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NURS 373 > Mental Health Assessment & Injury Prevention > Flashcards

Mental Health Assessment & Injury Prevention Flashcards

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1
Q

T or F: A more in-depth assessment is required for mental health patients.

A

TRUE

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2
Q

Components of risk assessment (4)

A

1) appearance

2) behaviour

3) cognition

4) thoughts

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3
Q

Mental status exam - ASEPTIC

A

A - appearance

S - speech

E - emotions

P - perceptions

T - thoughts

I - insights

C - cognitions

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4
Q

Appearance

A

grooming, facial expression, tremors, dress, skin condition, identifying characteristics (e.g. tattoos, piercings), scars, age, body build, position, alertness, affect

psychomotor:gait, pacing, crying, threatening, withdrawn, angry, suspicious, attention to events, eye contact, agitation, tremor, grimace

e.g. do they eed a lot of prompting for self-care

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5
Q

Speech

A

what are they saying?

is it appropriate for the situation?

rate, amount, style and tone of speech

loud, quiet, slow, rapid, over-talkative, pressured, mute, slurred, incoherent, stuttering, long pauses, mute

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6
Q

Emotions

A

emotional state: mood

visible expression: affect

description & variability; congruence of mood, range

appropriate for situaiton?

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7
Q

Perception

A

how they see themselves and others

understanding of reality

hallucinations, illusions, depersonalizations, derealizations

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8
Q

Thoughts

A

CONTENT:suicidal, homicidal, guilt, worthlessness, hopelessness, obsessions, ruminations, phobias, paranoia, hallucinations, delusions

PROCESS:coherence, logical, perseveration, flight of ideas, blocking, tangential, attention (distractible, concentration)

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9
Q

Insights

A

insight into illness and treatment

do they understand that they’re sick? do they want help?

judgement
good? poor?

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10
Q

Cognition (5)

A

LOC

Orientation

Attention

Memory

Intelligence

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11
Q

How nurses can help with mental, emotional and behavioural health

A

help children label emotions

promote a safe environment

intervene early to prevent long-term complications

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12
Q

Mental health

A

a person’s ability to process information

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13
Q

Emotional health

A

person’s ability to express feelings

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14
Q

Behavioural health

A

what a person does

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15
Q

Developing a collaborative treatment relationship

A

empathetic engagement

initiating a conversation

working toward intended therapeutic goal

treatment partner

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16
Q

Factors contributing to mental illness

A

stability and safety of the environment
-ACEs, toxic stress

co-morbid conditions

lack of access to resources

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17
Q

Co-morbid conditions that increase risk of mental illness (3)

A

1) cancer

2) chronic

3) life-threatening

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18
Q

T or F: Youth are more likely to act on suicidal ideation.

A

TRUE

frontal lobe underdeveloped

impulsive

though most attempts not lethal

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19
Q

Most common mental illnesses in children (2)

A

1) anxiety

2) depression

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20
Q

When treatment is needed for anxiety

A

interfering with enjoyment of life and ability to perform tasks

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21
Q

Anxiety symptoms

A

symptoms most days

trouble concentrating

irritable or easily upset

difficulty sleeping

unusually tired/sleepy

physical symptoms**

Alexithymia

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22
Q

Alexithymia

A

Don’t feel emotions or unable to describe what their emotions are

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23
Q

Primary goal of anxiety nursing care

A

to resume typical activities appropriate to development

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24
Q

Good question to ask to gauge how anxiety is affecting activities

A

Are they going to school?

