Term
| the concepts of mental health and mental illness are... |
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Definition
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Term
| who lobbied for the establishment of state hospitals for the mentally ill? |
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Definition
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Definition
first psychiatric nurse
circa 1955 |
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Definition
| the successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings and behaviors that are age-appropriate & congruent w local & cultural norms |
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Term
| mental illness definition |
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Definition
| maladaptive responses to stressors evidenced by thoughts, feelings and behaviors that are incongruent with the norm & interfere w the individ's social, occupational or phys. fx'ing |
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Term
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Definition
| the inability of the general pop. to understand the motivation behind a person's behavior |
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Definition
| considers that the rules, conventions & understanding of mental illness are conceived within an individual's own particular culture |
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Term
| influential factors on mental health/illness |
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Definition
| inherited factor, hormones, family, developmental events, culture, values, cognitive abilities, personality, support system, neg. influences, demographics, stressors |
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Term
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Definition
restoration of homeostasis
includes responses that stabilize internal biological processes & psychological preservation of self identity & self esteem |
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Definition
neg. or unhealthy
occur when the integrity of the individual is disrupted |
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Definition
| the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system |
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Definition
initial response to stress
3 stages: alarm reaction stage, stage of resistance, stage of exhaustion |
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Term
| the weakness in Miller and Rahe's life changes questionnaire |
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Definition
| doesn't address the person's ability to cope with or even how they perceive the stress |
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Term
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Definition
| a stimulus arising from the int. or ext. environment and is perceived by the person in a particular manner |
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Term
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Definition
a person's initial rxn to a precipitating event
either irrelevent, benign positive or stressful |
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Term
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Definition
occurs when the precip. event is determined to be stressful
1. which coping strategies are available to me?
2. will the option I choose be effective in this situation?
3. do I have the ability to use that strategy in an effective manner? |
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Term
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Definition
| the utilization of coping strategies in response to a stressful situation |
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Term
| adaptive coping strategies include... |
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Definition
awareness
relaxation
meditation
talking w/someone who cares
journaling
problem-solving
pets
music |
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Term
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Definition
| usu. in response to events of day to day living |
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Term
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Definition
person is less aware of environment
attention span & concentration decrease
may need help w/problem-solving |
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Definition
attention span extremely limited
awareness of environment very limited
may exhibit phys. symptoms |
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Term
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Definition
person is unable to focus on anything
misperceptions are common
loss of contact w reality may occur
basic fx'ing & comm. are ineffective
"going crazy" |
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Term
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Definition
| event that disturbs a person's homeostasis, during which usual coping mechanisms cannot resolve the problem |
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Term
| characteristics of a crisis |
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Definition
occurs to everyone at one time or another
precipitated by specific identifiable events
are personal by nature
are acute, not chronic
contains the potential for psychological growth or deterioration |
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Term
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Definition
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Term
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Definition
| personality disorder & mental retardation |
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Term
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Definition
| general medical conditions |
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Term
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Definition
| psychosocial & environmental problems |
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Term
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Definition
| global assessment of functioning (measures psychological, social & occupational functioning) |
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Term
| focus of mental health nursing |
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Definition
| the use of therapeutic interventions |
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Term
| mental health team consists of... |
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Definition
| psychiatrist, clinical psychologist, psych. clinical nurse specialist, psych. nurse, MHT or aide, psych. social worker, OT. psychodramatist, Chaplain, dietitian, art/music/recreational therapists |
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Term
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Definition
in emergency situations: person is dangerous to self or others
for observation & tx of mentally ill person
when person is unable to take care of basic personal needs (gravely disabled) |
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Term
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Definition
sought when person manifests behavior that is clearly & imminently dangerous to self or others
court hearing w/in 72 hrs |
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Term
| civil or judicial commitment |
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Definition
| person is court ordered to be committed due to gravely disabled to harmful to self or others |
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Term
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Definition
| person has a right to determine their own destiny |
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Term
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Definition
| one has the duty to benefit or promote the good of others |
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Definition
| a person has the right to be treated equally regardless of race, religion, sex, marital status, etc. |
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Term
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Definition
| a goal-directed method of communicating facts, feelings and meanings |
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Term
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Definition
description or classification of a mental disorder (illness)
DSM-IV-TR classifications
NANDA nursing diagnoses taxonomy II
Appedix E |
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Term
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Definition
| NOC-nursing outcome classification |
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Term
