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mental health > seminar slides (Therapeutic relationships,MSE,suicide) > Flashcards

seminar slides (Therapeutic relationships,MSE,suicide) Flashcards

1
Q

what is therapeutic communication?

A

an interpersonal interaction between the nurse and client whereby the focuses on the client’s specific needs to promote an effective exchange of information

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2
Q

non-therapeutic communication techniques

A

-failure to listen
-giving false reassurance
-giving advice
-probing
-cliches
-giving literal meanings
-changing subject

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3
Q

what is an MSE?

A

a critical assessment tool to assess an individuals current mental state

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4
Q

what is the purpose of an MSE

A

the MSE aids in collecting and organizing objective data at the time of the interview and helps determine the clients abilities, strengths, capabilities, and need for supports

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5
Q

what is the mini mental status exam (MMSE)

A

a 30-point questionnaire which is used to measure cognitive impairment (used with dementia)
examines attention, calculation, recall, language, ability to follow commands and orientation

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6
Q

factors influencing ability to complete MSE

A

-ability to participate or give feedback
-physical health
-emotional well being
-ability to communicate
-culture
-the interviewer’s approach

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7
Q

components of the MSE

A

-appearance
-behaviour
-speech/language
-mood and affect
-thought process
-thought content
-perceptual disturbances
-sensory/cognitive
-judgment/insight

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8
Q

what is appearance in the MSE

A

what the individual looks like
includes: height, weight, look stated age, grooming, hygiene, clothing, odour, identifying characteristics, facial expression

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9
Q

what is behaviour in the MSE

A

attitude of the individual during the interview, are they cooperative, hostile, shy, do they make eye contact
are there gestures or mannerisms (tremors, tics etc)
gait, posture, coordination, pacing, muscle rigidity, slow moving

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10
Q

speech characteristics in the MSE

A

assess for quality (coherent), quantity (amount) of speech, and rate
fluency/ease

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11
Q

what is mood in MSE

A

mood is what the client reports about their emotional state

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12
Q

euthymic

A

normal mood

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13
Q

euphoric

A

elated mood

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14
Q

dysphoric

A

depressed mood

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15
Q

what is affect in MSE

A

the clients emotional response during MSE
detected from facial expression, vocalization, and behaviours
described in range, intensity, and appropriateness

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16
Q

full Range in affect

A

emotions are consistent with stated feelings; congruent with situation

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17
Q

restricted range in affect

A

little outward expression

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18
Q

flat affect

A

almost abscent emotions

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19
Q

appropriateness in affect

A

either congruent or incongruent
emotions are appriopriate for situation or inappriopriate

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20
Q

lability in affect

A

rapid shift in emotional expressions; happy one moment, then tearful

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21
Q

thought process in MSE

A

the manner in which thoughts are formed and expressed: relevance, organization, flow of conversation (logic), goal-directed

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22
Q

linear thought process

A

the individual presents information in a logical flow, easy to follow the individual’s thoughts

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23
Q

circumstantial thought process

A

the individual takes a long time to make a point; provides very unnecessary information but eventually makes the point

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24
Q

tangential thought process

A

the individual diverts from the main topic of discussion and to discuss less important information, the individual does not respond specifically to the question asked

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25
Q

loose association thought process

A

lack of logical relationship between thoughts. conversation shifts from one topic to another in an unrelated manner (can be difficult to follow)

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26
Q

flight of ideas thought process

A

rapid, continuous verbalization, shifting from topic to topic, commonly seen in mania

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27
Q

word salad in thought process

A

incoherent mixture of words/phrases (dementia or schizophrenia)

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28
Q

clang association in thought process

A

words with similar sounds but are not associated in meaning (blue, shoe, sue)

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29
Q

echolalia in thought process

A

parrot like repetition of overheard words or phrases (autism)

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30
Q

neologism in thought process

A

new words or combination of words created by an individual - seen in schizophrenic disorder

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31
Q

perseveration in thought process

A

individual gives the same verbal response to various questions (cognitive impairment disorders)

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32
Q

thought blocking in thought process

A

thoughts interrupted by silence or delay in response

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33
Q

thought content in MSE

A

what is the individual thinking about

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34
Q

delusions in thought content MSE

A

false fixed beliefs based on an incorrect inference about reality; not shared by others; cannot be corrected by reasoning; thus interferes with thinking & reality

35
Q

obsessional ideas in thought content MSE

A

insistent thoughts (over and over in your head; “thoughts one can’t get rid of”)

36
Q

phobias in thought content MSE

A

irrational fears

37
Q

suicidal/homicidal ideations in thought content MSE

A

any thoughts/plans to hurt yourself or others, lethality

38
Q

thought content - delusions: thought broadcasting

A

belief that one’s thoughts are obvious/apparent to others or being broadcasted to the world

39
Q

thought content - delusions: delusions of paranoia

A

irrational distrust of others and/or belief others are harassing/threatening

40
Q

thought content - delusions: somatic delusions

A

delusions involving the body or bodily functions
(rotting on the inside)

41
Q

thought content - delusions: delusions of grandeur

A

exaggerated belief of one’s importance or power

42
Q

thought content - delusions: ideas of reference

A

belief that other people & events have special significance to the individual (a person on the TV is talking specifically to them)

43
Q

perceptions in MSE

A

taking in sensory information from one’s surrounding/environment and processing this into mental representations. it is the way an individual views oneself, the environment, and relationship to others in the environment
perceptual disturbances associated with mental illness are hallucinations and illusions

44
Q

hallucinations in perception MSE

A

sensory perceptions not associated with external stimuli and are not shared by others
examples: visual, auditory, olfactory, gustatory, tactile

