Week 1 Study Guide Flashcards
1
Q
What is the definition of mental health?
A
State of well-being in which everyone can realize thier own potential, cope with the normal stress of life, work productively, and contribute to the community.
2
Q
What does mental health provide people with?
A
Capacity for rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem
3
Q
What is considered emotional problems or concerns?
A
Mild to moderate distress
Mild or temporary impairment
4
Q
What is considered mental illness?
A
Markes distress
Moderate, disabling, or chronic impairment
5
Q
What attributes contribute to mental health?
A
Rational thinking
Effective coping
Resiliency
Self-control
Self-awareness
Developmentally on task
Happiness
Positive self-concept
Learning and productivity
Effective communication
Meaningful relationships
Spiritual satisfaction
6
Q
Fight stigma:
Talk…
A
openly about mental health
7
Q
Fight stigma:
Educate yourself…
A
and others on mental health
8
Q
Fight stigma:
Be conscious …
A
of your language
9
Q
Fight stigma:
Show empathy and…
A
compassion for those living with mental illness
10
Q
Fight stigma:
Stop the criminalization…
A
of those living with mental illness
11
Q
Fight stigma:
Push back against…
A
the way people who live with mental illness are portrayed in the media
12
Q
Fight stigma:
Advocate…
A
for mental health reform
13
Q
Fight stigma:
Encourage equality in…
A
how people perceive physical and mental health
14
Q
Fight stigma:
See the…
A
person not the illness
15
Q
What is the purpose of mental health parity?
A
Parity = equivalence
16
Q
How can we achieve mental health parity?
A
Require insurance companies to provide equal treatment coverage for psychiatric disorders
17
Q
Barriers to mental health access:
mental health need…
A
is increasing
18
Q
Barriers to mental health access:
Long waits such as…
A
60-90 days for appt, delay in follow up care
19
Q
Barriers to mental health access: Cost such as…
A
Income
Insurance parity
20
Q
Barriers to mental health access: Knowledge and
A
STIGMA
21
Q
Barriers to mental health access: feeling like…
A
just a number
22
Q
Client rights:
Receive…
A
treatment
23
Q
Client rights: Refuse…
A
treatment
24
Q
Client rights: Be treated with…
A
dignity
25
Client rights: be involved...
in treatment and planning decisions
26
Client rights: leave the hospital...
against medical advice
27
Client rights: be protected.,,
against harming self or others
28
Client rights: a timely...
evaluation in the event of involuntary
29
Client rights: hospitalization and...
legal counsel
30
Client rights: communicate privately...
by telephone and in person
31
Client rights: informed...
consent
32
Client rights: least restrictive...
means of treatment
33
Client rights: participate in...
religious worship
34
Client rights: have...
confidentiality
35
Least restrictive means of treatment: access the patient...
to see what's wrong
36
Least restrictive means of treatment: encourage the patient...
to go to their room to decrease stimulation
37
Least restrictive means of treatment: offer...
PRN medications orally
38
Least restrictive means of treatment: escort...
to a secluded area
39
Least restrictive means of treatment: administer...
PRN medications IM
40
Least restrictive means of treatment: restraints...
only used if patient is danger to self or others
41
What is a therapeutic milieu?
Refers to the surroundings and physical environment of the inpatient hospital unit
42
What does a therapeutic milieu provide?
Since of security/safety
Real life training ground for practicing communication and coping skills
Activities
RULES
Reality orientation
43
What is containment?
Provision of basis needs, such as food, shelter, safety and security
44
What is support?
offer encouragement, praise, positive feedback
45
What is validation?
respecting privacy, cultural needs, feelings lead to the client's holistic health
46
What is structure?
Control and limitation of maladaptive behaviors and settings limits
47
What is involvement?
Promoting the self-efficacy of the client
48
What are the 5 parts of therapeutic milieu?
Containment
Support
Validation
Structure
Involvement
49
What is deinstitutionalization?
