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Mental Health: Exam 1
Modules 1 & 2
97
Nursing
Undergraduate 2
07/19/2017

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Term
Trust vs. Mistrust
Definition
Infancy
(0-1.5 yr)
Forming attachment to mother, which lays foundations for later trust in others
Term
Autonomy vs. Shame and doubt
Definition
Early childhood
(1.5-3yr)
Gaining some basic control of self and environment (e.g., toilet training, exploration)
Term
Initiative vs. Guilt
Definition
Preschool
(3-6yr)
Becoming purposeful and directive
Term
Industry vs. Inferiority
Definition
School age
(6-12yr)
Developing social, physical, and school skills
Term
Identity vs. Role confusion
Definition
Adolescence
90-20yr)
Making transition from childhood to adulthood; developing sense of identity
Term
Intimacy vs. Isolation
Definition
Early adulthood
(20-35yr)
Establishing intimate bonds of love and friendship
Term
Generativity vs. Self-absorption
Definition
Middle adulthood
(35-65yr)
Fulfilling life goals that involve family, career, and society; developing concerns that embrace future generations
Term
Integrity vs. Despair
Definition
Later years
(65yr to death)
Looking back over one's life and accepting its meaning
Term
Infancy
(0-1.5 yr)
Forming attachment to mother, which lays foundations for later trust in others
Definition
Trust vs. Mistrust
Term
Early childhood
(1.5-3yr)
Gaining some basic control of self and environment (e.g., toilet training, exploration)
Definition
Autonomy vs. Shame and doubt
Term
Preschool
(3-6yr)
Becoming purposeful and directive
Definition
Initiative vs. Guilt
Term
School age
(6-12yr)
Developing social, physical, and school skills
Definition
Industry vs. Inferiority
Term
Adolescence
90-20yr)
Making transition from childhood to adulthood; developing sense of identity
Definition
Identity vs. Role confusion
Term
Early adulthood
(20-35yr)
Establishing intimate bonds of love and friendship
Definition
Intimacy vs. Isolation
Term
Middle adulthood
(35-65yr)
Fulfilling life goals that involve family, career, and society; developing concerns that embrace future generations
Definition
Generativity vs. Self-absorption
Term
Later years
(65yr to death)
Looking back over one's life and accepting its meaning
Definition
Integrity vs. Despair
Term
Erik Erikson
Definition
Erikson's developmental tasks
(1909-1994)
(trust vs. mistrust, etc.)
Term
Physiological needs
Definition
(1) Food, water, oxygen, elimination, rest, and sex
Term
Safety needs
Definition
(2) Security, protection, stability, structure, order, and limits
Term
Love and Belonging needs
Definition
(3) Affiliation, affectionate relationships, and love
Term
Esteem
Definition
(4) Self-esteem related to competency, achievement, and esteem from others
Term
Self-actualization
Definition
(5) Becoming everything one is capable of
Term
Self-transcendence
Definition
(6) Overcoming of the limits of the individual self and desires in spiritual contemplation and realization. (Not always included)
Term
(1) Food, water, oxygen, elimination, rest, and sex
Definition
Physiological needs
Term
(2) Security, protection, stability, structure, order, and limits
Definition
Safety needs
Term
(3) Affiliation, affectionate relationships, and love
Definition
Love and Belonging needs
Term
(4) Self-esteem related to competency, achievement, and esteem from others
Definition
Esteem
Term
(5) Becoming everything one is capable of
Definition
Self-actualization
Term
(6) Overcoming of the limits of the individual self and desires in spiritual contemplation and realization. (Not always included)
Definition
Self-transcendence
Term
Abraham Maslow
Definition
Maslow's Hierarchy of needs
(1908-1970)
(Physiological needs, safety needs, etc.)
Term
Relationship between mental and physical illness
Definition
Both are physical (not all are visible, even with equipment).
Often times interdependent (one causes the other and vice-versa).
Term
Mental health (WHO)
Definition
State of well-being that allows a person to cope with normal stressors, work productively, contribute to community and realize own potential.
