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57 Cards in this Set

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What is the Mental Health Continuum? (Notes)
- Mental Health Status Can be in a Range and Fluctuate
- Mild, Moderate, Severe, Psychosis
What is Mental Health? Mental illness? (P.5)
- Mental Health – Knowledge of Self; Meets Basic Needs; Assumes Responsibility for Behavoiur and Self-Growth; Maintains Relationship, Communicates Directly with Others

- Mental Illness – Person has Distorted View of Self; Unable to Maintain Personal Relationships; Unable to Adapt to Environment
What Does the ANA State About the Focus of Psychiatric Nurses? (P.18)
- Diagnosis and Treatment of Human Response to Actual or Potential Mental Problems
- Uses Theories of Human Behaviour as Science and Purposeful use of Self as Art
- Basic Level – Health Promotion, Intake Screening, Community Action
- Advanced Level – Psychotherapy, Psychobiological, Medications
What are the Differences Between the Basic Psychiatric Nurse Clinician and the Advanced Practice Nurse? (P.19,8)
- Basic – Works with Individuals Families, Communities, Groups to Promote Health, Assess Dysfunciton, Assist Clients to Regain or Improve Coping, and Prevent Disability

- Advanced – Full Range of Activities Mental Health Promotion, Illness Care, Diagnosis and Treatment of Mental Disorder; Provides Psychotherapy; Prescribes Medication
Review the History of Mental Illness; What Advances Took Place in the 20th Century? (P.17)
- American Psychiatric Association Established a Committee on Training Schools
- Johns Hopkins Taught Psychiatric Care in Nursing
- In 1930’s Somatic Therapy, Deep Sleep, Insulin Shock, and Electroshock
- In 1946 Congress Passed NIMH; Provides Funds for Education & Research
- Coming of Age came with way Mental Illness was Viewed and Treated
- Progression as Treatment from Confinement to Therapy
What is a Theory? A Conceptual Framework, a Concept? (P.26)
- Theory – Way to Abstract or Generalize Knowledge for Individual Circumstances
- Theory – Set of Interrelated Concepts that Provide Testable Relationships and Direction
- Theory – Group of Concepts Linked together to Understand Phenomenon
- Concepts – Basic Building Blocks of a Theory
- Conceptual Framework – Group of Concepts Linked to Provide Organizing or Viewing
Describe Freud’s Framework? (P.40)
- Personality – (Id, Ego, Superego)
- Stages of Psychosexual Development (Oral, Anal, and Phallic)
Describe Piaget’s Framework, Maslow’s, Erickson’s? (P.42, 44, 47)
- Piaget – Stage Theory of Cognitive Development
- Maslow – Hierarchy of Needs to Promote Human Behaviour
- Erickson – Psychosocial Development; Development Emphasis on Social Growth
Who was Hildegarde Peplau? (P.27)
- Described Nursing as Therapeutic Interpersonal for Growth of Nurse and Patient
- Three Phases of Nursing (Orientation, Working, and Termination)
What is the DSM-IV TR? (P.75)
- Updated Version in 2000 by American Psychiatric Association
- Text Revision Emphasizes Incremental Changes; Diagnosis and Criteria Unchanged
- Description of Diagnosis has Changed
- Five Axis of Assessment
What is the ICD-9/CM? (P.72)
- Comprehensive Listing of Clinical Diagnosis with Unique Numerical Code
- Clinical Modification – Accommodates More Complex Diagnostic Coding
What is the NANDA Taxonomy of Nursing Diagnosis? (P.76)
- Statement of Phenomenon of Concern to Nurses
What are NIC and NOC? (P.82)
- Nursing Intervention Classifications – Activities Nurses Carry Out to Assist Client Status or Behaviour
- Nursing Outcomes Classification – Relates Diagnosis; Interventions; Outcomes
What are the Advantages of Computerization of Health Records? (P.82)
- Frequent Availability or Paper Records