Legislation that resulted in the mass movement of severely mentally ill persons from state hospitals to outpatient care
50
What is the definition of stigma?
Widespread fear and misunderstanding of mental illness
51
What is stigma heightened by?
focus on extraordinary symptoms in film and literature
52
What is the diathesis-stress model?
Combination of genetic vulnerability and negative environmental stressors
53
Diathesis-stress model:
What is stress?
environmental stress or trauma
54
What model is the most accepted explanation for mental illness?
diathesis-stress model
55
Diathesis-stress model: What is the diathesis?
Biological predisposition
56
What does NAMI stand for?
National Alliance for Mental Illness
57
What are the goals of NAMI?
Communicating
Eliminating
Advocating
Improving
Integrating
Services
58
NAMI goals: Communicating...
that mental illnesses are brain disorders
59
NAMI goals: Eliminating...
stigma and discrimination
60
NAMI goals: Advocating...
for people with mental illness
61
NAMI goals: Improving...
access to treatment services
62
NAMI goals: Integrating...
mental illness into community life
63
NAMI goals: Services...
Support groups
Educational programs
Public Awareness events
Family to family
In our own voice
Participation station
Warm line
NAMI Walk
64
What is victimization?
Verbal abuse, bullying, threats, theft, physical assaults, rape
65
What is dual diagnosis?
co-occuring mental illness and substance use disorder
66
What is an acute care hospital?
Highly structured setting that optimizes safety and addresses crisis intervention
67
Average length of acute care hospital stay?
3-7 days
68
What is voluntary admission?
Both the individual and the health care professionals agree with the need for treatment and hospitalization. The individual signs a consent for treatment
69
How long can an individual be involuntarily held?
72 hrs against will
70
During a 72 hour hold...
Pt may become better with treatment and sign themselves in thus becoming voluntary
71
After 72 hour hold and patient still doesn't want to be in hospital...
Healthcare professionals deem it necessary, court system must be petitioned for further care
72
Medication adherence def:
Managing one's own care based on the plan of care developed as part of the health care team. Sticking to this developed plan of care
73
Recovery definition:
process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
74
Partial hospitalization definition:
Alternative for those that continue to need some supervision but are not appropriate for inpatient hospitalization
75
When is long-term hospitalization recommended?
Recommended if patient requires longer than 7 days for illness/symptom stabilization
76
Resilience definition:
Ability and capacity to secure resources needed to support well-being
77
What is resilience characterized by?
Optimism; Sense of mastery; Competence; Essential to recovery
78
What is the parietal lobe responsible for?
Receive and identify sensory information
Concept formation and abstraction
Proprioception and body awareness
Reading, mathematics
Right and left orientation
79
What is the frontal lobe responsible for?
Personality
Formulate goals
Initiate, plan, terminate actions
Decision making
Insight
Motivation
Social judgment
Voluntary motor ability starts in frontal lobe
80
What is the temporal lobe responsible for?
Language comprehension
Stores sounds into memory
Connects with limbic system "the emotional brain"
81
What is the occipital lobe responsible for?
Interprets visual images
Visual association
Visual memories
Language formation
82
What does damage to the frontal lobe cause?
• Paralysis, Inability to plan sequence of steps/actions; Persistence of a single thought (Perseveration) ***); Inability to focus on task (Attending); Mood changes (Emotionally Labile); Personality changes; Difficulty with problem solving; Inability to express language (Broca's Aphasia)
83
What is inability to express language term?
Broca's Aphasia
84
What is Broca's aphasia?
Inability to express language
85
What does damage to the parietal lobe cause?
Problems with reading, naming objects, drawing, & math.; Difficulty in distinguishing left from right. Lack of awareness of certain body parts and/or surrounding space. Apraxia: difficulty controlling fine and gross motor movement; (Schizophrenia & nihilistic delusions: things or even everything does not exist
86
What is apraxia?
difficulty controlling fine and gross motor movement
87
Apraxia is associated with damage to the...
parietal lobe
88
Schizophrenia and nihilistic delusions are associated with damage to the...
parietal lobe
89
What does damage to the temporal lobe cause?
