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Current Theories and Practice with Therapeutic communication
Current Theories and Practice with Therapeutic communication and relationships
71
Nursing
Undergraduate 3
01/30/2014

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Cards

Term
State of emotional, psychological, and social wellness evidenced by:
Definition

Satisfying interpersonal relationships

Effective behavior and coping

A positive self-concept

Emotional stability

Term
General criteria for diagnosis
Definition

Dissatisfaction with characteristics, abilites, accomplishments

Ineffective or unsatisfying relationships

Dissatifaction with one's place in the world

Ineffective coping with life events

Lack of personal growth

Term
Aspects of Mental health
Definition

Socia-emotional intellegence

Resilience

Spirituality

Term
DSM-5 purpose
Definition

Taxonomy of disrders

Standardize nomenclature

Identify defining characteristics or symptoms

Assist in identifing underlying causes

Term
Differences in DSM-IV AND DSM-V
Definition

In DSM-IV clinical disorders are listed on 3 seperate axes.

DSM-V has them listed on one

Term
Axis I
Definition

Prinicple disorder that needs immediat attention.

Ex-depressive epsiode, flare up of panic disorder

Usually the reason people go get treatment

Term
Axis II
Definition

Personality disorder that may shape the Axis I

Developmental disorders(learning disability)

Term
Axis III
Definition

Medical or Neurological problems that are relevant to pt current of past psychiatric problems

EX- severe asthma can precipate of panic attack

Term
Axis IV
Definition

Psychosocial stressors the individual has faced recently

EX- job loss, death, divorce

Term
Axis V
Definition

level of function the pt has gained at the time of assesment

Usually coded 0-100 scale

Term
Historical perspectives (Ancient times, Aristotle, Early christan)
Definition

Ancient: Displeasure of Gods, demonic or divine

Aristotle: imbalance of the four humors( water, yeloow and black bile, blood

Early Christian: possession by demons

Term
Dorothea Dix
Definition

Advocated for better treatment of mentally ill pt.

Opened 32 hospitals and offered asylum

Term
Linda Richards
Definition

First psychiatric nurse

Trained other nurses

Term
Harriet Bailey
Definition
Published first mental health nursing textbook
Term
Revolving door effect
Definition
Shorter hospital stays, decompensation, rephospitalization, dual diagnosis because of deinstitutionalization
Term
Values
Definition

Sense of right and wrong, code of conduct for living

Choosing, prizing, acting

Term
Therapeitic use of self
Definition

Use aspects of personality, experience, values, feelings, inteligence, needs, coping skills, perceptions to establish relationships beneficial to client,

 

Developed by Peplau

Term
4(5)Patterns of Knowing
Definition

Ways of Observing understanding client interacttion

Empirical-nursing science

Personal-life experiences

Ethichal-moral nursing knowledge

Aesthetic-art of nursing

Unknowing-nurse admits lack of knowledge of client

Term
Social relationship
Definition

frienship, socialization, companionship

Superficial communication

Term
Intimate
Definition

Emotional commitment

Individual needs met:assistance with helping each other meet needs

Term
Therapeutic relationship
Definition

Focus on needs, experience, feeling, ideas of client only

Joint agreement on areas to work one

Term
Peplau
Definition

Developed theory of nurse-client relationship

Resource-provides info

Counselor-helps pt to explore their thoughts and feelings

Surrogate-role playing helps pt to explore and identify feeling from the past

Technical support- coordinates professional services

Term
Basic level functioning
Definition
Counseling
Milieu therapy
self care activites
psychobiologic interventions
health teaching and promotion
case management
Term
Advance level functions
Definition

Psychotherapy

Prescriptive authority for drugs

Consultation,liason

Evaluation

Term
Distant zones
Definition

Intimate- 0-18in

Personal- 18-36in

Social 4-12 ft

Public- 12-25 ft

Theraputic 3-6ft

Term
Freud
Definition

Psychoanalytsis

Behavior results from ineffective personality development

Id-desires, wants

Superego- morals, ethical, values, opposite of id

Ego- balancin, mature, adaptive

Term
5 stages of Psychosexial development
Definition

Oral: <18mo, oral gratification, obesity, nail biting, drugs

Anal: 18-3yr, independence and control, OCD, perfection

Phallic:3-6yr, oedipus and electra complex, lgbta, identity

Latency: 6-12y, repressed sex and socialization, lack motivation

Genital: 12-adult, puberty and relations with opposite sex, fridigy, premature, ejaculation, impotence

