terminology ch 1, 2 Flashcards
attending
refers to an intensity of presence, being there for and in tune with the pt. (this minimizes the pt’s sense of isolation)
patient advocate
not a legal role but an ethical one
one who speaks up for another’s cause who helps others by defending and comforting them, esp when the other person lacks the knowledge, skills, ability or status to speak for himself/herself.
caring
the most natural and most fundamental aspect of human existence-involves how we relate to each other, how we show concern for each other in our daily life.
clinical algorithms
step by step guidelines prepared in a flowchart format. especially helpful in deciding what medications to use considering a wide variety of variables related to the pt’s personal situation (age, gender current meds, ethnic origin, allergies)
clinical/critical pathways
usually specific to the institution using them, used in relation to a specific population and serve as a “map” for specified treatments and interventions to occur within a specific time frame, often days.
clinical practice guidelines
systematically developed statements that identify, appraise and summarize the best evidence about prevention, diagnosis, prognosis, therapy, and other knowledge necessary to make informed decisions about specific health problems. The APA (american psychiatric association’s) clinical practice guidelines and the National quality measures clearinghouse offer such guidelines. US dept of health and human services sponsors a national guidelines pertaining to a wide range of medical mental health conditions (www.guidelines.gov)
Evidence Based Practice (EBP)
the method for using treatment approaches to medical illness and mental health illness that are scientifically grounded or evidence based.
nurse-patient partnership
emphasis on “relationship” in the recovery model
recovery model
a social model of disability rather than a medical model of disability. Originated from a 12-step AA. Refers primarily to managing symptoms, reducing psychosocial disability and improving role performance. goal is to empower those with mental illness to find meaning and satisfaction in their lives, realized personal potential and function at their optimal level of independence.
mandates of the recovery model
- mental health care is to be consumer and family driven
- care must focus on increasing consumer’s ability to be successful in coping with life’s challanges, facilitating recovery and building resilience–not just managing symptoms
- an individualized plan of care is to be at the core of consumer-centered recovery–recovery oriented services that allow consumers to realize improved mental health and quality of life.
- consumers must be partners in decision making in all aspects of care
psychiatric mental health nursing
a core mental health profession employs a purposeful use of self as its art and a wide range of nursing, psychosocial, and neurobiological theories and research evidence as its science.
three fundumental elements of pt advocacy
- ensure pts are informed of their rights in a particular situation, including the right to refuse treatment
- to support pts and decisions they make
- to protect pts which includes reporting threats to their well being.
biologically based mental illness/ psychobiological disorder
mental disorder caused by neurotransmitter dysfunction, abnormal brain structure,inherited genetic factors or other biological causes.
name some biologically influenced illnesses
schizophrenia bipolar disorder major depression obsessive-compulsive and panic disorders posttraumatic stress disorder autism Other severe and disabling mental disorders include: anorexia nervosa attention deficit/hyperactivity disorder many of the most prevalent and disabling mental disorders have been found to ahve strong biological influences; therefore we can look at these disorders as "diseases"
culture-related syndromes
appear to be more influenced by culture alone and are not seen in all areas of the world
- running amok (southeast asia) violet behavior
- pibloktoq ( greenland, alaska and arctic regions of canada) uncontrollable desire to tear one’s clothes off and expose oneself to severe winter weather
- anorexia nervosa (europe, north america, australia) voluntary starvation
Stigma
an attribute that is deeply discrediting where a person is reduced from a whole unusual person to a tainted, discounted one.
Processes that lead to stigmatization
stereotyping, labeling, separating, status loss, and discrimination in a context of power imbalance.
distress
painful symptom
disability
impairment in one or more important areas of functioning
resiliency
the ability to recover from or adjust easily to misfortune and change. Closely associated with the process of adapting and helps people facing tragedy, loss, trauma and severe stress. Resilient people recognize the feelings, readily deal with them and learn from the experience given time.
epidemiology
quantitative study of the distribution of disorders in human populations
prevalence rate
proportion of a population with a mental disorder at a given time
myths and misconceptions about mental illness
- to be mentally ill is to be different and odd
2. to be mentally healthy a person must be logical and rational
psychiatry’s definition of normal mental health
this definition of normal mental health changes over time and reflects changes in cultural norms, society’s expectations and values, professional biases, individual differences and even the political climate of the time.
some attributes of mental health
accurate appraisal of reality
ability to love and experience joy
capacity to deal with conflicting emotions
ability to live without (undue) fear, guilt or anxiety
ability to take responsibility for one’s own actions
ability to control one’s own behavior
think clearly (problem solve, use good judgement, reason logically, reach insightful conclusions, be creative)
relate to others (form relationshiips, have close, loving , adaptive relationships, experience empathy toward others, manage interpersonal conflict constructively)
attain self-defined spirituality
negotiate each developmental task
ability to work and be productive
maintain a healthy self concept and self-value
ability to play and laugh
DSM-5 The Diagnostic and Statistical Entities Manual of Mental Disorders
current official guidebook for categorizing and diagnosing psychiatric mental health disorders in the US
The DSM-IV-TR organized each psychiatric diagnosis into five levels (axes) relating to defferent aspects of disorder or diability. What is each Axis for?
Axis I particular disorder that may be a focus of treatment
Axis II personality disorders and mental retardation
Axix III general medical conditions believed to be relevant to the mental disorder in question
Axis IV psychosocial and environmental problems that affect diagnosis, treatment and prognosis
Axis V Global Assessment of Function (GAF) gave an indication of the persons’s best level of psychological, social and occupational functioning during the preceding year rated on a scale of 1- 100 ( 1 indicates persistent danger of severely hurting oneself or others and 100 indicates superior functioning in a variety of activities at the time of the eval and months prior)
co-occuring or dual diagnosis
example: a person with a heroin addiction would be diagnosed on axis I as having a substance-related disorder (DSM-5: opioid use disorder) and have a long standing antisocial personality disorder which would be noted on Axis II
mental illnesses
medical conditions that affect a person’s thinking, feeling, mood, ability to relate to others and daily functioning. the result of a chain of events that include flawed biological, psychological, social and cultural processes.. are treatable recovery is always a possibility
