mental health nursing

Question 1

Mental Health:

Answer 1

State of well-being in which individuals reach their potential, cope with normal stresses of life, work productivity, and contribute to the community

Question 2

World Health Organization (2019) defines health is:

Answer 2

“a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

Question 3

Traits of positive mental health

Answer 3

rational thinking
communication skills
learning
emotional growth
resilience
self esteem

Question 4

Mental Illness

Answer 4

Psychiatric disorders with definable diagnoses

Significant dysfunction in mental functioning related to:
1) Developmental
2) Biological
3) Physiological disturbances

Culturally defined & always changing

Question 5

Mental health vs mental illness

Answer 5

A real middle ground exists: stress discomft from everyday life

Conceptualized as points along a mental health continuum

Question 6

Resilience

Answer 6

how you bounce back

ability and capacity to secure resources needed to support well-being

characterized by:
1) ability to secure needed resources
2) capacity for regulating one’s own emotions and overcoming negative, self-defeating thoughts

Essential to recovery

Question 7

Social and Economic circumstances

Answer 7

Family

Schools and peer groups

Socioeconomic status

Educational advancement

Question 8

Environmental factors

Answer 8

Political climate & cultural considerations

Social & economic policies

Question 9

Stigma

Answer 9

Refers to the discrediting, devaluing, and shaming of a person because of a person because of characteristics or attributes that they possess

Question 10

Stigma involves 3 elements

Answer 10

A lack of knowledge (ignorance)

Negative attitudes (prejudice)

People behaving in ways that disadvantage the stigmatized person (discrimination)

Question 11

Five themes of stigma in mental health nursing;
Four themes are patient-related

Answer 11

Personal/patients stigma

Public/social stigma

Family stigma

Employment stigma

The fifth theme is related to stigma toward healthcare professionals working with patients with mental illnesses:

• Professional stigma

Question 12

How do we reduce stigma about the mental health population?

Answer 12

Self-reflection & education

A ‘bottom up’ approach

General public campaigns

Target the media to try and ensure more balanced and accurate coverage of mental health issues

Anti-discrimination policy and legislation

Question 13

Perceptions of Mental Health & Mental Illness

Answer 13

Mental illness versus physical illness:

Root of most mental disorders lies in intercellular abnormalities

Nature versus nurture:

Diathesis-stress model (most accepted explanation for mental illness)

Question 14

Diathesis-Stress Model

Answer 14

Diathesis- biological predisposition

Stress - environmental stress or trauma

Most accepted explanation for mental illness

Combination of genetic vulnerability and negative environmental stressors

Assertion:

Most psychiatric disorders result from a combination of genetic vulnerability and negative environmental stressors

Question 15

Psychiatric Mental Health Nursing

Answer 15

Promoting mental health through assessment, diagnosis, and treatment of behavioral and mental disorders

The nurse develops a nursing diagnosis and plan of care, implements the nursing process, and evaluates it for effectiveness

Use nursing, psychosocial, neurobiological theories, and research

Work with people throughout the lifespan

Employed in a variety of settings and among varied populations

Registered nurses work with individuals, families, groups, and communities, assessing their mental health needs

Assessing and providing a therapeutic environment or milieu as a treatment and management modality

Question 16

Trends affecting the future

Answer 16

Educational challenges

Demand for mental health professionals

Aging population

Cultural diversity

Science, technology, electronic healthcare

Advocacy & legislative involvement

Question 17

Classical Psychoanalysis

Answer 17

Purpose is to uncover unconscious conflicts

Seldom used today

Intrapsychic conflict ( at an early age) no longer considered to be the cause of all mental illness:

Free association - freely share whatever thoughts/ words come to mind to access the unconscious

Dream analysis

Defense mechanism recognition

Valid tools & concepts:
Transference
Countertransference

Question 18

Transference

Answer 18

refers to unconscious feelings that the patient has toward a healthcare worker that were originally felt in childhood for a significant other

Question 19

Countertransference

Answer 19

refers to unconscious feelings that the healthcare worker has toward the patient

Question 20

Interpersonal therapy is most effective in treating

Answer 20

Grief & loss
Interpersonal disputes
Role transition

Question 21

Maslow’s Hierarchy of Needs

Answer 21

Human beings are active participants in life, striving for self-actualization

When lowers needs are met, higher needs are able to emerge

Physiological needs

Safety

Belonging & love needs

Esteem needs

Self-actualization

Question 22

Implications for nursing

Answer 22

Emphasis on human potential & the patient’s strengths

Question 23

Prioritizing

Answer 23

establishes what is most important in the sequencing of nursing actions

Question 24

Theory of psychosocial development (Erikson)

