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NRS232: Mental Health Nursing > Unit 1 & 2 > Flashcards

Unit 1 & 2 Flashcards

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1
Q

Components of the Communication Process

A
  • Sender
  • Receiver
  • Message
  • Feedback
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2
Q

Types of Communication

A

Verbal

Nonverbal

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3
Q

Verbal Communication

A

10 - 35% (1/3) of the message

- considered less reliable

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4
Q

Nonverbal Communication

A

65 - 90% (2/3) of message

  • considered more reliable because they are usually unconscious behaviors
  • Includes body language, facial expressions, voice behaviors, autonomic physiologic responses, appearance, physical characteristics.
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5
Q

Points to evaluate during communication

A
  1. Verbal Communication
  2. Nonverbal Communication
  3. Congruency between verbal and nonverbal communication.
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6
Q

Therapeutic Communication Techniques

A
  1. Broad Opening Statement
  2. Offer general directive leads
  3. Use thoughtful silence
  4. Share observations about the client
  5. Clarify the client’s feelings
  6. Reflect the client’s feelings
  7. Clarify the content of client’s communication
  8. Reflect content
  9. Provide client with accurate information
  10. Use direct questioning
  11. Confront the client’s feelings when discrepancies or contradictions are perceived.
  12. Confront the content of client’s communication when discrepancies or contradictions are perceived.
  13. Verify perceptions of the client’s behaviors, thoughts, or feelings
  14. Focus or call attention to specific client statements or behaviors.
  15. Use self-disclosure when appropriate
  16. Summarize the main ideas or themes covered.
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7
Q

Barriers to Therapeutic Communication

A
  1. Changing the subject
  2. Probing questions
  3. Advising client
  4. Belittling the client
  5. Closed-ended questions
  6. False reassurances
  7. Giving approval
  8. Requesting and explanation
  9. Making a stereotyped comment.
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8
Q

Intervening in Psychotic Communication

A
  1. Do NOT reinforce a client’s psychotic communication
  2. Show interest in and concern for the client
  3. Can be difficult to communicate with a psychotic client
  4. May attempt to redirect client back to reality, but must be cautious with this.
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9
Q

Types of Relationships

A

Social
Intimate
Theraputic

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10
Q

Social Relationships

A

Most common

  • used to meet one’s own needs
  • for friendship/enjoyment
    eg. church group working towards a common goal, or for social contact.
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11
Q

Intimate Relationships

A
  • Meet the needs of others as well as self

- Between 2 persons who care about each other; exclusive.

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12
Q

Therapeutic Relationship

A
  • Between healthcare provider and a person or group with healthcare needs.
  • purposeful and helpful.
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13
Q

Therapeutic Nurse-Client Relationship

A
  1. Demonstrate acceptance of the client as a person
  2. Demonstrate respect
  3. Develop a bond of trust
  4. Demonstrate warms
  5. Maintain genuineness
  6. Demonstrate specificity in nurse-client interactions
  7. Convey empathy
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14
Q

Phases of the Therapeutic Relationship

A
  1. Orientation or Introductory Phase
  2. Working or Middle Phase
  3. Termination Phase
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15
Q

Orientation/Introductory Phase

Therapeutic Relationship

A
  • Exchange of information about each other
  • Establish frequency, length, and reason for contact
  • Develop therapeutic relationship
  • Identify problems and goals to be achieved.
  • Gather data in problem areas
  • Begin termination
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16
Q

Working/Middle Phase

Therapeutic Relationship

A
  • Active work on problems and goals
  • clients expresses thoughts and feelings
  • problem solving occurs
  • May be highly emotional
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17
Q

Termination phase

Therapeutic Relationship

A
  • Multiple reasons for termination
  • often evokes strong feelings in client and nurse
  • provide for discussion of these feelings
  • space contacts further apart
  • discourage new areas of exploration
  • referral to others.
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18
Q

Transference

A

a process whereby a client unconsciously and inappropriately displaces (transfers) onto individuals in his or her current life those patterns of behavior and emotions reactions that originated with significant figures from childhood.