Prosopagnosia: Difficulty in recognizing faces ; Wernicke's Aphasia: Difficulty in understanding spoken words; Difficulty with identification of, and verbalization about objects.; Short term memory and long-term memory loss.; Manic symptoms such as: Increased or decreased interest in sexual behavior, persistent talking.; Increased aggressive behavior.
90
What is difficulty in recognizing faces?
Prosopagnosia
91
What is Wernicke's aphasia?
Difficulty in understanding spoken words
92
What two conditions are associated with damage to the temporal lobe?
Wernicke's aphasia
Prosopagnosia
93
What is damage to the occipital lobe associated with?
Visual illusions - inaccurately seeing objects (See a person in the corner instead of a coat tree); Word blindness - inability to recognize words.; Difficulty in recognizing drawn objects. ; Inability to recognize the movement of object (Movement Agnosia).
94
What is word blindness?
Inability to recognize words or drawn objects
95
What is movement agnosia?
Inability to recognize the movement of an object
96
Word blindness is associated with damage to what lobe?
Occipital
97
Movement agnosia is associated with damage to what lobe?
Occipital
98
What does the corpus callosum do?
Relays information between hemispheres of brain
99
Damage to the corpus callosum is associated with...
people cannot integrate emotions and logical information.
100
Corpus callosum damage: What happens if left side of the brain is dominiant?
If the left (logical) brain side is dominant = less ability to feel emotion
101
Corpus callosum damage: what happens if the right side is dominant?
If the right (emotional) brain side is dominant = difficult to control emotions and problem-solve; loss of object constancy
102
What is the limbic system responsible for?
learning, memory, emotions and visceral responses
103
What do abnormalities in the limbic system cause?
Excessive emotional response
104
What is the hippocampus responsible for?
memory, and controls the endocrine and immune systems
105
What condition associated with alcoholism causes damage to the hippocampus?
Korsakoff's syndrome
106
What is Korsakoff's syndrome?
A person cannot form new memories despite intact intelligence
107
What does the amygdala do?
processes emotions; anxiety, fear, and pleasure
108
What does damage to the amygdala result in?
Damage has resulted in rage in animals. Plays a role in anxiety and OCD
109
What do the basal ganglia do?
Coordinated and aids in moving skeletal muscles
110
How perception works:
The __ __ __ sends us a signal- "I am being touched by something"
peripheral nervous system
111
How perception works:
The __ __ evaluates the sensation - "What does it feel like?"
sensory cortex
112
How perception works:
The __ is responsible for recalling memory - "Have a I been touched like this before?"
Hippocampus
113
How perception works:
The __ attaches an emotional response to the stimulation based on past experiences
Amygdala
114
How perception works:
The __ __ spring us into action - withdrawal, fear, return touch, etc.
basal ganglia
115
What imaging techniques show structure of anatomy?
CT
MRI
116
What imaging techniques show function of anatomy?
PET
SPECT
fMRI
117
What does a SPECT stand for?
single photon emission computed tomography
118
What concept is related to brain growth?
Learning, memory and perception are influenced by past experiences and the ability of the brain to organize information
119
Nursing interventions that lead to changes in brain activity:
Social...
connections
120
Nursing interventions that lead to changes in brain activity:
Give community...
resources
121
Nursing interventions that lead to changes in brain activity:
New...
learning
122
Nursing interventions that lead to changes in brain activity:
Healthy...
diet
123
Nursing interventions that lead to changes in brain activity:
Sleep and...
exercise
124
Nursing interventions that lead to changes in brain activity:
Healthy __....
anxiety
125
Nursing interventions that lead to changes in brain activity:
meditation and....
gratitude
126
Nursing interventions that lead to changes in brain activity:
ANT killing to combat...
cognitive disorders
127
Interventions that decrease stress will...
decrease cortisol levels which positively impact the PNS
128
What are the two main inhibitory/calming neurotransmitters?
