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Mental Health Nursing Final
Terms in this set (76)
Nursing Interventions for Withdrawal
-Assist patient in identifying thoughts and feelings
-Convey acceptance of the individual
-Encourage participation in groups and maintaining consistency with new behaviors learned from the group
-Challenge rationalizations of denial with reality
-Confront use of maladaptive defense mechanism
-Support any acknowledgement of the abuse
-Set firm limits as needed
-Provide information about substance abuse, causes and treatment
-Monitor for withdrawal syndrome
-Support drug/alcohol free lifestyle
-Recognize pt may have setbacks
-Avoid any enabling of pt bad behavior
-Encourage pt to be tested for HIV if any IV usage occurred
-Monitor drug testing
-Be aware of pts attempts to manipulate you
Legal responsibility of Healthcare worker regarding suspected or known abuse
The nurse has the responsibility to know state laws regarding their obligation to report abuse.
Nurses are to report any suspected or known abuse
Anticholinergic Meds, Names and S.E's
Also known as Antiparkinson Agents
Contraindications: Patients with known hypersensitivity should not use these medications.
Nursing interventions in Abuse
ENSURING SAFETY is the number one goal
-Know your own thoughts and feelings about abuse
-Remain nonjudgemental and show empathy
-Know your agency policy and use your resources
-Maintain a calm milieu
BE AN ADVOCATE
Lithium Use, S.E, Care
-Action: The exact action of lithium is not completely known at this time. It is not metabolized by the body. One hypothesis about the action of lithium is that there seems to be a connection between lithium and constancy of sodium concentration, which might help regulate and moderate information along the nerve cells, thus preventing mood swings. Another possibility is that lithium increases the reuptake of norepinephrine and serotonin, thereby decreasing hyperactivity.
-Uses: Lithium is used for the manic phase of bipolar disorder and sometimes for other depressive or schizoaffective disorders.
-Side Effects: Side effects can be numerous. Some of the more common ones are thirst and dry mouth, nausea and vomiting, abdominal pain, and fatigue.
Therapeutic Level 0.5 and 1.2 mEq/L
1.0 to 1.5 for acute mania.
Symptoms of toxicity begin at levels above 1.5 mEq/L
Watch for dehydration and fevers
Adequate fluid and sodium is essential.
Hard sugarless candy for dry mouth and thirst
Classifications of various studied Mental Illnesses
e.g: Mixed feelings or emotions
The state of having contradictory or conflicting emotional attitudes
Contributors to Teen Suicide
Anorexia Nervosa and Bulimia
(Obesity and Morbid Obesity are not considered eating disorders)
-Pt must acknowledge the disorder.
-correct dangerous eating patterns
-address psychological and situational factors that have led to / are maintaining the disorder
-often requires family and friend participation
Schizophrenia (negative symptoms)
Disturbance of affect: expression of emotion
Blunting: severe reduction in the intensity of affect expression
Flat affect: no signs of emotional expression
Inappropriate affect: (ex. schizophrenic starts laughing when talking about someone's death)
Avolition: decreased engagement in purposeful, goal-directed actions
Schizophrenia (positive symptoms)
Psychotic disorder; associated with high dopamine levels
Delusions of reference: (ex. person believes characters in a TV show are talking to him directly)
Delusions of persecution: (ex. person believes he is being deliberately interfered with, discriminated against, plotted against, threatened)
Delusions of grandeur: (person is remarkable in some significant way such as being a historical figure or religious icon)
Thought broadcasting: believe one's thoughts are broadcast directly from one's head to external world
Thought insertion: belief that thoughts are being placed in one's head)
Hallucinations: hearing voices
Disorganized thought: loosening of associations; ideas shift from one thought to another; word salad; schizophrenics invent new words (neologisms)
Disorganized behavior: inability to carry out activities of daily living; patient will either spontaneously move or remain rigid (catatonia)
MAOI's names, restricted foods, outcomes if meds used and foods not restricted
Signs of purging
Erosion of tooth enamel is the key sign.
Hoarseness when speaking.
Calluses on dorsum of hand (Russel's sign)
an effective technique that involves three steps: stating the behavioral limit (describing the unacceptable behavior), identifying the consequences if the limit is exceeded, and identifying the expected or desired behavior
the act of intentionally taking one's own life
Appearance of observable emotions
a temporary state of mind or feeling.
Personality Disorders, Care, Types and Meds
Brain Chemicals, calming, Excitatory, (Alertness)
1. Obsessions thoughts or fears
2. Compulsions: rituals driven by the obsessions
Anxiety and Nursing Interventions
1.) Assess level of anxiety
2.) Keep environmental stresses/stimulation low when anxiety is high- avoid offering many alternatives or decisions when anxiety is high
3.) Assist client to cope with anxiety more effectively- may need to administer anti anxiety meds
4.) Maintain accepting and helpful attitude toward client- do not attempt to remove a defense mechanism at any time
S/S of Autism, behaviors, and main symptom
Meds and Nursing interventions for Autism
Meds for ADHD
Play and Art Therapy
allows child to
1. describe what is troubling them
2. ...without feeling the need or pressure to put into words
-avoid limits of transductive thinking
3. avoid direct confrontation
Levels of Anxiety
Panic Attack Interventions
Stay with patient and acknowledge discomfort.
