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Question 1

________ admission
- Both the individual and the health care professionals agree with the need for treatment and hospitalization
- Person signs a consent form

_________ admission
- Health care professionals feel admit is necessary, Person does not want to be admit
- Can be admit against their will under 72 hour hold (weekends and holidays don’t count)
- During the 72 hour hold the pt may become better with treatment and end up agreeing to treatment making them a voluntary admission
- If after 72 hour hold the pt still doesn’t want to be there but the health care professionals deem it necessary, the court system will be _________ for further care

Answer 1

Voluntary admission
- Both the individual and the health care professionals agree with the need for treatment and hospitalization
- Person signs a consent form

Involuntary admission/commitment
- Health care professionals feel admit is necessary, Person does not want to be admit
- Can be admit against their will under 72 hour hold (weekends and holidays don’t count)
- During the 72 hour hold the pt may become better with treatment and end up agreeing to treatment making them a voluntary admission
- If after 72 hour hold the pt still doesn’t want to be there but the health care professionals deem it necessary, the court system will be petitioned for further care

Question 2

Inpatient admission criteria
- Danger to self ______ and/or ____
- Danger to others - _________
- Cant care for ______ and/or gross impairment of judgement, person is at risk r/t inability to protect themselves

Answer 2

Inpatient admission criteria
- Danger to self (SI) and/or SA
- Danger to others - homicidal ideations (HI)
- Cant care for basic needs and/or gross impairment of judgement, person is at risk r/t inability to protect themselves

Question 3

2 co-occurring chronic illnesses (depression and anxiety, depression and diabetes)

co-occurring mental illness and substance use disorder (depression and alcohol)

Answer 3

• Comorbidity – 2 co-occurring chronic illnesses (depression and anxiety, depression and diabetes)
• Dual diagnosis – co-occurring mental illness and substance use disorder (depression and alcohol)

Question 4

patient assessment
general risk identification includes assessing:
- history of violence – best predictor of future violence
- pts who are delusional, hyperactive, impulsive, irritable, or non-adherence to medication - higher risk for violence
- aggression by individuals occurs most often in the context of limit setting by the nurse – asking pt to do/not do something
- history of limited coping skills, lack of assertiveness, use of intimidation – higher risk for violence
- agitation, restlessness, escalating anxiety
- resistance to suggested treatment
- didn’t come willingly
- history of drug or alcohol misuse
- cognitive changes (delirium, psychosis, hallucinations, etc.) that may cause the person to misinterpret the environment or staff care activities

Answer 4

patient assessment
general risk identification includes assessing:
- history of violence – best predictor of future violence
- pts who are delusional, hyperactive, impulsive, irritable, or non-adherence to medication - higher risk for violence
- aggression by individuals occurs most often in the context of limit setting by the nurse – asking pt to do/not do something
- history of limited coping skills, lack of assertiveness, use of intimidation – higher risk for violence
- agitation, restlessness, escalating anxiety
- resistance to suggested treatment
- didn’t come willingly
- history of drug or alcohol misuse
- cognitive changes (delirium, psychosis, hallucinations, etc.) that may cause the person to misinterpret the environment or staff care activities

Question 5

Rights of hospitalized patient
Right to:
- Receive/refuse ________
- Dignity
- Involvement in planning
- AMA
- Protection from _____
- Legal counsel
- Communication
- Confidentiality
- Least restrictive means

Answer 5

Rights of hospitalized patient
Right to:
- Receive/refuse treatment
- Dignity
- Involvement in planning
- AMA
- Protection from harm
- Legal counsel
- Communication
- Confidentiality
- Least restrictive means

Question 6

social influences on mental health care
1- consumer movement/recovery
o consumers (groups of individuals with mental illness) began to advocate for their right and fought against discrimination and forced treatment
2- national alliance on mental illness (NAMI) – focuses on stigma
o communicating mental illness is a brain disorder
o eliminating stigma and discrimination
o advocating for people with mental illness
o improving access to treatment services
o integrating mental illness into community life
3- surgeon general report on mental health
o reports on seriousness of mental health and illness, treatment, etc.
4- new freedom commission on mental health
o streamlined system with less fragmentation in care
o advocated for early diagnosis and treatment
o adoption of principles of recovery
o increased assistance with housing/jobs
5- Fayette county mental health court
o Specialists help pts get housing and other services
o Team includes judges, prosecutors, providers, case workers
o Care is person centered
o Goal to reduce reoffending – keep pt out of jail
o Strict criteria to be eligible
o Treatment/medication may be alternative for some instead of jail term

Answer 6

social influences on mental health care
- consumer movement/recovery
o consumers (groups of individuals with mental illness) began to advocate for their right and fought against discrimination and forced treatment
- national alliance on mental illness (NAMI) – focuses on stigma
o communicating mental illness is a brain disorder
o eliminating stigma and discrimination
o advocating for people with mental illness
o improving access to treatment services
o integrating mental illness into community life
- surgeon general report on mental health
o reports on seriousness of mental health and illness, treatment, etc.
- new freedom commission on mental health
o streamlined system with less fragmentation in care
o advocated for early diagnosis and treatment
o adoption of principles of recovery
o increased assistance with housing/jobs
- Fayette county mental health court
o Specialists help pts get housing and other services
o Team includes judges, prosecutors, providers, case workers
o Care is person centered
o Goal to reduce reoffending – keep pt out of jail
o Strict criteria to be eligible
o Treatment/medication may be alternative for some instead of jail term

