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Flashcards in PMHNP exam Deck (153)
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1

Definition:
1. The client's right to assume that information given to the healthcare provider will not be disclosed
2. Protected under federal statute through the Medical Record Confidentiality Act of 1995
3. Pertains to verbal and written client information
4. Requires that the provider discuss confidentiality issues with clients, establish consent, and clarify and any questions about disclosure of information.
5. Requires that provider obtain a signed medical authorization and consent form to release medical records and information when requested by the client or another healthcare provider.

Confidentiality

2

Definition:
1. The first national comprehensive privacy protection act
2. Guarantees clients four fundamental rights: 1. To be educated about HIPAA privacy protection, 2. To have access to their own medical records, 3. To request amendment of their health information to which they object, and 4. To require their permission for disclosure of their personal information.

HIPAA

3

Definition:
1. When appropriate persons or organizations determine that the need for information outweighs the principle of confidentiality
2. If a client reveals an intent to harm self or others
3. Information given to attorneys involved in litigation
4. Releasing records to insurance companies.
5. Answering court orders, subpoenas, or summonses
6. Meeting state requirements for mandatory reporting of disease or conditions
7. Tarasoff principle: duty to warn potential victim of imminent danger of homicidal clients
8. In cases of child or elder abuse.

Exceptions to guaranteed confidentiality

4

Definition:
1. Persons younger than 18 years old who are married, parents, or self-sufficiently living away from the family domicile

Emancipated minors

5

Definition:
1. Duty: the NP had a duty to exercise reasonable care when undertaking and providing treatment to the client
2. Breah of duty: the NP violated the applicable standard of care in treating the client's condition.
3. Proximate cause: There is a causal relationship between the breach in the standard of care and the client's injuries.
4. Damages: The client experiences permanent and substantial damages as a result of the breach in the standard of care.

Four Elements of negligence that must be established to prove malpractice.

6

Definition:
1. Person has a diagnosed psychiatric disorder
2. Person is harmful to self or others as a consequence of the disorder
3. Person is unaware or unwilling to accept the nature and severity of the disorder
4. Treatment is likely to improve function

Commitment basic criteria

7

Developmental Stage for:
Trust vs. mistrust
Ability to form meaningful relationships, hope about the future, trust in others
Developmental failure: poor relationships, lack of future hope, suspicious of others

Infancy Birth-1 year

8

Developmental Stage for:
Autonomy vs shame and doubt
Self-control, self esteem, willpower
Developmental failure: poor self control, low self esteem, self doubt, lack of independence

Early childhood 1-3 years

9

Developmental Stage for:
Initiative vs guilt
Self-directed behavior, goal formation, sense of purpose
Developmental failure: Lack of self initiated behavior, lack of goal orientation

Late childhood 3-6 years

10

Developmental Stage for:
Industry vs inferiority
Ability to work; sense of competency and achievement
Developmental failure: Sense of inferiority; difficulty with working, learning

School-age 6-12 years

11

Developmental Stage for
Identity vs. role confusion
Personal sense of identity
Developmental failure: Identity confusion, poor self-identification in group settings

Adolescence 12-20 years

12

Developmental Stage for
Intimacy vs isolation
Committed relationships, capacity to love
Developmental failure: Emotional isolation, egocentrism

Early adulthood 20-35 years

13

Developmental Stage for
Generativity vs self-absorption or stagnation
ability to give time and talents to others, ability to care for others
Developmental failure: self-absorption, inability to grow and change as a person, inability to care for others

Middle adulthood 35-65 years

14

Developmental Stage for
Integrity vs despair
Fulfillment and comfort with life, willingness to face death, insight and balanced perspective on life's event
Developmental failure: Bitterness, sense of dissatisfaction with life, despair over impending death

Late adulthood greater then 65 years of age

15

Typical age of onset for intellectual disability

infancy-usually evident at birth

16

Typical age of attention deficit hyperactivity disorder

Early childhood per DSM 5 by age 12

17

Typical age of schziophrenia

18 to 25 years for men
25 to 35 years for women

18

Typical age of major depression

Late adolescence to young adulthood

19

Typical age of dementia

most common after age 85

20

Three primary psychic structures make up the mind and personality and are responsible for mental functioning:
Contains primary drives or instincts, urges, or fantasies
Drives are largely unconscious, sexual, or aggressive in content, and infantile in nature
Operates on the pleasure principle; seeks immediate satisfaction
Is present at birth and motivates early infantile actions

The Id

21

Three primary psychic structures make up the mind and personality and are responsible for mental functioning:
Contains the concept of external reality
Rational mind; responsible for logical and abstract thinking
Functions in adaptation
Mediates between the demands of drives and environmental realities
Operates on the reality principle
Begins to develop at birth as infant struggles to deal with environment
Responsible for use of defense mechanisms
The go says, "I think, I evaluate"

The Ego

22

Three primary psychic structures make up the mind and personality and are responsible for mental functioning:
Is the ego-ideal
Contains sense of conscience or right versus wrong
Also contains aspirations, ideals, and moral values
Regulated by guilt and shame
Begins to fully develop around age six as a child comes into contact with external authority figures such as other parents, schoolteachers, coaches, or religious figures
The superego says "I should or outght"

The Superego

23

Freud's psychosexual stages of development:
Primary means of discharging drives and achieving gratification:
Stage and Age:
Sucking, chewing, feeding, crying
Psychiatric disorders linked to failure of stage: schizophrenia, substance abuse, paranoia

Oral stage 0-18 months

24

Freud's psychosexual stages of development:
Primary means of discharging drives and achieving gratification:
Stage and Age:
Sphincter control, activities of expulsion and retention
Psychiatric disorders linked to failure of stage:
Depressive disorders

Anal Stage 18 months-3 years

25

Freud's psychosexual stages of development:
Primary means of discharging drives and achieving gratification:
Stage and Age:
Exhibitionism, masturbation with focus on Oedipal conflict, castration anxiety, and female fear of lost maternal love
Psychiatric disorders linked to failure of stage: Sexual identity disorders

Phallic stage 3-6 years

26

Freud's psychosexual stages of development:
Primary means of discharging drives and achieving gratification:
Stage and Age:
Peer relationships, learning, motor skills development, socialization
Psychiatric disorders linked to failure of stage: Inability to form social relationships

Latency stage 6 years to puberty

27

Freud's psychosexual stages of development:
Primary means of discharging drives and achieving gratification:
Stage and Age:
Integration and synthesis of behaviors from early stages, primary genital-based sexuality
Psychiatric disorders linked to failure of stage: Sexual perversion disorder

Genital stage Puberty forward

28

Which Theory?
Human development evolves through cognition, learning, and comprehending
Factors such as native endowment and biological and environmental factors set the course for a child's development.

Cognitive theory: Jean Piaget ( 1896-1980)

29

What are these?
Denial, Projection, Regression, Repression, Reaction formation, Rationalization, Undoing, Intellectualization, Suppression, Sublimation, Altruism

Defense Mechanisms

30

Avoidance of unpleasant realities by unconsciously ignoring their existence

Denial