Flashcards in Quiz #1: Theories & Therapies for Nursing Practice/Therapeutic Nurse-Patient Relationship/Legal & Ethics Deck (50)
What are the types of admissions to psychiatric hospitals?
-Patient applies for admission to the facility
-If < 18 y.o. parent/legal guardian may apply
-Patient retains all civil rights, including right to vote, have a driver’s license, buy and sell property, manage personal affairs, hold office, practice a profession and engage in a business
-Admission without patient’s consent
-Dangerous to self or others and/or unable to provide for own basic needs
-Can be initiated by HCP, family, police with the purpose of keeping pt and people around them safe
What is a Legal 2000 Hold in Nevada?
-Involuntarily admitted -> usually after 48H will determine if psych or drunk (e.g.)
-Now they are having psych NP in ER to help take off legal 2000 and discharge the patients if they don’t actually have a psych issue.
Legal 2000 Hold in Nevada affects the patients right to:
-Communicate with people outside the hospital
-Keep personal effects
-Enter into contractual relationship
-Refuse treatment-- Forcing medications (can refuse)
-Treatment in the least restrictive setting
Legal and Ethics: Incompetency
-Every adult is assumed to be mentally competent, meaning mentally able to carry out personal affairs
-To prove otherwise requires a court hearing
-If ruled incompetent, a person cannot vote, marry, drive or make contracts.
In order for a patient to be considered incompetent, they must show:
-Person has a mental disorder
-Disorder causes a defect in judgment
-Defect makes person incapable of handling personal affair
Levels of awareness
Levels of Anxiety
Stages of Psychosexual development
-Time (present time, what’s happening now!)
-Memories and feelings
Easily can be retrieved through conscious efforts
-Repressed memories, passion, unacceptable urges, trauma, effect the feelings; need help to retrieve it.
-Unable to retrieve without help from professional. (Mind represses so you can’t remember because it brings the trauma or experience that comes with it)
Personality Structure: Freud believed there were 3
3. Super Ego
Personality Structure: ID
-Characterized by drive, instinct and reflexes
-Cannot tolerate frustration, seeks to discharge tension and operates in pleasure.
Personality Structure: Ego
-Described as a problem solver and reality tester.
-Negotiates with the world
(In psych, we want the EGO reality more prominent than ID and superego.)
Personality Structure: Super Ego
-Operates in ideal
-Inevitable part of living
-Damage of self and d/t insecurities, threats and threats to satisfaction.
Defense Mechanisms of Anxiety
-Ward anxiety off
-Operate on unconscious mostly, it denies, falsifies and distorts reality to decrease threat.
Psychosocial Stages of Development
1. Oral Stage (0-1 years)
2. Anal Stage (1-3 years)
3. Phalic/Oedipal (3-6 years)
4. Latency (6-12 years)
5. Genital (12 and beyond)
Psychosexual Stages of Development: Oral Stage
-Age where ID and pleasure is the biggest.
Psychosexual Stages of Development: Anal Stage
-ID personality still present. Relief of discomfort identifies pleasure. Super ego may begin to develop (if restrictions are present).
-Defecation. Baby is able to exercise control.
-Best time for toilet training.
Psychosexual Stages of Development: Phalic/Oedipal
-Identity starts to develop (male and female role develops)
-Masturbation happens in this stage (expression of difference between male and female) pleasure is there.
-Conflict, oedipal and electra complex may develop.
Castration complex (sex organ becomes an identity of comfort)
Boy has special attraction (not sexually) to mother
Special attraction (not sexual) to father)
Psychosexual Stages of Development: Latency
-Continues to grow
-Focused on interacting with the environment
Psychosexual Stages of Development: Genital
-Puberty and adolescence (time for more awareness for sexual pleasure and role of person sexual interest)
-**Important because person develops trust during oral stage. Control in anal stage and role in phalic stage. (They use all this in order to form meaningful relationship)
Erickson’s Psychosocial Theory includes
1. Infancy (0-1.5 years) - Trust versus Mistrust
2. Toddler/Early Childhood (1.5-3 years) - Autonomy versus Shame and Doubt
3. Preschool (3-6 years) - Initiative versus Guilt
4. School Age (6-12 years) - Industry versus Inferiority
5. Adolescent (12-20) - Identity versus Role Confusion
6. Early Adulthood (20-35 years) - Intimacy versus Isolation
7. Middle Adulthood (35-65) Generativity versus Stagnation
8. Late Adulthood (65-Death) Ego Integrity versus Despair
Trust versus Mistrust
Trust developed by satisfying the need otherwise, mistrust develops.
Autonomy versus Shame and Doubt
-Autonomy: In this stage, caregivers often serve as a safe base from which to explore the world. When caregivers encourage independence, children will feel secure enough to take risks.
-Shame: Children whose caregivers discourage them may develop feelings of shame. If caregivers foster excessive dependence, the child may learn to doubt their own abilities.