Question 7

Patients rights under the law
Right to:
- Receive/refuse treatment
- Informed consent
o Risk, benefits, alternatives
o voluntarily accept treatment
o implied consent
o capacity and competency
- psychiatric advance directives
- restraints and seclusion
o orders and documentation required
o in an emergency, nurse may place pt in seclusion or restraint but obtains an order ASAP
o orders for restraint or seclusion are never written as PRN
- confidentiality
o HIPAA, Social media, After death, Professional communications
- Exceptions to rule
o Duty to warm and protect third parties
o Child and elder abuse reporting statutes
- Failure to protect patients

Answer 7

Patients rights under the law
Right to:
- Receive/refuse treatment
- Informed consent
o Risk, benefits, alternatives
o voluntarily accept treatment
o implied consent
o capacity and competency
- psychiatric advance directives
- restraints and seclusion
o orders and documentation required
o in an emergency, nurse may place pt in seclusion or restraint but obtains an order ASAP
o orders for restraint or seclusion are never written as PRN
- confidentiality
o HIPAA
o Social media
o After death
o Professional communications
- Exceptions to rule
o Duty to warm and protect third parties
o Child and elder abuse reporting statutes
- Failure to protect patients

Question 8

therapeutic _______
- provides sense of security/safety
- interactions with peers and staff help the pt engage and increase social competence and self worth
- real life training ground for practicing communication and coping skills
- provides activities, unit rules, reality orientation practices and groups

Answer 8

therapeutic milieu
- provides sense of security/safety
- interactions with peers and staff help the pt engage and increase social competence and self worth
- real life training ground for practicing communication and coping skills
- provides activities, unit rules, reality orientation practices and groups

Question 9

Warning signs of violence:
- ____________ (most important predictor) – pacing, restlessness
- increasing anxiety and tension – clenched jaw or fist, rigid posture, fixed or tensed facial expression, mumbling to self
- speech changes – rate, rhythm or volume, or silence
- verbal abuse – profanity, argumentativeness
- intense eye contact or avoidance of eye contact
- recent acts of violence
- possession of a weapon
- isolation that is uncharacteristic

Answer 9

Warning signs of violence:
- hyperactivity (most important predictor) – pacing, restlessness
- increasing anxiety and tension – clenched jaw or fist, rigid posture, fixed or tensed facial expression, mumbling to self
- speech changes – rate, rhythm or volume, or silence
- verbal abuse – profanity, argumentativeness
- intense eye contact or avoidance of eye contact
- recent acts of violence
- possession of a weapon
- isolation that is uncharacteristic

Question 10

___________
Step below PHP
Structured activities and group 1-2 days a week for 4 weeks or less
Goals: improve coping, enhance strengths for more functional independent life, build social skills and relationships

____________
- Highly structured
- Optimizes safety and crisis intervention
- Average length of stay = 3-7 days

___________
For pts needing longer than 7 days to stabilize illness/symptoms

______________
For pts that need some supervision but are not appropriate for inpatient hospitalization
Step between inpatient and fully independent home life
Ex: Goes to hospital for 6 hours for group therapy every day and then goes home every night
Goals: safety, reduce hospital admit, assist with coping

Answer 10

• Day treatment –
  Step below PHP
  Structured activities and group 1-2 days a week for 4 weeks or less
  Goals: improve coping, enhance strengths for more functional independent life, build social skills and relationships

Acute care hospital
- Highly structured
- Optimizes safety and crisis intervention
- Average length of stay = 3-7 days

Long term hospitalization - For pts needing longer than 7 days to stabilize illness/symptoms

• Partial hospitalization programs
  For pts that need some supervision but are not appropriate for inpatient hospitalization
  Step between inpatient and fully independent home life
  Ex: Goes to hospital for 6 hours for group therapy every day and then goes home every night
  Goals: safety, reduce hospital admit, assist with coping

Question 11

__________
An objectionable act that involves intentional use of force that results in or has the potential to result in injury to another individual

Answer 11

Violence
An objectionable act that involves intentional use of force that results in or has the potential to result in injury to another individual

Question 12

legislation that resulted in the mass movement of severely mentally ill persons from state hospitals to outpatient care

Answer 12

• Deinstitutionalization - legislation that resulted in the mass movement of severely mentally ill persons from state hospitals to outpatient care

Question 13

____________- Neurological process that removes unnecessary/damaged neuronal structures
- Improves networking capacity
- weeding out the weaker synpases
- As the brain develops, simple synapses are replaced by complex synapses
- Number of Adult neurons are ________ than newborns d/t synapses pruning
- Ongoing process
- _______pruning = schizophrenia, hallucinations