Serotonin and GABA
129
What are the two main excitatory neurotransmitters?
Dopamine and glutamate
130
What does serotonin regulate?
modulates mood, emotion, sleep, pain and appetite as related to mood, temperature regulation; some cognitive function
131
Serotonin is __ in people with depression and anxiety
LOW
132
What does GABA do?
reduces anxiety, aggression, and stress; regulates norepinephrine, adrenaline, dopamine and serotonin
133
GABA is DECREASED in which conditions?
Anxiety, mania, and schizophrenia
134
Do decrease anxiety, GABA needs to be __
increased
135
What does dopamine do?
pleasurable feelings, complex motor activities, plays a role in hallucinations
136
Dopamine is decreased in these conditions
Depression, addiction
137
Dopamine is increased in these conditions...
Mania, positive symptoms in schizophrenia
138
Too much glutamate results in...
Seizure activity and neurodegeneration in Alzheimers
139
Glutamate is decreased in these conditions...
Psychosis
Autism
OCD
Depression
Schizophrenia
140
What neurotransmitters are considered "other"
acetylcholine
histamine
norepinephrine
141
What is acetylcholine responsible for?
cognitive functioning; sleep–wake cycles. Plays a role in learning, memory. Regulates mood: mania, sexual aggression
142
Acetylcholine is low in...
Alzheimer's and sleep disorders
143
Acetylcholine is high in...
depression
144
What is norepinephrine responsible for?
level in the brain affects mood, attention, and arousal. Stimulates sympathetic branch of autonomic nervous system for “fight or flight” stress response
145
Norepinephrine is decreased in...
depression
146
Norepinephrine is increased in...
mania, anxiety, and schizophrenia
147
What is neuroplasticity?
The ability of the brain to change with learning is what is known as neuroplasticity; It is the lifelong ability of the brain to reorganize neural pathways based on new experiences.
148
What is synaptic pruning?
A neurological process which removes unnecessary or damaged neuronal structures from the brain; Improving the "networking" capacity of a particular area of the brain. Pruning = “weeding out" the weaker synapses.
149
Over pruning in schizophrenia may result in...
hallucinations
150
Gene theory suggests over pruning takes place in...
late adolescence and young adulthood
151
What are nursing interventions for family consultation?
Help understanding
Develop effective parenting skills
Teach about suicide risks
152
Stinking thinking #1
All...
All-or nothing thinking
153
Stinking thinking #2
Over...
overgeneralization
154
Stinking thinking #3
Mental...
mental filter
155
Stinking thinking #4
Dis...
discounting the positive
156
Stinking thinking #5
Jump...
jumping to conclusions
157
Stinking thinking #6
Mag...
magnification
158
Stinking thinking #7
emot....
emotional reasoning
159
Stinking thinking #8
Should...
"should" statements
160
Stinking thinking #9
Lab..
labelling
161
Stinking thinking #10
person...
personalization and blame
162
3 types of talk behavioral therapy
Interpersonal therapy
CBT
Dialectic behavior therapy (DBT)
163
What does interpersonal therapy focus on?
Focuses on interpersonal relationships by improving functioning and communication patterns
164
What are 3 techniques of interpersonal therapy?
Identification of emotion
Expression of emotion
Dealing with emotional baggage
165
Interpersonal therapy
Identification of emotion:
Helping the person identify what their emotion is and where it is coming from
166
Interpersonal therapy
Expression of emotion
This involves helping the person express their emotions in a healthy way
167
Interpersonal therapy
Dealing with emotional baggage
Looking at how past relationships affect current relationships.
168
What is CBT?
Based on cognitive psychology & behavioral theory. Thoughts cause feelings and behaviors, not external things, like people, situations, or events.
169
What is the benefit of CBT?
we can change the way we think in order to feel/act better even if the situation does not change
170
How long is CBT typically don?