45
Q

perception - hallucinations MSE: visual

A

client reports seeing things that are not present to others (i.e snakes on the wall)

46
Q

perception - hallucinations MSE: auditory

A

client reports hearing things others cannot (voices etc) seen in schizophrenia

47
Q

perception - hallucinations MSE: olfactory

A

client states she smells things with no supportive evidence (rotting garbage etc) seen in psychosis

48
Q

perception - hallucinations MSE: gustatory

A

client complains of constant taste in mouth (sour, milk etc)
-lithium actually causes metal taste in mouth*

49
Q

perception - hallucinations MSE: tactile

A

client reports feeling things on skin (i.e. bugs crawling all over body) seen in alcohol withdrawl

50
Q

perceptions - illusions MSE

A

misrepresentation of real sensory stimuli
perceiving a piece of wool as an insect, when in the shower you thought your phone range etc.

51
Q

sensory and cognition in MSE evaluates

A

-level of consciousness
-orientation
-memory(short - long - immediate)
-attention & concentration
-abstract reasoning

52
Q

sensory and cognition MSE: level of consciousness

A

alert, responsive, sleepy, confused, delirious

53
Q

sensory and cognition MSE: orientation

A

person (who), place (where), time (day,month, year) & situation (what is happening)

54
Q

sensory and cognition MSE: immediate memory

A

list 3 words & client recalls them after 10 minutes

55
Q

sensory and cognition MSE: recent memory

A

events in the past few hours (breakfast, morning care etc)

56
Q

sensory and cognition MSE: long term

A

memory of events from years ago

57
Q

sensory and cognition MSE: attention & cognition

A

able to maintain attention
are they easily distracted
i.e start at 20 subtract in 3’s

58
Q

sensory and cognition MSE: abstract reasoning

A

interpret a proverb
intellectual ability: who is the premier?
ability to have abstract/logical/illogical thinking

59
Q

insight MSE

A

does the client understand their situation? the client’s ability to examine ideas, thoughts, and feelings, problem solve, and understand their illness
i.e. what lead to your hospital admission

60
Q

judgment MSE

A

does the client have the ability for decision making?
one’s ability to reach a logical decision about a situation after reviewing/contemplating options or possibilities
I.e what would you do if the fire alarm went off on the unit

61
Q

risk for suicide/homicide MSE

A

assess the clients potential for self harm or harm to others
-ask overtly

62
Q

world suicide prevention day

A

sept 10th

63
Q

how many suicides a year globally

A

700 000

64
Q

more than __ of all deaths by suicides occur on the first attempt

A

1/2

65
Q

suicide deaths per day in canada

A

12

66
Q

nl # of suicides in 2021

A

81 reported

67
Q

males vs females suicide

A

males 3x more likely to DIE
females 3x more likely to ATTEMPT

68
Q

suicide accounts for __ of all deaths in Canadians ages 15-24 years

A

29%

69
Q

term: suicide

A

the act of killing oneself

70
Q

term: suicidal intent

A

thoughts about concrete plan to die by suicide

71
Q

term: suicide attempt

A

behaviour in which one responds to ambivalent feelings about living

72
Q

term: suicidal ideation

A

thoughts about wanting to die

73
Q

protective factors from suicide

A

-hope
-children
-strong supports
-gratification in life
-positive coping skills
-cultural, religious, and personal beliefs (may be forbidden)

74
Q

risk factors for suicide

A

-history/previous attempts
-family history
-hopelessness
-lack of social supports
-losses (finances, loved one, job, gambling)
-childhood trauma
-mood disorders/substances related disorders
-terminal illness
-barriers to mental health treatment

75
Q

risk groups for suicide

A

-age groups(teens, mid-aged adults, elderly)
-gender diverse populations
-indigenous people
-incarcerated people
-dx of mental illness
-substance misuse

76
Q

warning signs of suicide (IS PATH WARM)

A

-Ideation
-Substance misuse

-Purposelessness
-Anxiety
-Trapped
-Hopelessness

-Withdrawn
-Anger
-Reckless behaviour
-Mood changes

77
Q

vulnerable times for suicide risk in hospital

A

-shift change/report
-meal-times
-busy times on the unit/when staff are busy with something else

78
Q

methods to die by suicide

A

-violent (hanging, firearms(men), drug ingestion(female)
-ingestion(poisoning, overdose, pesticides)
-drowning
-jumping
-crashing a vehicle

79
Q

what to do if suicide intent is present in hospital

A

-ensure safety
-do not react
-be non-judgmental
-do not minimize feelings
-be empathetic but avoid false hope/cliches
-observe client 1:1

80
Q

conducting an assessment - susicide: CPR

A

C- Current thoughts; MSE, explore anything unusual and inquire
P-plan, do they have one
R-resources; educate them on

81
Q

SAD PERSONS scale to assess suicidal intent

A

S-sex (male)
A-age (<19 or >45)
D-depression

P-previous attempt
E-ethanol abuse (or drugs)
R-rational thinking loss(delirium/delusions)
S-social supports lacking
O-organized plan
N-no spouse
S-sickness(chronic illness, pain)
one point for each factor they are eligible for

82
Q

follow up for SAD PERSONS score

A

0-2: home with appropriate follow up
3-6: admit or discharge with appropriate follow up
7-10:admit to hospital

83
Q

additonal risk factors for suicide (besides sad persons)

A

-up to 4 weeks following discharge
-recent self harm/ history of violence
-choice of method
-young asian females
-care givers without adequate social/financial support or carers of the severely cognitive imapired

mental health (10 decks)

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