Answer 13

Synaptic pruning - Neurological process that removes unnecessary/damaged neuronal structures
- Improves networking capacity
- Pruning = weeding out the weaker synpases
- As the brain develops, simple synapses are replaced by complex synapses
- Number of Adult neurons are lower than newborns d/t synapses pruning
- Ongoing process
- Overpruning = schizophrenia, hallucinations

Question 14

the brain and emotions
___________– relays information between the 2 cerebral hemispheres
- if damaged – people cant integrate emotions and logical information
- if left brain (_______ side) is dominant = less ability to feel emotion
- if right brain (__________ side) is dominant = difficult to control emotions and problem solve, loss of object constancy

Answer 14

the brain and emotions
corpus callosum – relays information between the 2 cerebral hemispheres
- if damaged – people cant integrate emotions and logical information
- if left brain (logical side) is dominant = less ability to feel emotion
- if right brain (emotional side) is dominant = difficult to control emotions and problem solve, loss of object constancy

Question 15

GABA: inhibitory/calming
- Major inhibitory mechanism
- Reduces anxiety, aggression, and stress
- Regulates no repinephrine, adrenaline, dopamine, and serotonin

__creased GABA = anxiety, mania, and schizophrenia

Answer 15

GABA: inhibitory/calming
- Major inhibitory mechanism
- Reduces anxiety, aggression, and stress
- Regulates no repinephrine, adrenaline, dopamine, and serotonin

Decreased GABA = anxiety, mania, and schizophrenia

Question 16

contraindications fro seclusion and restraints
- unstable medical and psychiatric conditions
- COPD
- Spinal injury
- Seizure
- Pregnancy
- Delirium or dementia

Answer 16

contraindications
- unstable medical and psychiatric conditions
- COPD
- Spinal injury
- Seizure
- Pregnancy
- Delirium or dementia

Question 17

de-escalation techniques
- early response
- assess pt and situation
- identify stressors
- identify pt needs
- stay calm
- use calm clear tone of voice
- be genuine and empathetic
- be assertive – not aggressive
- avoid arguing
- give several clear options
- invest time
- be honest
- maintain pt self-esteem and dignity
- avoid invading personal space
- maintain personal safety

Answer 17

de-escalation techniques
- early response
- assess pt and situation
- identify stressors
- identify pt needs
- stay calm
- use calm clear tone of voice
- be genuine and empathetic
- be assertive – not aggressive
- avoid arguing
- give several clear options
- invest time
- be honest
- maintain pt self-esteem and dignity
- avoid invading personal space
- maintain personal safety

Question 18

Tim’s Law
Assisted _________ treatment statute
- Named after a Lexington man with schizophrenia with __________ (person doesn’t believe they have a mental illness)
- Helps to stop the revolving door of jails, hospitals, and homelessness

Answer 18

Tim’s Law
Assisted outpatient treatment statute
- Named after a Lexington man with schizophrenia with anosognosia (person doesn’t believe they have a mental illness)
- Helps to stop the revolving door of jails, hospitals, and homelessness

Question 19

least restrictive means of treatment
when the pt appears agitated the health care professional will:
- ______ the pt to see whats wrong
- encourage the pt to go to room for decreased _________
- offer PRN meds (route ____)
- escort to ______ area
- admin PRN meds (route ____)
- use _______ only if pt is a danger to self or others

Answer 19

least restrictive means of treatment
when the pt appears agitated the health care professional will:
- assess the pt to see whats wrong
- encourage the pt to go to room for decreased stimulation
- offer PRN meds PO
- escort to seclusion area
- admin PRN meds IM
- use restraints only if pt is a danger to self or others

Question 20

____________
An objectionable act that involves intentional use of force that results in or has the potential to result in injury to another individual

__________
an action or behavior that results in a verbal or physical attack

______________
Normal emotional response to frustration of desires, a threat to someones needs, or a challenge that varies in intensity from mild irritation to intense fury/rage

Answer 20

Violence
An objectionable act that involves intentional use of force that results in or has the potential to result in injury to another individual

aggression
an action or behavior that results in a verbal or physical attack

Anger
Normal emotional response to frustration of desires, a threat to someones needs, or a challenge that varies in intensity from mild irritation to intense fury/rage

Question 21

revolving door treatment - cycle of repeated hospitalizations and discharges for individuals with severe mental illness

began in 1960’s with community mental health movement and ____________
- psychotropic drug development
- pts were deinstitutionalization to communities lacking in services
- patients were without _____ to function independently in a community
- pts returned to ED for care and repeated admissions to psychiatric inpatient units

Managed care company’s strategies (may contribute to revolving door treatment):
- ________ inpatient length of stay
- applying stringent ________ criteria
- limited community support

Answer 21

revolving door treatment
cycle of repeated hospitalizations and discharges for individuals with severe mental illness

began in 1960’s with community mental health movement and deinstitutionalization
- psychotropic drug development
- pts were deinstitutionalization to communities lacking in services
- patients were without skills to function independently in a community
- pts returned to ED for care and repeated admissions to psychiatric inpatient units