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Definition
| NIC-nursing interventions classification |
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Term
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Definition
coordination of care
health teaching/health promotion
milieu therapy
pharma, biological & integrative therapies
prescriptive authority & treatment
psychotherapy
consultation |
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Term
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Definition
| measures the success or failure of the intervention in meeting the outcome criteria |
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Term
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Definition
| an interaction b/t 2 ppl in which input from both contributes to a climate of healing, growth promotion and illness prevention |
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Term
| therapeutic nursing process |
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Definition
| nurse offers a series of planned, goal-oriented activities that are useful to relieve discomfort, promote growth, learning & satisfying interpersonal relationships |
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Term
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Definition
| the client will demonstrate more adaptive coping strategies for dealing with life issues/situations |
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Term
| 8 phases of a therapeutic relationship |
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Definition
1. beginning the relationship
2. clarifying a problem & concern
3. making a contract or working agreement
4. building a relationship
5. exploring goals & solutions, gathering data & expressing feelings
6. developing an action plan
7. working through conflicts or disturbing feelings
8. ending the relationship |
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Term
| what is the nurse's most important tool? |
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Definition
| therapeutic communication |
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Term
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Definition
sit squarely facing the client
open posture (no crossing arms/legs)
lean toward client
establish eye contact
relax |
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Term
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Definition
| use it to increase the size of the quadrant that represents the open or public self |
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Term
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Definition
known to self
known to others |
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Term
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Definition
unknown to self
known to others |
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Term
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Definition
known to self
unknown to others |
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Term
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Definition
unknown to self
unknown to others |
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Term
| group therapy vs therapeutic groups |
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Definition
| leaders generally have advanced degrees vs is focused on group relations |
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Term
| 11 curative factors of groups |
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Definition
| 1. instillation of hope 2. universality 3. imparting of info 4. altruism 5. corrective recapitulation 6. dev. of socializing techniques 7. imitative behavior 8. interpersonal learning 9. group cohesiveness 10. catharsis 11. existential factors |
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Term
| initial or orientation phase of group development |
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Definition
1. establish rules & goals
2. leader promotes trust & ensures that rules don't interfere w/fulfillment of the goals
3. members are overly polite |
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Term
| middle or working phase of group development |
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Definition
1. productive work is undertaken
2. leader becomes more of a facilitator
3. trust has been established
4. conflict is managed by the group themselves |
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Term
| final or termination phase of group development |
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Definition
1. sense of loss may be experienced
2. feelings of abandonment & grief |
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Term
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Definition
production is high but morale is low
one "leader" |
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Term
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Definition
focuses on members
production lower but moral is higher |
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Term
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Definition
no focus
productivity & morale are both low |
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Term
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Definition
| is hostile, negative & sarcastic |
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Term
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Definition
| impedes the group process |
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Term
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Definition
| authoritative & manipulative |
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Term
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Definition
looks for sympathy
"poor me" |
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Term
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Definition
| dominates the conversation |
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Term
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Definition
| talks about their accomplishments to get attention |
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Term
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Definition
| shares intimate details about himself & inhibits the group process w/excessive premature self-disclosure |
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Term
| family as a system in therapy |
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Definition
| the focus is on interactions b/t members so that a change in one creates a change in others, which in turn results in a change in the entire family unit |
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Term
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Definition
disengagement & extreme seperativeness
decrease in comm. & lack of support |
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Term
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Definition
enmeshment
exaggerated dependency/connectedness & over-involvement |
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Term
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Definition
| will help to identify the occurrences of mental health disorders throughout the generations |
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Term
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Definition
| goal is to manipulate the environment so that all aspects of the client's hospital experience are considered therapeutic |
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Term
| basic ideas of milieu therapy |
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Definition
the client owns his/her own behavior & environment
peer pressure is a useful tool
inappropriate behavior is dealt w/as it occurs
restrictions & punishment are avoided |
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Term
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Definition
enables a person to:
act in their own best interest
stand up for himself w/o anxiety
comfortably express their feelings
exercise their own rights w/o denying the rights of others |
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Term
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Definition
passive
seek to please others at their own expense |
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Term
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Definition
these ppl stand up for themselves & their own rights while protecting the rights of others
openly expresses feelings
respects self & others |
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Term
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Definition
these ppl defend their own basic rights but violate the rights of others