Term
Mental health (USDHHS)
Definition
Provides people with the capacity for rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem.
Term
Mental illness
Definition
All mental disorders with definable diagnoses. Manifested in significant dysfunction that may be related to developmental, biological, or psychological disturbances in mental functioning (APA).
Term
Mental health disorders that are seen worldwide
Definition
Schizophrenia and bipolar disorder
Term
Concepts regarding mental illness within cultures
Definition
No standard measure for mental health, in part because it is culturally defined and is based on interpretations of effective functioning according to societal norms (WHO)
Term
Patricia Benner
Definition
"Caring" as foundation for nursing.
Provide comfort, promote nurse-patient relationships, teaching, coaching, bearing witness to pt's suffering.
Term
Dorothea Orem
Definition
Goal of self-care as integral to the practice of nursing.
Nurse must promote self-care activities for the pt.
Term
Callista Roy
Definition
Continual need for people to adapt physically, psychologically, and socially.
Nurse must assist pt in adapting so that he/she can cope more effectively with changes.
Term
Hildegard Peplau
Definition
Theory of interpersonal relationships
(1909-1999)
Enhances comfort and wellbeing while relieving suffering and promoting growth.
Nurse-pt relationship is the foundation of nursing practice.
Shifted focus from what RN's do TO the pt, to what RN's do WITH the pt.
Term
Effective measures when caring for pt with mental illness
Definition
Therapeutic communication
Pt centered care
Nurse-patient relationships
Active listening
Self-assessment during assessment of pt
Term
Facilitative skills checklist
Definition
Good eye contact
Verbal comments follow interviewee's lead
Encourage talking about feelings
Ask open ended questions
Restate and clarify
Summarize
Statements reflect feelings of interviewee
Share relavant feelings
Give feedback
Responses facilitate communication
Assist to list available alternatives
ID specific observable goals
ID next step towards goals
Term
Therapeutic communication techniques
Definition
Silence
Active listening (Observing nonverbal behavior, reflecting, understanding pt's social setting, detecting false notes, give feedback)
Clarifying (paraphrasing, restating, reflecting, exploring)
Asking open-ended questions
Term
Positive reinforcement
Definition
Presenting a motivating item to the person after the desired behavior is exhibited, making the behavior more likely to happen in the future. Keyword: Reinforcement (Not a stimulus as the behavior has already happened)
Term
Negative reinforcement
Definition
A behavior is strengthened by stopping, removing, or avoiding a negative outcome or a bad stimulus that prevents good behavior.
Term
Techniques to protect pt from self-destructive behavior
Definition
Tracking patient's whereabouts and activities
one-to-one observation
Inspect bags and packages of visitors
Inspect comfort foods
Prohibit intimacy between pt's
Maintain a locked/secure facility
Seclusion, medical/physical restraints
Calling a "code" (psychiatric emergency)
Term
Milieu
Definition
Refers to surroundings and physical environment. A well-managed milieu offers patients a sense of security and promotes healing. Includes activities, unit rules, reality orientation practices, and unit environment.
Term
Behavior therapy
Definition
Modeling, operant conditioning, systematic desensitization, avesion therapy.
Changes in maladaptive behavior can occur without insight into the underlying cause.
Used to treat phobias, alcoholism, schizophrenia, etc.
Term
Modeling
Definition
A type of behavior therapy.
Therapist provides a role model for specific identified behaviors, and the patient learns through imitation.
Term
Operant conditioning
Definition
A type of behavior therapy.
Uses positive reinforcement to increase desired behaviors.
Term
Systematic desensitization
Definition
A type of behavior therapy.
The pt is exposed to increasing levels of a stimulus that the pt is afraid of while practicing specific relaxation techniques. With time, pt is desensitized to the stimulus.
Term
Aversion therapy
Definition
A type of behavior therapy.