Managed care company’s strategies (may contribute to revolving door treatment):
- reducing inpatient length of stay
- applying stringent admission criteria
- limited community support

Question 22

patient behavior: _______________
when angry expression turns to hostility and abuse or aggression (any activity that is meant to cause physical harm)
- may begin as accusations, comments about competence, and irrelevant personal remarks

danger signs:
- persistent swearing
- sexist or racist comments
- personal or specific threats of harm
- intimidating comments
- terroristic threats
- any physical behavior directed at a person

nurse response
- call for help
- protect self
- verbal intervention
o control non verbal communication
o short sentences
o don’t agree just to agree
o explain aggression will not achieve desired goal – if person is still rational

Answer 22

patient intimidation/acting out
when angry expression turns to hostility and abuse or aggression (any activity that is meant to cause physical harm)
- may begin as accusations, comments about competence, and irrelevant personal remarks

danger signs:
- persistent swearing
- sexist or racist comments
- personal or specific threats of harm
- intimidating comments
- terroristic threats
- any physical behavior directed at a person

nurse response
- call for help
- protect self
- verbal intervention
o control non verbal communication
o short sentences
o don’t agree just to agree
o explain aggression will not achieve desired goal – if person is still rational

Question 23

surroundings and physical enviro of the inpatient hospital unit

Answer 23

milieu

Question 24

_________
Normal emotional response to frustration of desires, a threat to someones needs, or a challenge that varies in intensity from mild irritation to intense fury/rage
- Normal human emotion
- when handled appropriately and expressed assertively, can provide individual with a positive force to solve problems and make decisions concerning life situations
- is only a problem when it is not handle appropriately and it is expressed aggressively
- is capable of being under personal control

Answer 24

Anger
Normal emotional response to frustration of desires, a threat to someones needs, or a challenge that varies in intensity from mild irritation to intense fury/rage
- Normal human emotion
- when handled appropriately and expressed assertively, can provide individual with a positive force to solve problems and make decisions concerning life situations
- anger = problem when it is not handle appropriately and it is expressed aggressively
- anger is capable of being under personal control

Question 25

early treatments - s/s were believed to be behavioral (under persons control) - abnormal behaviors could be adjusted by: o restraining devices – padded helmets, hand mittens, chemical restraints, straight jacket o surgery – lobotomy, insulin therapy, hydrotherapy, sedative cold wet packs, electro-shock therapy

Answer 25

early treatments - s/s were believed to be behavioral (under persons control) - abnormal behaviors could be adjusted by: o restraining devices – padded helmets, hand mittens, chemical restraints, straight jacket o surgery – lobotomy, insulin therapy, hydrotherapy, sedative cold wet packs, electro-shock therapy

Question 26

state of well being in which everyone can realize their own potential, cope with stresses, work productively, and contribute to the community

Answer 26

- Mental heath – state of well being in which everyone can realize their own potential, cope with stresses, work productively, and contribute to the community

Question 27

limbic system: ___________ - memory - controls the endocrine and immune systems limbic system: __________ - processes emotions – anxiety, fear, and pleasure - damage in animals = rage ____________ - coordinates and aids in moving skeletal muscles

Answer 27

limbic system: hippocampus - memory - controls the endocrine and immune systems limbic system: amygdala - processes emotions – anxiety, fear, and pleasure - damage amygdala in animals = rage basal ganglia - coordinates and aids in moving skeletal muscles

Question 28

ability and capacity to secure resources needed to support well-being characterized by - optimism - sense of mastery - competence essential to recovery

Answer 28

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

Question 29

patient behavior: _______________ loss of rationality - pt asking challenging questions - pt in your personal space - refusing!! your requests - releasing!! – throwing things (not at you), banging fists, sighing loudly nurse response - isolate the interaction – move the pt, others, allow yourself and exit - reduce enviro stimulation - speak clear, slow, few words - non-verbal communication - firm, empathy - allow releasing as long as its not threatening

Answer 29

patient defensiveness loss of rationality - pt asking challenging questions - pt in your personal space - refusing your requests - releasing – throwing things (not at you), banging fists, sighing loudly nurse response - isolate the interaction – move the pt, others, allow yourself and exit - reduce enviro stimulation - speak clear, slow, few words - non-verbal communication - firm, empathy - allow releasing as long as its not threatening

Question 30

seclusion and restraint - last resort - pt is danger to self or others - less restrictive interventions have been ineffective - modification to care plan - safe and appropriate techniques used

Answer 30

seclusion and restraint - last resort - pt is danger to self or others - less restrictive interventions have been ineffective - modification to care plan - safe and appropriate techniques used

Question 31

neurotransmitters ____________ - Cognitive function – learning, memory - Sleep wake cycles

Answer 31

Acetylcholine - Cognitive function – learning, memory - Sleep wake cycles Decreased acetylcholine = Alzheimer’s and sleep disorders Increased acetylcholine = depression

