Mental Health Exam 3/Final Study Guide PDF

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A review of all the material you will need to know for the final exam...

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What should you keep in mind about daily routines for OCD pts?$ Schedule changes may make them more anxious @ What is an assessment question one should ask for OCD?$ Did they have strict rules growing up? @ What is Staff splitting?$ Patient is trying to pin staff against each other “the other nurse said you don’t know what you’re doing”  let the patient know you and the other nurse talk directly to one another @ What is a main priority for BPD patients?$ Ensure safety! (Afraid of being alone), abandoned @ Is treatment for BPD quick?$ no!—select all question- not this answer! @ Theory of Object Constancy $ Stage 1: (birth to 1 month) Normal autism Stage 2: (1-5 months) Symbiosis – The infant perceives mother-infant as single entity. Stage 3: (5-10 months) Differentiation – The infant recognizes distinction from the mother. Stage 4: (11-18 months) Practicing – The ability to walk and explore expands the child’s sense of the separateness. Stage 5: (18-24 months) Rapprochement – Toddlers move away and come back for emotional refueling. Need for independence alternates with dependence. Stage 6: (2-5 years) Object constancy – The child realizes that the mother is permanent, even if not physically present. @ Nursing priorities for Antisocial Personality Disorder$ Limit setting- clarify the rules and expectations, understood by patienttherapeutic approach Ensuring safety Try to understand where they’re coming from/what they’re experiencing @ Nursing interventions for Somatic Symptom Disorder$ Let them talk about their pain, but then refocus to discussing coping skills to dealing with their stress @ psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause$ somatic symptom disorder @ disorders characterized by physical symptoms for which no known physical cause exists. $

Somatization Disorder @ ADHD strategies$ if do not follow directions well=tell them the directions, ask patient to repeat directions to you @ Types of therapy for Oppositional Defiant Disorder$ Parent Training Parent-child Interaction Therapy Family Therapy and anger management. The focus is to help the child improve problem solving, reduce impulsivity and manage anger.

@ a childhood disorder in which children are repeatedly argumentative and defiant, angry and irritable, and in some cases, vindictive oppositional defiant disorder @ What are traits of Conduct disorder?$ Physical aggression, violate others, anger, rule setting- antisocial PD, children @ a persistent pattern of deviant behavior involving aggression to people or animals, destruction of property, deceitfulness or theft, or serious rule violations. Usually in children$ conduct disorder @ What is important when creating a treatment plant with a patient who has an Eating Disorder?$ Want patient input to aid in setting outcomes @ Nursing interventions for Anorexia Nervosa$ precise meal times observation after meals daily weigh ins @ What is a sign a patient w/ Bulimia Nervosa is improving?$ Good sign when they can discuss their feelings @ Difference between PTSD vs. Acute Stress Disorder $ Acute Stress: < 30 days, stress response begins to resolve after the traumatic event @ Panic Attacks vs. Dissociative Disorders $ Dissociative- Unconscious memory enters into conscious awareness causing dissociation, difficult to understand Panic- conscious @ $ Conversion Disorder @

Factitious Disorder Imposed on another$ Ex- Made my child sick because no one was paying us any attention @ Group therapy: When is it used? What are the benefits? $ Listening to others experiences is good! @ Nursing interventions with sexual assault$ Safety! Establish trust and rapport Strict confidentially Non-judgment manner Stress that they did the right thing to save their life. Encourage verbalization. Assess the signs and symptoms of physical trauma. Carefully explain all procedures before doing them (e.g., "I will perform a vaginal examination and do a swab. Have you had a vaginal examination before?" [rectal examination in case of a male who has been raped]) @ Diazepam (Valium) should not be prescribed to a patient with panic disorder/anxiety if$ Addiction problems or hx of addiction @ This medication can be prescribed for mood instability and anger control$ Zoloft @ If a loved one is dying/terminal illness, what is it called when the spouse is distant and starts doing things without pt $ Anticipatory Grief @ An inability to experience pleasure from activities usually found enjoyable$

Anhedonia @ Afraid of heights$ Acrophobia @ Agoraphobia $ Afraid of going outside may be caused from a traumatic childhood event @ Recent severe, traumatic event, symptom of trauma, unconscious $ Dissociative fugue state @ Desensitization $ Gradual exposure treatment @ channeling threatening devices into acceptable outlets (e.g. working out), or an alcoholic who volunteers at AA$ Sublimation

@ $Bereavement overload Main symptom before depression, causes elderly to become suicidal @ What stage of grief is demonstrated if a SI still has grief 1 year after death? preoccupation @ $Depersonalization @ Recommended treatment for Substance Use$ Recommend group therapy Beneficial to hear from others with similar experiences @ Sexual Assault Patient nursing priority$ want to provide safe environment @ If an elderly client shares that his child hits him. Are we required to report to proper agency? $ Yes @ What should the nurses response be if a patient feels it is okay when their partners apologize and buy them gifts?$ Important to teach about the cycle of abuse @ Abusers want ______ and ______ over others$ power and control @ Priority action for patient having aggressive outburst $ make sure all other patient’s are removed from the area to keep them safe @ If a 30 year old man is very suspicious and has poor relationships, what stage of Erickson’s therapy psychological adjustment was not met$ trust vs. mistrust phase @ What is a goal of Group therapy goal, what can it help establish?$ being able to listen to others and learn from their experiences @ Priority RN intervention for a patient who is in the ER after sexual assault$ safety, ensure safe secure environment @ If an elderly client says his child hits him- RN action-report (if with staff, in safe envir)time frame for reporting$ right away!—within 2hrs? @ What nursing intervention shows the pt the RN understands the etiology of agoraphobia? Traumatic experience as a child$

do you remember a traumatic event that happened to you as a child @ Narcissistic personality disorder traits$ feeling very entitled, no empathy, hypersensitive to criticism, most important, don’t understand others @ What disorder has characteristics of being preoccupied with perfection and having difficult relaxing and discarding items$ OCD @ Is it beneficial for family members to do family therapy with client with anorexia nervosa$ Yes, it is necessary, good for recovery, gain insight into illness @ Is death a complication of anorexia nervosa$ yes increased risk of mortality @ If a patient has prescription for Pain Rx ordered as PRN, what is the proper nursing intervention if the patient asks for it?$ As long as it is administered per MAR Give medication do not try to convince them to do something else…do not delay if they ask for it @ Appropriate therapy for oppositional defiant disorder$ behavior modification @ _____ is caused by trauma/dissociative type of personality what symptom would this patient exhibit$ loss of awareness Assessment of someone in fugue state= history of severe/recent trauma @ What is the nursing interventions required if a kid presents to the ER w/ their mother and has bad bruising on the arms/legs, is sensitive to touch, and has an injury to abdomen$ Think of child abuse if parent delayed treatment= red flag @ If a client makes the comment, “hey you dumb blonde/idiot,” what would be appropriate/inappropriate responses from the RN$ Appropriate= unacceptable behavior, is something wrong, I do not understand why you are saying that Inappropriate to say don’t talk to me like that- rude @ Mother sending emotional mixed messages about love is an example of $ BPD @

If a patient has superficial cuts, scratching herself with knife and fork, what is the first thing you do?$ 1-1 observation @ Someone doing sit ups in their room, has anorexia nervosa, what is the nursing intervention?$ Take her mind off of it, Lets go walk over here and look at this, change the topic @ If a four year old’s dad dies and says He is coming back, what stage is this?$ Magical thinking=normal...