- Reduce Costs; Increase Revenues
- Prevents Loss
What is Physical Space Between People? How Does this Effect Boundaries? (P.91)
- Space Two Between People has Great Meaning in Communication
- Four Zones in North America
- Public – 12ft; Social 9-12ft; Personal 18in – 4ft; Intimate <18in
- Use Space Between Persons to Understand & Interpret Non-Verbal Behaviours
Review all Therapeutic Communication Techniques? (P.93)
- Listening, Silence, Broad Openings, Restating, Clarification, Reflection, Focusing
- Informing Suggestions, Confronting
Define the Nursing Process? (P.96)
- Way of Thinking that Allows Nurses to Reflect on Care and Work in Organized Manner
What are Common Defense Mechanisms how are they Used? (P.94)
- Unconscious Responses Used to Protect Self from Internal & External Stressors
- Denial, Projection, Repression, Rationalization, Introjection, Displacement
- Reaction Formation, Regression, Suppression, Sublimation, Symbolization
What is the Difference Between Transference and Counter-Transference? (P.723)
- Transference – Clients Reflect on Therapists in ways Reflecting Own Past Experiences
- Counter Transference – Nurses Experience Strong Emotions Towards Client
What are the Steps in the Nursing Process? (P.96)
- Assessment, Nursing Diagnosis, Outcomes, Planning/Interventions, and Evaluations
What is Outcome Identification? (P.98)
- Each ND Must be Identified with Specific Outcomes (Short & Long Term)
What is the Johari Window how does it Relate to You as a Person and a Nurse? (Notes)
- Known to Self and Others; Known Only to Others
- Known Only to Self; Know Neither to Self Nor Others
- “Healthy Person” is Known to Self and Others
Define and Give Descriptions of Each Phase of the Nurse Client Relationship? (P.100)
- Preinteraction – Look Into Chart; History
- Orientation – Get to Know and Establish Trust
- Working – Implementing Interventions to Achieve Outcomes
- Termination – End of Relationship Because Client has Achieved Independence
Define Culture, What is the Effects of Culture on Therapeutic Management in Psychiatric-Mental Health Care? (P.106, 108)
- Culture- Complex whole, Including Knowledge, Belief, Art, Morals, Law, Custom
- If Clients Belief System is Different then Effect of Treatment Must Be Considered
What is Cultural Blindness? (P.107)
- Misguided Attempt to Treat All Persons Fairly by Ignoring Differences
- Acting as if Differences Don’t Exist
What Communication Barriers Must be Overcome when the Client and the Nurse do not Speak the same Language? (P.111)
- Non-Verbal Communications Must be Interperted
- Translators Must Know Must Be Culturally Aware Not Simply Translate Language
What is a Controlled Trial? A Blinded Trial? Double Blinded Trial? (P.120)
- Controlled Trials – Epidemiological Studies Conducted Like True Experiments
- Blinded – Subjects Do Not Know if they are Receiving Treatment or Placebo
- Double Blinded – Neither Subject or Person Evaluating Know
What is Interrater Reliability? (P.122)
- DSM Diagnosis have Substantial Agreement Between Different Evaluators
- Accord on Diagnosis Between Different Evaluators on the Same Examination
What is an Epidemiological Study? (P.120)
- Controlled Clinical Trials Conducted Like True Experiments
What is the Tip of the Iceberg Phenomenon? (P.125)
- Many Persons have Symptoms but Few Seek Care
What is Epidemiology? Epidemic? Endemic? (P.120)
- Epidemiology – Study of Causes and Distribution of Injuries
- Epidemic – Disease that Spreads within a Population
- Endemic – Constantly and Regularly Found in Population
What are Neurotransmitter? What Effects do they have in Mental llness? (P.62, Notes)
- Neurotransmitters – Unique Chemical Messengers that Travel from Axon of One Cell to Dendrite of Another