Question 32

deinstitutionalization - legislation that resulted in the mass movement of severely mentally ill persons from state hospitals to outpatient care - many hospitals ______ as a result - many patients successfully transitioned into _________ with the use of new psychotropic medications - many ended up in _______ o most don’t receive treatment for mental illness in jail o high risk of being ________ - verbal or physical abuse, bullying, threats, theft, rape, exploitation by partners, families, healthcare providers, or inpatient staff o once released most don’t have healthcare o criminal records make it hard to find jobs/housing o many end up homeless, in ED, or re-arrested

Answer 32

deinstitutionalization legislation that resulted in the mass movement of severely mentally ill persons from state hospitals to outpatient care - many hospitals closed as a result - patients successfully transitioned into the community with the use of new psychotropic medications - many ended up in jail/prison o most don’t receive treatment for mental illness in jail o high risk of being victimized - verbal or physical abuse, bullying, threats, theft, rape, exploitation by partners, families, healthcare providers, or inpatient staff o once released most don’t have healthcare o criminal records make it hard to find jobs/housing o many end up homeless, in ED, or re-arrested

Question 33

early theories of mental illness - inheritance theory – transmitted through generations - moral degeneracy theory – mentally ill by virtue of bad character - germ theory – insanity is contagious and needs to be segregated - septic foci theory – insanity is an infection and removing the infection by surgery would be a cure (bleeding or leeches possible treatments)

Answer 33

early theories of mental illness - inheritance theory – transmitted through generations - moral degeneracy theory – mentally ill by virtue of bad character - germ theory – insanity is contagious and needs to be segregated - septic foci theory – insanity is an infection and removing the infection by surgery would be a cure (bleeding or leeches possible treatments)

Question 34

T/F - Learning, memory, and perception are influenced by past experiences and the ability of the brain to organize information - Faulty neurotransmitter connections and brain lobe deficits may result in psychiatric symptoms - Factors that negatively impact the brain can't be changed - The brain can't change or heal - Synapses pruning is the neurological process which removes unnecessary or damaged neuronal structures form the brain - A person can develop healthy ways to deal with stress

Answer 34

T - Learning, memory, and perception are influenced by past experiences and the ability of the brain to organize information T - Faulty neurotransmitter connections and brain lobe deficits may result in psychiatric symptoms F - Factors that negatively impact the brain can be changed F - The brain can change and heal with neuroplasticity T - Synapses pruning is the neurological process which removes unnecessary or damaged neuronal structures form the brain T - A person can develop healthy ways to deal with stress

Question 35

Nursing interventions and education for healthy brains - Social connections – provide community resources - New learning - Healthy diet - Sleep hygiene (low blood flow to brain, crave sugar = low sleep) - Exercise - Healthy anxiety - Meditation (activates frontal lobe) - Gratitude - Atop ANT (automatic negative thoughts to combat cognitive distortions/negative thinking - Stress reduction – decrease cortisol levels which positively impact the parasympathetic nervous system, decreases BP, decreases infection rates, and decreases weight gain o Relaxation therapy o Meditation o Deep breathing o Anything that decreases the stress response and regulates the body’s system

Answer 35

Nursing interventions and education for healthy brains - Social connections – provide community resources - New learning - Healthy diet - Sleep hygiene (low blood flow to brain, crave sugar = low sleep) - Exercise - Healthy anxiety - Meditation (activates frontal lobe) - Gratitude - Atop ANT (automatic negative thoughts to combat cognitive distortions/negative thinking - Stress reduction – decrease cortisol levels which positively impact the parasympathetic nervous system, decreases BP, decreases infection rates, and decreases weight gain o Relaxation therapy o Meditation o Deep breathing o Anything that decreases the stress response and regulates the body’s system

Question 36

___________ an action or behavior that results in a verbal or physical attack - tends to be used with violence - behavior is intended to threaten or injure the victims security or self esteem - can cause damage with words or strikes to body (fists, kicks, weapons) but it always is designed to punish - not always inappropriate, sometimes necessary for self-protection

Answer 36

aggression an action or behavior that results in a verbal or physical attack - tends to be used with violence - behavior is intended to threaten or injure the victims security or self esteem - can cause damage with words or strikes to body (fists, kicks, weapons) but it always is designed to punish - not always inappropriate, sometimes necessary for self-protection

Question 37

cycle of repeated hospitalizations and discharges for individuals with severe mental illness

Answer 37

- Revolving door treatment - cycle of repeated hospitalizations and discharges for individuals with severe mental illness

Question 38

_______________ Immediate and mandatory debriefing for staff and pt who took part/witnessed the seclusion/restraint episode Components - Improvements - Team response - Safety - Policies - Procedure - Pt dignity - Staff education

Answer 38

Critical incident debriefing Immediate and mandatory debriefing for staff and pt who took part/witnessed the seclusion/restraint episode Components - Improvements - Team response - Safety - Policies - Procedure - Pt dignity - Staff education

Question 39

Factors that hurt the brain - Unhealthy habits - Lack of interest - Obesity - Negative thinking/thought distortions - Sedentary lifestyle - Substance use - Brain injury - Enviro toxins - Phobia, unfound worry - Anxiety - HTN - Lack of appreciation - Insomnia