hinders interpersonal relationships |
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Term
| passive aggressive behavior |
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Definition
aka indirect aggression
these ppl use action instead of words to convey their message
these ppl defend their own rights by expressing resistance to social & occupational demands |
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Term
| behavioral components of assertive behavior |
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Definition
intermittent eye contact
body posture
distance/phys. contact
gestures
facial expression
voice, fluency, timing, listening, thoughts, content |
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Term
| thought-stopping techniques |
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Definition
| the person practices interrupting negative thought processes with the word "stop" & shifting his/her thoughts to ones that are considered pleasant & desirable |
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Term
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Definition
consists of:
the physical self or body image
personal identity
self esteem |
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Term
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Definition
| subjective perception of one's physical appearance based on reaction & feedback from others |
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Term
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Definition
| composed of moral self, ethical self, self-consistency & self ideal/self expectancy (what we want to be) |
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Term
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Definition
| degree of regard a person has for himself |
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Term
| what adults can do to help children develop healthy self esteem |
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Definition
a sense of competence
unconditional love
a sense of survival
realistic goals
a sense of responsibility
reality orientation |
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Term
| 3 types of stimuli that manifest in low self esteem |
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Definition
focal--failing a test, losing a job, breaking up w/a bf/gf
contextual--"I knew you weren't smart enough to pass that exam"
residual--being consistently ridiculed as a child |
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Term
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Definition
| physical closeness, touching, sexual behavior, eye contact, privacy & pollution |
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Term
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Definition
| beliefs, feelings, choices, needs, time alone, interests, confidences, individual differences & spirituality |
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Term
| outcome criteria for therapy |
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Definition
person would develop the ability to accept constructive criticism
person would develop the ability to make decisions independently |
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Term
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Definition
is age inappropriate
interferes w/adaptive functioning
is misunderstood by others in terms of cultural inappropriateness |
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Term
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Definition
Pavlov
organisms can learn to respond to a stimulus in a specific way
(ring bell & dog salivates) |
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Term
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Definition
Skinner
the learning of a particular action or type of behavior that is followed by a reinforcement (either + or -)
"the connection b/t stimulus & response is strengthened or weakened by the consequence of the response" |
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Term
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Definition
| reinforcements are given for increasingly closer approximations to the desired response |
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Term
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Definition
| imitating the behavior of others |
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Term
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Definition
| decrease in freq or disappearance of a response when the + reinforcement is withheld |
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Term
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Definition
| a contract for behavioral change is developed |
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Term
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Definition
| token are given for good behavior that can be turned in for certain privileges |
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Term
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Definition
| removes the person from the environment |
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Term
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Definition
aka counterconditioning
serves to dec or stop a neg. behavior by introducing a more adaptive behavior |
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Term
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Definition
an unpleasant consequence is given for the undesirable behavior
ex. antibute given to alcoholics that makes them sick if they drink |
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Term
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Definition
| mental imagery of an aversive stimulus to divert a person from an undesirable behavior |
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Term
| systematic desensitization |
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Definition
| systematic hierarchy of events assoc. with the phobic stimulus is used to gradually desensitize the person |
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Term
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Definition
aka implosive therapy
the person is flooded with a continuous presentation of the phobic stimulus until it no longer elicits anxiety |
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Term
| plan & evaluation of tx for mental health |
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Definition
all members of the tx tream must be made aware of the behavior modification plan
consistency among all staff is req'd for implementation to be successful
eval. of care is based on achievement of the outcome criteria |
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Term
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Definition
| used to create a change in the person's thinking & belief system |
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Term
| indications (reasons) for cognitive therapy |
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Definition
depression, panic disorder, generalized anxiety disorder
also phobias, OCD, PTSD, substance abuse, personality disorders, eating disorders |
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Term
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Definition
| for people w/developmental disorders |
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Term
| length of & goal for cognitive therapy |
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Definition
12-16 weeks (short term)
to learn to identify & alter the dysfx'l beliefs that predispose them to distort experiences |
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Term
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Definition
aka "cognitive errors"
thoughts that occur rapidly in response to a situation & without rational analysis |
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Term
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Definition
| we automatically draw a conclusion without the facts |
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Term
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Definition
| a conclusion is based on only one incident |
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Term
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Definition
all or none thinking
black or white thinking |
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Term
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Definition
| conclusion is based on a selected part of the evidence |
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Term
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Definition