- Dopamine – Too Much Schizophrenia; Too Little Parkinsons & Depression
- Norepinephrine – Too Much Mania & Anxiety; Too Little Depression
- Seratonin – Too Much Axiety; Too Little Depression
- Gaba – Too Much Reduces Anxiety; Too Little More Anxiety
- Ach – Too Much Depression; Too Little Parkinsons & Alzheimers
- Histamine – Too Little Depression
Review Basic Brain Anatomy know Functions of Thalamus Limbic System, Hypothalamus, Cortex, Cerebellum? (P.56-58)
- Thalamus – Relays Wide Range Sensory Input to Cerebral Cortex; Critical Structure for Consciousness
- Hypothalamus – Central Brain Structure Involved in ANS and Endocrine System; Plays Role in Nervous Mechanisms Underlining Moods and Motivational States
- Cortex – Part of Brain Consisting of Four Lobes: Frontal, Temporal, Parietal, Occipital
- Cerebellum – Large Portion of Base of Brain; Coordinates Voluntary Movements
What Functions does the Brain Regulate? (Notes)
- Monitor External World
- Monitor Composition of Body Fluids
- Regulates Skeletal Muscle Contractions
- Regulates Internal Organs
- Regulates/Initiates Basic Drives
- Conscious Sensation
- Memory
- Mood
- Thought
- Regulates Sleep Cycle
- Language
What are the Differences Diagnostically between an MRI and a CT Scan? (P.59)
- Magnetic Resonance Imaging – Can Separate out Feature of the Brain (Magnetic Field)
- Computerized Tomography – Uses X-rays to Form Image
What does a PET Scan Measure? (P.192)
- Positive Emission Tomography
- Tool to Measure Blood Flow Patterns in the Brain
- Uptake of Neurotransmitters
How do Antipsychotic Medications Produce Desired Effects? (P.684)
- Bind to Specific Brain Receptor; Most Act on CNS; Specifically Bind to Dopamine
What are the Movement Disorders? Dystonia, Akathisia Oculogyric Crisis? Tardive Dyskinesia? (P.242, 689)
- Dystonia – Muscle Spasms Last Few Seconds to Days; Localized to Few Muscles
- Akathisia – Affects Motor Function and Behaviour
- Oculogyric Crsis – Extraocular Spasm Forces Eues to a Fixed Upward Gaze
- Tardive Dyskinesia – Troublesome Movement Disorder Found in Schizophrenia
What is the Older Terminology of Antipsychotic Medications? (P.686)
- Neuroleptic
What is a Therapeutic Window? (P. 887)
- Time for Peak Effectiveness of a Drug
What is a Half Life? (P.684)
- Time Required for Plasma Concentration to Decrease to Half of Initial Value
Where do Most Psychiatric Drugs Act? (P.688)
- Bind to Brain Dopamine Receptors;
- Produce Degree of Indifference to Internal and External Stimuli
- Ignore Stimuli but Respond to Pain
. Know Positive and Negative Symptoms and How they Respond to 1st and 2nd Generation Antipsychotic Medications? (P.686, 688)
- Positive – Hallucinations, Delusions, Disorganized Thought Process, Paranoia
- Negative – Withdrawl, Lack of Initiative, Failure to Maintain Hygiene
- Postive Symptoms Result in Socailly Disruptive Behaviours; Doing To
- Negative Symptoms Do Not Respond to Classical Antipsychotics; Withdrawing
- 1st – Associated with Movement Disorders
- 2nd -
What does it Mean High Potency and Low Potency? (P.686)
- High - Only Small Amount has Significant Antipsychotic Effects
- Low – Requires Larger Doses to Produce Significant Antipsychotic Effects
Know Neurotransmitters? What Disorder is Connected with Excess or Deficient Neurotransmitters?
See #32
Know Absorption Times i.e. Pills etc? (P.?)
- All Current Antipsychotics are Well Absorbed Given Orally & Intermuscular Injection
- Oral 1 to 4 hrs; Injection 15 to 30 min
Know the Differences Between Long Acting and Short Acting Preparations of Antipsychotic Medications? (P.688)
- Short Acting – Antipsychotic Meds are well Absorbed 15-30 min Injection; 1-4 hrs PO
- Have Effect of 24 hrs or Less