Term
Sullivan
Definition

Interpersonal

developed 5 life stages and 3 developmental cognitive modes

Believed that unsatisfying relatinships were the bassis for all emotional problems

Described the concept of therapeutif milieu or community

Term
Interpersonal theory
Definition

Infancy: anxiety reduction via oral gratification

Childhood: delay in gratification

Juvenile: satisfying peer relationships

preadolescence: satisgying same-sex relationships

eary adolescence: satisfying opposite-sex relationships

Late adolescence: lasting intimate opposite sex relationships

Term
3 cognitive modes
Definition

prototaxic: infancy and childhood involves brief unconnected experience that have no relationship to one another(schizophremia)

Parataxic: Early childhood. connect hings in sequences but does not see logical sense. Child will replay experiences to reduce stress (paranoia)

Syntaxic: school age-preadolescence. maturity. sees self and the world withing contex of environment

Term
Erickson 8 stages of development
Definition

Sensory- trust vs mistrust, suspiciousness, bad relationships

Muscular-autonomy vs shame and doubt, low self esteem, dependency

Locomoter- initaitive vs guilt, passive, guilt

Latency-industry vs inferiority, unmotivated, unreliable

Adolescence- idenity vs role confusion, rebellion, etoh/drugs, bad relationship, regression

Young adult- intimacy vs isolation, emotiona immaturity, deny need for personal relationships

Adulthood- generativity vs stagnation, inability to show concern for others

Maturity- integrity vs despair, can't deal with aging and death, hoplessness

 

 

Term
Maslow
Definition
Self actualization, esteem, love/belonging, safety,physiological
Term
Peplau interpersonal theory
Definition

Infant-learning to depend on others-communication with caregiver

Toddler- learning to delay satisfaction- some delay in self gratification for others

Early childhood-identifyin oneself- appropiate roles and behaviors through others perception off self

late childhood-developing skills in participation-competition, cooperation, compromise

Term
Watson
Definition
Caring-healing relationships
Term

 

Inpatient hospital treatment 
 
Definition

Rapid assessment, stabilization of symptoms, 

discharge planning 

 

 Client-centered multidisciplinary approach to brief stay 

 
Term
Indications of inpatient
Definition
Immenent danger, depress and sucidal, peverlypsychotice, experiving alcohol ar drug withrdrawl
Term
Milieu Therapy
Definition

Therapeutic community in which the 

entire social structure of the unit or 

residence is designed to be part of the 

helping process

  • Safe
  • support
  • activity scheldule
Term
Maturational crises
Definition
Expected life changes that may evoke a crisis
Term
Situational crises
Definition
Unexpected life changes that evoke a crisis such ad divorse, death, serious illness
Term
Primary goal of crisis intervention
Definition

to assist 

the client in resolving the immediate problem and 

regaining emotional equilibrium

Term
ECT
Definition
enhance dopamine sensitivity, reduce uptake of serotnon, increase gaga, and activate the systems in the brain that use norepinephrine
Term
Primary prevention
Definition
Stress managment education
Term
Secondary prevention
Definition

early identification of mental health 

problems 

 
Term

Tertiary prevention

 

Definition

: monitoring, coordinating psychiatric 

rehabilitation services 

Term
Antipsychotics
Definition

 treats symptoms of psychosis, delusions, hallucinations, schizophrenia, manic phase of bipolar.