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19
Q

Countertransference

A

the tendency of the nurse to displace feelings belonging to people in the nurse’s past onto the client.

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20
Q

Characteristics of Mental Health

A
  • Happiness
  • Control over own behavior/accountable
  • Reality orientation
  • Relationships with others
  • Meaningful work
  • Expression of feelings
  • Good self-esteem/self-concept
  • Ability to think effectively
  • Stress management
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21
Q

Factors that affect mental health

A
  1. Inherited characteristics
  2. Biological factors (neurotransmitter balance, brain structure)
  3. Sociocultural factors
  4. Psychological factors
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22
Q 
Mental Illness
(definition)
A

a point in time when an individual has an impairment in relation to daily activities

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23
Q

Characteristics of Mental Illness

A
  • Dissatisfaction with one’s self
  • Dissatisfaction with One’s place in the world
  • Ineffective or unsatisfying interpersonal relationships
  • Distortion of Reality
  • Altered mood states
  • overuse of defense mechanisms to deal with anxiety
  • ineffective adaptation to the events of one’s life
  • nonproductive, inappropriate or bizarre behavior.
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24
Q

Misconceptions about mental illness

A
  • Once you are mentally ill, you are always mentally ill
  • If a mentally ill wanted to be better or healthy, they could be
  • Everyone who is mentally ill is odd or different
  • People who have a mental illness are dangerous
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25
Q

Role of Psychiatric-Mental Health Nurse

A
  • Health promotion/maintenance
  • Intake screening and evaluation
  • Coordination of milieu therapy
  • Case management
  • Self-care activities
  • Psychobiological activities
  • Health teaching of client and family
  • Crisis intervention
  • Home health care
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26
Q

Healthy defense mechanisms

A

Altruism and sublimation

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27
Q

Intermediate defense mechanisms

A

repression
reaction formation
displacement
rationalization

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28
Q

immature defense mechanisms

A

projection
dissociation
splitting
denial

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29
Q

Altruism

A

Dealing with anxiety by reaching out to others.

Ex. a nurse who lost a family member in a fire is a volunteer firefighter.

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30
Q

Sublimation

A

Dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression.
Ex. a person who has feelings of anger and hostility towards his work supervisor sublimated those feelings by working out vigorously at the gym during his lunch period.

31
Q

Suppression

A

voluntarily denying unpleasant thoughts and feelings

Ex. A person who has lost his job states he will worry about paying his bills next week.

32
Q

Repression

A

putting unacceptable ideas, thoughts, and emotions out of conscious awareness.
Ex. a person who has a fear of the dentist’s drill continually “forgets” his dental appointments

33
Q

Displacement

A

shifting feelings related to an object, person, or situation to another less threatening object, person, or situation.
Ex. a person who is angry about losing his job destroys his child’s favorite toy

34
Q

Reactive formation

A

overcompensating or demonstrating the opposite behavior of what is felt
Ex. a person who dislikes her sister’s daughter offers to babysit so that her sister can go out of town

35
Q

Undoing

A

Performing an act to make up for prior behavior.

Ex. An adolescent completes his chores without being prompted after having an argument with his parent

36
Q

Rationalization

A

Creating reasonable and acceptable explanations for unacceptable behavior
Ex. A young adult explains he had to drive home from a party after drinking alcohol because he had to feed his dog

37
Q

Dissociation

A

Temporarily blocking memories and perceptions for consciousness.
Ex. An adolescent witnesses a shooting and is unable to recall any details of the event

38
Q

Splitting

A

demonstrating an inability to reconcile negative and positive attributes of self or others
Ex. A client tells a nurse that she is the only one who cares about her, yet the following day, the same client refuses to talk to the nurse

39
Q

Projection

A

Blaming others for unacceptable thoughts and feelings

Ex. A young adult blames his substance use disorder on his parents’ refusal to buy him a new car.