1) Pairing of a maladaptive behavior with a noxious stimulus (pairing smell of alcohol with electric shock)
2) Punishment (Punishment after pt has had an alcoholic drink)
3) Avoidance training (Pt avoids punishment by pushing glass of alcohol away within a certain time limit)
Term
Cognitive behavioral therapy
Definition
A type of psychotherapy in which negative thoughts about the self and the world are challenged in order to alter unwanted behavior patterns and symptoms or treat mood disorders such as depression.
Term
Milieu therapy
Definition
Milieu is an all-inclusive term that recognizes the people, the setting, the structure, and the emotional climate as all-important to healing.
Milieu therapy takes naturally occurring events in the environment and uses them as rich learning opportunities for patients.
Term
Therapeutic alliance/relationship
Definition
In it, a nurse maximizes his communication skills, understanding of human behaviors, and personal strengths to enhance the patient's personal growth.
Term
Transference
Definition
Occurs when the patient unconsciously and inappropriately displaces (transfers) onto the nurse feelings and behaviors related to significant figures in the patient's past (e.g., the pt may say "you remind me of my father")
Term
Counter-transference
Definition
Occurs wehn the nurse unconsciously and inappropriately displaces onto the patient feelings and behaviors related to significant figures in the nurse's past. Frequently the pt's transference evokes counter-transference in the nurse.
Term
Outpatient psychiatric mental health care
Definition
Intended for patient centered and negotiated care rather than imposed for long term care. Examples:
PCP's
Specialty psychiatric care providers
Patient-centered medical/health homes
community clinics
Psychosocial rehab program
Clinical case management
Psychiatric home care
Assertive community treatment (ACT)
Intensive substance abuse program
Partial hospitalization program (PHP)
Term
Inpatient psychiatric mental health care
Definition
Intended for safety, stabilization of symptoms and return to community. Examples:
ED
Crisis stabilization unit
Locked psychiatric inpatient unit
Term
Primary services provided in psychiatric case management
Definition
Coordinating mental, physical, and spiritual health, social and educational services, vocational realms of care for the psych patient.
Term
DSM-5
Definition
Used to diagnose psychiatric disorders.
Term
NANDA-I
Definition
Standardized list of nursing diagnoses provide the framework for identifying appropriate nursing interventions for dealing with the patient's reaction to the disorder/disease/condition.
Term
Nursing outcomes classification (NOC)
Definition
Comprehensive source of standardized outcomes, definitions of the outcomes, and measuring scales that help to determine the outcome of nursing interventions.
Term
Nursing interventions classification (NIC)
Definition
Any treatment, based upon clinical judgment and knowledge, that a nurse performs to enhance patient'client outcomes, including direct and indirect care through a series of nursing activities.
Term
Function of RN in regards to mental illness
Definition
Diagnosing and treating responses to psychiatric disorders, coordinating care, counseling, giving medication and evaluating responses, and providing education.
Term
Function of Clinical nurse specialist in regards to mental illness
Definition
The same as NP as long as CNS has obtained prescription authority.
Term
Function of NP in regards to mental illness
Definition
Diagnosing psychiatric conditions, prescribing psychotropic medications and integrative therapy, and conducting psychotherapy; they are involved in case management, consulting, education, and research.
Term
Ethnocentrism
Definition
Universal tendency of humans to think their way of thinking and behaving is the only correct and natural way.
Term
Somatization
Definition
Psychological distress is experienced as physical problems.
Term
Enmeshment
Definition
A relationship between two or more people in which personal boundaries are permeable and unclear. This often happens on an emotional level in which two people "feel" each other's emotions, or when one person becomes emotionally escalated and the other one does as well. (Two people "mesh" together).
Term
Quality and Safety Education for Nurses (QSEN)
Definition
1) Patient-centered care
2) Quality improvement
3) Safety
4) Informatics
5) Teamwork and collaboration
6) Evidence-based practice (EBP)
Term
Primary goal of QSEN
Definition
To prepare future nurses with the knowledge, skills, and attitudes (KSAs) required to enhance quality, care, and safety in the health care settings in which they are employed.
Term
HEADSSS psychosocial interview technique
Definition
Home environment (Relations w/ parents, etc.)
