Psych Test #1

  1. Mental Health Recovery Model vs. EBP Model
    • Recovery - Consumer and family driven
    • EBP - increases gap between research and practice
  2. Hildegard Peplau
    • Mother of Psych nursing
    • Trust is needed between nurse and patient
  3. Milieu
    everything going on around the patient
  4. The 5 A's of EBP
    • Ask a question.
    • Aquire the literature
    • Appraise the literature
    • Apply the evidence
    • Assess the performance
  5. Clinical algorithms
    provide step-by-step guidelines prepared in a flowcart
  6. Attributes of Nursing
    • Caring
    • Attending
    • Patient advocacy
  7. The sucessful performance of mental functions, resulting in the ability to engage in productive activites, enjoy fulfilling relationships, and make changed or cope with adversity.
    Mental Health
  8. 7 signs of Mental Health
    • Happiness
    • Control over behavior
    • Apprasial of reality
    • Effectiveness in work
    • Healthy self-concept
    • Satisfying relationships
    • Effective coping strategies
  9. A clinically significant behavioral or psychological syndrome experienced by distress, disability, or the risk of suffering disability or loss of freedom.
    Mental Illness
  10. Emotional intelligence
    Put emotions at the center of skills for living
  11. Recognizing your emotions as they occur
    Managing your emotions internally
    Emotional self-control
    Recognizing emotions in others
    Handling relationships
    ....are all abilities of?
    Emotional intelligence
  12. Resiliency
    The ability to recover or adjust to misforturne and change
  13. Emotional contagion
    Our tendency to automatically mimic the emotion that we see in the other person
  14. A part of us that deals with relationships and the valuse and addresses questions of purpose and the meaning of life.
    Union of people.
    Grounding sense of identity
  15. Epidemiology definition
    the quantitative study of the distribution of disorders in human populations
  16. Prevalence rate definition
    the proportion of a population with a mental disorder at a given time.

    (How common in a population)
  17. Purpose of mental health epidemiology
    • Identifies high risk groups
    • Identifies high risk factors
    • Uses information to improve clinical practives and plan public health policies
  18. A broad field that addresses what happens to people with illnesses who are seen by clinical providers.
    Clinical epidemiology
  19. Mental Health parity
    • Equality for mental health
    • requires mental health insurers to provide same benefits are provided for med-surg coverage
  20. Culture and mental illness
    Must consider norms of the culture prior to diagnosing.
  21. Axis I
    Dominant disorder
  22. Axis II
    Personality disorder or Mental retardation
  23. Axis III
    Medical disorders related to mental disorder
  24. Axis IV
    Socioeconomic, enviornmental problems
  25. Axis V
    GAF  #now/#in the past year
  26. GAF
    • Global Assessment of Functioning scale
    • Scale of 0-100 (100 being the best)
  27. Importance of Nurse-Client Relationship
    • To build trust
    • First and most pivotal step in achieving effective management.
  28. Genuineness
    • Enhances therapeutic relationships
    • Ability to meet person to person
  29. Empathy
    • Enhances therapeutic relationships
    • Understanding what another person is going through
  30. Positive Regard
    • Enhance therapeutic relationships
    • Viewing an individual as having worth
  31. Safety to enhance a therapeutic relationship
    Providing a safe environment.
  32. Confidentiality to enhance therapeutic relationship
    Can not keep secrets that may jeopardize a client's well-being
  33. Reliability to enhance therapeutic relationships
    keep appointments, don't make unrealistic promises
  34. Clear boundries
    • Enhance therapeutic relationships
    • enhance safety
    • Maintain focus on client
  35. Goals of therapeutic nurse-client relationships
    • Facilitating communication of distressful thoughts
    • Assisting problems solving and with ADLs
    • Helping client to examine self-defeating behaviors and find alternatives
    • Promoting self-care and independence.
  36. Social relationships
    • A friendship
    • Mutual needs are met
    • Give advice
    • Roles may shift during interaction
  37. Intimate relationships
    • Emotional commitment 
    • Mutual needs are met
    • Personal and intimate information is shared.