Answer 39

Factors that hurt the brain - Unhealthy habits - Lack of interest - Obesity - Negative thinking/thought distortions - Sedentary lifestyle - Substance use - Brain injury - Enviro toxins - Phobia, unfound worry - Anxiety - HTN - Lack of appreciation - Insomnia

Question 40

neurotransmitter _______________ - Pleasure feelings - Complex motor activities - Plays role in hallucinations

Answer 40

Dopamine: excitatory - Pleasure feelings - Complex motor activites - Plays role in hallucinations Decreased dopamine = depression and addiction Increased dopamine = mania and symptoms in schizophrenia

Question 41

health conditions involving changes in emotion, thinking or behavior (or a combination of these). Associated with distress and/or problems functioning in social, work or family activities.

Answer 41

- Mental illness – health conditions involving changes in emotion, thinking or behavior (or a combination of these). Associated with distress and/or problems functioning in social, work or family activities.

Question 42

neurotransmitter ______________ - Mood - Attention - Arousal - Stimulates sympathetic branch of autonomic nervous system for fight or flight stress response

Answer 42

Norepinephrine - Mood - Attention - Arousal - Stimulates sympathetic branch of autonomic nervous system for fight or flight stress response Decreased norepinephrine = depression Increased norepinephrine = mania, anxiety, schizophrenia

Question 43

__________ – involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving - never punitive - goal – safety for pt and others - only used for the management of violent or self-destructive behavior that puts others safety at risk

Answer 43

seclusion – involuntary confinement of a patient alone in a room or area from which the patient is physically prevented from leaving - never punitive - goal – safety for pt and others - only used for the management of violent or self-destructive behavior that puts others safety at risk

Question 44

combination of genetic vulnerability and negative environmental stressors

Answer 44

- Diathesis-stress model - combination of genetic vulnerability and negative environmental stressors diathesis = biological predisposition stress = environmental stress/trauma diathesis stress model = combination of genetic vulnerability and negative environmental stressors - most accepted explanation for mental illness - most psych disorders result from a combo of genetic vulnerability and negative enviro stressor

Question 45

_________ – manual method, physical or mechanical devise, material/equipment that immobilized or reduces the ability of a patient to move body freely - never restrain in prone position - increased danger in child restraint

Answer 45

restraint – manual method, physical or mechanical devise, material/equipment that immobilized or reduces the ability of a patient to move body freely - never restrain in prone position - increased danger in child restraint

Question 46

Neurotransmitters ______________ - Major inhibitory mechanism - Reduces anxiety, aggression, and stress - Regulates no repinephrine, adrenaline, dopamine, and serotonin

Answer 46

GABA: inhibitory/calming - Major inhibitory mechanism - Reduces anxiety, aggression, and stress - Regulates no repinephrine, adrenaline, dopamine, and serotonin Decreased GABA = anxiety, mania, and schizophrenia

Question 47

serotonin: inhibitory/calming - Mood - Emotion - Sleep - Pain - Appetite - Temperature regulation - Some cognitive function ___creased serotonin = depressive and anxiety disorders

Answer 47

serotonin: inhibitory/calming - Mood - Emotion - Sleep - Pain - Appetite - Temperature regulation - Some cognitive function Decreased serotonin = depressive and anxiety disorders

Question 48

__________- the quantitative study of the distribution of mental disorders in human populations.

Answer 48

Epidemiology - the quantitative study of the distribution of mental disorders in human populations.

Question 49

Barriers to the delivery of adequate and accessible mental healthcare - ___creasing need for mental health care - Limited access to mental health services o Transportation o Long waits for appointments o Income/cost o Insurance - Provider limitations - Stigma o Fear and misunderstanding o Film and literature

Answer 49

Barriers to the delivery of adequate and accessible mental healthcare - Increasing need for mental health care - Limited access to mental health services o Transportation o Long waits for appointments o Income/cost o Insurance - Provider limitations - Stigma o Fear and misunderstanding o Film and literature

Question 50

feelings that may precipitate anger: - anxiety - discounted - embarrassed - frightened - fear - humiliated - hurt - ignored - inadequate - insecure - unheard - out of control of the situation - rejected - threatened - tired - vulnerable

Answer 50

feelings that may precipitate anger: - anxiety - discounted - embarrassed - frightened - fear - humiliated - hurt - ignored - inadequate - insecure - unheard - out of control of the situation - rejected - threatened - tired - vulnerable

Question 51

situations that may precipitate anger: - withdrawal/substance abuse or addictions - diagnosed by psychiatric illness - internal stimuli – auditory hallucinations - attention-seeking - sleep deprivation - pain - stress - past trauma - loss of personal power - difference in expectations or goals - difference in knowledge - poor communication - inaccurate or incomplete information - environment – too hot, too loud, etc.

Answer 51

situations that may precipitate anger: - withdrawal/substance abuse or addictions - diagnosed by psychiatric illness - internal stimuli – auditory hallucinations - attention-seeking - sleep deprivation - pain - stress - past trauma - loss of personal power - difference in expectations or goals - difference in knowledge - poor communication - inaccurate or incomplete information - environment – too hot, too loud, etc.