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25
Anxiety nursing care
assessment of mental, emotional and behavioural symptoms learning how to cope learning about biological connection to emotions CBT medication
26
Coping strategies (3)
1) relaxation techniques 2) play 3) discussing feelings
27
Something to tell parents to get them on board with meds
warranted in some cases world is different can't raise them the way we did
28
Depression types (2)
1) temporary - acute 2) chronic
29
Depressions symptoms - behavioural
sad, crying withdrawn lower grades don't want to go to school angry clingy
30
Depressions symptoms - emotional
low self-esteem hopelessness guilt lack of interest tiredness
31
Depressions symptoms - mental
trouble concentrating slower cognitive processing all-or-nothing thinking suicidal thoughts
32
Depressions symptoms - physiological
constipation fatigue non-specific/unwell appetite changes altered sleeping patterns
33
Important thing to assess for with depression
suicide risk! adolescents - parent shouldn't be in the room "thoughts of harming self?" "do you have a plan?"
34
What happens if a client discloses?
need assessment at the hospital individualized, different supports call 911 if they leave - need 911 to get them safety plan
35
T or F: Someone that is motivated to harm themselves will find a way.
TRUE
36
Depression treatment
CBT meds environmental supports referrals
37
Common side of depression meds
suicidal ideation
38
T or F: Clients tend to do better upon admission for depression.
TRUE removing from stressful environment routine trained personal medication side effects being monitored safety peer support no phones!
39
T or F: It is not necessary to involve parents and family in depression treatment. The focus should be on the client.
FALSE look at environment family, school can't put them back into the same environment without changing things
40
Suicide warning signs (many)
preoccupation with death giving away possessions talking about death loss of energy loss of interest altered sleep patterns reckless behaviour sudden changes at school worthless sudden cheerfulness etc.
41
What is the highest single risk factor for suicide?
depression
42
High risk groups for suicide (2)
1) Indigenous 2) LBGTQ2S+
43
Common things used for suicide attempt
Tylenol and Advil what they can get their hands on lock these things up
44
Risk factors for suicide (many)
social isolation depression and/or substance abuse impulsive formulated plan previous attempt family history current illness easy access to lethal toxins, fire arms life changing events
45
Protective factors for suicide
intact social supports sense of belonging absence of depression and substance use impulse control no definite plan no previous attempt no fam history medically healthy no access to lethal toxins, fire arms no significant stressors
46
Suicidal ideation
preoccupation with suicidal thoughts
47
Suicide attempt
intended to cause death or serious injury
48
Parasuicide
behaviours ranging from gestures to serious attempts to kill oneself
49
Nursing care for suicide
recognize warning signs assess crisis management prevention
50
T or F: Youth who express suicidal feelings and have a specific plan should be monitored at all times/
TRUE
51
T or F: Intoxicated youth who express suicidal feelings and have a plan should be restrained or in a protective environment.
TRUE until a psychiatrist or psychologist can assess them
52
Substance abuse - greatest concern
high doses mixed drugs individuals vulnerable
53
T or F: It is more dangerous to youth to experiment with substances in this day in age.
TRUE e.g. fentanyl
54
Most effective way to reduce incidence of substance use
prevention!
55
T or F: Programs that focus on negative long-term effects of substances are ineffective.
FALSE don't think about the future
56
What types of substance abuse programs are effective?
peer-led that emphasize immediate consequences ones that elicit a emotional response
57
Substance use nursing care
prevention promote overall health and success educating about signs early treatment emergency overdose treatment
58
Factors that impact eating behaviours in children (4)
1) relationships with peers and caregivers 2) stress 3) exposure to adverse events 4) GI tract changes
59
T or F: Children with an eating disorder often have often psychiatric issues.
TRUE
60
Characteristics of an individual with anorexia
turns away from food introverted avoids intimacy/sexual activity negates feminine role model child role high achiever high control body image distortion denies illness
61
Characteristics of an individual with bulimia
turns to food extroverted seeks intimacy aspires to feminine role acts out variable school performance loses control less frequent body image recognizes illness often sexually active
62
Nursing care for eating disturbance
food is medicine! complications of nutritional status assess for physical side effects
63
Main physical side effects of eating disturbances (3)
1) UTI 2) vital sign changes (hypotension) 3) electrolyte imbalances***
64
Refeeding syndrome
phosphate deficiency when someone increases food intake after period of starvation
65
Goals of care for disturbances in eating behaviours (3)
1) reinstitution of normal nutrition or reversal of severe malnutrition 2) resolution of the disturbed pattern of family interactions 3) individual psychotherapy
66
What is goal of care is focused on first for eating related disturbances and why?
nutrition! brain isn't functioning can't do therapy if brain isn't functioning
67
Treatment for eating related disturbances
CBT pharmacological therapy family therapy*** hospitalization
68
T or F: You should not let a client with an eating related disturbance see their weight.
FALSE give them the choice
69
Behavioural health needs
maladaptive behaviour patterns that impede psychosocial adjustment when try to cope with cognitive dysfunction acting out trouble at school trouble at home ADHD, LD
70
Nursing care for behavioural health needs
developmental and medical history description of behaviour physical examination -hearing and vision testing psychological testing provide support and education to family building fam's self-esteem
71
When should injury prevention education for parents start?
during pregnancy prenatal classes
72
Injury prevention in infancy
aspiration of foreign objects -no baby powder suffocation (safe sleep) MVA falls poisoning burns drowning bodily damage
73
Children should be in a rear-facing car seat until age....
2
74
Up until what age can children not anticipate danger?
age 7 can't cross street by themselves
75
Injury prevention in toddlerhood
poisoning*** MVA drowning burns falls choking
76
Injury prevention in preschool
less prone to falls than toddlers poisoning playground injuries pedestrian accidents
77
Focus on parental education for preschool injury prevention
helmets on bikes parents modelling behaviour establishing habits
78
Injury prevention in school age
most common: MVA diminished injuries
79
Focus on parental education for school-age injury prevention (3)
effective car restraint systems door-lock mechanisms appropriate passenger –seating locations (back seat)
80
Injury prevention in adolescence
biggest cause: physical injuries vehicle-related injuries fire-arms sports injuries substance use don't think it will happen to them sense of strength and confidence
81

NURS 373 (12 decks)

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