Brief, time limited and structured, usually 16 sessions
171
How is CBT conducted?
Homework and self-counseling skills
Collaborative effort between therapist and patient Goals are identified by the patient
172
What is DBT?
Developed to treat chronically suicidal individuals commonly with borderline personality disorder; Combines cognitive and behavioral techniques with mindfulness.; Emotional regulation; Interpersonal effectiveness; Distress tolerance; Mindfulness; Self Management skills
173
What are the 4 primary modes of DBT?
Group skills training
Individual psychotherapy
Telephone contact
Therapist consultation and team meetings
174
A group consists of..
two or more people; Pursuing common goals and/or interests
175
Each group has characteristics that influence it's progress and outcomes...
Size; Defined purpose; Degree of similarity among members; Rules; Boundaries; Content (what is said in the group); Process (underlying dynamics among group members)
176
Psychoeducation group:
Groups to increase knowledge or skills about a specific psychological or somatic subject
177
Examples of specific psychologic or somatic subjects
Medication or Health education; Dual-diagnosis; Symptom management; Goal Setting/Review; Recreational Activity; Interpersonal Skills
178
Therapeutic community meeting group:
Every interaction occurring on an inpatient milieu has the potential to be therapeutic. The community meeting is the essential venue at which unit happenings are processed and integrated into treatment
179
Support and self-help group:
These groups are structured to provide patients with the opportunity to maintain or enhance personal and social functioning through cooperation and shared understanding of life’s challenges (i.e. AA, survivors of Cancer, bereavement…)
180
Group psychotherapy:
This is a specialized group intervention requiring skilled leaders such as an advanced practice nurse. Expertise is necessary for this group since the goal is to bring about personality change.
181
What are some advantages of working with groups?
Engage multiple patients in treatment at the same time; Participants benefit from feedback, knowledge, and life experiences of others; Provides a safe setting to try out new behaviors and communication skills; Promotes a feeling of belonging
182
What are some disadvantages of working with groups?
Time constraints an individual may feel cheated for participation time; Concern for confidentiality; Disruptive members; Not all patients benefit from group treatment
183
Intervention for monopolizing group member?
Remind entire group to provide equal chances to contribute
Speak directly to member, privately when necessary
184
Intervention for demoralizing group member
Listen objectively; ask in private about cause of anger; empathize matter-of-factly
185
Intervention for silent member
Determine cause; require response to ease group discomfort; provide extra time for member to think about a response and come back to them
186
4 phases of group development are...
Planning
Orientation
Working
Termination
187
Group development:
Planning phase
Name, objectives, schedule, setting, types of patients for inclusion of the group
188
Group development:
Orientation phase
Leader structures atmosphere of respect, confidentiality and trust. Group purpose and rules are stated
189
Group development:
Working phase
Group leaders encourages a focus on problem solving. As group members begin to feel safe, conflicts may be expressed and pose a growth opportunity for the group “storming, norming and preforming”
190
Group development:
Termination phase
Encourage members to reflect on progress made and identify post termination goals.
191
What are individual informal roles of group members?
Agressor
Blocker-oppositional
Recognition seeker
Play person
Dominator
192
Functional roles:
Task Roles-
Initiator-contributor:
Suggests or proposes new ideas or different ways of regarding the problem or goal
193
Functional roles:
Task Roles-
Information seeker
tries to clarify the groups roles
194
Functional roles:
Task Roles-
Information giver
Provides facts or shares experiences as an authority figure
195
Functional roles:
Task Roles-
coordinator
Shows or clarifies how ideas can work
196
Functional roles:
Task Roles-
orienteer
notes progress towards goal
197
Functional roles:
Task Roles-
Recorder
Keeps notes and acts as memory
198
Yalom's therapeutic factors:
Instillation of hope
Leader shares optimism about successes of group treatment, and members share their improvements
199
Yalom's therapeutic factors:
Universality
Members realize that they are not alone
200
Yalom's therapeutic factors:
Imparting of information
Participants receive formal teaching by the leader or advice from peers
201
Yalom's therapeutic factors:
Altruism
Members gain/profit from giving support to others improving self-value
202
Yalom's therapeutic factors:
Corrective recapitulation
Members repeat patterns of behavior in the group that they learned in their families; with feedback from the leader and peers, they learn about their own behavior
203
Yalom's therapeutic factors:
Development of socailizing skills
Members learn new social skills based on others feedback and modeling
204
Yalom's therapeutic factors:
Imitative behavior
Members may copy behavior from leader or peers and can adopt healthier habits
205
Yalom's therapeutic factors:
Interpersonal learning
Gain insight based on feedback
206
Yalom's therapeutic factors:
Group cohesiveness
This arises in a mature group when each member feels connected to the other members, the leader, and the group. Members can accept both positive feedback and constructive criticism.
