Ati Psych Ch 4-6

Front 1

Adaptive use of Defense Mechanisms

Back 1

Helps ppls acheive their goals in acceptable ways. Defense mechanisms become maladaptive when they interfere with functioning, relationships, and orientation to reality

Front 2

Healthy Defense Mechanisms - 4

Back 2

(altruism, sublimation, humor, and suppression)

Front 3

Intermediate Defense - 6

Back 3

Repression, reaction formation, somatization, displacement, rationalization, undoing

Front 4

Immature Defense Mechanisms - 8

Back 4

Projection, acting-out behaviors, dissociation, devaluation, idealization, splitting, passive aggression, and denial

Front 5

Altruism

Back 5

Deal w/anxiety by reaching out to others

Front 6

Sublimation

Back 6

Dealing w/unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression
(ex: person who has feelings anger toward work supervisor sublimates those feelings by working out vigorously at the gym during his lunch period)

Front 7

Suppression

Back 7

Voluntarily denying unpleasant thoughts + feelings

Person lost job - says will worry about bills next week

Front 8

Repression

Back 8

Putting unacceptable ideas, thoughts, and emotions out of conscious awareness

Front 9

Displacement

Back 9

Shifting feelings related to an object, person, or situation to another less threatening object, person or situation

Person angry about losing job destroys child's fav toy

Front 10

Reaction Formation

Back 10

Overcompensating or demonstrating the ooposite behavior of what is felt

Person who dislikes her sister's daughter offters to babysit so that her sister can go out of town

Front 11

Somatization

Back 11

Developing a physical symptom in place of anxiety

A school-age child develops abdominal pain to avoid going to school where bullied

Front 12

Undoing

Back 12

Performing an act to make up prior behavior

Adolescent completes his chores w/out being prompted after having an argument w/parent

Front 13

Rationalization

Back 13

Creating reasonable and acceptable explanations for unacceptable behavior

Had to driv ehome drunk from party bc had to feed dog

Front 14

Passive Aggression

Back 14

Indirecting behaving aggressively but appearing to be compliant

person's coworker aggres to take on one of her assignments but then doesn't meet deadline

Front 15

Acting-out behaviors

Back 15

Managing emotional conflicts thru actions, rather than self-reflection

Preschooler told to share toys, so she throws the toys across the room

Front 16

Dissocation

Back 16

Temporarily blocking memories and perceptions from consciousness

Adolescent witnesses a shooting and is unable to recall any details of the event

Front 17

Devaluation

Back 17

Expressing negative thoughts of self or others

*passed up for job - says his job is better anyways doesn't need it

Front 18

Idealization

Back 18

Expressing extremely positive thoughts of self or others

School-age boy boasts about hsi older bro and his accomplishments

Front 19

Splitting

Back 19

Demonstrating an inability to reconcile negative and positive attributes of self or others

PT tells nurse she is the only one who cares about her, yet following day - same PT refuses to talk to nurse

Front 20

Projection

Back 20

Blaming others for unacceptable thoughts and feelings

Young adult blames his substance abuse on his parents refusal to buy him new car

Front 21

Denial

Back 21

Pretending the trust is not reality to manage the anxiety of acknowledging what is real

Front 22

Normal Anxiety

Back 22

Healthy life force that is necessary for survival, normal anxiety motivates ppl to take action. Ex: potentially violent situation occurs on the mental health unit - nurse moves rapidly to defuse situation. Anxiety experienced by nurse during situation helped him perform quickly+efficiently.

Front 23

Acute State Anxiety

Back 23

Level of anxiety precipitated by an imminent loss or change that threatens one's sense of security. Ex: sudden death of loved one

Front 24

Chronic Trait Anxiety

Back 24

Usually develops over time - often starting in childhood. Adult who experiences this may display that anxiety in physical symptoms - fatigue and frequent headaches

Front 25

Mild Anxiety

Back 25

Occurs in normal experience of every day living
Increases one's ability perceive reality
Identifiable cause
-->Vague feeling of mild discomfort, impatience, apprehension

Front 26

Moderate

Back 26

Occurs when mild anxiety escalates
Slightly reduced perception + processing of info occurs, and selective inattention may occur
Ability to think clearly is hampered, but learning and problem solving may still occur
Concentration difficult, tiredness, pacing, increased HR and RR

**PT usually benefits from the direction of others

Front 27

Severe Anxiety

Back 27

Perceptual field greatly reduced w/distorted perceptions
Learning and prob solving don't occur
Confusion, feelings of impending doom, aimless activity

**PT not usually able to take direction from others

Front 28

Panic-Level

Back 28

Markedly disturbed behavior
PT not able to process what is occuring in the environment and may lose touch w/reality
PT experiences extreme fright + horror
Dysfunction in speech, inability to sleep, delusions, and hallucinations

Front 29

Management of Milieu refers to

Back 29

management of the total environment of the mental health unit in order to provide the least amoutn of stress, while promoting the greatist benefit for all PTs

Front 30

Goal Of Milieu for PT

Back 30

While in this environment - PT will learn tools necessary to cope adaptively, interact more effectively and appropriately, and strengthen relationship skills.