Question 52

Visualizing the brain Structured imaging techniques show _________ (ex: tumors, atrophy) - CT - MRI Functional imaging techniques show brain _________ (physiological changes) - PET - Single photon emission computed tomography (SPECT) - Functional MRI

Answer 52

Visualizing the brain Structured imaging techniques show anatomy (ex: tumors, atrophy) - CT - MRI Functional imaging techniques show brain function (physiological changes) - PET - Single photon emission computed tomography (SPECT) - Functional MRI

Question 53

Dopamine: excitatory - Pleasure feelings - Complex motor activites - Plays role in hallucinations ___creased dopamine = depression and addiction ___creased dopamine = mania and symptoms in schizophrenia

Answer 53

Dopamine: excitatory - Pleasure feelings - Complex motor activites - Plays role in hallucinations Decreased dopamine = depression and addiction Increased dopamine = mania and symptoms in schizophrenia

Question 54

process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential

Answer 54

- Recovery – process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential

Question 55

Acetylcholine - Cognitive function – learning, memory - Sleep wake cycles __creased acetylcholine = Alzheimer’s and sleep disorders __creased acetylcholine = depression

Answer 55

Acetylcholine - Cognitive function – learning, memory - Sleep wake cycles Decreased acetylcholine = Alzheimer’s and sleep disorders Increased acetylcholine = depression

Question 56

_____________ decrease in energy, rationality returns, reachable teachable moments staff interventions - therapeutic rapport - revise care plan

Answer 56

tension reduction decrease in energy, rationality returns, reachable teachable moments staff interventions - therapeutic rapport - revise care plan

Question 57

_________ nervous system - sends signals ________ cortex – where touch sensation is evaluated

Answer 57

peripheral nervous system - sends signals sensory cortex – touch sensation is evaluated in the sensory cortex

Question 58

Norepinephrine - Mood - Attention - Arousal - Stimulates sympathetic branch of autonomic nervous system for fight or flight stress response __creased norepinephrine = depression __creased norepinephrine = mania, anxiety, schizophrenia

Answer 58

Norepinephrine - Mood - Attention - Arousal - Stimulates sympathetic branch of autonomic nervous system for fight or flight stress response Decreased norepinephrine = depression Increased norepinephrine = mania, anxiety, schizophrenia

Question 59

following the plan of care developed as part of the health care team

Answer 59

- Adherence – following the plan of care developed as part of the health care team

Question 60

Major brain functions - Maintenance of homeostasis - Regulation of _______ nervous system and hormones - Controls biological drives and behavior o Sleep and wake cycle o Circadian rhythm o Sex - Conscious mental activity – thinking, problem solving - Memory - Social skills

Answer 60

Major brain functions - Maintenance of homeostasis - Regulation of autonomic nervous system (ANS) and hormones - Controls biological drives and behavior o Sleep and wake cycle o Circadian rhythm o Sex - Conscious mental activity – thinking, problem solving - Memory - Social skills

Question 61

__________- The lifelong ability of the brain to change with learning - New pathways are laid down as we learn, experience, and acquire new knowledge and skills - To learn or memorize a fact or skill = there must be a persistent functional change in the brain the represents the new knowledge

Answer 61

Neuroplasticity - The lifelong ability of the brain to change with learning - New pathways are laid down as we learn, experience, and acquire new knowledge and skills - To learn or memorize a fact or skill = there must be a persistent functional change in the brain the represents the new knowledge

Question 62

milieu characteristics conducive to violence: - environment – too hot, too loud, etc. - overcrowding - inexperienced staff - controlling staff - poor limit setting - revocation of privileges

Answer 62

milieu characteristics conducive to violence: - environment – too hot, too loud, etc. - overcrowding - inexperienced staff - controlling staff - poor limit setting - revocation of privileges

Question 63

interventions - begin interventions prior to any signs of escalation - non-threatening, non-directive interactions will help in developing a therapeutic relationship - approach patient in a controlled, non-threatening, caring manner - allow space (1 foot further than the patient can reach) – perceived as less of a threat - ensure escape route - do not take it personally or respond in kind if pt invades space or is verbally abusive - speak slowly, short sentences, low and calm voice - open ended statements and questions - identify what is behind the angry feelings and behaviors - encourage pt to assume responsibility for choices made - talk to the pt in a quiet and visible place - avoid medical jargon pharmacological interventions - PRN meds - Long term treatment of A/A/V is based on treating the underlying psychiatric disorder

Answer 63

interventions - begin interventions prior to any signs of escalation - non-threatening, non-directive interactions will help in developing a therapeutic relationship - approach patient in a controlled, non-threatening, caring manner - allow space (1 foot further than the patient can reach) – perceived as less of a threat - ensure escape route - do not take it personally or respond in kind if pt invades space or is verbally abusive - speak slowly, short sentences, low and calm voice - open ended statements and questions - identify what is behind the angry feelings and behaviors - encourage pt to assume responsibility for choices made - talk to the pt in a quiet and visible place - avoid medical jargon pharmacological interventions - PRN meds - Long term treatment of A/A/V is based on treating the underlying psychiatric disorder

