Unit 1A Flashcards
Mental health
A state of well-being in which the individual realizes his or her own abilities, can cope with normal stresses of life, can work productively and faithfully, and is able to make a contribution to his or her community
Mental health traits
Appropriate perception of reality
Ability to adapt to change
Ability to problem solve
At an appropriate developmental level for age
Find pleasure from activities
Have hope, goals, and dreams
Mental illness
Thoughts, feelings, and behaviors that are incongruent to local and social norms
Can be a maladaptive response to stressors
Mental illness traits
Lack of energy or inner drive
Cannot enjoy anything
Feeling anxious/depressed/worried every day
Emotional outburst/dysregulation
Sleeping too much or too little
Becoming withdrawn and not socializing
Changes in appetite
What does the DSM-5 do?
Helps to diagnose mental health disorders
Identifies and list diagnostic criteria for mental health illnesses
Does not include psychiatric medications
What did the Americans with disabilities act of 1990 ensure?
It ensured rights for people with disabilities including mental health disorders or illnesses
What defect in neurotransmission may cause anxiety?
Reduced activity of GABA and excess serotonin
What defect in neurotransmission may cause autism?
May be due to excess serotonin
What defect in neurotransmission may cause depression?
May be due to decreased dopamine and serotonin
What defect in neurotransmission may cause mania?
Excess norepinephrine and dopamine
Low serotonin
What defect in neurotransmission may cause Parkinson’s disease?
Loss of dopamine and acetylcholine
What does the limbic system control?
Main regulator of emotions found in the frontal lobe
Lack of restful sleep has been associated with what?
Psychosis
Stress
A biological, physiological, social, or chemical factor that causes physical or emotional tension and may be a factor in the etiology in certain illnesses
Any “change“ causes stress
Adaptive coping
“Good” coping
Remains optimistic, keeps a sense of humor, blocking bad thoughts, prioritizing restructuring, reaching out, support groups, and self-care
Maladaptive coping
“Bad” coping
Excessive worrying about problems, procrastination, escaping, hopelessness, eating issues, deflection, self-harm, and avoidance
Cognitive reframing
Change the negative into a positive
Anxiety
A feeling of worry, unease, apprehension, typically about an event or something with an uncertain outcome that can manifest itself as compulsive behaviors
-Is linked to self preservation and stress
-all humans have developed coping mechanisms to deal with stress and manage anxiety
Mild stage of anxiety 
You are able to identify the cause of what triggered the anxiety, mild discomfort, and fidgeting.
-The nurse can assist the patient through therapeutic communication and provide comfort while helping a client to solve the problem
Moderate stage of anxiety
You can identify the cause of what triggered the anxiety, inattentive, can still problem solve, tired, poor concentration, shaking, increased heart rate and respirations, headaches, and insomnia.
-The nurse can provide direction, decreased stimuli, and give anti-anxiety medications.
Severe stage of anxiety
Distorted perceptions, no longer able to problem solve, feeling of “impending doom “, sweating, tachycardia and hyperventilation, rapid speech, and cannot take direction from others.
-The nurse must stay with the client and decrease all stimuli while keeping the patient safe and providing medications such as lorazepam and beta blockers 
Panic stage of anxiety
Markedly disturbed behavior from the norm, out of touch with self (depersonalization), out of touch with reality (derealization), extreme fright and hyperactivity, fight or flight is activated, delusions, hallucinations, and can become violent.
-nurse must stay with a client, do not leave them alone, focus on telling them they are safe and re-orienting them to reality
-give diazepam or clonazepam, beta blockers, SSRI’s, and SNRI’s.
Necessary loss
Things you must give up in order to grow
Actual loss
Tangible loss from death, job, divorce, destruction, physical ability, and mental ability
Perceived loss
Thing that has felt like loss of confidence that others cannot feel
Anticipatory loss
Preparatory distress felt prior to the actual loss
Maturational loss
Expected due to developmental stages of life like leaving home and going to college
Situational loss
Unanticipated loss caused by external events like loss of home in a tornado
Grief
Deep sorrow
Intense emotional feelings that we suffer from in response to a perceived or real significant loss
Mourning
A state of grief in which people can feel sad, guilty, angry, helpless, hopeless, and have despair
Bereavement
Form of grief that is reserved for a loss from death
Stages of grieving
DABDA
Denial
Anger
Bargaining
Depression
Acceptance
Adaptive grief
“Normal”
Will go through DABDA
Somatic manifestations: Sleeping and eating difficulties, decreased energy, fatigue, palpitations, headaches
Psychological manifestations: Depressed, irritable anxious mood, withdrawn , blunted, and flat affect
Remain functional and show some acceptance by six months. Maintain hope and self-concept
Maladaptive grief
“ Abnormal”
Does not go through the DABDA stages and gets stuck on denial or anger
Somatic manifestations: Similar to normal grief but exaggerated
Psychological manifestations: More severe including feelings of worthlessness, experience low self-esteem, substance abuse, psychological distress, and clinical depression
unable to see past the event and still not at baseline function after 12 months
Transference
When the patient unconsciously transfers or redirects feelings from someone in their past/current relationships onto the nurse
Counter transference
When the nurse unconsciously transfers or redirects feelings about past experiences or people onto the patient
Maslow hierarchy of needs
Behavioral theory
Focused on actions rather than thoughts and feelings
Cognitive theory
Explains how we interpret our daily lives and develop the insight to change when needed (how we adapt)
Pre interaction stage of a nurse patient relationship
Review patient’s chart, examine self biases, and prepare milieu for patient care
Orientation stage of nurse patient relationship
Establish trust, rapport, and respect
Establish a contract with patient dealing responsibilities of both parties as well as boundaries
Patient is more dependent on nurse
Working stage of nurse patient relationship
Promote patient insight and perception of reality
Shift power from nurse to patient
Frequently reevaluate plan and changes needed
Termination stage of nurse patient relationship
Discuss what the patient has accomplished and shared feelings about ending the relationship
Provided a plan for continuation of care with another provider if needed
Maintain professional boundaries
Patient is now independent
Therapeutic Milieu
Therapeutic environment that provides safety, support, structure, allows client to input feelings, explores feelings, provides empathy, acknowledges everyone’s contributions, build self-worth and self-respect, encourages independence, handles conflict and confrontation in ways that do not harm and allow people to change and grow.
Assertive communication
Ability to express positive and negative ideas and feelings in an open, honest, indirect way. It recognizes all parties and their points of view in a respectful way
- it involves compromise not winners and losers 
Passive communication
Person considers only others needs, wants, and feelings
Does not stand up for themselves, their beliefs, their feelings or their needs
Often easily taken care of or dependent personality traits
- Extreme lack of confidence, insecurity conflict, subservient.
- Rarely prone to anger and less pushed too far
Aggressive communication
Person considers only their needs, wants, and feelings
Ignores, bullies, criticizes, humiliate, dominates, controls, disrespects others and their ideas
-unwilling to compromise
- Can I have a bad mood changes, low tolerance threshold, outburst, yelling, and potential physical violence
Passive aggressive communication
Incongruent behaviors
Appear passive but act out anger and subtle, indirect ways
Feelings of being powerless makes them resentful leading them to undermine the object of the resentments
- Typically have a hard time communicating their needs and often deny that there is an issue
- Can become aggressive when pushed too far
