Unit 1 Flashcards
Mental health
Successful mental functioning leads to productive activities.
Ability to adapt to change
Cope with adversity
Mental illness
Maladaptive responses to stressors from the internal or external environment that are incongruent with local or cultural norms…effects peoples basic needs
Delusion
False fixed beliefs
TNI’s for delusion?
- Listen
- Acknowledge
- Distract with reality based topic
Hallucination?
False sensory perception. No stimuli…can involve all 5senses
Psychosis
Non-reality base thinking that includes hallucinations and delusions and disorganized thought
What is the difference between mental health and mental illness?
Mental illness affects people’s basic needs
What theories relate to the etiology of mental illness?
Hereditary
- Biochemical neurotransmitters
- Physical illnesses..MS, stroke
- Environmental -poverty, socioeconomic status
What is the patients legal status based on?
The type of admission..voluntary or involuntary
What is involuntary admission?
Clients held against their will due to being dangerous to self or others.
What is treatment over objection?
Court ordered tx to inpatient or outpatient. When client refuses care a health team determines it is necessary for the clients well being and improvement.
What are court ordered inpatient settings?
Hospitalization
Can force medications if inpatient
Describe court ordered AOT?
Court ordered assisted outpatient treatment is a 6 month order, which can be renewed.
2. Pts with ongoing illness and had at least 2 involuntary hospitalization so within the past 2 yrs.
What is primary prevention?
Identifying and treating Risk Factors in healthy people!
What is secondary prevention?
Early identification of problems and prompt initiation of treatment. Recognizing symptoms and referral for tx.
What is tertiary prevention?
Long tern after care, resocialization, recovery..reducing residual defects
Give examples of primary prevention?
Teaching parenting skills
Teach stress management
Provide education and support to people in transitional periods..widow, new retires,
Describe trust in a helping behavior.
Feeling of having confidence in a persons presence, reliability
Describe respect in a helping behavior.
Nonjudgmental , believe in the worth of the individual regardless of unacceptable behavior
Describe genuiness in a helping behavior
Nurses ability to be real, open and honest
Describe self understanding as helping behavior
Ability to recognize and acknowledge ones own feelings and be able to your reaction can affect the situation
Describe structuring as a helping behavior
Develop a relationship with client by establishing the amount of time, providing direction and purpose for the therapeutic relationship
Describe empathy
Able to understand the situation from the clients point of view.
Describe self disclosure
Intentional boundary crossing,revealing own personal information-thoughts, feelings. Can only be done to help pt
Describe concretness
Using specific terms when discussing feelings, experiences, and behaviors; avoid using general terms
Describe immediacy in helping behaviors
The ability to work with here and now problems
Describe attentive listening
Listening using all senses, paying attention to verbal and non warble messages
Describe offering self
Being available to client
What is reflection?
Repeat what the client has said.
Reflection of feelings is
Verbalizing the implied feeling expressed by the content of pts communication
Give an example of broad opening
What would you like to discuss?
Where would you like to begin?
Closed ended question is looking for what?
Yes or no answer
What is meant by seeking consensual validation?
Searching for mutual understanding, determining if nurse has understood the client
Give an example of consensual validation.
” tell me whether my understanding agrees with yours…nurse describes what she thinks she heard pt say
What is voicing doubt?
Expressing uncertainty as to the reality of the clients perceptions.
When is voicing doubt used?
Usually with clients experiencing delusional thinking.
Describe a general lead
Gives encouragement to the client to continue
Give examples of general leads
Go on. And then? I see..... Hmm..... Tell me more about...
What is providing feedback?
Sharing ones perception of the clients behavior.
What is this statement an example if? Your contributions helped the group work together.
You interrupted the group leader
Providing feedback
What therapeutic technique is used in this example? During the last half hour we have talked about your plans which are…..
You said that……
Summarizing
When do u use focusing?
When concentrating on a single point by using questions who, what, where, and how
What is the difference btn seeking consensual validation and seeking clarification?
Validation is nurse describes what she thinks she heard client say.
Clarification is to make the meaning clear..when you say…..do you mean…..
What is confrontation?
Identifying a discrepancy between what is said and what was done. “You said you were going to group today but you didn’t.”
Describe stereotyping.
Generalized beliefs about groups, negates their. Uniqueness as individuals
Describe defensive
Attempt to protect something or someone from negative comments
What is challenging?
Demanding proof.
What is meant by probing?
Persistent questioning of pt. Using why or “what makes you” or “what made you”
Describe a social relationship.
No structure No time frame Friends and family No boundaries Meets both parties needs Use sympathy
Describe a therapeutic relationship
Time limit-definite end Common goals and purpose Nurse client Planned Meets the needs of the client only Use of empathy
What are the 3 phases of the nurse client relationship?
Orientation, working, termination
What are typical tasks for the orientation phase of a nurse client relationship?
Creating an environment of trust and rapport
2. Establishing contract for intervention, expectations and responsibilities for both parties
3. Gather assessment data
4 identify strengths and limitations
5. Formulating nursing dx
6. Set goals
7. Explore feelings of both
Describe the working phase in a nurse client relationship
Maintain trust and rapport
2. Promote clients insight and perception of reality
3. Problem solving
4. Overcoming resistance as level of anxiety increases in response to discussion of painful issues
Continuously evaluating progress toward goal attainment.
Describe the termination phase of the nurse client relationship
Progress has been made toward attainment of goals
- Plan for continuing care or assistance during stressful events is mutually established by both parties
- Feelings about termination are explored. Nurse should share feelings of sadness and loss…pt learns they are acceptable feelings.
What is transference?
A client unconsciously displaces feelings to the nurse if she reminds the pt of someone from the past. Can have anger or overwhelming affection. Need to sort out feelings or therapy won’t work with this nurse.
What is counter transference?
Nurse behavior and emotional response to the client maybe related to unresolved feelings toward someone from her past. Nurse over identifies with pts feelings. Could develop a social or personal relationship.
Why is counter transference bad?
Nurse attempts to rescue or give advice
2. Encourages and promotes client dependence
3. Nurses anger can bring feelings of discuss toward pt
4. Nurse is bored and apathetic in sessions
5. Nurse has difficulty setting limits on pts behavior
6. Nurse defends pt behaviors to staff
Should be terminated
Define mood.
An emotion that may have major influence on a persons perception of the world.
What is meant by affect?
The emotional REACTION associated with an experience.
Describe insight
The ability to solve problems and make decisions.
Knowledge about self awareness of limitations. Awareness of consequences of actions. Awareness of illness.
Give examples of thought content
Delusions-unrealistic ideas or beliefs
- Suicidal or homicidal ideas
- Obsessions-magical thinking
- Paranoia
What is thought process?
Flight of ideas, continuous and rapid
Associative looseness-shift from 1 unrelated topic to another
What is ineffective coping?
You are unable to correctly assess the stressors, and/or inability to use available resources.
Define complicated grieving
Occurs after the death of a significant other where grieving process fails to follow the normal expectations and pt becomes functionally impaired.
What is the difference between complicated grieving and risk for complicated grieving?
Complicated grieving is already becoming functionally impaired where risk for, it could happen.
What is ineffective self health management
Unable to integrate a daily therapeutic regime for treating illness and it’s sequela to meet specific health care goals.
What is the difference between Noncompliance and ineffective self health management?
Non compliance is more of a behavioral problem where ineffective self health management is unable to maintain health for financial, physical or transportation reasons