Refresher: Psychiatric Nursing 1 Flashcards

1
Q

What is a nurse-client relationship?

A

2-way; series of interaction between the nurse and the client

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2
Q

What is the GOAL of the nurse-client relationship?

A

GOAL: Positive behavioral change

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3
Q

What are the 5 elements of therapeutic relationship?

A

T - rust
R - apport
U - nconditional positive regard (Acceptance)
S - etting limits
T - herapeutic communication/therapeutic use of self

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4
Q

Therapeutic Behaviors:

sincerity and honesty

A

Therapeutic Behaviors:

Genuineness

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5
Q

Therapeutic Behaviors:

ability to identify one’s feelings

A

Therapeutic Behaviors:

Concreteness

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6
Q

Therapeutic Behaviors:

consideration to the pt as a unique human being; Acceptance

A

Therapeutic Behaviors:

Respect

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7
Q

Phases of Therapeutic Relationship:
no contact with the client; datas are from secondary sources (chart, book, journals)
= Self awareness

A

Phases of Therapeutic Relationship:

Pre-interaction

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8
Q

Phases of Therapeutic Relationship:

establish trust: assess the client; establish mutual agreement (goals, plans); informing about termination

A

Phases of Therapeutic Relationship:

Orientation

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9
Q

Phases of Therapeutic Relationship:
longest phase; achieving goals and sharing facts; resolve the problem
= highly individualized

A

Phases of Therapeutic Relationship:

Working

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10
Q

Phases of Therapeutic Relationship:
moving towards independence; observe regressive behaviors (going back to previous state)
Management:
- reinforce the previous management

A

Phases of Therapeutic Relationship:

Termination

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11
Q
  • defined as “dynamic” (changing) process of exchanging info
    = Adaptive
  • composed of verbal and non verbal techniques (should be combined)
A

Therapeutic Communication

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12
Q

What are the 4 elements of the Therapeutic Communication?

A
  1. Sender - encoder/source of the message
  2. Message - actual info being transmitted
  3. Receiver - decoder/recipient of the message
  4. Feedback - receiver’s response
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13
Q

What inhibits communication process?

A

Barriers

ex. noise

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14
Q

Non-verbal communication:

“physical space” between nurse and pt/sender and receiver; not too far, not to near (3-6ft/one arm and half)

A

Non-verbal communication:

Proxemics

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15
Q

Non-verbal communication:

body movements such as gestures, facial expressions, mannerisms

A

Non-verbal communication:

Kinetics

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16
Q

Non-verbal communication:

intimate physical touch; always ask for Consent

A

Non-verbal communication:

Touch

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17
Q

Non-verbal communication:

agreeing; listening; encourages the pt to talk

A

Non-verbal communication:

Silence

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18
Q

Non-verbal communication:

“voice quality” (tone, inflection); how the message is delivered

A

Non-verbal communication:

Paralanguage

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19
Q

Describe therapeutic verbal communication

A

therapeutic, appropriate, simple, adaptive, concise, and credible

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20
Q
Therapeutic Verbal Communication:
S - pecific
M - measurable
A - ttainable
R - ealistic
T - imebounded

Ex: “Let me sit here with you for 5 mins”

A

Therapeutic Verbal Communication:

Offering Self

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21
Q

Therapeutic Verbal Communication:

such as “ah huh, yes, no”

A

Therapeutic Verbal Communication:

Active listening

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22
Q

Therapeutic Verbal Communication:

Ex: “You said Hannah was the best. can you describe her?”

A

Therapeutic Verbal Communication:

Exploring

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23
Q

Therapeutic Verbal Communication:

You are giving the pt an opportunity to open up

A

Therapeutic Verbal Communication:

Broad Openings

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24
Q

Therapeutic Verbal Communication:

Ex: “I noticed you have combed your hair today”

A

Therapeutic Verbal Communication:

Making observation

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25
Q

Therapeutic Verbal Communication:

Ex: “ In the past 15 mins, we have talked about…”

A

Therapeutic Verbal Communication:

Summarizing

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26
Q

Therapeutic Verbal Communication:
Pt: I am hearing voices
Ex: “What are the voices telling you?”

A

Therapeutic Verbal Communication:

Encouraging description of perception/Acknowledging

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27
Q

Therapeutic Verbal Communication:
Pt: I am hearing voices
Ex: “I know that the voices are real to you, but there are no voices here”

A

Therapeutic Verbal Communication:

Presenting reality

28
Q

Therapeutic Verbal Communication:

Ex: “Do you mean?”

A

Therapeutic Verbal Communication:

Seeking clarification

29
Q

Therapeutic Verbal Communication:

help the pt in solving the problem, but not solve the problem for them

A

Therapeutic Verbal Communication:

Reflecting

30
Q

Therapeutic Verbal Communication:
make it clearer
Pt: I am down
Ex: “You feel depressed?”

A

Therapeutic Verbal Communication:

Restating

31
Q

Therapeutic Verbal Communication:

Ex: “Go on../Tell me more..”

A

Therapeutic Verbal Communication:

General leads

32
Q

Ex: “Let us look at it more closely”

A

Therapeutic Verbal Communication:

Focusing

33
Q

What are the common pitfalls (mistakes) in non Therapeutic Communication?