  38. Therapeutic relationship
    • Consistently focused on clients problems and needs, not the nurse.
    • Clients problems are explored, solutions are discussed and implemented
  39. Non-therapeutic nurse-client relationship issues
    • Nurse trying to meet her own needs
    • Nurse tries to solve clients problems
    • Nurse takes on role or friend or family
    • Poor boundries
  40. Clinical solution to non-therapeutic relationships
    seeking peer counseling to help get a healthy perspective and maintain therapeutic relationship.
  41. Auto-diagnosis
    • Nurse needing to to aware of own triggers and issues
    • Self-reflection
  42. Boundries
    invisible lines that define the amount and kind of contact between individuals
  43. Why do we have boundaries?
    • To determine patterns of how people relate
    • Promote feelings of safety
    • Promote autonomy
  44. Clear boundries
    • Firm but flexible
    • Promotes safety
  45. Diffuse boundries
    • Little distinction between individuals
    • Loss of autonomy
  46. Transference
    client unconsciously transfers unresolved feelings, attitudes and wishes into present significant relationships in an attempt to resolve them in a more satisfying way.
  47. Counter transference
    • nurse/therapist displaces onto the client, feelings related to people in the nurse's past relationships.
  48. Modeling
    • Values formed through the example of others.
    • Vivid example of values in action.
  49. Values
    • Provide a framework for which life goals a person will develop.
    • Culturally oriented.
  50. Pre-orientation phase of Nurse-Client relationship
    • Prior to meeting the client
    • Quick auto-diagnosis/self-reflection.
  51. Orientation phase of Nurse-Client relationship
    • Establish trust, parameters, contract, confidentiality, boundaries.
    • Meet the patient
    • *Termination begins
  52. Working phase of Nurse-Client relationships
    • Maintain relationship
    • Gather further data
    • Promote clients skills, self-esteem, use of language
    • Facilitate behavioral changes
    • Evaluate problems and goals
  53. Termination phase of Nurse-Client relationship
    • Deal with intense feelings
    • Summarize goals and objectives
    • Provide client with community resources
  54. Communication
    The process of sending a message to one or more persons
  55. Stimulus
    one person has a need to communicate with another
  56. Sender of communication
    initiates interpersonal contact and sends messsage
  57. Receiver of communication
    • Evaluates and interprets message
    • Gives feedback
    • Validation of message is most important
  58. Clearest messages are:
    well organized and expressed in a manner that is familiar to the receiver
  59. Use of silence
    • NOT an absence of communication
    • worthwhile as long as it is serving some function and not frightening to the client
  60. Active listening
    • Paying undivided attention to what client is saying and doing
    • Do not focus on self
    • Done in a environment which is free from distrctions
  61. Clarifying techniques for communication
    • Paraphrasing, restating, reflecting, exploring
    • Give opportunity to check that the message was correctly understood.
  62. Paraphrasing
    Receiver restates in different words that basic content of the clients message
  63. Restating
    • repetition of the same keywords that client has spoken
    • restate feelings as well
  64. Reflecting
    Nurse reflects back on the feelings without repeating the exact words
  65. Exploring
    • Enables further examination of important ideas, relationships and experiences.
    • ie...asking for an example
  66. Open-ended questions
    • Can not be answered in a few short words
    • Increases participation
  67. Closed-ended questions
    • Can be answered with yes or no
    • * Use with clients experiencing high level of anxiety or have disorganized thinking.
  68. Indirect or Implied questions
    • Can be used when you dont want to pressure client.
    • Use sparingly
    • Avoid with paranoid clients
  69. Giving approval or disapproval during communication
    Ineffective techniques of communication
  70. Asking "why" questions during communication
    Imply criticism and feels like an interrogation.