207
Yalom's therapeutic factors:
Catharsis
Through experiencing and expressing feelings, therapeutic discharge of emotion is shared.
208
Yalom's therapeutic factors:
Existential resolution
Members examine aspect of life, (i.e. loneliness, mortality, responsibility) that affect everyone in constructing meaning.
209
What is photolight therapy?
First-line treatment for depression with a seasonal onset
Efficacy due to influence of light on melatonin
Effective as medication
210
What are negative effects of photolight therapy?
Headache and jitteriness
211
What is electroconvulsive therapy?
Under anesthesia and with a muscle relaxant, ECT is the application of electricity to temporal regions of the brain to induce a brief seizure. Unilateral (electrodes placed on one hemisphere of brain/scalp) vs. bilateral- one electrode on each temple area
212
Most effective treatment for depression
ECT
213
ECT is the primary treatment in...
severe malnutrition, exhaustion, & dehydration d/t lengthy depression
214
What is the second most common indication for ECT?
Psychotic illness
215
What is the course of treatment for ECT?
• 2-3 treatments per week for a total of 6 to 12 treatments; Must reorient for several hours after treatments
216
ECT is also used in...
Delusional depression; Failure of previous med trials-refractory depression; Schizophrenia with catatonia
217
What are the risks of ECT?
Stress on heart at seizure onset and up to 10 minutes post
Stresses the brain as a result of increased cerebral oxygen, blood flow, and intracranial pressure
Confused and disoriented for several hours-must reorient frequently
Retrograde amnesia-loss of memory of events leading up to and including the treatment
218
When is ETC contraindicated?
Brain tumors and subdural hematomas
219
What should the nurse assess for prior to ECT and after?
HTN
CHF
Arrhythmias
220
What is Transcranial magnetic stimulation?
MRI-strength magnetic pulses stimulate focal areas of the cerebral cortex
221
What is contraindication of transcrainial magnetic stimulation?
metal
222
What are adverse reactions of transcranial magnetic stimulation?
Headache and lightheadedness
No neurological deficits or memory problems
Seizures rarely
Most are mild and include scalp tingling and discomfort at administration site.
223
What are invasive procedures?
Vagus nerve stimulation and deep brain stimulation
224
What is vagus nerve stimulation?
Originally used to treat epilepsy; Decreases seizures and improves mood; Used for treatment resistant depression; Electrical stimulation boosts the level of neurotransmitters
225
What are the side effects of vagus nerve stimulation?
Voice alteration (nearly 60% of patients)
Neck pain, cough, paresthesia, and dyspnea, which tend to decrease with time
226
What is deep brain stimulation?
More invasive than VNS; Surgically implanted electrodes (in the brain) Stimulates regions identified as underactive in depression
227
What was deep brain stimulation originally used to treat?
Parkinsons
228
What is St Johns Wort?
Flower processed into tea or tablets; Thought to increase serotonin, norepinephrine, and dopamine; Useful in mild to moderate depression
229
What is Ginseng for?
stress and fatigue
230
What is Valerian root or chamomile used for?
stress
insomnia
depression
