Final Exam Flashcards
What is Dorothea Dix known for?
- Creation of asylums
2. Moral treatment
What is Linda Richards known for?
- First American psychiatric nurse
2. McLean Hospital; first to train nurses in psych setting
Hildegard Peplau’s theory?
3 phases: orientation, working, termination
Therapeutic nurse-patient relationship
What is Sigmund Freud’s psych theory?
- All human behavior is caused & explainable
- Repressed sexual impulses, desires as motivation for behavior
- Id, ego, superego
- Behaviors are due to subconscious thoughts
What are differences between Id, Ego, and Superego?
Id: instinctive, for pleasure, immediate satisfaction, subconscious
Ego: rationality, logicality, reality, conscious
Superego: right & wrong, morality, ideal, sub and conscious
Characteristics of Sullivan’s Interpersonal Theories
- Five life stages
- Three develop. cognitive modes:
- Prototaxic (infancy, childhood)
- Parataxic (early childhood)
- Syntaxic (school-aged)
B.F. Skinner’s Operant Conditioning theory
- All behavior is learned
- rewards or punishments
- recurrence of rewarded behavior
Clubhouse Treatment Model
4 Rights of Members: -place to come to -meaningful work -meaningful relationships -place to return to (lifetime membership) Focus on health, not illness
Assertive Community Treatment setting (ACT)
(one of the MOST effective!!)
- one of the most effective treatment settings
- problem-solving orientation
- direct service instead of referral
- intense; no time restraints
4 “patterns of knowing”
- Empirical (derived from nursing science)
- Personal (from life experiences)
- Ethical (from moral nursing knowledge)
- Aesthetic (from art of nursing)
Components of Orientation Phase
- Meeting nurse, client
- Establishment of roles
- Discussion of purposes, parameters of future meetings
- Clarification of expectations
- Identification of client’s problems
- Nurse–client confidentiality, duty to warn/self-disclosure
Components of Working Phase
•Problem identification: issues or concerns identified by
client; examination of client’s feelings and responses
•Exploitation: examination of feelings and responses;
development of better coping skills, more positive self-
image, behavior change, independence
•Possible transference/counter-transference
Components of Termination phase
•Begins when client’s problems are resolved
•Ends when relationship is ended
•Deals with feelings of anger or abandonment that may
occur; client may feel termination as impending loss.
Nurse-Patient distant zones
- Intimate (0 to 18 inches)
- Personal (18 to 36 inches)
- Social (4 to 12 feet)
- Public (12 to 25 feet)
- Therapeutic communication: most comfortable when nurse and patient are 3 to 6 feet apart
Catharsis
- To alleviate or increase feelings of anger
- Example: watching a movie knowing that it will make you cry, and you go for the purpose of crying
Hwa-Byung Angry Behavior
- Korean; insomnia, depression, somatization in lower abdomen
- Experienced by middle-aged Korean females
Bouffee delirante
-French; short-lived psychosis
Amok Anger
-Malaysian; rage or vendetta against a person, society, or object
Mental illnesses treated with Lithium
- Bipolar
- Conduct disorders
- mental retardation
Mental illnesses treated with Carbamazepine (anticonvulsant)
- dementia
- psychosis
- personality disorders
Mental illnesses treated with atypical antipsychotics (clozapine, risperidone, olanzapine)
- dementia
- brain injury
- mental retardation
- personality disorders
Interventions for “Triggering” phase of anger
- Approach in nonthreatening, calm manner
- Convey empathy; listening
- Encourage verbal expression of feelings
- Suggest patient go to a quieter area
- Use PRN medications
- Suggest physical activity such as walking
Interventions for “Escalation” phase of anger
- Take control; provide directions in firm, calm voice
- Direct patient to room or quiet area for time-out
- Offer medication again
- Let patient know aggression is unacceptable; nurse or staff will help maintain/regain control
- If ineffective, obtain help from other staff (show of force)
Interventions for “Crisis” phase of anger
-Inform patient that behavior is out of control, and staff
is taking control to provide safety and prevent injury
-Use of restraint or seclusion only if necessary