Exam 2 Flashcards
(32 cards)
What is self-efficacy? How does it affect a person’s response to life’s challenges?
a belief that personal abilities and efforts affect the events in one’s life.
A person who believes that his or her behavior makes a difference is more likely to take action. People with high self-efficacy set personal goals, are self-motivated, cope effectively with stress, and request support from others when needed.
People with low self-efficacy have low aspirations, experience much self-doubt, and may be plagued by anxiety and depression.
What is hardiness? What are the 3 components? How does it relate to hental health?
ability to resist illness when under stress.
1.Commitment: active involvement in life activities
2.Control: ability to make appropriate decisions in life activities
3.Challenge: ability to perceive change as beneficial rather than just stressful
What are neologisma?
invented words that have meaning only for the client
In a mental helath assessment, what are 3 motor behaviors of note?
Automatisms: repeated purposeless behaviors often indicative of anxiety, such as drumming fingers, twisting locks of hair, or tapping the foot
*Psychomotor retardation: overall slowed movements
*Waxy flexibility: maintenance of posture or position over time even when it is awkward or uncomfortabl
What are 5 common terms for assessing affect?
*Blunted affect: showing little or a slow-to-respond facial expression
*Broad affect: displaying a full range of emotional expressions
*Flat affect: showing no facial expression
*Inappropriate affect: displaying a facial expression that is incongruent with mood or situation; often silly or giddy regardless of circumstances
*Restricted affect: displaying one type of expression, usually serious or somber
What is labile?
When the client exhibits unpredictable and rapid mood swings from depressed and crying to euphoria with no apparent stimuli, rapidly changing
What is thought process? How can it be inferred by the RN? What is thought content?
Thought process refers to how the client thinks. The nurse can infer a client’s thought process from speech and speech patterns.
Thought content is what the client actually says.
What are 11 common assesments of disrupted thought prosseses?
Circumstantial thinking: a client eventually answers a question but only after giving excessive unnecessary detail
*Delusion: a fixed false belief not based in reality
*Flight of ideas: excessive amount and rate of speech composed of fragmented or unrelated ideas
*Ideas of reference: client’s inaccurate interpretation that general events are personally directed to him or her, such as hearing a speech on the news and believing the message had personal meaning
*Loose associations: disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts
*Tangential thinking: wandering off the topic and never providing the information requested
*Thought blocking: stopping abruptly in the middle of a sentence or train of thought; sometimes unable to continue the idea
Thought broadcasting: a delusional belief that others can hear or know what the client is thinking
*Thought insertion: a delusional belief that others are putting ideas or thoughts into the client’s head—that is, the ideas are not those of the client
*Thought withdrawal: a delusional belief that others are taking the client’s thoughts away and the client is powerless to stop it
*Word salad: flow of unconnected words that convey no meaning to the listener
What are 11 rights of psychiatric patients?
To be informed about benefits, qualifications of all providers, available treatment options, and appeals and grievance procedures
*Least restrictive environment to meet needs
*Confidentiality
*Choice of providers
*Treatment determined by professionals, not third-party payers
*Parity
*Nondiscrimination
*All benefits within scope of benefit plan
*Treatment that affords greatest protection and benefit
*Fair and valid treatment review processes
*Treating professionals and payers held accountable for any injury caused by gross incompetence, negligence, or clinically unjustified decisions
What are the benefits of mandated outpatient treatment in cases of patients who are released but need ongoing care?
shorter inpatient hospital stays, though these individuals may be hospitalized more frequently;
reduced mortality risk for clients considered dangerous to themselves or others;
protection of clients from criminal victimization by others.
more cost-effective than repeated involuntary hospital stays.
What is a tort?
tort is a wrongful act that results in injury, loss, or damage. Torts may be either unintentional or intentional
What are the 4 determinants of malpractice?
Duty: A legally recognized relationship (i.e., physician to client, nurse to client) existed. The nurse had a duty to the client, meaning that the nurse was acting in the capacity of a nurse.
2.Breach of duty: The nurse (or physician) failed to conform to standards of care, thereby breaching or failing the existing duty. The nurse did not act as a reasonable, prudent nurse would have acted in similar circumstances.
3.Injury or damage: The client suffered some type of loss, damage, or injury.
