Mental health exam 1 quizlet PDF

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Mental health exam 1

What is the area of the brain that mediates anger experiences, judging events as aversive or rewarding? amygdala What nursing diagnosis should be considered for potential for anger or aggression? -risk for other directed violence -risk for self directed violence -ineffective coping -stress overload -impaired impulse control

Why should therapeutic communcation be used? to establish the nurse is: safe, confidential, reliable, consistent

What is a therapeutic relationship? -needs of pt identified and explored -clear boundaries established -problem solving approaches taken -new coping skills developed -behavioral change encouraged

How do you develop rapport w/ patient? factors actors that help nurse-patient relationship -consistency -pacing -listening -initial impressions -promoting pt comfort and balancing control

-pt factors inclue: trust and active participation

What are the difference between a mental health RN and mental health NP? RN: diagnosing and treating responses to disorders, coordinating care, counseling, giving meds, educating, evaluating response

APRN: diagnosing psych conditions, prescribing meds and therapies, conducting psychotherapy, case management, consulting, education research

What are some ways to promote patient growth? -genuineness -empathy (not sympathy) -positive regard: attitudes and actions -attending -suspending value judgments -helping pt develop resources

How can the nurse enhance communication? using silence, active listening, listening with empathy

How do you demonstrate empathy? "temporarily living in the other's life, moving about in it delicately without making judgments"

"ability to understand a patient's experience and communicate in a manner that conveys recognition of patients concerns and perspectives

What is the DSM-5 and ICD-9? DSM5- diagnostic and statistical manual of mental health used strictly in America ICD9- international classification of disease, clinical description of mental and behavior disorders

What is NANDA-I? describes a nursing diagnosis as a clinical judgment about individual, family, or community responses to actual or potential health problems and life processes

What mental disorder is more common in America vs other countries? anorexia

What is incidence? number of new cases that develop in a given period of time

What is prevalence? number of cases of a disease that are present in a particular population at a given time

What is comorbidity? the simultaneous presence of two chronic diseases or conditions in a patient.

What is the criteria needed for person to be hospitalized or receive outpatient treatment for mental illness? -imminent danger of harming others -imminent danger of harming self -unable to care for basic needs and/or gross impairment of judgement, placing an individual at imminent risk based on inability to protect oneself

What is milieu therapy? -milieu is the overall environment and interactions of the environment. A well managed milieu offers pts a sense of security and promotes healing. Structed aspects of the milieu include activities, unit rules, reality orientation practices and unit environment. The interactions between pts and staff. Can serve as real life training for practicing communication and coping skills

What are the levels of prevention?

primary secondary tertiary

What is the difference between mental health RN working in community setting vs inpatient setting? RN in outpatient setting: strong problem solving and clinical skills, cultural competence, flexibility, knowledge of community resources, autonomy

What the different types of patient confidentiality? -HIPPA -confidentiality after death -confidentiality of professional communications -confidentiality and HIV status

What are exceptions to patient confidentiality rules? duty to warn and protect third parties and child and elder abuse reporting statutes

What would be included in discharge planning? ...

What is negligence? failure to use ordinary care in any professional or personal situation when you have duty to do so

What is malpractice? act or omission to act that breaches the duty of due care and results in or is responsible for ones injuries

What is battery? intentional tort; an offensive touching or use of force on a person without the person's consent

What is false imprisonement? intentional tort; a person is restricted in their personal movement within any area without justification or consen

What is duty and breach of duty? -duty: represent oneself capable of caring for psychiatric pts -breach of duty: nursing conduct falls below the standard of care

What is the difference between voluntary and involuntary admission? -if criteria for admission is met pt is given option of voluntary admission. If they do not wish to be hospitalized but provider feels admission is necessary, pt can be involuntary admitted. These pts still have rights and can petition the court for release.

What three boundaries need to be eastablished in a nurse/pt relationship -physical boundaries -the contract: time, confidentiality, agreement -personal space

What is blurring of boundaries? when relationship slips into social context and/or when nurse's needs are met at expense of patient's needs

-transference and counter transference

What is the difference between transference vs counter transference? -transference: pt unconsciously and inappropriately displaces onto nurse feelings and behaviors related to significant figures in pts past, intensified in relationships of authority -countertransference: nurse displaces feelings r/t ppl in nurses past onto pt, pts transference to nurse often results in contertransference in nurse, common sign of countertransference in nurse is overidentification w/ pt

What would the RN do during the mental health assessment? ...

What are considerations the RN would think about while chosing nursing diagnosis? patient safety, compatible/appropriate, realistic and individualized, evidence-based

What are the factors involved in mental status examination? -spiritual/religious assessment -cultural and social assessment -validating assessment -use rating scales

What are the first phase of the nurse/pt relationship? -orientation phase: establish rapport, parameters of relationship, formal or informal contract, confidentiality, terms of termination

What is the second phase of the nurse/pt relationship? -working phase: maintain relationship, gather further data, promote pts problem solving skills, self esteem and use of language, facilitate behavioral change, overcome resistant behaviors, evaulute problems and goals (redefine as necessary), promote practice and expression of alternative adaptive behavior

What is the third stage of the nurse/pt relationship? -termination phase: summarize goals and objectives achieved, discuss ways for patient to incorporate new coping strategies learned, review situations of relationship, exchange memories

What are the different types of communication techniques? -clarification: paraphrasing, restating, reflecting, exploring, projective questions, presumption questions -reflection -restatement

How would you handle pt asking too many questions? Redirection, "we are here to talk about you"

How do you know a patient is listening to you? Use reflection? reflects and mirrors what the nurse believes the client's feelings to be underneath the words. It mirrors, or reflects, the patient's feelings, not words, back to the client so that the client's feelings can be further explored and expressed by the patient

Whare are barriers of communcation? personal, environmental and relationship factors can affect communication

cultural considerations: communication style, eye contact, touch, bias/prejudice

What are nontherapeutic communication techniques? -excessive questioning -giving approval or disapproval -giving advice -asking why questions

Is there a relationship between emotions/stress and immune stress? Yes, interaction between nervous system and immune system during alarm phase of GAS, negatively affects body's ability to produce protective factors

What role does prayer/exercise have for patients? coping, strerss relief

What are comorbidities of violence? pt w/ PTSD, substance abuse disorder, depression, anxiety, psychosis, personality disorder

How would you respond to hallucinating pt? -Safety first/stay with pt -Do you recogonize voice? -What are they saying? -Are they asking you to hurt yourself/others?

A mental health nurse in an outpatient setting will need to have: -strong problem solving and clinical skills -cultural competence -flexibility -knowledge of community resources -autonomy

What are the three stages of the general adaption syndrome? 1. alarm stage: initial, brief, fight or flight, increased hr, bp, pupils dilate 2. adaption stage 3. exhaustion stage- resources depleted stress chronic,

Distress vs eustress distress- negative, draining energy that results in anxiety, depression, confusion, helplessness/hopelessnessm fatigue

eustress- positive, beneficial energy that motivates and results in feelings of happiness, hopefulness, purposeful movement...