Shared Flashcard Set

Details

Basic Concepts of Psych Nursing
From "Foundations of Psychiatric Mental Health Nursing" (Varcarolis)
89
Nursing
01/18/2011

Additional Nursing Flashcards

 


 

Cards

Term
Mental Health
Definition

When a person is in harmony

with self and others

Term
Mental Illness
Definition

Behaviors described as

"strange" or "different."

Term
5 Axes in the DSM-IV-TR
Definition

1. Clinical Disorders

2. Personality Disorders

3. General medical conditions

4. Psychosocial and environmental problems

5. Global assessment and functioning (GAF)

Term
Mental Health Continuum
Definition

Physical

Personal

Interpersonal

Societal level

Term
Issues Affecting Mental Illness
Definition

Homelessness

Aging

Unemployment

Lack of community resources

50% of 80 y.o. will have dementia

Dual diagnoses

Term
Resilience
Definition
how well we adapt to changes
Term
Culture
Definition
our perception of people and things
Term
Nature vs. Nurture
Definition
Biological vs. environmental stressors
Term
Id
Definition
Core of our being


*Drives and instincts
Term
Ego
Definition
mediator between id and superego


*functions on reality principle
Term
Superego
Definition
Develops between ages 3 and 5
Term
Conscious
Definition
all experiences combined with awareness
Term
Preconscious
Definition
Not in our immediate awareness
Term
Unconscious
Definition
Memories, feelings, and thoughts


not readily available
Term
Erikson's Impact on Nursing
Definition
provides a development model that covers