Offlabel- insomia,agressive behavior, anxiety, in alzheimers

 Work by blocking recptoms of dompanine

Check prolactin levels

breast enlargment, weight gain

sugar free drinks 

 

 

Term
Second generation antisychotics
Definition

inhibt the reuptake of serotonin

lower incidence of extrapyramidal effects

Term
Third generation antipsychotic
Definition

dopamine system stabilizers

works in bipolar and depression

Term
Extrapyramidial reactions
Definition

shuffle, toungue out,

tardive duskinea, akinesia, akathesia,parkinsonia sundrome

Term
Acute dystonic reations
Definition

spastic movement

oculogryric crisis

torticolic

opisthonus

protrusion of tongue

Term
Parkinsonian syndrome
Definition

akinesia

muscular rigidy

tremor

stooped posture

drooling

masklike face

 

Term
Akathesia
Definition

restlessness

shortly after initaion of tx

common

inability to sit still

Term
Akinesia
Definition

dimines spontaneity

few gestures

apathy

unspontaneous speech

Term
Tardive dyskinesia
Definition

Facial and oral movements

extremity movemt

trunk movements

Term
NMS
Definition

Hyperthermia

Severe EPS with fever

can be fatal

Term
Antidepressent
Definition

Takes up to 4 weeks

SSI- Block reuptake of serotonin

Cyclic- primarily block reuptake of norepinephrine,

MAOI- block enxyme metabolism

Term
MAOI
Definition

LOW incidence of sedation and antichologenic effects

not eat tryamine

not with othe antidepressent demerol. antiHTN

Not for suicide

phenlizine(nardil)

Tranylcyrpomine (parnate)

Isocarboxaxid (Marplan)

Term
SSRI
Definition

only for mild to moderate depression

side effectm akathiseia, insomnia, sexual dysfunction, anxiety, agritation

Less weight gain

 

Term
Serontonine syndrome
Definition

From taken MAOI and SSRI together

agitation, sweating, fever, tachycardia, ridigy, hyperreflexia, death

Term
Cyclic antidepressents
Definition

block cholingeric receptors which causes dry moth, constipation urinary hesitency, blurred near verion

sexual dysfunction

Term
Antichologenic
Definition

Geodon

Antiparkinson

Stabilizes the dopameneginic effects

Term
Mood stabilizing Medication
Definition

Used to treat bipolar

Lithium

It normalizes the reuptake of serotonine, norepinephrine, acterylcholin, and dopamine

0.8-1.2

levels monitered every 2-3 days

side effects:diarrhea, nauser, hand tremor, poluuria, metallic taste in mothe

Toxic effects: severe diahrea, vomiting,drowsiness, muscle weaknes, lack of cordination

Teaching- check blood, drive when not dizzy

Term
Antianxiety
Definition

Reduce anxiety

Bezodiazepines

calming effect and potentiate the effects of GABA

sIDE EFFECTS: physical dependence, depression, poor coordination

Client teaching: withdrawl can be fatal,take alcohol up a notch, slower reflex

Term
Pregnancy factors
Definition

avoid gestational weeks 6-10

lower dose before birth

start meds back after breastfeeding

Term
Children
Definition

Antipsychotic-not good

antidepressent- suicidal risk can increase

Doses- multiple smaller during day

Term
Acetylcholine 
Definition

involved in voluntary movement, learning, memory, and sleep

Too much acetylcholine is associated with depression, and too little in the hippocampus has been associated with dementia.

Term
Dopamine 
Definition

correlated with movement, attention, and learning

 

activation level, mood, movement

Too much dopamine has been associated with schizophrenia, and too little is associated with some forms of depression as well as the muscular rigidity and tremors found in Parkinson’s disease.

Term
Norepinephrine 
Definition

associated with eating, alertness

 

mood, activation level

Too little norepinephrine has been associated with depression, while an excess has been associated with schizophrenia

Term
Epinephrine 
Definition

involved in energy, and glucose metabolism

Too little epinephrine has been associated with depression.

Term
Serotonin 
Definition

plays a role in mood, sleep, appetite, and impulsive and aggressive behavior

Too little serotonin is associated with depression and some anxiety disorders, especially obsessive-compulsive disorder. Some antidepressant medications increase the availability of serotonin at the receptor sites.

Term
GABA (Gamma-Amino Butyric Acid) 
Definition

inhibits excitation and anxiety

Too little GABA is associated with anxiety and anxiety disorders. Some antianxiety medication increases GABA at the receptor sites.

Term
Endorphins 
Definition
involved in pain relief and feelings of pleasure and contentedness
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