Understanding the Role of Renewable Energy in Sustainable Development, Exams of Health sciences

Download Understanding the Role of Renewable Energy in Sustainable Development and more Exams Health sciences in PDF only on Docsity! Mental Health- Concepts - Level 3 Exam Questions with Answers Latest Update 5 A's - Correct Answers -steps for incorporating EBP into clinical practice 1. Ask a question: identify a problem 2. Acquire literature: search for scientific evidence 3. Appraise the literature: evaluate the research for relevance and merit 4. Apply the evidence: choose interventions 5. Assess the performance: evaluate using clearly defined criteria RTC - Correct Answers -randomized controlled trail -pts are chosen at random to receive one of the different clinical interventions or be in a control group w no treatment Resources for clinical practice - Correct Answers -internet resources: Cumulative Index to Nursing and Allied Health Literature, PubMed, Cochrane reviews and self-tests -clinical practice guidelines: statements based on literature review that appraise and summarize the best evidence to guide clinicians in making informed decisions bake specific health problems --The American Psychiatric Association's Clinical Practice Guidelines and the National Quality Measures Clearinghouse offer such guidelines -Clinical algorithms: step by step guidelines prepared in a flowchart or decision tree format -Clinical/critical pathways: serve as a map for specified treatments and interventions to occur within specific time frames that have been shown to improve clinical outcomes --include tests, health teaching, and medications --time specific format Research-Practice Gap - Correct Answers -There is a wide gap between the best evidence treatment and its translation into practice The Recovery Model - Correct Answers -more of a social model than a medical model -emphasis on rehabilitation and recovery -originated from the 12 step program of AA and the Consumer/Survivor/Ex-patient Movement -one of the leading models promoted by the substance abuse and mental health services administration -recovery: refers to managing symptoms, reducing psychosocial disability, and improving role performance -encourages supportive relationships -recovery is evidenced by functioning in work, having a life in the community/social life, and reduction of symptoms -empowers pts to realize their full potential and independence within the limitations of their illness -pts are partners in care -care plans are individualized Trauma-Informed Care - Correct Answers -recognizes that trauma is almost universally found in the histories of mental health pts and is a contributor to mental health issues, substance abuse, chronic health conditions, and contact w the criminal justice system -trauma: includes physical, sexual, and emotional abuse, war, natural disasters, etc. -instead of "what's wrong w you?" asks "what happened to you?" -avoids traumatizing the pt -open relationship between pt and provider QSEN - Correct Answers -Quality and safety education for nurses -overall goal is to prepare future nurses w the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the healthcare system -6 standards: pt centered care, teamwork and collaboration, EBP, quality improvement, safety, informatics The Art of Nursing - Correct Answers -"too great an emphasis on evidenced based medicine oversimplifies the complex and interpersonal nature of clinical care" -caring: giving of self while preserving the importance of self -attending: intensity of presence, being there for and in tune w the pt, active listening, body posture, eye contact, touching, or giving attentive physical care -patient advocacy: speaking up for another's cause, ethical role Mental Health - Correct Answers -successful performance of mental functions, resulting in the ability to engage in productive activities, enjoy fulfilling relationships, and cope w adversity -psychiatry's definition evolves over times and reflects changes in cultural norms -fundamental to health Mental Illness - Correct Answers -medical conditions (dysfunctions of the brain and neurotransmitters) that affect a person's thinking, feeling, mood, ability to relate to others, and daily functioning -the result of flawed biological, psychological, or social processes -treatable and sometimes curable DSM-5 - Correct Answers -The Diagnostic and Statistical Manual of Mental Disorders -current guidebook for categorizing and diagnosing psychiatric mental health disorders in the US -rooms designed w safety in mind: closet rods/ shower bars that break w minimal weight, heavy furniture that can't be used as a weapon, locked windows, etc. -crisis intervention, stabilization, and pt safety are goals -group therapy -some get therapeutic passes to leave for limited periods Other treatment facilities for Mental Health - Correct Answers -State Acute Care System: role varies state to state; tend to serve the seriously ill, the uninsured, or those that have exhausted limited benefits, most states house court related care including those found not guilty by reason of insanity -General Hospital Psychiatric Units: floors dedicated to Mental Health -Pediatric Psychiatric Care: same treatment, apart from adults -Geriatric Psychiatric Care: takes into account the effects of aging on psychiatric symptoms, dementia is a common problem w this population -Veterans Administration Centers: active military personal, federally funded -Forensic Psychiatric Care: incarcerated populations -Alcohol and Drug Abuse treatment centers -self-help options: alcoholics anonymous and other support groups Ethical dilemma - Correct Answers -results when there is a conflict between two or more courses of action, each carrying w