Mental Health Exam 1 Quizlet, Quizzes of Nursing

Download Mental Health Exam 1 Quizlet and more Quizzes Nursing in PDF only on Docsity! Mental Health Exam 1 Quizlet DSM-5 Gives each mental disorder criteria for a definable diagnosis Diathesis-stress model a psychological theory as the result of an interaction between a pre-dispositional vulnerability (genetics or biologics) which is the diathesis, and a stress (environment) caused by life experiences, etc Mental Health Parity Act passed in 1996 to ensure there was adequate coverage for mental health illnesses and that annual lifetime reimbursement limits on mental health services were similar to other medical benefits Milieu therapy -Recognizes that the staff, client, setting, structure, and the emotional climate are important to healing -should offer the client a sense of security and promote healing. Both staff and clients establish behavioral limits, so all members of the team participate in the plan of care. -if the client demonstrates distress or anxiety about visitors, the nurse should advocate for the client and explain that they have a right to refuse visitors Tertiary prevention -treats the disease intending to prevent worsening of symptoms or worsening of a disease, such as depression -would focus on preventing suicide, or loss of employment, and disruption to the family process - also includes crisis screening/care and treatment Secondary prevention include identifying problems early, screening, and prompt, effective treatment is the goal of secondary prevention The goal of primary prevention is to prevent or delay the onset of symptoms in predisposed clients. Clinical pathways provide standardization in treatment for inpatient treatment informed consent -When a client signs it is the provider's responsibility to explain the procedure, alternatives to the procedure, who will be performing the procedure, and the risks and benefits of the procedure. - when can health care professionals override treatment refusal? refusal when a client is actively suicidal or homicidal. A suicidal or homicidal client who refuses treatment may be in danger or a danger to others. This situation should be treated as an emergency, and treatment may be performed without informed consent Involuntary admissions are commonly reserved for those people who are suicidal, homicidal, or extremely disabled and in need of acute care Mental Status Evaluation Assessment of the client's orientation to reality is part of this evaluation. When assessing a client's orientation, the nurse should ask the client to identify their name, date, residential address, and situation. Three levels of awareness the conscious, preconscious, and unconscious The unconscious includes all repressed memories, passions, and unacceptable urges that are deep below the surface of awareness The conscious part of the mind contains all the material a person is aware of at any one time. the preconscious in Freud's theory, the level of consciousness in which thoughts and feelings are not conscious but are readily retrieveable to consciousness Transference is a concept from classic psychoanalysis that refers to unconscious feelings that a client has toward the nurse that were originally felt in childhood for a significant other Countertransference -is when the nurse unconsciously displaces feelings related to significant figures in the nurse’s past onto the client -can develop from overinvolvement or inappropriate feelings for a client and impairs the therapeutic relationship. The superego the instinctual part of the mind that responds immediately to wants and desires. It is chaotic and animal-like, seeking pleasure and avoiding pain The ego the decision making part of the mind. It also seeks pleasure, but uses reason and logic to do so. It tries to get the unrealistic id to cooperate in a society bound by laws and social norms. the id the voice that incorporates the values and morals which are learned from one's parents and society. It tries to persuade the id and ego to turn to moral and goals rather than seeking pleasure Freud's Psychosexual Stages oral stage, anal stage, phallic stage, latency stage, genital stage most common anti-anxiety agents enhance the effects of GABA examples: Lorazepam (Ativan), Diazepam (Valium), Clonazepam (Klonopin), and alprazolam (Xanax) Buspirone (BuSpar) drug that reduces anxiety w./o the sedative effect. SSRIs block the reuptake of serotonin thereby making more of this neurotransmitter available EX: -Fluoxetine (Prozac), Setraline (Zoloft), Citalopram (Celexa) Escitalopram (Lexapro), and fluvoxamine (Luvox) Tricyclic antidepressants (TCAs) were widely used before the development of SSRIs. they have more side effects and take longer to reach optimal therapeutic dose; far more lethal in overdose. EX; Notriptyline (Pamelor), Amitriptyline (Elavil), and Imipramine (Tofranil) MAOIs class of antidepressants that can have a desired effect in the brain while exerting potentially dangerous effects elsewhere. Must avoid tyramine rich foods with these EX: Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (EMSAM), and tranylcypromine (Parnate) tyramine rich foods aged cheese, pickled or smoked fish, and wine Lithium used as a mood stabilizer in patients with bipolar (manic-depressive) disorder. may