Front 31

Orientation Phase

Back 31

Nnurse: introduce self + state purpose
-set contract meeting time, place, frequency, duration, and date of termination
-Discuss confidentiality
-Build trust by establishing expectations + boundaries
-Set goals w. PT
-explore PT's ideas, issues, and needs
-explore meaning of testing behaviors

Front 32

Working Phase

Back 32

Nurse: Maintain relationship as stated contract
- Perform ongoing assessment
- Facilitate PT's expression of needs + issues
- Promote PT's self-esteem
- Explore/deal with restistance/ dm's
-rec transference/contertransferance

Front 33

Termination Phase

Back 33

Nurse: provide opportunity for PT to discuss toughts/feelings about term
-Discuss PT's prior experience w.separation + loss
- Elicit PT's feelings about therapeutic work in the nurse-PT relationship
-Summarize goals+Acheivements
-Discuss ways for PT to incorporate new healthy behaviors into life
-Maintain limits of final termination

Front 34

Blurred Boundaries

Back 34

Occur if relationship begins to meet needs of nurse rather than PT, or if relationship becomes social rather than therapeutic

Front 35

Transference

Back 35

When PT views member of HC team as having characteristics of another person has been significant to PTs personal life

-->sees nurse as mom, treats like own mom
**Transference by PT is more liekly to occur w/a person in authority

Front 36

Countertransference

Back 36

When HC team member displaces characteristics of people in her past onto PT

reminds of friend she hates - treats like it

Front 37

Acute Care Settings for Mental Health Care

Back 37

Provide intense treatment+supervison in locked units for PTs w/severe mental illness
Helps stabilize mental illness symptoms and promotes the PT's return to the community
*Private or state owned

Front 38

Community Settings for Mental Heath Care

Back 38

Primary care provided in community-based settings - clinics, schools, daycare centers, partial hospitalization programs, drug/alc treatment facilities, forenscic settings, psychosocial rehab programs, telephone crisis counseling centers, and home health care

Front 39

Nurse's job in Community Care Program

Back 39

Help to stabilize/improve PT's mental functioning w/in a community and teach, support, and make referrals in order to promote positive social activities

Front 40

Nursing Interventions in Community Setting

Back 40

Provide for primary treatment and primary, secondary, and tertiary prevention of mental illness

Front 41

Factors affecting future of mental health care

Back 41

Increase in aging population
Increase in cultural diversity w/in US
Expansion of technology, which may provide new settings for client care, as well as new ways to treat mental illness more effectively

Front 42

Criteria to justify admission to acute care facility

Back 42

Clear risk of PT's danger to self or others
-FAILURE of community-based treatment
- Dangerous decline in mental health status of PT undergoing long-term treatment
- PT having a medical need in addition to mental illness

Front 43

Goals of Acute Mental Health Treatment

Back 43

Prevention of PT harming self/others
Stabilizing mental health crisis
Return of PT who are severely ill to some type of community care

Front 44

3 levels of implementing community care by Nurses for interventions/teaching

Back 44

Primary, secondary, tertiary

Front 45

Primary Prevention

Back 45

Promotes health and prevents mental health probs from occurring

ex: nurse leads group for parents of toddlers, discussing normal toddler behavior and ways to promote healthy development

Front 46

Secondary Prevention

Back 46

Focuses on early detection of mental illness

ex: nurse screens parents of children who have developmental disorders

Front 47

Tertiary Prevention

Back 47

Focuses on rehab and prevention of further probs in PTs previously diagnosed

ex: Nurse leads support group for PTs who have completed a chem dependency program

Front 48

Partial Hospitalization Programs

Back 48

Provide intense short-term treatments for PTs who are well enough to go home very night and have a responsible person at home to provide support and safe encironment.

*certain detox programs are a specialized form of this for PT who requires medical supervison, stress management, addiction counseling, and relapse prevention

Front 49

Assertive-Community Treatment (ACT)

Back 49

Nontraditional case management and treatment by an interdisciplinary team for a caseload of ptS W/SEVERE MENTAL ILLNESS WHO ARE NONCOMPLIANT w/trandition treatment

*helps to reduce reoccurences of hospitalizations and provides crisis interventions, assistance w/independent living, and info regarding resources for necessary support services

Front 50

Community Mental Health Centers

Back 50

Provide a variety of services for wide range of community PTs, including:
-Educational groups
- Medication dispensing programs
- Individual counseling programs

Front 51

Psychosocial Rehab programs

Back 51

Provide structured range of programs for PTs in a mental health setting:
residential services + day programs for older adults for whom care is probvided

Front 52

Home Care

Back 52

Provides mental health assessment, interventions, and family support in PT's own home. This is implemented most often for children, older adults, and PT with medical conditions.