exam 1 topics 1 & 2 Flashcards
(104 cards)
1
Q
define mental health
A
basic wellbeing – overall state of wellbeing and balance
- BOTH good and bad
2
Q
define mental illness
A
a diagnosable psychiatric disorder
3
Q
define behavioral health
A
an individuals response to alterations in mental and physical health
4
Q
what can impact a patients response to any situation
A
cultural and social values, prior experiences, and existing methods of coping
5
Q
define behavioral health care
A
the prevention, diagnosis, and treatment of those responses
6
Q
what is the mental health continuum?
A
a range of wellbeing having mental health and mental illness at the two extreme ends
- going from wellbeing to emotional problems to mental illness
7
Q
define ‘well-being’
A
—Occasional stress to mild distress
—No impairment
8
Q
define ‘emotional problems/concerns’
A
—Mild to moderate distress
—Mild or temporary impairment
9
Q
define ‘mental illness’ as a catagory in the mental health continuum
A
—Marked distress
—Moderate to disabling or chronic impairment
10
Q
how did society view insane asylums and state hospitals at first for behavioral health?
A
- as punishment from god
- insane asylums were to punish the devil out of the person; maltreatment was torture and normalized
11
Q
what impact did WWII have on behavioral health
A
many soldiers came back with “shell shock” aka PTSD
12
Q
what was established after WWII
A
National Institute of Mental Health in 1946
13
Q
what was a problem with treatment after WW11 (before 1950)
A
state hospitals were available to provide restrictive care but couldn’t respond to community or home treatments
14
Q
when did deinstitutionalization begin
A
1950s
15
Q
what did deinstitutionalization bring for BH nursing
A
less restrictive settings & more care
- Influx into unsheltered population, nursing homes
- Community Health and Controlled Substances legislation contributed to this shift in approach
16
Q
when was the ‘decade of the brain’
A
1990s
17
Q
what did the ‘decade of the brain’ bring to behavioral health
A
- new insights, imaging, human genome
(issue with cost of these) - new types of treatments
- improved outcomes and research
18
Q
what are the mental health parity laws
A
passed in 2008, federal law that requires health insurance companies to provide equal coverage for mental health and substance use disorders
- removed barriers to care and improved affordability
- availability of care is still limited
(restrictions on what pt gets a bed)
19
Q
what were Nightingale’s Notes on Nursing (1859)
A
- thought the inhumane treatment of the mentally ill did not align with nursing
- importance of observing patients to better understand their illness
- observe pt to see “what does my pt need from me to get better”
20
Q
what was Peplau’s Theory of Interpersonal Relations in Nursing (1952)
A
“perfect mother” of BH nursing
- groundbreaking conceptualization of the nursing role as a partner in the client’s care and treatment
- therapeutic nurse-client relationship
- holistic, individualized care
21
Q
what was Watson’s theory
A
theory of Human Caring: focuses on the importance of interpersonal relationships between nurses and patients, pt should not be treated as an object
REMEMBER: lightbulb going off reminding you to CARE for patient
22
Q
what was Benner’s theory
A
Benner’s Stages of Clinical Competence of a nurse (Novice to Expert)
23
Q
what was Orem’s theory
A
need to promote pt’s self care activities
REMEMBER: orgasm- self care
24
Q
what was Roy’s theory?
A
assisting client to adapt and cope more effectively with change
REMEMBER Rookie Of the Year: adapting to change, new level of skill
25
what was Neuman's theory?
encourage client use of stress-reduction techniques
REMEMBER: new things = stress, we want to alleviate
26
what was Travelbee's theory?
use communication to validate and alleviate the client’s suffering
REMEMBER: TRAVEL to see bary the BEE to communicate with him and end ur suffering
27
levels of care in BH
- inpatient
- community
- home
28
what is the most restrictive care?
state hospitals (higher level of care = more restrictive)
29
what are the rights of a client when it comes to treatment?
RRIPC
1. receive treatment
2. refusal (unless they are court ordered; went before judge to hear both sides from professionals who cared for the client)
3. informed consent
4. confidentiality (HIPAA laws apply but there is an exception)
5. psychiatric Advanced directives
30
what is a psychiatric Advanced directives
when a client who has hx of psychiatric illness, made an advance directive on what they want done if they are unable to make decision in the future
31
what is the least restrictive alternative (LRA)
- court-ordered outpatient treatment program for people who meet the criteria for commitment to an inpatient facility, but are not currently in one
- must follow the conditions of the court order, or they may be taken back into custody and returned to an inpatient facility.
