Satisfying interpersonal relationships

Effective behavior and coping

A positive self-concept

Emotional stability

Dissatisfaction with characteristics, abilites, accomplishments

Ineffective or unsatisfying relationships

Dissatifaction with one's place in the world

Ineffective coping with life events

Lack of personal growth

Socia-emotional intellegence

Resilience

Spirituality

Taxonomy of disrders

Standardize nomenclature

Identify defining characteristics or symptoms

Assist in identifing underlying causes

In DSM-IV clinical disorders are listed on 3 seperate axes.

DSM-V has them listed on one

Prinicple disorder that needs immediat attention.

Ex-depressive epsiode, flare up of panic disorder

Usually the reason people go get treatment

Personality disorder that may shape the Axis I

Developmental disorders(learning disability)

Medical or Neurological problems that are relevant to pt current of past psychiatric problems

EX- severe asthma can precipate of panic attack

Psychosocial stressors the individual has faced recently

EX- job loss, death, divorce

level of function the pt has gained at the time of assesment

Usually coded 0-100 scale

Ancient: Displeasure of Gods, demonic or divine

Aristotle: imbalance of the four humors( water, yeloow and black bile, blood

Early Christian: possession by demons

Advocated for better treatment of mentally ill pt.

Opened 32 hospitals and offered asylum

First psychiatric nurse

Trained other nurses

Sense of right and wrong, code of conduct for living

Choosing, prizing, acting

Use aspects of personality, experience, values, feelings, inteligence, needs, coping skills, perceptions to establish relationships beneficial to client,

Developed by Peplau

Ways of Observing understanding client interacttion

Empirical-nursing science

Personal-life experiences

Ethichal-moral nursing knowledge

Aesthetic-art of nursing

Unknowing-nurse admits lack of knowledge of client

frienship, socialization, companionship

Superficial communication

Emotional commitment

Individual needs met:assistance with helping each other meet needs

Focus on needs, experience, feeling, ideas of client only

Joint agreement on areas to work one

Developed theory of nurse-client relationship

Resource-provides info

Counselor-helps pt to explore their thoughts and feelings

Surrogate-role playing helps pt to explore and identify feeling from the past

Technical support- coordinates professional services

Psychotherapy

Prescriptive authority for drugs

Consultation,liason

Evaluation

Intimate- 0-18in

Personal- 18-36in

Social 4-12 ft

Public- 12-25 ft

Theraputic 3-6ft

Psychoanalytsis

Behavior results from ineffective personality development

Id-desires, wants

Superego- morals, ethical, values, opposite of id

Ego- balancin, mature, adaptive

Oral: <18mo, oral gratification, obesity, nail biting, drugs

Anal: 18-3yr, independence and control, OCD, perfection

Phallic:3-6yr, oedipus and electra complex, lgbta, identity

Latency: 6-12y, repressed sex and socialization, lack motivation

Genital: 12-adult, puberty and relations with opposite sex, fridigy, premature, ejaculation, impotence

Interpersonal

developed 5 life stages and 3 developmental cognitive modes

Believed that unsatisfying relatinships were the bassis for all emotional problems

Described the concept of therapeutif milieu or community

Infancy: anxiety reduction via oral gratification

Childhood: delay in gratification

Juvenile: satisfying peer relationships

preadolescence: satisgying same-sex relationships

eary adolescence: satisfying opposite-sex relationships

Late adolescence: lasting intimate opposite sex relationships

prototaxic: infancy and childhood involves brief unconnected experience that have no relationship to one another(schizophremia)

Parataxic: Early childhood. connect hings in sequences but does not see logical sense. Child will replay experiences to reduce stress (paranoia)

Syntaxic: school age-preadolescence. maturity. sees self and the world withing contex of environment

Sensory- trust vs mistrust, suspiciousness, bad relationships

Muscular-autonomy vs shame and doubt, low self esteem, dependency

Locomoter- initaitive vs guilt, passive, guilt

Latency-industry vs inferiority, unmotivated, unreliable

Adolescence- idenity vs role confusion, rebellion, etoh/drugs, bad relationship, regression

Young adult- intimacy vs isolation, emotiona immaturity, deny need for personal relationships

Adulthood- generativity vs stagnation, inability to show concern for others

Maturity- integrity vs despair, can't deal with aging and death, hoplessness

Infant-learning to depend on others-communication with caregiver

Toddler- learning to delay satisfaction- some delay in self gratification for others