40
Q

Denial

A

Pretending the truth is not reality to manage the anxiety of acknowledging what is real
Ex. A parent who is informed that his son was killed in combat tells everyone he is coming home for the holidays.

41
Q

Regression

A

Demonstrating behavior from an earlier developmental level. Often exhibited as childlike or immature behavior.
Ex. A school-aged child begins wetting the bed and sucking his thumb after learning his parents are separating.

42
Q

Levels of Anxiety

A

Normal
Acute
Chronic
(Can be further broken down into Mild, Moderate, Severe, and Panic-level)

43
Q

Normal Anxiety

A

A healthy life force that is necessary for survival, normal anxiety motivates people to take action.
Ex. A potentially violent situation occurs on the mental health unit, and the nurse moves rapidly to defuse the situation. This anxiety helped her move quickly and efficiently.

44
Q

Acute Anxiety

A

A state
Precipitated by an imminent loss or change that threatens one’s sense of security.
Ex. the sudden death of a loved one precipitates an acute state of anxiety
(CCE’s are another example HAHA)

45
Q

Chronic Anxiety

A

a Trait
Usually develops over time, often starting in childhood. The adult who experiences chronic anxiety may display that anxiety in physical symptoms, such as fatigue and frequent headaches.

46
Q

Mild anxiety

A

Occurs in the normal experience of everyday life

  • identifiable cause
  • vague feeling of mild discomfort, restlessness, irritability, impatience and apprehension
  • May exhibit finger or foot tapping, fidgeting, lip-chewing as mild tension-relieving behaviors
47
Q

Moderate anxiety

A
  • escalation of mild anxiety
  • reduced perception of reality, and selective inattention may occur
  • ability to think clearly is hampered, but learning and problem solving may still occur.
  • concentration difficulties, tiredness, pacing, change in voice pitch, voice tremors, shakiness, and increased heart rate and respiratory rate.
  • somatic complaints: headache, backache, urinary urgency/frequency, insomnia, etc.
  • client usually benefits from the direction of others
48
Q

Severe anxiety

A
  • perceptual field is greatly reduced with distorted perceptions
  • learning and problem-solving do not occur
  • confusion, feelings of doom, hyperventilation, tachycardia, withdrawal, loud and rapid speech, and aimless activity.
  • Client is usually not able to take direction from others
49
Q

Panic-level anxiety

A
  • Markedly disturbed behavior
  • not able to process what is occurring in the environment and may lose touch with reality.
  • extreme fright and horror
  • Immobility can occur
  • dysfunction in speech, dilated pupils, severe shakiness, severe withdrawal, inability to sleep, delusions, and hallucinations.
50
Q

Three Primary Levels of Basic Communications

A
  • Intrapersonal communication
  • Interpersonal communication
  • Public communication
51
Q

Intrapersonal Communication

A

communication that occurs within an individual. Also identified as “self-talk”.
Allows the nurse to assess a client and/or situation and critically think about the client/situation before communicating verbally.

52
Q

Interpersonal communication

A

communication that occurs between two or more people in a small group.
-Most common in nursing and requires an exchange of information with an individual or small group.

53
Q

Public communication

A

occurs within large groups of people.
Commonly occurs during educational endeavors where the nurse is teaching a large group of individuals, such as in a community setting.

54
Q

Transpersonal communication

A

Communication that addresses an individual’s spiritual needs and provides interventions to meet those needs.

55
Q

ID

A

One of three psychological process that make up the Freudian system of personality. (Id, Ego, Superego)
ID is the source of all primitive drives and instincts and is considered to be the reservoir of all psychic energy.

56
Q

Ego

A

The ego is one’s sense of self and provides for such functions as problem solving, mobilization of defense mechanisms, reality testing, and the capability of functioning independently. The ego is said to be the mediator between one’s primitive drives (the id) and internalized parental and social prohibitions (the super ego)

57
Q

Superego

A

The supergo is the internal representative of the values, ideals, and moral standards of society. The superego is said to be the moral arm of the personality.