Answer 24

Eight stages of development

Personality continues to develop through old age

Question 25

Primary prevention

Answer 25

Occurs before any problem appears Seeks to reduce rate of new cases

Question 26

Secondary prevention

Answer 26

Early identification of problems, screening, and prompt, and effective treatment While it does not stop the actual disorder from beginning, it is intended to delay or avert progression

Question 27

Tertiary prevention

Answer 27

Treatment with a focus on preventing progression to a severe course, disability, or even death Closely related to rehabilitation

Question 28

Inpatient Care Settings

Answer 28

Crisis Stabilization/Observational Units General Hospitals & Private Hospitals State Psychiatric Hospitals

Question 29

Entry to Acute Inpatient Care

Answer 29

Direct admission on referral Emergency department or crisis service Voluntary or involuntary Voluntary: you want to be a in psych inpatient unit Involuntary: you do NOT want to be in a psych inpatient unit

Question 30

Therapeutic Milieu

Answer 30

"Middle place" Surroundings and physical environment - Managing behavioral crisis - Safety - Unit design Goals of unit design - Promote an environment of safety and empower patients to partner with clinical staff and take ownership of their own health and safety

Question 31

Enculturation

Answer 31

transmission of culture’s worldview, beliefs, values, and practices to its members -Deviance from cultural expectations can be defined as illness by other members of the group

Question 32

Ethnocentrism

Answer 32

The universal tendency of humans to think their way of thinking and behaving is the only correct and natural way.

Question 33

Cultural awareness

Answer 33

Examine beliefs, values, and practices of own culture Recognize that during a cultural encounter, three cultures are intersecting: Culture of the patient, nurse, and setting

Question 34

Bioethics

Answer 34

used in relation to ethical dilemmas surrounding health care

Question 35

Ethics

Answer 35

The study of philosophical beliefs about what is considered right or wrong in a society

Question 36

Ethical dilemma

Answer 36

conflict between two or more courses of action, each with favorable and unfavorable consequences

Question 37

Autonomy

Answer 37

right to make their own decision

Question 38

Beneficence

Answer 38

benefit to the patient

Question 39

Nonmaleficence

Answer 39

do no harm

Question 40

Justice

Answer 40

fairness, equally

Question 41

Fiedely

Answer 41

being faithful

Question 42

Veracity

Answer 42

being truthful

Question 43

Seclusion

Answer 43

involuntary confinement of a patient alone in a room from which the patient is physically prevented from leaving used for self-destructive or violent behavior

Question 44

Physical Restraint

Answer 44

purposely limiting or obstructing the freedom of a person's bodily movement

Question 45

Mechanical Restraint

Answer 45

restraint of a person by the application of a device to the person's body, or a limb of a person, to restrict the person movement

Question 46

Chemical Restraint

Answer 46

the intentional use of any medications to subdue, sedate, or restrain an individual

Question 47

Patients Rights Under the Law

Answer 47

Right to treatment Right to refuse treatment Right to informed consent Patient is informed of risks, benefits, and alternatives Person must voluntarily accept treatment Implied Consent Capacity & competency Rights regarding psychiatric advance directives Rights regarding restraint and seclusion: -Orders and documentation -In an emergency, a nurse may place a patient in seclusion or restraint but obtains a written or verbal order as soon as possible thereafter -Orders for restraint or seclusion are never written as an as needed or as a standing order

Question 48

Involuntary commitment

Answer 48

Emergency commitment. ( temporary admission) Person confused or demented; emergency admission Used for observation, diagnosis and treatment Generally for 24 to 96 hours Court hearing before discharge or next admission

Question 49

Mental Status Examination(MSE)

Answer 49

A component of all medical exams and may be viewed as a psychological equivalent of the physical exam, it is important in neurological and psychiatric evaluations

Question 49

Nursing Process

Answer 49

ADPIE

Question 50

SAD PERSONS scale for assessing the risk for suicide:

Answer 50

Sex Age Depression Previous Attempt Ethanol Abuse Rational Thinking loss Social Supports Lacking Organized plan No spouse Sickness