32
assault definition
intentionally putting someone in fear of harmful or offensive contact
33
battery definition
intentionally causing harmful or offensive contact without consent
34
what is Tort Law
- recognizes emotional and psychological harm as a type of injury
- set in place to protect patients from harm/ actions of others
2 types:
1. intentional infliction of emotional distress
2. negligent infliction of emotional distress
35
what are we mandated to report
must report suspected cases of abuse, child abuse, elder abuse, or threats of violence against others to the appropriate authorities, negligence of impaired clients
36
what is the exception to client confidentiality
your duty to warn and protect (ex patient saying they are going to kill themselves or someone else)
37
common liability lawsuits in BH
- failure to take suicide threats seriously
- negligent supervision
- failure to maintain safe environment
38
our role in patient advocacy
- advocate for pt rights
- support their decision making regarding treatment
- report any incidents of abuse or neglect to the appropriate authorities for immediate action
39
our role in legislative involvement
- stay informed about local and national legislation affecting mental healthcare
- in times of fiscal crisis, advocate for continued funding and support vulnerable populations who may not have voice
40
our role in community outreach
- in both outpatient and community settings to provide care and education to underserved populations
- ex include those in criminal justice system or homeless
41
our role in family support
- work w pt and family to provide timely info, guidance, and instructions to help family/caregivers understand & support the pt's needs at home
42
our role in community collaboration
- work w community leaders and organizations to establish effective health promotion and disease prevention (tailored to needs & resources of local community)
43
right to informed consent
You have the right to be informed about your condition, proposed treatment, risks, and alternatives before consenting to treatment.
44
right to refuse treatment
In most cases, you can refuse recommended treatment, except in emergency situations when you pose a danger to yourself or others.
45
right to freedom from unreasonable restraint
Restraints should only be used as a last resort for safety reasons and for the shortest duration possible
46
what is the time limit on restraints for adults (18 and older)
4 hours
47
how often can an order for restraints be renewed?
up to these time limits for a maximum of 24 consecutive hours
48
what is the time limit on restraints for children 9 through 17
2 hours
49
what is the time limit on restraints for children under 9
1 hour
50
right to treatment
if involuntarily committed, you have the right to receive quality care and treatment aimed at improving your condition
51
when can confidentiality rights be broken
in cases of abuse, neglect, or threats to harm yourself or others
- court orders
- to other healthcare providers involved in pt case
52
what should treatment aim for with the Doctrine of Least Restrictive Alternative
aim to integrate you into the community as much as possible, rather than keeping you in an inpatient or highly restrictive setting unnecessarily
53
how Tort Law impacts nurses
- nurses can be held liable for intentional torts (e.g., assault, battery) or unintentional torts (e.g., negligence, malpractice) that cause harm to clients
- failure to protect clients from self-harm or properly monitor suicidal clients can result in negligence claims
54
what is Milieu therapy
safe environment, structured, group treatment method all in one room
55
what is our role in Milieu management
- maintain safe, theraputic environment
- monitor pt interactions, intervene when needed to de-escalate
- promote calm, structured milieu conducive to treatment
56
when should we use seclusion and restraint
- as a last resort for SAFETY
- follow protocols for ordering, monitoring, and discontinuing seclusion/restraint
- need to do 1 on 1 observation
57
what is our duty to warn and protect
- we have to warn potential victims of serious threats made by clients
- take precautions to protect identifiable potential victims
58
what does active listening look like
Giving my full attention, making eye contact, and allowing clients to express themselves without interruption
59
what does reflection look like
Repeating or rephrasing what the client has said to show understanding and encourage further exploration of thoughts/feelings
60
what does Interpersonal Therapy (IPT) focus on
focuses on improving interpersonal relationships and addressing interpersonal issues contributing to psychological distress
61
goals of Interpersonal Therapy (IPT)
building social support and improving communication skills
62
what does Cognitive Behavioral Therapy (CBT) aim to do
aims to modify dysfunctional thoughts, beliefs, and behaviors through cognitive restructuring and behavioral techniques
63
goals of Cognitive Behavioral Therapy (CBT)
developing coping strategies and changing unhelpful thinking patterns
64
what is Dialectical Behavior Therapy (DBT)
Combines cognitive behavioral techniques with mindfulness, distress tolerance, and emotion regulation skills
65
goals of Dialectical Behavior Therapy (DBT)
reducing self-harm behaviors and improving emotional dysregulation
66
