Mental Health Exam 1

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Dorthea Dix

First nurse to promote quality mental health nursing care.

1950

The first antipsychotic drugs came out after this year.

Freud's Psychoanalytic Theory

Nurses began to focus on human behavior, early stages of sexual development, and use of maladaptive defense mechanisms. (Theory)

Sullivan's Interpersonal Theory

Nurses recognized that humans are social beings who develop interpersonal relationships that could result in stress or anxiety, the use of maladaptive behaviors, or alteration of the development of one's personality. (Theory)

Skinner's Behavior Theory

Nurses recognized that interventions could be used to bring out changes in thoughts, feelings, and observed behavior. (Theory)

Erikson's Developmental Theory

Personality development begins at birth ans continues across the lifespan until death. (Theory)

Peplau's Interpersonal Theory

Focuses primarily on the nurse-client relationship in which problem solving skills are developed. Four phases occur: orientation, identification, exploitation, and resolution. (Theory)

Orem's Behavioral Nursing Theory

Focuses on self-care deficit. (Theory)

Roy's Theory of Adaptation

Beings use coping mechanisms to adapt to both internal and external stimuli. (Theory)

Parse's Theory of Human Becoming

The role of the nurse is to guide the client or simply be with him or her to bear witness to the client's experiences; meaning, rhythmicity, and transcendence. (Theory)

amok

Dissociative episode followed by outburst of violent behavior directed at people or objects.

bilis and colera

Acute nervous tension, headache, trembling, screaming, stomach disturbance, and even loss of consciousness.

boufee delirante

Sudden outburst of agitated and aggressive behavior, confusion, or psychomotor excitement.

brain ***

Difficulty concentrating, remembering, and thinking; associated with challenge of schooling.

dhat

Severe anxiety and hypochondriacal concerns.

falling out/blacking out

Sudden collapse; may occur without warning, but sometimes preceded by feelings of dizziness. Person claims inability to see and may feel powerless to move.

ghost sickness

Preoccupation with death and the deceased. Bad dreams, weakness, feelings of danger, anxiety, and hallucinations may occur.

hwa-byung or "anger syndrome"

Insomnia, fatigue, panic, fear of impending death, indigestion, and anorexia.

pibloktog

Abrupt dissociative episode accompanied by extreme excitement.

rootwork

Illness ascribed to hexing, witchcraft, sorcery, or evil influence of another person.

shenjing shuairo

Physical and mental fatigue, dizziness, headaches, sleep disturbance, and memory loss.

q2h

How often should you offer food and bathroom to a restrained patient?

q15min

How often should we evaluate and document on a restrained patient?

q24h

How often should an order for restraints be renewed?

blunted response

Severe reduction or limitation in the intensity of one's affective response to a situation.

flat response

Absence or near absence of any signs of affective responses such as an immobile face and monotonous tone of voice when conversing with others.

inappropriate response

Discordance or lack of harmony between ones voice and movements with ones speech or verbalized thoughts.

labile response

Abnormal fluctuation or variability of ones expressions, such as repeated, rapid or abrupt shifts.

restricted/constricted response

A reduction in ones expressive range and intensity of affective responses.

blocking

Sudden stoppage in the spontaneous flow or stream of thinking or speaking for no apparent reason.

circumstantiality

The person gives much unnecessary detail that delays meeting a goal or stating a point.

tangentiality

Occurs when a person responds to a question with a reply that is appropriate to the general topic but does not specifically answer the question.

echolala

Parrot-like repetition of words or phrases.

echopraxia

The repetitive imitation of movements of another person.

flight of ideas

Characterized by over productivity of talk and verbal skipping from one idea to another; fragments not sentences.

looseness of association

Synonymous with the term derailment; a disturbance of thinking shown by speech in which ideas shift from one unrelated, or minimally unrelated subject to another; usually complete sentences.

neologism

Describes the use of a new word or combination of several words coined or invented by a person and not readily understood by others.

word salad

Disturbance in form of thought; clients speech contains a mixture of words and phrases that lack comprehensive meaning or logical coherence.

mutism

Refusal to speak even though the person may give indication that he or she is aware of the environment.

clang association

A type of thinking in which the sound of a word substitutes for logic during communication.

obsession

Insistent thoughts, recognized as arising from the self.

compulsions

Insistent, repetitive, intrusive, or unwanted urges to perform an act contrary to ones ordinary wishes or standards.

Axes I

Clinical disorders fall under this axes.