Question 64

neurotransmitters: inhibitory/calming (2) neurotransmitters: excitatory (2) neurotransmitters: other (3) - Dopamine - Glutamate - serotonin - GABA - Acetylcholine - Histamine - Norepinephrine

Answer 64

neurotransmitters: inhibitory/calming - serotonin - GABA neurotransmitters: excitatory - Dopamine - Glutamate neurotransmitters: other - Acetylcholine - Histamine - Norepinephrine

Question 65

part of brain __________ – memory and emotions - Is there an emotional connection of a pervious/similar touch experience? - part of limbic system - processes emotions – anxiety, fear, and pleasure

Answer 65

Amygdala – memory and emotions - Is there an emotional connection of a pervious/similar touch experience? - part of limbic system - processes emotions – anxiety, fear, and pleasure

Question 66

Glutamate: excitatory __creased glutamate = seizure activity and neurodegeneration in Alzheimer’s __creased glutamate = psychosis, autism, OCD, depression, and schizophrenia

Answer 66

Glutamate: excitatory Increased glutamate = seizure activity and neurodegeneration in Alzheimer’s Decreased glutamate = psychosis, autism, OCD, depression, and schizophrenia

Question 67

____________ - Required insurance companies to provide equal treatment coverage for psychiatric disorders as other medical issues __________ - Coverage for most uninsured American through expanded Medicaid eligibility

Answer 67

Mental health parity act - Parity = equivalence - Required insurance companies to provide equal treatment coverage for psychiatric disorders as other medical issues Patient protection and affordable care act - Coverage for most uninsured American through expanded Medicaid eligibility

Question 68

what does ________ look like: - irritability - frowning or grimacing - red face - pacing - fidgeting or twisting of hands clenching and unclenching of fists - speech changes - increased in rate and volume, slowed, or silence - making increased demands

Answer 68

what does anger look like: - irritability - frowning or grimacing - red face - pacing - fidgeting or twisting of hands clenching and unclenching of fists - speech changes - increased in rate and volume, slowed, or silence - making increased demands

Question 69

staff self-assessment - nurses must be self-aware of strengths, needs, concerns, and vulnerability - if not nursing interventions may be impulsive or emotion based - nurse must be aware of words, tone of voice, non-verbal communication (body posture and facial expression) staff safety - avoid dangle items - know layout - stand to the side of pt and encourage pt to sit

Answer 69

staff self-assessment - nurses must be self-aware of strengths, needs, concerns, and vulnerability - if not nursing interventions may be impulsive or emotion based - nurse must be aware of words, tone of voice, non-verbal communication (body posture and facial expression) staff safety - avoid dangle items - know layout - stand to the side of pt and encourage pt to sit

Question 70

milieu consists of: - containment – provision of basic needs, food shelter, safety and security - support – offer encouragement, praise, and positive feedback - validation – respecting privacy, cultural needs, feelings lead to the clients holistic health - structure – control and limitation of maladaptive behaviors and setting limits - involvement – promoting the self efficacy of the client

Answer 70

milieu consists of: - containment – provision of basic needs, food shelter, safety and security - support – offer encouragement, praise, and positive feedback - validation – respecting privacy, cultural needs, feelings lead to the clients holistic health - structure – control and limitation of maladaptive behaviors and setting limits - involvement – promoting the self efficacy of the client

Question 71

– difficulty controlling fine and gross motor movements

Answer 71

- Apraxia – difficulty controlling fine and gross motor movements

Question 72

continuum of mental health and mental illness good mental health and well being - occasional stress to ______ distress - ____ impairment mental health problems – emotional problems or concerns - mild to _______ distress - mild or ________ impairment mental health problems – mental illness - ________ distress - moderate to ________ impairment or chronic impairment

Answer 72

continuum of mental health and mental illness good mental health and well being - occasional stress to mild distress - no impairment mental health problems – emotional problems or concerns - mild to moderate distress - mild or temporary impairment mental health problems – mental illness - marked distress - moderate to disabling impairment or chronic impairment

Question 73

Fighting Stigma - Talk openly - Educate self and others - Be conscious of language - Show empathy and compassion - Stop the criminalization - Push back against the way mental illness is portrayed - Advocate for mental health reform - Encourage equality in physical and mental illness - See the person not the illness

Answer 73

Fighting Stigma - Talk openly - Educate self and others - Be conscious of language - Show empathy and compassion - Stop the criminalization - Push back against the way mental illness is portrayed - Advocate for mental health reform - Encourage equality in physical and mental illness - See the person not the illness

Question 74

Neurotransmitters ______________ - Mood - Emotion - Sleep - Pain - Appetite - Temperature regulation - Some cognitive function

Answer 74

serotonin: inhibitory/calming - Mood - Emotion - Sleep - Pain - Appetite - Temperature regulation - Some cognitive function Decreased serotonin = depressive and anxiety disorders