| exaggerating the negative significance of the event |
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Term
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Definition
| undervaluing the positive significance of the event |
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Term
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Definition
| thinking that the worst will always happen |
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Term
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Definition
| taking complete responsibility for a situation without considering the other contributing factors |
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Term
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Definition
our core beliefs
more difficult to change than our automatic thoughts |
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Term
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Definition
guided discovery
the client is asked to describe feelings assoc. with specific situations |
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Term
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Definition
| visualizing the situation |
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Term
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Definition
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Term
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Definition
journaling
one of most frequently used method of recognizing automatic thoughts |
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Term
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Definition
| use imagery before an occurrence in order to be able to handle it when it does occur |
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Term
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Definition
| activity scheduling, graded task assignments, behavioral rehearsal, distraction, relaxation exercises, assertiveness training, role modeling, social skills training, thought-stopping techniques |
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Term
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Definition
usu. begins @ 17-18 yrs. old
genetic, neurotransmitter function & trauma factors
psychosocial & environmental factors |
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Term
| definition of schizophrenia |
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Definition
| disturbances in thought processes, perception & affect result in a severe deterioration of social & occupational functioning |
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Term
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Definition
illusions: visual, auditory, tactile, gustatory, olfactory
hallucinations: *auditory most common
body image & ego boundaries: depersonalization, distortion of body parts, diffusion of self, difficulty with sexual identity
illogical thinking
language changes
delusions
inappropriate affect
ambivalence
changes in motor behavior |
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Term
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Definition
| thinking is characterized by speech in which ideas shift from one unrelated subject to another |
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Term
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Definition
| the psychotic person invents new words |
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Term
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Definition
choices of words are governed by sound
ex. rhyming everything |
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Term
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Definition
| a group of words that are put together randomly, without a logical connection |
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Term
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Definition
the parrot-like repetition of words that have been spoken by another person
ex. time for lunch, time for lunch... |
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Term
| affect of schizophrenic person |
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Definition
| their affect (emotion) is not in keeping with what one would normally expect |
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Term
| + symptoms of schizophrenia |
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Definition
involve thoughts
ex. delusions, bizarre behavior, paranoia, hallucinations, disorganized speech, mutism |
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Term
| - symptoms of schizophrenia |
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Definition
involve emotions
ex. flat or inappropriate affect, poverty of thought, lack of energy, emotional ambivalence, anhedonia |
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Term
| priority intervention of schizophrenic person |
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Definition
| is to assess for s/s of any physical problem |
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Term
| nursing diagnoses for schizophrenia |
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Definition
social isolation
self-care deficit
*disturbed thought processes
impaired verbal comm.
disturbed sensory perception
risk for violence
ineffective coping
disabled family coping
disturbed personal identity
ineffective health maintenance |
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Term
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Definition
the alleviation of anxiety
the relief from the emotional conflict & freedom from anxiety that is achieved by using defense mechanisms
ex. pt. refuses to talk about her mastectomy b/c she becomes anxious |
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Term
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Definition
attention from others
when an external gain is derived from an illness
ex. attention, disability benefits, monetary gain, or release from responsibility |
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Term
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Definition
a subjective warning of danger in which the specific nature of the danger is unknown
usu. occurs w/new or unknown situations but can arise when there is threat from past experiences |
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Term
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Definition
is present in small degrees & can motivate people
necessary for survival |
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Term
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Definition
interferes w/one's ability to think
aka extreme nervousness
usu. occurs suddenly & lasts a short period of time |
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Term
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Definition
present over a period of months or yrs
person appears to be stable but exhibits tremulous motor activity & rigid posture |
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Term
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Definition
severe
causes disintegration of the personality, resulting in the inability to function normally
limit stimulants |
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Term
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Definition
inc. HR, respirations, urination, diarrhea
dry, cotton mouth
dec. appetite
cold sweat & pale appearance
irregular menses
change in BP & body temp
dilated pupils |
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Term
| behavioral manifestations of anxiety |
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Definition
Are you
Not sure of yourself
Xenophobic
Insomniac
Escaping responsibilities
Tense
You are surely suffering from an anxiety disorder |
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Term
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Definition
mild
increased alertness & perception
inc. awareness & ability to solve problems |
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Term
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Definition
moderate
the person can only focus or concentrate on one thing
pacing, voice tremors, inc. rate of talking, more competitive, feelings of restlessness, inability to relax, verbalizes expected danger, selective inattention, dec. perceptual field, mm tension, sweating, GI upset |
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Term
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Definition
severe
ability to perceive is reduced
focus is on small or scattered details
inapprop. verbalization or inability to comm. clearly
dec. intellectual thought processes
lack of determination or ability to perform
feelings of purposelessness
sense of impending doom (ft. or flt.)