reduce the excitatory neurotransmitter glutamate and exert an antimanic effect. First-generation antipsychotics These drugs are strong antagonists (blocking the action) of the D2 receptors for dopamine. Examples are haloperidol (Haldol), and chlorpromazine (Thorazine). Second-generation antipsychotics These drugs produce fewer EPS and target both the negative and positive symptoms of schizophrenia -Examples are Clozapine (Clozaril), Risperidone (Risperdal), Quetiapine (Seroquel), and Olanzapine (Zyprexa Drug Treatment for Attention-Deficit/Hyperactivity Disorder Both methylphenidate (Ritalin, Daytrana—a transdermal system) and dextroamphetamine (Adderall, Vyvanse) are helpful in these conditions. The Sympathetic Nervous System plays a significant role during stressful situations. The sympathetic nervous system prepares the body for the fight-or-flight response. Parasympathetic Nervous System is dominant when an individual is in a non-stressful state emotion or in a therapeutic group setting Effective use of silence Nurse should remain quiet and allow time for the client to respond Techniques of active listening include Facing squarely using an open posture, leaning forward when a person is talking. Using good eye shows the nurse is listening and not distracted Therapeutic Use of Self The most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client is to clarify his/her own personal attitudes, values, and beliefs. Understanding one's attitudes, values, and beliefs are referred to as self-awareness. Restatement involves repeating the main idea of what the client has said. It allows the client to know whether the statement has been understood and provides an opportunity to continue Focusing facilitates the client's ability to focus on and pay attention to the matters at hand and should reflect the client's priorities. Acceptance lets the client know the nurse is interested in them and respectful of them and their thoughts. It also allows the client to recognize that the nurse is open, honest, and is without bias or judgment. Offering general leads encourages the client to continue Using open-ended questioning questioning allows the nurse to gather more information without limitations or influence. Using broad openings allow the client to take the initiative in introducing the topic and emphasizes the importance of the client's role in the interaction. Short phrases are best used for clients whose anxiety and/or aggression is increasing. These can only understand simple short, phrases. It is also appropriate for the nurse use the intervention of a “time out” with such a client. culture depending on culture variations in symptoms can occur panic attacks in latin americans and northern europeans often involve sensations of choking, smothering, numbness, or tingling, as well as fear of dying Assessment of Risk Factors Childhood neglect, spousal abuse, and parental substance use are all environmental risk factors. Psychological risk factors include temperament and resilience outcome of music therapy Improved psychological functioning Behavioral interventions use a reward system to reward appropriate behavior, which in turn reduces maladaptive behavior art therapy The expression of confusing emotions is an outcome group therapy Improved impulse control is an outcome Conduct disorder is a persistent pattern of behavior in which the rights of others are violated and societal norms or rules are disregarded. The behavior is usually abnormally aggressive and can frequently lead to destruction of property or physical injury Complications associated with conduct disorder disorder include juvenile delinquency, drug and alcohol abuse and dependency, and juvenile court involvement Intermittent explosive disorder Higher than normal levels of inflammatory markers are found in clients with intermittent explosive disorder assessment of abuse and neglect -. It is important for the nurse to evaluate whether or not the reported mechanism of injury is consistent with the actual injury itself. -Often, the history does not match the injury, which may be due to the abuser's wish to conceal the abuse. -The nurse should not assume the bruises were caused by abuse; the client's explanation is an important step in the data collection process of potential abuse. -A nurse must collect data prior to getting the supervisor and prescriber involved. -Reporting abuse is initiated after a thorough collection of subjective and objective data. Parents who physically abuse their own children are more likely to end up as targets for abuse by their offspring A parent’s refusal to allow an adolescent to answer questions indicates control and potential abuse Normal development findings in adolescents indicates the client should be able to answer health related questions and share decision making with their parents and care team Mistreatment includes failure to provide for the older adults’ basic needs or to protect them from harm Asking the client to answer the questions without looking at the adult child could make the client feel feel more fearful or uncomfortable and could put the client at risk for more abuse at home. The nurse should avoid trying to prove abuse, making accusations, placing blame, or judgment because it decreases trust.