58
Q

DSM-5

A

Diagnostic and Statistical Manual of Mental Disorders, fifth edition
A medical manual that was published in 2013 for the purpose of classifying mental disorders and that influences treatment recommendations and reimbursement.

59
Q

Incidence

A

refers to the number of new cases of mental disorders in a healthy population within a given period of time.
Ex. the number of Atlanta adolescents who were newly diagnosed with major depression between 2000- 2001. Usually done annually.

60
Q

Prevalence

A

describes the total number of cases, new and existing, in a given population during a specific period of time, regardless of when they became ill.
Ex. the number of adolescents who screen positive for major depression in New York City schools between 2000 - 2010.

61
Q

Clinical epidemiology

A

A broad field that examines health and illness at the population level.

62
Q

Psychodynamic Therapy

A

A therapeutic modality based on classical psychoanalysis but with less focus on the early development of pathology. It uses free association, dream analysis, transference, and countertransference. The therapist is actively involved and interacts with the client in the here and now.

63
Q

Interpersonal Psychotherapy

A

A therapeutic modality that emphasizes what goes on between people. The basis of the therapy is on building interpersonal skills and correcting faulty processes of interacting.
(Sullivan & Meyer)

64
Q

Hildegard Peplau

A

Nursing theorist that developed an interpersonal theoretical framework that has become the foundation of psychiatric mental health nursing practice.
-Promoted the primary role of the nurse as a psychotherapist or counselor rather than a mother surrogate, socializer, or manager.

65
Q

Ida Orlando

A

Initiated the term “nursing process” and began to delineate its components. She presents a general theoretical framework for all nurse-patient relationships that focused on the patient identifying the meaning of behavior and what the nurse could do to help. She also wrote the classic book “The Dynamic Nurse-Patient Relationship”

66
Q

June Mellow

A

Introduced second theoretical approach to psychiatir nursing, called “nursing therapy”, which applied psychoanalytical theory in one-to-one interactions with patients who had schizophrenia/ She emphasized the provision of corrective emotional experiences rather than investigation of pathological processes.

67
Q

Maslow’s Hierarchy of Needs

Most basic to top of pyramid

A
  • Physiological needs (food, water, oxygen, elimination, rest, and sex)
  • Safety needs (security, protection, stability, structure, orders, and limits)
  • Love and belonging needs (affiliation, affectionate relationships, and love)
  • esteem (self-esteem r/t competency, achievement, and esteem from others)
  • Self-actualization (becoming everything one is capable of)
  • Self-transcendence
68
Q

Which therapy is the most commonly used, accepted, and empirically validated psychotherapeutic approach?

A

Cognitive-behavioral therapy

69
Q

Mileu Therapy

A

a philosophy of care in which all parts of the environment are considered to be therapeutic opportunities for growth and healing. The milieu includes the people (patients and staff), setting, structure, and emotional climate.

70
Q

What are the tree stages of General Adaptation Syndrome (GAS)?

A
  1. The alarm (or acute stress) stage
  2. The resistance stage
  3. The exhaustion stage
71
Q 
The alarm (or acute stress) stage
(of GAS)
A

the initial, brief, and adaptive response (fight of flight) to the stressor. During the alarm stage their are 3 principle responses. (Sympathetic, Corticosteroids, and Endorphins) This stage is intense, and no organism can sustain this level or reactivity for long. If the organism survived they move to resistance stage.

72
Q

The resistance stage (of GAS)

A

could be called adaptation stage because it is during this time sustained and optimal resistance to the stressor occurs. Usually, stressors are successfully overcome; however, when they are not, the organism may experience the final exhaustion phase.

73
Q

The exhaustion phase (of GAS)

A

occurs when attempts to resist the stressor prove futile. At this point, resources are depleted, and the stress may become chronic, producing a wide array of psychological and physiological responses and even death. One of the most important concepts of this theory is that regardless of the threat, the body responds the same physiologically.

NRS232: Mental Health Nursing (5 decks)

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