Early childhood-identifyin oneself- appropiate roles and behaviors through others perception off self

late childhood-developing skills in participation-competition, cooperation, compromise

Rapid assessment, stabilization of symptoms, 

discharge planning 

 Client-centered multidisciplinary approach to brief stay 

Therapeutic community in which the 

entire social structure of the unit or 

residence is designed to be part of the 

helping process

• Safe
• support
• activity scheldule

to assist 

the client in resolving the immediate problem and 

regaining emotional equilibrium

early identification of mental health 

problems 

Tertiary prevention

: monitoring, coordinating psychiatric 

rehabilitation services 

 treats symptoms of psychosis, delusions, hallucinations, schizophrenia, manic phase of bipolar.

Offlabel- insomia,agressive behavior, anxiety, in alzheimers

 Work by blocking recptoms of dompanine

Check prolactin levels

breast enlargment, weight gain

sugar free drinks 

inhibt the reuptake of serotonin

lower incidence of extrapyramidal effects

dopamine system stabilizers

works in bipolar and depression

shuffle, toungue out,

tardive duskinea, akinesia, akathesia,parkinsonia sundrome

spastic movement

oculogryric crisis

torticolic

opisthonus

protrusion of tongue

akinesia

muscular rigidy

tremor

stooped posture

drooling

masklike face

restlessness

shortly after initaion of tx

common

inability to sit still

dimines spontaneity

few gestures

apathy

unspontaneous speech

Facial and oral movements

extremity movemt

trunk movements

Hyperthermia

Severe EPS with fever

can be fatal

Takes up to 4 weeks

SSI- Block reuptake of serotonin

Cyclic- primarily block reuptake of norepinephrine,

MAOI- block enxyme metabolism

LOW incidence of sedation and antichologenic effects

not eat tryamine

not with othe antidepressent demerol. antiHTN

Not for suicide

phenlizine(nardil)

Tranylcyrpomine (parnate)

Isocarboxaxid (Marplan)

only for mild to moderate depression

side effectm akathiseia, insomnia, sexual dysfunction, anxiety, agritation

Less weight gain

From taken MAOI and SSRI together

agitation, sweating, fever, tachycardia, ridigy, hyperreflexia, death

block cholingeric receptors which causes dry moth, constipation urinary hesitency, blurred near verion

sexual dysfunction

Geodon

Antiparkinson

Stabilizes the dopameneginic effects

Used to treat bipolar

Lithium

It normalizes the reuptake of serotonine, norepinephrine, acterylcholin, and dopamine

0.8-1.2

levels monitered every 2-3 days

side effects:diarrhea, nauser, hand tremor, poluuria, metallic taste in mothe

Toxic effects: severe diahrea, vomiting,drowsiness, muscle weaknes, lack of cordination

Teaching- check blood, drive when not dizzy

Reduce anxiety

Bezodiazepines

calming effect and potentiate the effects of GABA

sIDE EFFECTS: physical dependence, depression, poor coordination

Client teaching: withdrawl can be fatal,take alcohol up a notch, slower reflex

avoid gestational weeks 6-10

lower dose before birth

start meds back after breastfeeding

Antipsychotic-not good

antidepressent- suicidal risk can increase

Doses- multiple smaller during day

involved in voluntary movement, learning, memory, and sleep

Too much acetylcholine is associated with depression, and too little in the hippocampus has been associated with dementia.

correlated with movement, attention, and learning

activation level, mood, movement

Too much dopamine has been associated with schizophrenia, and too little is associated with some forms of depression as well as the muscular rigidity and tremors found in Parkinson’s disease.

associated with eating, alertness

mood, activation level

Too little norepinephrine has been associated with depression, while an excess has been associated with schizophrenia

involved in energy, and glucose metabolism

Too little epinephrine has been associated with depression.

plays a role in mood, sleep, appetite, and impulsive and aggressive behavior

Too little serotonin is associated with depression and some anxiety disorders, especially obsessive-compulsive disorder. Some antidepressant medications increase the availability of serotonin at the receptor sites.

inhibits excitation and anxiety

Too little GABA is associated with anxiety and anxiety disorders. Some antianxiety medication increases GABA at the receptor sites.