TOPIC 1 - foundations Flashcards
psychiatric nursing was not taught until
1950s
psychotropic drugs first developed in
early 1950s
community mental health center act of 1963
push towards community care rather than institutionalization when possible
DSM-5
official manual for psychiatric medical diagnosis
what can PMH-APRN nurses do that RN’s cannot?
prescribe and perform counseling/psychotherapy consultations
report duty to warn
milieu refers to
the environment in which holistic treatment occurs and includes all members of the treatment team
boundary violations
actions that overstep established boundaries to meet the needs of the nurse
SAMHSA’s six key principles of trauma informed approach
- safety
- trustworthy and transparent
- peer support
- collaboration and mutuality
- empowerment, voice, and choice
- cultural, historical, and gender issues
differences in types of mental health admissions
voluntary - inpatient or outpatient
emergency involuntary - limited, observational, inpatient
involuntary - long term, inpatient or outpatient
concepts of due process
writ of habeus corpus
least restrictive alternative doctrine
Tarasoff doctrine - duty to warn
assess and predict risk of violence to others
assess likelihood client will act of expressed threats
identify specific individuals being threatened
identify appropriate actions to protect victims
child abuse reporting vs elder abuse reporting
child abuse is required in all states, elder abuse is not
willfully not reporting suspected abuse, neglect, or exploitation is
a misdemeanor
seclusion vs restraint
seclusion - involuntary confinement of a person alone in a room or area from which the person is physically prevented from leaving.
restraint - any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a person to move his or her arms, legs, body, or head freely.
restraints of use of seclusion is only permitted when
there is a written prescription by provider and the prescription includes a specific time limit for the intervention + criteria for release
continuous observation is required every 15 min
documentation for restraint and seclusion use
clients behavior leading to restraint
less invasive interventions attempted
time client is placed in and released from
assessments and observations of client during intervention
debriefing after intervention (with client input)
double bind messages
sent to create meaning, can be defensively used to hide what is actually going on
therapeutic communication techniques
silence, accepting, giving recognition, offering self, broad openings, encouraging description of perception, encourage comparison, restate, reflect, clarification, verbalize the implied, translate into feelings, summarize, formulate plan
non-therapeutic communication techniques
excessive questions, giving approval agreeing, disapproving, premature advice, “why” questions, minimize feelings, false reassurance, judging values, changing the subject, extensive silence
freud’s psychoanalytic theory
believed adult personality develops based on early childhood experiences within developmental stages
sullivan’s interpersonal theory
the purpose of all behavior is to get needs met through interpersonal interactions and to decrease or avoid anxiety
anxiety arises in fundamental conflicts between individuals and their environments
peplau’s theory was influenced by …
sullivan’s work
nurse client relationship according to peplau
orientation phase
working phase - identification and exploitation
resolution/termination
behavioral theories - pavlov’s classical conditioning
pairing a behavior with a condition that reinforces or diminishes the behaviors occurrence
behavioral theories - skinner’s operant conditioning
voluntary behaviors occur more frequently with positive reinforcement
cognitive behavioral therapies
identify and tests distorted beliefs allowing client to change way of thinking and improve behavior
ABC theory of cognitive therapy
automatic thought, beliefs, consequence of belief
moral component of personality structure according to freud
superego
psychoanalytic theory
freud
interpersonal theory
sullivan, papleu
behavioral theory
pavlov, watson, skinner
cognitive theory
beck