entire life span, allowing nurses to

form diagnoses
Term
Sullivan's Impact on Nursing
Definition
How people pursue satisfaction and security
Term
Maslow's Impact on Nursing
Definition
Our needs are hierarchically arranged; this assists with prioritization
Term
Behavioral theory
Definition
Focuses on behavior management and modification
Term
Cognitive Theory
Definition
Focuses on challenging the irrational thought
Term
Biological
Definition
Focuses on all aspects of biotheories
Term
Nurses as team members
Definition
Full team must plan care within first 72 hours of admission
Term
Ensuring client safety
Definition
Check personal belongings, follow unit precautions, track client's location, monitor client aggression
Term
Managing daily unit functions
Definition
Physical assessment, monitor milieu, medication administration, pain management, and medication adherence
Term
Primary intervention
Definition
Before anything happens
*Teaching coping skills
Term
Secondary Intervention
Definition
Early detection
*Assessing for mental illness
Term
Tertiary Intervention
Definition
Maintenance at highest level of functioning
*Adaptation
Term
Nursing skills needed
Definition
Strong problem solving and clinical skills, cultural competence, flexibility, focus on client's strength
Term
Key Elements of Client Assessment
Definition
Housing, income, family and support system, substance abuse, and physical well-being
Term
Case Manager Role
Definition
Coordinate mental, physical, and spiritual needs
Term
Issues Impacting Patient Compliance
Definition
Figure out what motivates client
Term
Basic level nursing interventions
Definition
Counseling, promote self-care, health education
Term
Rehab vs. Recovery Models
Definition
*Rehab focuses on learning to live with MI
*Recovery focuses on consumer's strength to achieve highest level of functioning
Term
Issues confronting clients with a
serious mental illness
Definition
Finding meaning and purpose, establish goals, physical illness, depression, suicide, substance abuse, isolation, victimization, and loneliness
Term
Anosognosia
Definition
Inability to recognize deficit because of illness
Term
Medication side effects
Definition
Some side effects may dissipate or cause noncompliance
Term
Residual symptoms
Definition
Symptoms that may cause frustration with client
Term
Relapse and losses
Definition
Each relapse causes more loss of function and relationship problems
Term
Partial hospitalization
Definition
intensive, outpatient 24-hour therapy that is short-term
Term
Psychiatric home care
Definition
used when severe mental problems are combined with chronic health problems
Term
Assertive Community Tx
Definition
Team tx approach in community setting for serious mental diseases
Term
Community MH Center
Definition
for those who have no access to private care
Term
Therapeutic use of self
Definition
Ability to use one's personality in an attempt to establish and structure interventions
Term
Goals of nurse/client relationship
Definition
Focus on client's problems
Term
Social vs. Therapeutic Relationship
Definition
Social: mutual needs are met
Therapeutic: Only client's needs are met
Term
Importance of clinical supervision
Definition
Help identify counter-transference and boundary issues
Term
Dealing with stress
Definition
Developing awareness, achieving balance, making choices, developing detached concern, practicing altruistic egoism, exercising free will, developing goals, and fostering hope
Term
Autognosis
Definition
*Assist client to greater self-awareness
*Resolve emotional problems through move to increased MH
Term
Johari window
Definition
1. Known to self and others
2. Known only to others
3. Known only to self
4. Known to neither self nor others
Term
Threats to role of nurse
Definition
Lack of professional attire, lack of structure, decisions re: patient's chart, need for self-awareness, fear of injury, fear of rejection, frustration over inability to change patient
Term
Blurring of boundaries
Definition
When a relationship becomes social and nurse's needs come first
Term
Transference
Definition
When feelings are transferred from client to person in authority
Term
Counter-transference
Definition
tendency of authority figure to displace feelings onto client
Term
Pre-orientation phase
Definition
Prior to meeting client
Term
Orientation
Definition
establish parameters, contract formed, confidentiality, and termination begins
Term
Working phase
Definition
Patient will have intense emotions and defense mechanisms
Term
Termination phase
Definition
Discussed during first interview
*Achieved when: symptoms are relieved, improved sense of ID, goal accomplishment, improved social functioning
Term
Things hindering nurse/client relationship
Definition
Inconsistency and unavailability
Term
Things helping the nurse/client relationship
Definition
Values clarification, pacing, listening, initial impressions, and comfort control
Term
Genuineness
Definition
Verbal and non-verbal behavior
Term
Positive Regard
Definition
Patient's respect and acceptance of nurse
Term
Empathy
Definition
See things from other person's perspective
Term
Trustworthiness
Definition
The patient considers the nurse to be responsible, dependable, and accountable.
Term
Clarity
Definition
Specific and clear communication
Term
Assertiveness
Definition
The nurse is intentional about gaining information from the client
Term
Somatic therapy
Definition
Impacts physical attributes
Term
Psychotherapeutic therapy
Definition
Classical analysis, psychodynamic, short-term, interpersonal
Term
Cognitive Therapy
Definition
Challenges irrational thought
Term
Behavioral Therapy
Definition
Modeling, operant conditioning, desensitization and aversion
Term
Group Therapy
Definition
Gives insight, interpersonal learning, hope, guidance, catharsis, and universality
Term
Milieu Therapy
Definition
Focuses on maintaining client's environment
Term
Voluntary admission
Definition
Can be formal or informal
Term
Emergency involuntary admission
Definition
When: patient needs medical attention, is a danger to self or others, or is unable to perform ADLs based on mental illness.
Term
Observational/involuntary admission
Definition
Lasts from 1-15 days.
For observation, dx, and tx
Is court ordered
Term
Long term/formal commitment
Definition
Requires judicial review. Lasts for 60-100 days.
Term
Unconditional discharge
Definition
There is no further treatment required
Term
Conditional discharge
Definition
Court ordered discharge
Term
AMA or Elopement
Definition
Only voluntary admissions can leave AMA.
Term
Informed consent
Definition
Dr. is ultimately responsible for informing patient of risks
Term
Right to Communication
Definition
Patient contributes to plan of care, if desired
Term
Right to freedom from harm/dignity and respect
Definition
Risk of harm must be greater than side effects of medication
Term
Right to treatment
Definition
Criteria: humane environment, certified staff, and individualized care
Term
Right to least restrictive settings
Definition
Seclusion is the last resort
Term
Right to aftercare
Definition
right to have follow-up from competent professional
Term
Right to Confidentiality
Definition
Being careful of HIPAA issues
Term
Duty to Warn
Definition
Professional has duty to warn when patient presents with intent to harm others
Term
Duty to protect
Definition
Applicable when patient threatens someone specifically
Term
Conditions for Restraint/Seclusion
Definition
1. Behavior is harmful to self/others
2. Behavior presents danger to facility
3. When least restrictive measures are insufficient
4. Client requests seclusion or decreased stimulation
Term
Purposes of psych assessment
Definition
1. Establish rapport
2. Understand current problem
3. Assess current level of psych func.
4. ID what client and family hope to gain from tx
5.perform MSE
6. ID behaviors
7. other areas that need to be modified
8. form a plan of care
Term
Why do you need a med assessment?
Definition
Medical conditions must be ruled out first