them favorable and unfavorable consequences -based partly on our own morals Bioethics - Correct Answers -a specific term that refers to the ethical questions that arise in health care -5 basic principles: -beneficence: the duty to act so as to benefit or promote the good of others -autonomy: respecting the rights of others to make their own decisions -justice: the duty to distribute resources or care equally, regardless of personal attributes -fidelity (no maleficence): maintaining loyalty and commitment to the pt and doing no wrong to the pt -veracity: one's duty to communicate truthfully Mental health laws - Correct Answers -vary from state to state -mental health care must receive coverage equitable to other physical medical conditions -mental health care and substance abuse coverage are included in the affordable care act Civil Rights and Mental Health - Correct Answers -people with mental illnesses are guaranteed the same rights under federal and state laws as any other citizen -the right to vote, the right to civil service ranking, the rights related to granting forfeit or denial of a driver’s license, the right to make purchases and to enter contractual relationships, the right to press charges against another person -the mentally ill in prisons and jails are afforded the same protections -many states have mental health courts to process criminal cases involving defendants w mental illnesses -least restrictive alternative doctrine: the least drastic means must be taken to achieve a specific purpose Recovery in Mental Health - Correct Answers -staying in control of their life, hope, understanding disabilities and strengths, life beyond mental illness -does not refer to a "cure", illness is chronic Due process in Civil Commitment - Correct Answers -involuntary civil commitment to a mental hospital is a massive curtailment of liberty which requires due process protections in the civil commitment procedure -in most states a pt can challenge commitments through a writ of habeas corpus (formal written order) Requirement for hospital admission - Correct Answers -a well-defined psychiatric problem must be established based on current illness classification in the current DSM- 5 -the nature causes an immediate crisis situation or that other less restrictive alternatives are inadequate Voluntary admission - Correct Answers -sought by the pt or the pts guardian through a written application to the facility -have the right to demand and obtain release Involuntary admission - Correct Answers -commitment -made without the pts consent -persons in need of psychiatric treatment, present danger to self or others, or unable to meet his or her own basic needs -the pt must retain freedom from unreasonable bodily restraints -have the right to informed consent -have the right to refuse medication including psychotropic and antipsychotic medications -3 different commitment procedures are available: judicial determination, administrative determination, and agency determination -a specified number of physicians must certify that a person's mental health status justifies detention and treatment Emergency involuntary hospitalization - Correct Answers -commitment for a specified period to prevent dangerous behavior that is likely to cause harm to self or others Observational or temporary involuntary hospitalization - Correct Answers -longer duration than emergency hospitalization Long-term or formal commitment - Correct Answers -extended care for the mentally ill -generally 60-180 days Involuntary outpatient commitment - Correct Answers -a preventive measure allowing a court order before the onset of a psychiatric crisis that would result in an inpatient commitment -pt must follow to access goods, like benefits and housing -may face inpatient admission if he or she fails to participate in treatment Discharge for Hospital - Correct Answers -depends on pts admission status -pts w voluntary admission have the right to request and receive release -conditional release: usually require outpatient treatment for specified period to determine the pts adherence w medication protocols ability to meet basic needs and ability to reintegrate into the community -unconditional release: the termination of a pt institution relationship -against AMA: disagreement between mental health care providers and pts as to whither con hospitalization is necessary Pt Rights - Correct Answers -right to treatment: mental health treatment must be provided by the public hospital -right to refuse: may withdrawal at any time -right to determine if they would rather be involuntarily committed or medicated -right to informed consent, voice grievances, and recommend changes without fear of punishment -neither voluntary or involuntary admission determines whether pts are capable of making informed decisions -if found incompetent the court may appoint a legal guardian, the person the guardian protects is called the ward, usually family members -implied consent is not the same as informed consent -right to advance directive for mental decision making -right to use the least restrictive means of restraint for the shortest duration is always the general rule and even the law, verbal interventions, then medication -restraints are used when the immediate physical safety of the pt, a staff member, or others is in jeopardy and is d/c at the earliest time -right after death: cannot divulge info after a person's death that could not have been legally shared before death -if voluntarily committed, the pt has the right to request discharge and leave within 4 hours unless the physician determines d/c is unsafe Duty to Warn - Correct Answers -a psychotherapist has a duty to warn a pts potential victim of potential harm -all 50 states have enacted