Test 6 MH Communication Flashcards
3.Describe how Dr. Hildegard Peplau saw the nurse as.
-Resource person. Provides information.
-Counselor. Helps patients to explore their thoughts and feelings.
-Surrogate. By role-playing or other means, helps the patient to explore and identify feelings from the past.
-Technical support. Coordinates professional services
Describe how Dr. Peplau saw the nurse pt relationship.
-Orientation: Patient feels a need and a will to seek out help.
-Identification. Expectations and perceptions about the nurse-patient relationship are identified.
-Exploration: Patient will begin to show motivation in the problem-solving process, but some testing behaviors may be seen; patient may have a need to “test” the nurse’s commitment to his/her individual situation.
-Resolution: Focus is on the patient developing self-responsibility and showing personal growth.
5.Describe the major breakthroughs in pharmacologic help for mental illness and when this occurred. What were the first psychotropic medications?
-In 1955, a group of psychotropic medications called phenothiazines was discovered to have the effect of calming and tranquilizing people.
-Chlorpromazine HCI (Thorazine)
-Patients were able to function more independently & by the mid 1950’s & mid
1970’s the # of patients hospitalized w/mental illnesses in the U.S. was cut approx. in half due to the use of psychotropic drugs.
9.Describe Aggressive Communication
-Communication that is not self-responsible.
-Aggressive statements most often begin with the word “you.”
-Aggressive communication, like aggressive behavior, is meant to harm another person.
-Aggressive communication can be nonverbal (A person’s tone, vocal pitch, or body language can be aggressive)
-It is a form of the defense mechanism projection, or blaming, and it attempts to put responsibility for the aggressor’s feelings on the other person.
- Describe Assertive Communication
- is self-responsible
- Use “I” messages, expresses the speaker’s thoughts and feelings honestly.
-Keep in mind right to say “no”
- What is “Therapeutic Communication?”
- “Communication between a health care professional and a patient that is aimed at improving the patient’s physical or psychological health and well-being”
• Therapeutic communication is purposeful: Nurses are trying to determine the patient’s needs.
- Give an example of the following blocks to therapeutic communication and its effect on the pt.
False Reassurances/Social Cliches:
- “Don’t worry! = Tells patient his or her concerns are not valid
-Everything will be just fine.” = May jeopardize patient’s trust in nurse
Minimizing/Belittling:
“We have all felt that way sometimes.” = Implies that the patient’s feelings are not
special
The word why:
-“Why did you refuse your breakfast?” = Patient feels obligated to answer something he or she may not wish to answer or may not be able to answer and Probes in an abrasive way
Advising:
- “You should eat more.” = Places a value on the action
- “If I were you, I would take those pills so I would feel better.” = Gives the idea that
the nurse’s values are the “right” ones and Sounds parental
Agreeing or Disagreeing:
-“You were wrong about that.” = Places a “right” or “wrong” on the action
-“I think you’re right.”
Give an example of the following blocks to communication and its effect on the pt.
Closed-Ended Questions:
“Can you tell me how you feel?” = Allows a “yes” or “no” answer
“Do you smoke?” = Discourages further exploration of the topic
“Can I ask you a few questions?” = Discourages patient from giving information
Providing the answer with the question:
-“Are you afraid?” = Combines a closed-ended question with a solution
-“Didn’t the food taste good?” = Discourages patient from providing his or her own
answers
“Do you miss your mom today?”
Changing the subject:
- The patient is asking a question about his/her prognosis, and the nurse, “Did the doctor say anything about discharging you today?” = Discounts the importance of
the patient’s need to explore personal thoughts and feelings and May be a reflection of the nurse’s own discomfort with this topic
Approving/Disapproving:
-“That’s the way to think about it!” = Can sound judgmental
-“Good for you!” = Can set the patient up for failure if the approval or disapproval
does not help; can lower the nurse’s credibility
-“That’s not a good idea.”
- Using the Therapeutic Communication Technique of Reflecting/Repeating/Parroting has what effect on the pt?
-Encourages exploring the meaning of the statement
-Can be irritating if overused
- Describe HIPAA, include who developed it, what it does, what it allows, and what it addresses.
- The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Joint Commission are intimately involved in documentation and privacy issues.
-Was developed by the Department of Health and Human Services to provide national standards pertaining to the electronic transmission and communication of medical information between patients, providers, employers, and insurers.
-HIPAA allows more control on the part of the patient as to what part of his or her information is disclosed.
-It addresses the security and privacy involved with medical records and how that information is identified and passed between care providers.
- Describe Voluntary Commitment versus Involuntary Commitment.
Involuntary commitment:
-People who need to be hospitalized against their will (this is reserved for those exhibiting behavior that makes them potentially dangerous to themselves or to others).
- Average legal hold is 48-72hrs.
Voluntary commitment:
- patients who are hospitalized for some type of mental illness are there voluntarily; that is, at some point they realized they needed help.
-Patients who agree to voluntary treatment are legally allowed to sign themselves out; however, this is often discouraged by the treatment staff except under certain
- List the different forms of help that each community should offer to people in need, according to the Mental Health Centers Act of 1963.
- Hospital emergency rooms
- Shelters
- Crisis centers
- Social service offices
- Define Ethnicity.
Ethnicitv: defines one’s more personal traits and identifies a person with his or her shared heritage (language, country of origin, skin color).
Dietary preferences for Hispanic American
-Rice, corn, tortillas, tropical fruits, vegetables, nuts, legumes, eggs, cheese, seafood, poultry, infrequent sweets & red meat
-Tortillas eaten @ most meals
-Animal protein from ground poultry, pork, goat Veggies often incorporated into the main dish
Dietary no-no for the Orthodox Jewish Pt
- Blood by ingestion (blood sausage, raw meat, blood transfusion ok)
-Mixing dairy products & meat dishes at same meal
-Pork
-Predatory fowl
-Shellfish & scavenger fish (shrimp, crab, lobster, escargot, catfish, fish w/fins & scales ok)
-Foods labeled “pareve” are neutral & can be consumed w/milk or meat.
- Give an example of how some cultures view illness. Asian-American;
- yin-yang theory, which promotes the idea that energy forces exist between organisms and objects in the universe.
-the hot/cold theory, which says that diseases should be treated by adding or subtracting heat or cold or dryness or moisture to restore balance.
- Give an example of how some cultures view illness. Native-American
Naturalistic or holistic perspective: espouses that human beings are only one part of nature. Natural balance or harmony is essential for health.
- What is the general rule of thumb when considering cultural issues?
Differences exist within all groups, and nurses are responsible to ask when unsure of certain practices
- Define primary prevention
Primary: prevention of the development of disease in a susceptible or potentially susceptible population (includes health promotion & immunization)
- Define secondary prevent
Secondary: Early diagnosis and treatment to shorten duration and severity of an illness, reduce contagion, and limit complications
- Define tertiary prevention.
Tertiary: Health care to limit the degree of disability or promote rehabilitation in chronic, irreversible disease
- Define Cultural Awareness
Cultural Awareness:
Being conscious of one’s own culturally shaped values, beliefs, perceptions & biases.????
Define Cultural Blindness.
Cultural Blindness: is an inability to recognize the values, beliefs, and practices of others because of strong ethnocentric preferences.