phys & emotional discomfort
poor recall, inability to connect details |
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Term
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Definition
panic
complete disruption of ability to perceive
diff'y verbalizing, unable to focus on reality, physiological, emotional & intellectual changes, disoriented, feelings of terror, dissociation, no self control |
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Term
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Definition
has a physical & psychological component
occurs more in women; onset in the 20's |
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Term
| diagnostic criteria of panic disorder |
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Definition
1+ episodes were unexpected & not triggered by a situation where the victim was the focus of attention
4+ attacks in a one week period OR
1+ attacks followed by a period of at least a month of persistent fear of having another attack |
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Term
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Definition
must have 4 of the following:
dyspnea or SOB
palpitations
chest pain or discomfort
choking or smothered sensation
vertigo or uneasy feelings
diaphoresis
feelings of unreality or derpersonalization
syncope
nausea or abdominal distress
hot/cold flashes
paresthesias
fear of losing control or dying |
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Term
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Definition
fight or flight
somatization
impaired cognition
learning |
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Term
| what to do with a client in a state of panic |
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Definition
give clear, simple, concise directions
avoid decision making by the client
stay with the client
do not isolate
avoid touching the client
allow motor outlets for the client
advise activity that involves no thought |
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Term
| coping mechanisms/ego defense |
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Definition
| the main fx is to inc. self esteem, avoid or eliminate anxiety & maintain feelings of self worth & adequacy or soften failures |
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Term
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Definition
"shell shock" or "combat fatigue"
DSM-IV--category reserved for persons who experience a psychological trauma that is considered to be outside the realm of usual human experience |
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Term
| diagnostic criteria for PTSD |
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Definition
an identifiable stressor that causes distress
reliving the event by experiencing recurrent & intrusive recollections of every detail
recurrent dreams or nightmares
suddenly responding as if the traumatic event were occurring
detachment from others
dec. interest in activities |
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Term
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Definition
2+ of the following:
hyper alertness
startle response
insomnia
guilty feeling of surviving or what one had to do to survive the experience
diff'y concentrating
impaired memory
avoiding activity that causes recall of the event
intense symptoms when exposed to an event similar to the traumatic event |
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Term
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Definition
| recurrent obsessions, recurrent compulsions or both |
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Term
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Definition
a persistent painful, intrusive thought, emotion or urge that one is unable to suppress or ignore
common obsessiobs: religion, sex, violence, contamination |
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Term
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Definition
the act of performing repetitious, uncontrollable but seemingly purposeful act to prevent some future event or situation
resistance to the act increases anxiety; yielding decreases anxiety (primary gain)
person is aware of the senselessness & does not derive pleasure from the act |
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Term
| what is the most common form of anxiety disorders? |
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Definition
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Term
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Definition
| an irrational fear of something that is out of proportion to the stimulus |
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Term
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Definition
| a panic attack to a specific stimuli |
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Term
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Definition
most common phobic disorder
fear of being alone in public places
usu. occurs in women (66%) 18-35 y.o.
