Term
| What did Dorothea Dix do that is related to mental health |
|
Definition
| Led a crusade for humane treatment |
|
|
Term
| 2. What does the term “Deinstitutionalization” refer to and what were the conditions that caused it to occur? |
|
Definition
| Moving care to the community setting: commitment laws changed during the 1970s that made it more difficult to commit a person for inpatient treatment involuntarily-( more civil rights) |
|
|
Term
| What are the rights of the persons committed to a mental institute? |
|
Definition
Voluntary- all of their civil liberties, may d/c treatment whenever they choose
Involuntary- All civil rights except the right to leave the hospital |
|
|
Term
| 4. What are the three stages of the nurse-client relationship—be able to apply the terms to a situation and decide what phase of the relationship is represented |
|
Definition
Phase I- orientation (initial phase involves assessment and analysis; est. trust, assess client, nursing diag. formulated, problems prioritized, mutually agree on goals) (introduce, set time, behaviors)
Phase II- working (planning outcomes and applying interventions to help the client achieve their goals; encourage expression of problems, thoughts, feelings, collaboration and mutual problem solving, coping tech. are taught or recognized, adaptive behaviors are implemented) (maintains relationship, ongoing assessment, encourage, foster positive behavior)
Phase III- termination (the endpoint of the relationship; problems should be solved at this point, nurse evaluates outcomes for the entire relationship, mutual agreement, does the client show regression?) (provide opportunity to discuss loss, summarize goals and achievements, express own feelings to help client, maintain limits) |
|
|
Term
| 5. Be familiar with terms in your textbook related to therapeutic and nontherapeutic techniques—apply them in conversations |
|
Definition
Therapeutic- purposeful and goal directed, safe, professional
Nontherapeutic- closed, |
|
|
Term
| What is the “Duty to Warn”? |
|
Definition
protective privilege ends when public peril begins”
is the client dangerous to others?
Is the danger the result of a serious mental illness?
Is the danger imminent?
Is the danger targeted at identifiable victims? |
|
|
Term
| 7. What happens when a person is disoriented---what area is usually the first symptom and how does this abnormality typically progress |
|
Definition
|
|
Term
| 8. What is the most serious complaint that a mentally ill person could present with? How would you apply this to prioritization of care? |
|
Definition
|
|
Term
| Apply the Axis system and understand what is included in all 5 Axis that is used with the DSM IV Classification |
|
Definition
Axis I- clinical disorder that is the focus of tx such as major depression, autism
Axis II- personality disorders, mental retardation
Axis III- general medical conditions such as asthma
Axis IV- psychosocial and environmental problems such as educational deficits, housing problems and financial difficulties
Axis v- Global assessment of functioning (GAF) assigns a numerical value representing the client’s current level of functioning compared to the highest level of functioning during the past year. Expressed as a fraction such as 45/70 |
|
|
Term
| What is a GAF? What would expected values be for a person who is well-adjusted and coping well versus a person who is seriously mentally ill? |
|
Definition
Global Assessment of Function
A high GAF score indicated high levels of functioning 60 to 100
Scores between 50 and 60 indicate moderate severity of symptoms
Clients with suicidal ideations are given a score of 50
Clients with a score of 10 could have persistent symptoms of violence, severe ability for self-harm, or evidence of minimal personal hygeine |
|
|
Term
| What do the terms transference and countertransference mean? |
|
Definition
Transference-the client experiences an emotional reaction toward the nurse based on past experiences
Countertransference- the nurse responds to the client with feelings from based on feelings from their past |
|
|
Term
| What nursing actions are included with maintaining the “Therapeutic Mileau”? |
|
Definition
Scientific planning r/t social and physical environment with a goal of assuring that every interaction and activity is therapeutic
Nurse maintains therapeutic environment, teaches skills, promotes communication, and uses role-modeling |
|
|
Term
| Be familiar with the various aspects of spirituality and how they relate to patient care. Pg 110 &123 |
|
Definition
Belief in God or a higher power
Practice of religion
Cultural beliefs and practices
Relationship with the environment
*should serve as a source of comfort during stressful or traumatic times |
|
|
Term
| What are the goals and expected outcomes for “therapeutic communication |
|
Definition
Nurses goal is to help the client as they work to explore their feelings, understand and gain insight into their mental illness or other related issues, and assist them as they work to change
-Establish rapport
-actively listen
-gain the client’s perspective
-explore the client’s thoughts and feelings
-guide the client toward problem solving |
|
|
Term
| Review the various aspects and broad guidelines of conducting a mental health exam |
|
Definition
Cultural information that is useful should be integrated into the treatment plan
It is not always useful to discard “neutral” issues if they can be integrated into the plan of care
Harmful practices should be “re-patterned” into healthful or “health enhancing” ones |
|
|
Term
| Be able to differentiate between a conversation that is social and one that is therapeutic |
|
Definition
Social –less goal oriented, more superficial, usually doesn’t involve the expectation of helping the client regarding emotional concerns
Therapeutic- takes place between the nurse and client and focus is on the client’s thoughts, feelings, behavior, roles and expectations |
|
|
Term
| Review and apply ego defense mechanisms |
|
Definition
Id-seeks instant gratification and pleasure; is impulsive, unthinking, and disregards societal rules (primitive and instinctive)
Superego- (opposite from Id) reflects one’s ethical and moral values, the “conscience”, foundations for the superego are in one’s cultural beliefs, parental and social expectations-rules of society and standards of behavior
Ego- (reality based) balance impulses from the Id and demands from the superego, reality based or the “I” component, uses a system of validation and testing, represents successful functioning in the world based on mature and adaptive behavior |
|
|
Term
| What does the “revolving door effect” refer to related to mental illnesses and inpatient care? |
|
Definition
| Deinstitutionalization- moving care to the community setting- and excellent idea but problems in applications due to: inadequate funding, planning failed to consider non-medical issues, and REVOLVING DOOR in many instances |
|
|
Term
| Review the various types of therapeutic groups. What is the difference in a “closed” versus “open” group? |
|
Definition
|
|
Term
| Apply the terms primary, secondary, and tertiary care |
|
Definition
Primary- prevent problem from ever occurring
Secondary- early diagnosis and treatment
Tertiary- continued support and rehabilitation |
|
|
Term
| . Maslow’s Heirarchy of Needs |
|
Definition
Physiologic needs- basic needs to sustain life such as air, food, and water
Safety and security- the need to establish security, stability, and consistency out of the chaos of life
Love and belonging- refers to an individual’s desire for acceptance and belonging to others
Self esteem and esteem for others- one’s needs for self-mastery and recognition by others
Self-actualization- represents the “loftiest” need describing self- awareness and the desire to become the best that one can become |
|
|
