version 2 exam 1 Flashcards
mental health is
PEES
positive self concept
effective coping
emotional stability
sastifaction
mental illness is
Disatisfaction
Ineffective coping
Inflated self
Lack of growth
Ineffective relations
Disatisfation
3 roles of a counselor
stress management, behavior mod, crisis intervention
4 aspects of milieu therapy
promote growth through role modeling
teach skills
maintain therapeutic enviornment
encourage communication btwn people
self awareness is
the process in which a nurse gains recognition of their feelings, beliefs, and attitudes
eriksons stages of devleopment
o Trust v mistrust (infant). Task: view world as safe and reliable. Relationships are nurturing, stable, dependable.
o Autonomy v shame/doubt (toddler). Task: achieve sense of control and free will
o Initiative v guilt (preschool): Beginning to dvt conscience; learning to manage conflict/anxiety
o Industry v inferiority (school-age). Task: emerging confidence in own abilities
o Identity v role confusion (adolescence). Task: formulating sense of self & belonging
o Intimacy v isolation (young adult). Task: forming adult, loving relationships & meaningful attachments
o Generativity v stagnation (middle adult): being creative & productive & establish next generation
o Ego integrity v despair (maturity): accepting responsibility for oneself/life
sullivan and peplau
quality of relationships
rogers
people have positive qualities and the capacity to change; promotion of self-esteem – humans deserve Unconditional positive regard, genuineness, empathetic understanding
positive reinforcement vs negative
- Positive reinforcement: a reward, such as a privilege or token, is given for desirable behavior
- Negative reinforcement: a negative/unpleasant factor is removed so acceptable behavior is encouraged
how one perceives and thinks about a situation determines feelings and behavior
beck
factors that serve as a guide for effective intervention
- Adequate perception
- Adequate support
- Adequate coping
- Directive interventions vs. supportive interventions
o Directive: designed to assess person’s health status & promote problem solving (ie offering person new info, knowledge, or meaning, and raising self-awareness by providing feedback
o Supportive: aimed at dealing w person’s needs for empathetic understanding (encouraging person to identify & discuss feelings, etc)
psych rehab
- provision of services to help people with severe and persistent mental illness living the community
- Goal is recovery of mental health;
collaborative partnership - Focuses on a person’s strength, skill-building, empowerment; give them the skills they need to function at their highest level
The Nurse and 4 Psychosocial Interventions
- Enhance the client’s social and psychological functioning
- Improve social skills
- Improve interpersonal relationships & Communication
- Improve communication
goal of partial hospitalization
symptom relief
goal of day treatment
recovery
4 aspects of the clubhouse model
· A place to come to
· Meaningful work
· Meaningful relationships
· A place to return to
3 roles nurse has on interdisciplinary team
Milieu management and counseling
* Health promotion, illness prevention, and rehabilitation → holistic care
* Evaluate the effectiveness of treatment and refer to resources
values v belief v attitudes
- Values-abstract standards that give a person a sense of right and wrong and establish a code of conduct for living.
- Beliefs–ideas that one holds to be true
- Attitudes–general feelings or a frame of reference around which a person organizes knowledge about the world.
7 self disclosure guidelines
Must respect the nurse’s (physical) and client’s (psychological) safety
Very selective, and brief
Common day-to-day experience related to the client’s concern
From the past
Do not involve value-laden topics
Short; keeps focus on client’s concerns
Self-Awareness Issues
3 aspects of hardiness
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1. Commitment (active involvement in activities
2. Control (ability to make decisions in life activities
3. Challenge: ability to perceive change as beneficial rather than just stressful
healthy response to stressful circumstances
resilliance
MOA of antipsychotics
blocks dopamine
AE of antispychotics 3
acute dystonia
pseudoparkinsonism
akathesia
3 meds to treat ePS
benzotropine/trihexphenidyl(anticholinergic) and diphenhydramine (benadryl)
4 ss of metabolic syndrom
obesity, HTN, hyperglycemia, high cholesterol
3 1st gen antipsychs
Chlorpromazine
Thioridazine
haloperidol
2 2nd gen antipsychs
Clozapine
quetiapine
3rd gen antipsych
aripiprazole
AE of 1st gen antipsychs and teaching
Neuroleptic malignant syndrome (muscle rigidity (BOARD LIKE), high fever, delirium) - REPORT TO HCP
AE of 2nd gen antispsychs and teachign
agraulocytosis - Low WBCs
- Need routine lab work
- Report s/s infection
TCA med
imipramine
serotonin syndrome
similar to neuroleptic syndrome but not board like movement
MAOi med
phenelzine
EDUCATION FOR MAOI med and which med
phenelzine
NO tyramine foods
* Mature or aged cheeses or dishes made with cheese, such as lasagna or
pizza. All cheese is considered aged except cottage cheese, cream
cheese, ricotta cheese, and processed cheese slices.
NO DRIED FRUITS/no pickled veggies
* Aged meats such as pepperoni, salami, mortadella, summer sausage,
beef logs, meat extracts, and similar products. Make sure meat and
chicken are fresh and have been properly refrigerated.
* Italian broad beans (fava), bean curd (tofu), banana peel, overripe
fruit, and avocado.
* All tap beers and microbrewery beer. Drink no more than two cans or
bottles of beer (including nonalcoholic beer) or 4 oz of wine per day.
* Sauerkraut, soy sauce or soybean condiments, or marmite
(concentrated yeast).
* Yogurt, sour cream, peanuts, brewer’s yeast, and monosodium
glutamate (MSG).
how long do TCA, SSRI and MAOI take to work
TCA: 4-6
ssri: 2-3
maoi: 2-4
MOA of anticonvulsants
increase gaba
2 teaching for valproic acid and lithium
blood level monitoring
take w meals
5 se if lithium levels too high
severe diarrhea, vomiting, drowsiness, muscle weakness, lack of coordination
*think stumbling to the bathroom
2 causes of lithium toxicity
renal impairment
low Na
2 ae of valproic acid
weight gain, alopecia, hand tremor
MOA of benzos
mediation of gaba
med that is a benzo
lorazepam
buspirone class
not a benzo but an antianxiety med
MOA of stimulants
release neph, dopamine, serotonin
3 med names of stimulants
Methylphenidate, amphetamine, dextroamphetamine
2 teaching for amphetamines
take after meals to prevent weight loss
no sugar, caffeine, chocolate
teaching for disulfiram
no alcohol (including shaving cream, deodorant, OTC cough meds)
name 8 medication nonadherance reasons
Increased restrictions on patient’s lifestyle
Unsupportive significant others
Remission of target symptoms
Increased suicidal ideation
Increased suspiciousness
Unrealistic expectations of drug effects
Polypharmacy
History of nonadherence
dopamine 4
complex movements, motivation, cognition, regulation of emotional response
Neph 6
attention, learning, memory, sleep, wakefulness, mood regulation
serotonin 7
food intake, sleep, wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions - inhibitory
acetylcoline 2
sleep-and-wakefulness cycle; signals muscles to become alert
frontal lobe
executive function, planning, problem solving
parietal lobe
perception, arithemtic, spelling
temporal lobe
memory, understanding, language
midbrain
in brainstem , sleep consciousness awareness via RAS
pons
in brainstem, primary motor
limbic system structures
thalamus, hypothal, hippocampus, amygdala
thalamus 3
activity, sensation, emotion
hypothalamus 2
Endocrine, impulses
hippocampus 2
emotions, memory
