
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
Nurse patient relationship stages
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
Conditions to develop therapeutic nurse-patient relationship
``` Rapport Trust Respect Genuineness Empathy ```
55
Introductory/orientation phase of the nurse-pt relationship Opens the relationship Develop rapport to decrease patient anxiety
``` 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
Working phase- patient nurse relationship Nurse-patient work together to meet the patients goals Phase won't begin until trust and rapport are established
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
What NT is associated with memory deficits and muscle weakness?
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
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.
Cultural bound syndrome
59
Interventions for cultural bound syndrome
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
What defines and influences cultures?
Beliefs practices values Learned Influenced Acculturation
61
The road to recovery is..
A stepwise process
62
The recovery model | Steps
``` Stage 1-moratorium Stage 2- awareness Stage 3- preparation Stage 4- rebuilding Stage 5- growth ```
63
Components within each recovery stage
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
What is the DSM V? What is its relationship with mental health?
The DSM V is a diagnostic tool that helps classify mental health disorders user by health professionals. Using a multi-axial system
65
DSM V Axis
``` I- major clinical syndromes II- personality d/o, MR III- general medical conditions IV- psychosocial/environmental function V- global assessment function (GAF) ```
66
*psychological and biological needs of the patient The study of the biological foundations of cognitive, emotional and behavioral processes.
Psychobiology
67
Goals of nurse patient relationship
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
Pre-interaction phase | Nurse-pt relationship
Before any interaction with the patient Nurse examines own thoughts feelings and beliefs Exploring support/needs Includes these to facilitate nurse-or interactions
69
Termination phase | Nurse-or relationship
Evaluate progress of goals Review referral resources Encourage expression of emotions Ensure therapeutic closure
70
Ability to use ones personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing interventions.
Therapeutic use of self

Mental health- 405 (4 decks)

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