  71. Why do people want to commit suicide?
    To solve a problem or stop the pain
  72. Reg flag for suicide awareness
    • Someone states that they are hopeless
    • Early morning rising
  73. Causes of suicide within a hospital
    Absent or incomplete suicidal ideation during initial assessment or reassessment
  74. Biologic reasons for committing suicide
    • Neurotransmitter imbalance
    • Genetics
    • Alterations in brain structure (esp. frontal lobe)
  75. Psychological reasons for committing suicide
    • interpersonal conflicts
    • negative thinking patterns
  76. Sociological factors for committing suicide
    isolation from a group
  77. Suicidal ideation
    Direct or indirect thoughts of suicide
  78. Suicidal threats
    Direct written or verbal messages of intent to committ
  79. Suicidal gestures
    • Actions resulting in minor injury
    • No intent to die
  80. Suicidal attempts
    Serious actions with intention to die
  81. Antidepressants and risk for suicide
    Contribute to suicide behavior -- SSRIs -- d/t having more energy and still being depressed, now they have to energy to do it.
  82. Risk factors for suicide
    • Suicide plan
    • Previous attempts
    • Social support
    • Recent losses
    • Medical problems
    • Alcohol/drugs
  83. SADPERSONS scale
    • Assessment tool to determine suicide risk 
    • Range from 0-10
  84. Interventions for suicide risk
    • Do not leave alone
    • Communicate to team
    • Accept and Listen
    • Instill hope
    • Initiate precautions
  85. "No self harm" contracts
    • Specify length of time
    • Not a guarantee that client won't hurt themselves
    • Continue to monitor
  86. Depression in children
    More hyperactive and aggitated
  87. Resources for family of suicide
    NAMI - National Alliance of Mental Illness
  88. Schizophrenia
    • Brain disease caused by too much dopamine
    • Treatable NOT curable - life long meds
    • Genetic disposition
  89. Criteria for Schizophrenia
    • Lasting 6 months
    • Active symptoms for 2 months
    • 2 of the following active symptoms: Delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms
  90. GABA system
    • Inhibitory system
    • Neurotransmitters calm you down
  91. Gludamate
    • Excitatory system
    • Neurotransmitters excite you
  92. Anhedonia
    inability to experience pleasure/joy
  93. Positive symptoms
    • Extra symptoms present in someone
    • Delusion
    • Speech
    • Hallucinations
    • Waxy flexibility
    • Akathesia
  94. Circumstantiality
    • (+) symptom
    • Go off tract but eventually come back
  95. Tangeniality
    • (+) positive symptom
    • Go off tract and never come back
  96. Perservation
    • (+) symptom
    • Keeps going on about a thought
  97. Associative looseness
    • (+) symptom
    • Jump from topic to topic
  98. Neologisms
    • (+) symptom
    • Word that patient makes up
  99. Echolalia
    • (+) symptom
    • Imitate another persons speech
  100. Clang association
    • (+) symptom
    • Associating a work that sounds familiar
  101. Word salad
    • (+) symptom
    • No words match up
    • Random words
  102. Hallucination
    • (+) symptom
    • Sensory perception when no external stimuli exists
  103. Akathesia
    • (+) symptom
    • Extreme motor agitation can not stay still.
  104. Echopraxia
    Imitate actions of another person
  105. Negative symptoms
    • Things missing in a person
    • Energy, pleasure, desire...
  106. Anergia
    Lack of energy
  107. Anhhedonia
    Lack of pleasure
  108. Avolition
    Lack of desire
  109. Dysphoria
    depressed, sad mood
  110. Schizophreniform
    S/S more than 1 month but less than 1 year
  111. Schizoaffective
    • Happens generally later in life
    • Severe mood swings
    • Some psychotic s/s
  112. Brief psychotic episode
    • Sudden onset
    • At least 1 (+) symptom
    • Lasting at least 1 day but less than 1 month
  113. Shared psychotic episode
    Involves 2 individuals and they share the same delusion
  114. Delusional disorder
    • Non-bizarre delusions
    • At least 1 month in duration
  115. Psych assessment
    • Medical exam
    • Use of meds and compliance
    • Safety
    • Assess support system
    • Assess relationships
Card Set
Psych Test #1
Mental Health & Mental Illness