Maintain a calm style and demeanor.
Speak in short, simple sentences.
Give one direction at a time.
Treat hyperventilation, can provide a brown paper bag, and focus on breathing with the patient.
compelling; strong desire that is difficult to control; irresistible impulse
A persistent, unwanted thought or idea that keeps recurring
ways to deal with or overcome the negative effects of stress
Antidepressants and Young people
Phobia and Phobia Disorders and Treatments
Anti-Anxiety Meds and S.E's
Main goal of Deinstitutionalization
Freud's Personality Parts
id, ego, superego
the principles of right and wrong that guide an individual in making decisions
Purposes of Psychopharmacology
CBT (cognitive behavioral therapy)
action therapy in which the goal is to help clients overcome problems by learning to think more rationally and logically
A trait that helps an organism survive and reproduce
The client or client's guardian chooses commitment to a mental health facility in order to obtain treatment. A voluntarily committed client has the right to apply for release at any time. This client is considered competent, and so has the right to refuse medication and treatment.
procedure of placing some people with mental illnesses in a psychiatric hospital or another facility based on their potential danger to themselves or others or their inability to care for themselves
Coping vs Defense Mechanisms
the consent it is presumed a patient or patient's parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed
An ethical principle requiring that research participants be told enough to enable them to choose whether they wish to participate.
Nursing care of an ECT pt. (electroshock therapy)
Nursing interventions and meds for Schizophrenia
Purposes of 1950's Psychotropic Meds
Therapeutic Communication techniques and purposes
Blocks in communication
Asking for explanations
Changing the subject
self-serving communication that does not take a listener's feelings and rights into account
Goals of Psychotherapy
hope for recovery, gain new perspectives, and providing a caring trusting relationship
Maslow's Hierarchy of Needs
(level 1) Physiological Needs
(level 2) Safety and Security
(level 3) Relationships, Love and Affection, (level 4) Self Esteem,
(level 5) Self Actualization
authoritarian, permissive, and authoritative
Peplau's Nurse Roles
Peplau's Therapeutic Relationship Stages
Medical Complications of Eating Disorders
Only half the women with bulimia nervosa are amenorrheic or have very irregular menstrual periods compare to almost all of those with anorexia nervosa. Some women with bulimia nervosa experience serious dental problems such as breakdown of enamel and even loss of teeth. Moreover, frequent vomiting or chronic diarrhea can cause dangerous potassium deficiencies, which may lead to weakness, intestinal disorders, kidney disease, or heart damage.
Medical treatments that are outside mainstream medical practice
Qualities of a Nurse in a therapeutic relationship
Psychological disorder in which the symptoms take a bodily form without apparent physical cause.
The belief about this disorder is that the symptom, e.g., the paralysis or blindness, is al- lowing the patient to avoid a situation that is unacceptable to him or her. This unacceptable situation is the source of extreme anxiety, which is converted into the dysfunction. The dysfunction, then, is relieving the anxiety. This is called primary gain and is believed to be the function of the paralysis or blindness
Secondary gain is the extra benefits one may acquire as a result of staying ill. Secondary gain includes extra emotional support such as sympathy and love or financial benefits. Much of this is occurring at the unconscious level.
La belle indifference
Even though the patient is concerned enough about the symptoms to consult a physician, he or she may give the impression of really not caring about the problem.
is converting anxiety into a physical symptom.
SSD (Somatic Symptom Disorder)
1. treatment is immediate, supportive, and directly responsive to the immediate crisis
2. interventions are goal directed
3. feelings of the client are acknowledged
4. intervention provides opportunities for expression and validation of feelings
5. connections are made between the meaning of the event and the crisis
6. client explores alternative coping mechanisms and tries out new behaviors
1. decrease emotional stress and protect the victim
2. assist the victim(s) to organize and mobilize resources
3. return to pre-crisis status or a higher functional level
1. assess the situation and individual(s) involved in the crisis
2. determine possible interventions with input from a spiritual care provider, other family, significant others, or close friends, as well as health care providers
3. implement the intervention plan
4. the crisis resolves and/or an anticipatory plan emerges from the solution to the problem
any event that disrupts a person's previously effective coping mechanisms.
Nursing Process define and steps
Phases of Crisis
Behavior Modification Purpose
Definitions of Mental Health
1) Normality as a statistical concept--those that occur most frequently in the population, do not take into account community standards and cultural values
2) Normality as ideal mental health--grounded in the belief of universal application, goals like competence, autonomy, and resistance to stress are White middle class values
3) Abnormality as the presence of certain behaviors--biases occur with respect to diagnosis and treatment
THIS SET IS OFTEN IN FOLDERS WITH...
Mental Health Nursing- Medications
Mental Health Nursing- Medications
621 - Mental Health and Nursing
Mental Health Nursing FINAL
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