- Long Acting – Long Duration of Action; Given by Injection Only
- Manufactured as Preparation of Sesame Oil
- Oil Slows Diffusion Into Adjacent Muscle
- However Once Diffused Becomes Rapidly Dissolved
Know Major Classifications of Drugs: for example Mood Stabilizers, Antipsychotics, Stimulants? (P. 684, David, Google)
- Mood Stabilizers – Used to Treat Mood Disorders
- Depression (Antidepressants); Mania (Mood Stabilizers)
- Antipsychotics – Control Symptoms of Psychosis such as Hallucinations
- Controls Bizarre or Paranoid Behaviour
- Stimulants – Drugs Increase Activity of SNS and Produce Sense of Euphoria
Know Downside of Taking TCA’s? (P.692)
- Tricyclic Antidepressants
- First Clinical Antidepressants; Used to Treat Mood Disorders
- “Dirty Drugs” Act on Many Receptor Systems
- Cause Blurred Vision, Dry Mouth, Rapid Heart Rate, Constipation, Urinary Retention
Why is Clozaril a Dangerous Drug to Take? (P.243, 686)
- Occasionally and Severely Causes Agranulocytosis
- Death of WBCs that is Fatal in Certain Clients
- Comes at the Risk of Life-Threatening Bone Marrow Depression
What is Lithium, How is it Used? What are the Side Effects? What Cautions must you take with this Drug? (P.700)
- Used to Prevent and Control Mania

- Side Effects Include Thirst and Polyuria
- Also Causes Termors which Effect Fine Motor Activities
- Chronic Diarrhea Can be a Sign of Early Toxicity

- Cardiotoxic and Not Used in 1st Trimester of Pregnancy
- Interacts with Body Sodium Metabolism
What is Serotonin Syndrome, Neuroleptic Malignant Syndrome? (P.695)
- Rare and Potentially Dangerous Interaction with MAOI
- Caused by SSRI and MAOI Interaction
- Agitation, Sweating, Rigidity, Fever, Hyperreflexia, Coma, or Death
What do You Need to Watch Out for with MAOI’s? (P.697)
- Inhibit Metabolism and Detoxification of Biogenic Amines
- Injestion May Cause Severe Stimulation of Nervous System Pathways
- Sympathomimetic Drugs Available OTC Must be Avoided
- Avoid Foods Containing Tyramine (Cheese, Salami, Sauerkraut, Beer, Yeasts, etc…)
- Avoid Beverages Such as Beer & Red Wines
What Problematic Interactions with Drugs Can Interfere with Antipsychotic Medication?
- Sorry, Can’t Find it Either
What are the Signs and Symptoms of Angranulocytosis? (P.701)
- Loss of Functioning Polymorphonuclear White Blood Cells
- Leads to Serious Infections
- Persons Require Wekly Testing of Blood Counts & Often of Liver Enzymes
What are SSRI’s What are Side Effects of these Drugs, What do they Treat? (P.694)
- Selective Seratonin Reuptake Inhibitors
- First-Line Medications for Moderate Depression
- Obsessive Compulsive Disorders; Bulimia; PMS
- Inhibit Reuptake of Seratonin After Release into Neural Synapse
- Long Elimination Half-Life of 2 wks
What are MAOI’s? What Cautions Must You Take with these Drugs? (P.696)
- Used to Treat Depression; Has Dangerous Reactions with Certain Drugs & Foods
- Should be Used Only with Highly Motivated Clients
- Works by Blocking Monoamine Oxidase which Metabolises (Norepinephrine, Serotonin, Dopamine)
- See # 53