Education and employment (School performance)
Activities (Sports, after-school activities)
Drug, alcohol, or tobacco use
Sexuality (level of activity, protection)
Suicide risk or symptoms of depression or other mental disorder
"Savagery" (Violence/abuse in home, etc.)
Term
Neurological disorders that mimic Depression
Definition
CVA
Alzheimer's disease
Brain tumors
Huntington's disease
Epilepsy
Multiple sclerosis
Parkinson's disease
Term
Infections that mimic depression
Definition
Mononucleosis
Encephalitis
Hepatitis
Tertiary syphilis
HIV
Term
Endocrine disorders that mimic depression
Definition
Hypo and hyperthyroidism
Cushing's syndrome
Addison's disease
Parathyroid disease
Term
GI disorders that mimic depression
Definition
Liver cirrhosis
Pancreatitis
Term
Cardiovascular disorders that mimic depression
Definition
Hypoxia
CHF
Term
Respiratory disorders that mimic depression
Definition
Sleep apnea
Term
Nutritional disorders that mimic depression
Definition
Thiamine deficiency
Protein deficiency
B12 & 6 deficiency
Folate deficiency
Term
Collagen vascular diseases that mimic depression
Definition
Lupus erythematosus
Rheumatoid arthritis
Cancer
Term
Neurological disorders that mimic anxiety
Definition
Alzheimer's disease
Brain tumor
Stroke
Huntington's disease
Term
Infections that mimic anxiety
Definition
Encephalitis
Meningitis
Neurosyphilis
Septicemia
Term
Endocrine disorders that mimic anxiety
Definition
Hypo and hyperthyroidism
Hypoparathyroidism
Hypoglycemia
Pheochromocytoma
Carcinoid
Term
Metabolic disorders that mimic anxiety
Definition
Low calcium
Low potassium
Acute intermittent porphyria
Liver failure
Term
Cardiovascular disorders that mimic anxiety
Definition
Angina
CHF
Pulmonary embolus
Term
Respiratory disorders that mimic anxiety
Definition
Pneumothorax
Acute asthma
Emphysema
Term
Drug effects that mimic anxiety
Definition
Stimulants
Sedatives (withdrawal)
Lead or mercury poisoning
Term
Medical conditions that mimic psychosis (memorize)
Definition
Temporal lobe epilepsy
Migraine headaches
Temporal arteritis
Occipital tumors
Narcolepsy
Encephalitis
Hypothyroidism
Addison's disease
HIV
Term
Drug effects that mimic psychosis
Definition
Hallucinogens (e.g., LSD)
Phencyclidine
Alcohol withdrawal
Stimulants
Cocaine
Corticosteroids
Term
Drugs that depress the CNS
Definition
Alcohol, barbiturates, benzodiazepines, anesthetics, anticonvulsants, opioids, clonidine
Term
Foods to avoid while taking MAOIs
Definition
Aged cheese, pickled foods, wine, beer, yeast foods, avocado, anything dried/smoked, chocolate, fava beans, ginseng, caffeine.
Term
Lithium therapeutic level
Definition
Therapeutic range 0.4-1.0 mEq/L
(fine tremor, polyuria, mild thirst, nausea, discomfort, weight gain)
Term
Lithium labs
Definition
renal and thyroid function, WBC with differential, serum electrolytes, and glucose periodically during therapy.
Term
Lithium toxic levels
Definition
Early toxicity (1.5 mEq/L)
Advanced toxicity (1.5-2.0 mEq/L)
Severe toxicity (2.0-2.5 mEq/L)
>2.5 = convulsions, oliguria, death
Term
Atomoxetine side effects
Definition
treats ADHD
Dizziness, fatigue, mood swings, insomnia, nausea, vomiting, constipation, sex problems, decreased appetite
Term
St. John's wort interactions
Definition
Taking with MAOIs can cause serotonin syndrome.
Causes increased metabolism of oral contraceptives, statin drugs, some psychotropic medications.
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