4.Causation: The breach of duty was the direct cause of the loss, damage, or injury. In other words, the loss, damage, or injury would not have occurred if the nurse had acted in a reasonable, prudent manner.
What are the 3 most common intentional torts?
battery, assault, false imprisonment
What are 6 ways to avoid liability?
Practice within the scope of state laws and nurse practice act.
*Collaborate with colleagues to determine the best course of action.
*Use established practice standards to guide decisions and actions.
*Always put the client’s rights and welfare first.
*Develop effective interpersonal relationships with clients and families.
*Accurately and thoroughly document all assessment data, treatments, interventions, and evaluations of the client’s response to care.
What are the definitions of the following ethical responsibilities of nurses?
Utitiliarianism
Deontology
Autonomy
Beneficence
Nonmalficence
Veracity
Fidelity
Utilitarianism: considers which action would produce the greatest benefit for the most people.
Deontology: decisions should be based on whether an action is morally right with no regard for the result or consequences.
Autonomy: a person’s right to self-determination and independence.
Beneficence refers to one’s duty to benefit or to promote the good of others.
Nonmaleficence: do no harm to others either intentionally or unintentionally.
Justice: treating all people fairly and equally without regard for social or economic status, race, sex, marital status, religion, ethnicity, or cultural beliefs.
Veracity: duty to be honest or truthful.
Fidelity: the obligation to honor commitments and contracts.
What is the critia in warning third parties?
Is the client dangerous to others?
*Is the danger the result of serious mental illness?
*Is the danger serious?
*Are the means to carry out the threat available?
*Is the danger targeted at identifiable victims?
*Is the victim accessible?
What are Engel’s 5 stages of grief (not Kubler Ross)?
hock and disbelief: The initial reaction to a loss is a stunned, numb feeling accompanied by refusal to acknowledge the reality of the loss in an attempt to protect the self against overwhelming stress.
2.Developing awareness: As the individual begins to acknowledge the loss, there may be crying, feelings of helplessness, frustration, despair, and anger that can be directed at self or others, including God or the deceased person.
3.Restitution: Participation in the rituals associated with death, such as a funeral, wake, family gathering, or religious ceremonies that help the individual accept the reality of the loss and begin the recovery process.
4.Resolution of the loss: The individual is preoccupied with the loss, the lost person or object is idealized, and the mourner may even imitate the lost person. Eventually, the preoccupation decreases, usually in a year or perhaps more.
5.Recovery: The previous preoccupation and obsession ends, and the individual is able to go on with life in a way that encompasses the loss.
What are cognitive responses to grief?
Disruption of assumptions and beliefs
Questioning and trying to make sense of the loss
Attempting to keep the lost one present
Believing in an afterlife and as though the lost one is a guide
What are emotional responses to grief?
Emotional responses
Anger, sadness, anxiety
Resentment
Guilt
Feeling numb
Vacillating emotions
Profound sorrow, loneliness
Intense desire to restore bond with lost one or object
Depression, apathy, despair during phase of disorganization
Sense of independence and confidence as phase of reorganization evolves
What are spiritual responses to grief?
Disillusioned and angry with God
Anguish of abandonment or perceived abandonment
Hopelessness, meaninglessnes
What are behavorial response to grief?
Functioning “automatically”
Tearful sobbing, uncontrollable crying
Great restlessness, searching behaviors
Irritability and hostility
Seeking and avoiding places and activities shared with lost one
Keeping valuables of lost one while wanting to discard them
Possibly abusing drugs or alcohol
Possible suicidal or homicidal gestures or attempts
Seeking activity and personal reflection during phase of reorganization
What are physiologic response to grief?
Headaches, insomnia
Impaired appetite, weight loss
Lack of energy
Palpitations, indigestion
Changes in immune and endocrine systems
What are possible medical conditions exasperated by supression of anger?
migraine headaches, ulcers, or coronary artery disease, HTN, and emotional problems such as depression and low self-esteem.
What is intermittent explosive disorder?
Intermittent explosive disorder (IED) is a rare psychiatric diagnosis characterized by discrete episodes of aggressive impulses that result in serious assaults or destruction of property. The aggressive behavior the person displays is grossly disproportionate to any provocation or precipitating factor.