Axes II

Personality disorders or mental retardation fall under this axes.

Axes III

General medical conditions (DM,HTN) fall under this axes.

Axes IV

Psychosocial/environmental problems (housing) fall under this axes.

Axes V

Global assessment of functioning falls under this axes.

compensation

Unconscious use of a specific behavior to make up for a real or imagined inability or deficiency, thus maintaining self-respect or self-esteem. ie: Unattractive man selects expensive, stylish clothes to draw attention to himself.

conversion

Unconscious expression of a mental conflict as a physical symptom to relieve tension or anxiety. ie: Woman experiences blindness after witnessing a robbery.

denial

Unconscious refusal to face thoughts, feelings, wishes, needs, or reality factors that are intolerable. ie: Woman denies that her marriage is failing by telling her estranged husband that all couples go through marital slumps and "things will be better tomorrow."

displacement

Unconscious shifting of feelings such as hostility or anxiety from one idea, person, or object to another. ie: Teen-aged son slams door when told he can't attend a concert.

dissociation

Separation and detachment of a strong, emotionally charged conflict from one's consciousness. ie: Male victim of car-jacking exhibits symptoms of traumatic amnesia the next day.

identification

Unconscious attempt to identify with personality traits or actions of another to preserve one's self-esteem or to reach a specific goal. ie: Teenager dresses, walks, and talks like his favorite basketball player.

introjection

Unconscious application of the philosophy, ideas, customs, and attitudes of another person to one's self. ie: Psychiatric client who claimed to be Moses grew a beard and long hair, wore a blanket and sandals, and read his Bible daily.

projection

Unconscious assignment of unacceptable thoughts or characteristics of self to others. ie: Man who was late for work blames wife for not setting the alarm clock.

rationalization

Unconscious justification of one's ideas, actions, or feelings to maintain self-respect, prevent feelings of guilt, or obtain social approval. ie: Student states he didn't make the golf team because he was sick.

reaction formation

Unconscious demonstration of the opposite behavior, attitude, or feeling of what one would normally show in a given situation. ie: Man who dislikes his mother-in-law is very polite and courteous toward her.

regression

Retreat to past developmental stages to meet basic needs. ie: Woman acts like a teenager on her first date with a fellow employee.

restitution

Negation of a previous consciously intolerable action or experience. ie: Man sends flowers to fiancée after embarrassing her at a cocktail party.

sublimation

Unconscious rechanneling of intolerable or socially unacceptable impulses or behaviors into activities that are personally or socially acceptable. ie: College student with hostile feelings joins the debate team.

substitution

Unconscious replacement of unacceptable impulses, attitudes, needs, or emotions with those that are more acceptable. ie: A student nurse decides to be a teacher because he or she is unable to master clinical competencies.

suppression

Voluntary rejection of unacceptable thoughts or feelings from conscious awareness. ie: Student who failed a test states she isn't ready to talk about her grade.

symbolization

Use of external objects to become an outward representation of an internal idea, attitude, or feeling. ie: An engagement ring symbolizes love and a commitment to another person.

Rogers' 8 Conditions for a Therapeutic Relationship

Empathy, respect, genuineness, self-disclosure, concreteness/specificity, confrontation, immediacy of relationship, and client self-exploration.

Phases of a Therapeutic Relationship

Initiation/Orientation, Working, and Termination.

Therapeutic milieu

An environment that provides client the opportunity to interact with staff and other clients. It gives the client the opportunity to practice interpersonal skills, provide feedback to peers about behavior, and work together to develop problem-solving skills.

Class 1 Crisis

Dispositional or situational crisis in which a problem is presented with a need for immediate action, such as finding housing for the homeless during subzero temperatures.

Class 2 Crisis

Life transitional or maturational crisis that occurs during normal growth and development, such as going away to college or experiencing a planned pregnancy.

Class 3 Crisis

Situational crisis due to a sudden, unexpected, traumatic event or disaster, such as the loss of a home during a hurricane or earthquake.

Class 4 Crisis

Maturational or developmental crisis involving an internal stress and psychosocial issues, such as questioning one's sexual identity or lacking the ability to achieve emotional independence.

Class 5 Crisis

Situational crisis due to a preexisting psychopathology, such as depression or anxiety, that interferes with activities of daily living (ADL) or various areas of functioning.

Class 6 Crisis

Psychiatric situational crisis or emergency, such as attempted suicide, drug overdose, or extreme agitation, resulting in unpredictable behavior or the onset of an acute psychotic disorder.

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