onset is gradual or sudden
causes depression, fatigue, tension, paresthesias |
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Term
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Definition
| compelling desire to avoid situations in which a person may be criticized by others or exposed to unfamiliar people |
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Term
| ways people deal with social phobias |
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Definition
| may use drugs or alcohol to decrease anxiety |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
| fear of storms or lightning |
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Term
|
Definition
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Term
|
Definition
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Term
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Definition
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Term
|
Definition
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Term
|
Definition
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Term
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Definition
pt. has physical symptoms for which there is no know organic cause (in at least 3 areas of the body)
usu. occurs in people under 30 y.o. |
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Term
| defense mechanisms involved in somatoform disorders |
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Definition
| repression, denial & displacement |
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Term
| assessment of people with somatoform disorders |
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Definition
person appears needy & dependent
person has vast history of various surgeries |
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Term
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Definition
one or more symptoms that affect voluntary motor or sensory fx that suggests a medical or neurological condition
the symptoms are not intentionally feigned (ex. false pregnancy) |
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Term
| hallmarks of conversion disorder |
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Definition
psychological factors are identified as being r/t the onset or exacerbation of the symptoms
specific conflict or stressors precede the dev. of the conversion symptoms |
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Term
| s/s of conversion disorder |
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Definition
pt. seems indifferent
primary gain is dec. anxiety; secondary gain is attention from others
most common s/s suggest a neurologic disorder: paralysis, blindness, seizures |
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Term
| 6 major criteria for hypochondriasis |
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Definition
1. preoccupation with fears or ideas of having a serious disorder
2. misinterpretation of symptoms
3. preoccupation of symptoms
4. preoccupation causes signif. distress or impairment of social life
5. has lasted at least 6 months
6. symptoms are not accounted by any other anxiety disorder |
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Term
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Definition
preoccupation with an imagined defect in one's appearance
signif. impairment in functioning |
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Term
|
Definition
| amnesia, fugue, identity disorder |
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Term
|
Definition
| loss of memory or inability to recall important personal information |
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Term
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Definition
sudden, unexpected travel away from home with the inability to recall one's past
pt. assumes a new identity & fills in the blanks |
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Term
|
Definition
2+ distinct identities or personality states
NOT the effect of substances |
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Term
|
Definition
| relaxation therapies (imagery, change or scenery, massage, exercise, biofeedback, systematic desensitization, therapeutic touch, hypnosis) |
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Term
|
Definition
BuSpar
Ativan
Traxene
for short term use |
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Term
|
Definition
believed to depress activity in the brainstem & limbic center
increases the action of GABA, which causes mm relaxation & sedation |
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Term
| most common indicators for using benzos |
|
Definition
anxiety disorders
ETOH withdrawal
sleep disorders
seizure disorders
neuromuscular disease |
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Term
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Definition
| drowsiness, hiccups, lassitude, loss of dexterity, dry mouth, NV, HAs, constipation, ab'l cramping, dizziness, blurred vision |
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Term
| do not take benzos with... |
|
Definition
CNS depressants
opioids
MAO inhibitors
tricyclic antidepressants |
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Term
| nursing implications for person using benzos |
|
Definition
hypersensitivity
pregnant females/those of childbearing age
nursing mothers
elderly or debilitated |
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Term
|
Definition
chlordiazepoxide (Librium)
Clonzepam (Klonopin)
Clorzpate (Tranxene)
Diazepam (Valium)
Lorazepam (Ativan)
Midazolam (Versed)
Triazolam (Halcion) |
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Term
|
Definition
Buspirone
doesn't suppress the CNS
no evidence of dependence, w/drawal, sedation
s/e: dizziness, N, HA, nervousness, lightheadedness, excitement
do not take with Haldol or MAOIs |
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Term
|
Definition
beta-blocker
works well for social phobias
s/e: most are transient: bradycardia, lightheadedness, heart block |
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Term
|
Definition
reduce likelihood of adverse effects
inhibits the reuptake of serotonin, norepinephrine & dopamine |
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Term
|
Definition
**discontinue the med!!!
s/s: delirium, agitation, tachy, sweating, myoclonus, hyperreflexia, course tremors, hyperthermia, seizures, rhabdomyolysis, renal failure, cardia dysrhythmias, DIC |
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Term
|
Definition
for OCD
inhibits norepinephrine
long term can cause dental problems assoc. with reduced saliva production |
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Term
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Definition
an emotional disturbance in which person has inc. psychological pain
as a result, they are maladaptive
ex: phobic disorders, anxiety |
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Term
|
Definition
reality oriented
no hallucinations or delusions
uses coping mechanisms in an attempt to dec. anxiety (primary gain) |
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Term
|
Definition
out of touch with or denies reality
bizarre, inappropriate behavior
creates their own "new world" & w/draws from society to be in this new world
delusions, hallucinations, autism
coping mechanisms are ineffective so their personality disintegrates |
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Term
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Definition
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Term
|
Definition
| fear of strangers or foreigners |
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Term
|
Definition
| used in times of stress, anxiety, distress without any choice or conscious thinking |
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Term
|
Definition
| conscious strategies chosen to decrease anxiety/stress |
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|
Term
| best time to educate a person who has OCD? |
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Definition
| right after they have performed their "ritual" |
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Term
|
Definition
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Term
|
Definition
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