A
  1. giving advice
  2. talking about self
  3. telling the client is wrong (dispute, aggression) = lost of trust
  4. false reassurance
  5. asking WHY: demands an answer, arouses deep seated feelings
    - Except: Suicidal (direct questioning because time is of the essence)
34
Q

Spheres:
pleasure, principle, irrational
= Antisocial personality disorder

A

Spheres:

ID

35
Q

Spheres:

reality-based

A

Spheres:

EGO

36
Q

Spheres:
conscience, ego ideal
= Obsessive-compulsive personality disorder

A

Spheres:

SUPEREGO

37
Q
Defense mechanisms:
unconsciously forgetting (di sinasadya)
A

Defense mechanisms:

Repression

38
Q
Defense mechanisms:
consciously forgetting (sinasadya)
A

Defense mechanisms:

Suppression

39
Q

Defense mechanisms:
plastic/plastik/orocan
what it says is different deep inside

A

Defense mechanisms:

Reaction formation

40
Q

Defense mechanisms:
reasoning out/making excuses (nagdadahilan)
Ex: “Bumagsak ako kasi pachill chill lang ako e.”

A

Defense mechanisms:

Rationalization

41
Q

Defense mechanisms:
blaming others
Ex: “Yung TopRank kasi pinabayaan kami..”

A

Defense mechanisms:

Projection

42
Q

Defense mechanisms:
blaming self
Ex: “ Kung sana ginawa ko lang yung best ko”

A

Defense mechanisms:

Introjection

43
Q

Defense mechanisms:
idolization (certain features)
Ex: Idol yung papa, ginaya yung porma

A

Defense mechanisms:

Identification

44
Q

Defense mechanisms:
weak on one aspect but strong on another aspect
Ex: weak on sports, bumawi on acads

A

Defense mechanisms:

Compensation

45
Q

Defense mechanisms:
unacceptable of the truth
Ex: “Why am I here, I am not sick and I don’t have any health problems.”

A

Defense mechanisms:

Denial

46
Q

Defense mechanisms:
channeling of anxiety (divert)
Ex: Nagaway ang magbebe, sinuntok ang pader sa galit instead na siya

A

Defense mechanisms:

Displacement

47
Q

Defense mechanisms:

going back to the previous developmental stage

A

Defense mechanisms:

Regression

48
Q

Defense mechanisms:
hugas kamay; trying to relieve guilt feeling
Ex: Niloloko ang asawa, tuwing umuuwi nagdadala ng favorite food ni Mrs.

A

Defense mechanisms:

Undoing

49
Q

Defense mechanisms:
anxiety turned to physical symptom
Ex: kinakabahan tapos naiihi

A

Defense mechanisms:

Conversion

50
Q

Defense mechanisms:

  • reasoning “detailed” manner/references
  • using high level of words
A

Defense mechanisms:

Intellectualization

51
Q

Defense mechanisms:
the unavailable makes available
Ex: Gusto mag med school pero kulang sa pera, so naghanap ng other school

A

Defense mechanisms:

Substitution

52
Q

Defense mechanisms:
the unaccepctable makes acceptable
Ex: gusto manakit physically, so pumasok ng boxing

A

Defense mechanisms:

Sublimation

53
Q

Crisis:
predictable (expected)
Ex: monthly bills, marriage, pregnancy, graduation

A

Crisis:

Maturational/Developmental

54
Q

Crisis:
unpredictable (unexpected)
Ex: accidents, unwanted pregnancy

A

Crisis:

Situational

55
Q

Crisis:
calamities/acts of God
Ex: rape, abuse, tsunami, flood

A

Crisis:

Adventitious/Social

56
Q

Stages of Death and Dying:

unacceptable of the truth (shock/disbelief)

A

Stages of Death and Dying:

D - enial

57
Q

Stages of Death and Dying:

projection (blaming others)/introjection

A

Stages of Death and Dying:

A - nger

58
Q

Stages of Death and Dying:
bargain, unrealistic offers
Ex: “Lord, ako na lang po wag na lang po ang anak ko.”

A

Stages of Death and Dying:

B - argaining

59
Q

Stages of Death and Dying:
Suicidal (ensure safety precautions)
- most dangerous

A

Stages of Death and Dying:

D - epression

60
Q

Stages of Death and Dying:

moving forward

A

Stages of Death and Dying:

A - cceptance

61
Q

Disturbances of Appearance:
repeated purposeless behaviors (neurotransmitter problem)

Is different from mannerism (muscle memory)

A

Disturbances of Appearance:

Automatism

62
Q

Disturbances of Appearance:
slowed movements
common to depressed and manic pts

A

Disturbances of Appearance:

Psychomotor retardation

63
Q

Disturbances of Appearance:
maintenance of an awkward posture
the movement is molded

to differentiate with catatonia, move the pt

A

Disturbances of Appearance:

Waxy flexibility

64
Q

maintenance of an awkward posture
whatever the movement, movements came back

to differentiate with waxy flexibility, move the pt

A

Catatonia

65
Q

Disturbances of Appearance:
purposeless imitation
whatever you do, the pt copies/imitates (mirror-like imitation)

A

Disturbances of Appearance:

Echopraxia