child abuse reporting statues: a def. of child abuse, a list of individuals required or encouraged to report abuse, and the go agency designed to receive and investigate the reports, penalties for failure to report -elder abuse reporting statutes: a growing number of states an enacting, for adults 65 and older or those w physical or mental limitations -those that do not report are guilty of a misdemeanor -conflicting messages: double messages or mixed messages, the verbal message is not reinforced or is contradicted by the nonverbal message -double bind messages: messages that are sent to create meaning but also used defensively to hide what is really occurring, create confusion, and attack relatedness -silence is an effective tool, those who lack confidence in their ability to express themselves may communicate a need for support and encouragement through their silence, only worthwhile as long as is serving some function -active listening -clarifying techniques -paraphrasing -restating -reflecting: may take the form of a question or a simple statement that conveys the nurses observations -sharing observations -exploring -"what if" -"the miracle question" Nontherapeutic techniques - Correct Answers -excessive questioning -giving approval: the pt then sees such a response as a way to please the nurse -disapproving: implies that the nurse has the right to judge the pts thoughts and feelings -advising: often when we ask for advice our real motive is to discover if we are thinking along the same lines as someone else -asking "why": very often implies criticism, more useful to ask what is happening Patient centered partnership - Correct Answers -implies a pts allowance for control over his or her health care decisions -the basis of all psychiatric nursing treatment -creative process, unique to each nurse -non adherence w treatment and poor outcomes in therapy are related to a pt feeling unheard, disrespected, or otherwise unconnected -specific goals and functions: facilitating communication of distressing thought, assisting w problem solving w ADLS, help pt examine self-defeating behaviors, promoting self- care and independence -choose a setting where the nurse and the pt feel safe -chairs should be arranged so that conversion can include normal tones and eye contact -assume the same height -avoid face to face stance -the pt should not be between the nurse and the door -avoid using the desk as a barrier Social relationships vs. therapeutic relationships - Correct Answers -social relationship: a relationship that is primarily initiated for the purpose of friendship, socialization, enjoyment, or accomplishment of a task, mutual needs are met therapeutic relationship: the nurse maximizes his or her communication skills, understanding of human behavior and personal strengths to enhance the pts growth -the focus needs to be on the pts ideas, experiences, and feelings -ALWAYS focused on the pt, nurses feelings aside -the nurse must have: accountability, clinical competence, delay judgment, and supervision of more experienced clinicians -when encounters are brief, they are called a therapeutic encounter and can still have an effect on the pt -a sense of genuineness helps the relationship -the nurse should display empathy, UNDERSTANDING the pts feelings -positive regard implies respect, the ability to view another person as being worthy of being cared about -the pt leads the clinical interview Establishing boundaries - Correct Answers -do not let the relationship slip into a social context -be careful of over helping when the pt can do something for themselves -do not assume control "for their own good" -watch for narcissism: having to find weakness in pts in order to feel helpful Transference - Correct Answers -the process whereby a person unconsciously and inappropriately displaces onto individuals in his or her current life those patterns of behavior and emotional reactions that originated in relation to significant figures in childhood -seem intensified in figures of authority Countertransference - Correct Answers -the tendency of the nurse to displace onto the pt feelings related to people in his or her past -the nurse must recognize their own feelings in order to allow the pt to grow and to empower them -we disempower our pts by experiencing them not as individuals but rather as inner projections -a feeling of strong positive or negative reaction to a pt almost always signals countertransference Orientation phase - Correct Answers -a few meetings or longer -nurse clarifies role -rapport develops -a contract of a meeting time develops -confidentiality is discussed -provide a good atmosphere -termination should also be discussed Working phase - Correct Answers -allows for the pt to experience increased level of anxiety and demonstrate dysfunctional behavior in a safe setting while experimenting w new and more adaptive coping behaviors -the nurse can help the pt identify problem behaviors or thoughts that are beyond the pts awareness -intense emotions: anger, anxiety, self-hatred, hopelessness, and helplessness may surface -defense mechanisms: acting in anger, withdrawing, intellectualizing, manipulating and denying are expected -avoid giving advice -use verbal tracking to provide the pt w cues that you understand what has been said Termination phase - Correct Answers -the final phase -may occur when pt is discharged or when the students clinical rotation ends -summarize the goals and objectives -discuss ways for the pt to incorporate new coping strategies into life -review situations that occurred while working together -exchange memories of the experience -maintaining contact after discharge is not acceptable and is in opposition to the goals of a therapeutic relationship