what is behavior modification
uses principles of operant conditioning, such as positive/negative reinforcement and punishment, to increase good behaviors and decrease bad ones
67
what does aversion therapy do
pairs an unwanted behavior with an unpleasant stimulus to create an aversion and reduce the behavior's occurrence
68
what does exposure therapy do
gradually exposes individuals to feared objects or situations in a safe environment to reduce anxiety and avoidance behaviors over time
69
what is Major Depressive Disorder characterized by
by persistent sadness, anhedonia, changes in appetite/sleep, fatigue, feelings of worthlessness, and suicidal ideation
70
risk factors for Major Depressive Disorder
stressful life events, trauma, chronic medical conditions, and family history
71
screening tools for Major Depressive Disorder
PHQ-9 and Beck Depression Inventory are commonly used
72
when does Persistent Depressive Disorder begin usually
often begins in childhood or adolescence and may be influenced by early life experiences and attachment issues
73
how long do feelings of depression last to be classified as Persistent Depressive Disorder
2 years
74
what is Persistent Depressive Disorder
chronic, low-grade depressed mood lasting for at least two years, with periods of more severe symptoms
75
what age group is Disruptive Mood Dysregulation Disorder (DMDD) usually seen in
children and adolescents
76
what is Disruptive Mood Dysregulation Disorder
severe, recurrent temper outbursts and a persistently irritable or angry mood
77
what can Disruptive Mood Dysregulation Disorder be related to
difficulties with emotion regulation and environmental stressors
78
screening tools for Postpartum Depression
Edinburgh Postnatal Depression Scale can aid in early detection and intervention
79
what is Postpartum Depression
occurs in some women after childbirth and can involve feelings of sadness, anxiety, and difficulty bonding with the baby
80
what is Premenstrual Dysphoric Disorder characterized by
by severe mood, behavioral, and physical symptoms that occur during the luteal phase of the menstrual cycle and remit after the onset of menses
81
what can influence Premenstrual Dysphoric Disorder
cultural attitudes towards menstruation and gender roles can influence the experience and reporting of symptoms
82
what does an evidence based approch to assessment and prevention of suicide and non suicidal self injury include
- client risk factors
- protective factors
- social and spiritual supports
- psychosocial history
83
what are client risk factors
Previous attempts, mental illness, substance abuse, access to lethal means, impulsivity, hopelessness, recent losses or stressors
84
what are protective factors
Strong social/spiritual support, coping skills, responsibility to family, future plans, cultural/religious beliefs
85
what are social and spiritual supports we can provide the patient
involving the client's support system and reconnecting them with spiritual/religious resources
86
what are the different parts of a psychosocial history
exploring past traumas, losses, relationship issues, and patterns of self-harm to identify triggers
87
what are ways we can help with suicide prevention
safety planning, means restriction, teaching coping strategies, and providing resources like crisis hotlines and support groups
88
how are evidence based screening tools beneficial
they aid in risk assessment and monitoring
89
what are the parts of a nursing assessment
ADPIE
assessment
diagnosis
planning
implementation
evaluation
90
what types of medications are fluoxetine, sertraline, and escitalopram
Selective Serotonin Reuptake Inhibitors (SSRIs)
91
what are theraputic effects of Selective Serotonin Reuptake Inhibitors (SSRIs)
Increase serotonin levels to improve mood
92
what are major adverse effects of Selective Serotonin Reuptake Inhibitors (SSRIs)
Nausea, insomnia, sexual dysfunction
93
client/family education for Selective Serotonin Reuptake Inhibitors (SSRIs)
Take consistently, watch for serotonin syndrome, may take 4-6 weeks for full effects
94
nursing considerations for Selective Serotonin Reuptake Inhibitors (SSRIs)
Monitor for worsening depression/suicidality initially, serotonin syndrome
95
what drug class do duloxetine and venlafaxine fall under
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
96
therapeutic effects of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Increase serotonin and norepinephrine to elevate mood
97
major adverse effects of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Nausea, dizziness, increased blood pressure
98
client/family education for Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Avoid abrupt discontinuation due to withdrawal effects
99
nursing considerations for Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Monitor blood pressure, discontinuation symptoms
100
what drug class do amitriptyline and nortriptyline fall under
Tricyclic Antidepressants (TCAs)
101
therapeutic effects of Tricyclic Antidepressants (TCAs)
Inhibit reuptake of norepinephrine and serotonin
102
major adverse effects of Tricyclic Antidepressants (TCAs)
Anticholinergic effects, sedation, weight gain
103
client education for Tricyclic Antidepressants (TCAs)
Avoid abrupt discontinuation, risk of overdose
104
nursing considerations for Tricyclic Antidepressants (TCAs)
Assess for anticholinergic effects, cardiac monitoring
