N126 Exam 1 Set 2

Front 1

Anxiety

Back 1

sense of dread relating to an unspecified danger or loss
Normal anxiety

Front 2

Normal anxiety

Back 2

healthy life response that provides the energy to handle life

Front 3

Acute anxiety

Back 3

temporary response to loss of security. Example: anxiety before an exam

Front 4

Chronic anxiety

Back 4

persistent anxiety not related to any actual problelm

Front 5

4 levels of anxiety

Back 5

mild, moderate, severe, panic

Front 6

Assessing a patient’s level of _____ is a basic requirement for successful therapeutic intervention in any setting

Back 6

anxiety

Front 7

Mild anxiety

Back 7

*Heightened perceptual field, grasps all aspects of environment, able to identify anxiety producing issues
*Works effectively, problem solves
*restless, impatient, mild tension-relieving behaviors (tapping foot, nail biting)

Front 8

Moderate Anxiety

Back 8

*narrowed perceptual field, Needs help to focus, selective inattention
*problem solves (not optimally), guidance from others helps
*shakiness, urinary frequency & urgency, increased pulse, more extreme tension-relieving behaviors (pacing)

Front 9

Severe Anxiety

Back 9

*tunnel vision, not able to attend to events in environment even when pointed out *unable to see connections, distorted perceptions *feelings of dread/impending doom, confusion, intense somatic symptoms (D/N/HA), tachycardia, loud and rapid speech, demanding attitude

Front 10

Panic Level Anxiety

Back 10

*unable to focus, may have hallucinations/delusions.
*disorganized, irrational thinking
*sense of terror, agitation or immobility, mute or unable to speak in an understandable way, severe shakiness

Front 11

Mild to Moderate Anxiety Interventions

Back 11

Calm voice
Use exploring and clarification techniques to help patient focus on the problem causing distress
Explore previously successful ways of relieving anxiety
Provide outlets for working off excess energy

Front 12

Severe to Panic Anxiety Interventions

Back 12

Remain calm and stay with the person
Minimize environmental stimuli
Use simple clear statements
Set limits to keep person safe
Medication may be needed

Front 13

Denial

Back 13

escaping unpleasant realities by ignoring them, this is an Immature Defense Mechanism

Front 14

Denial maladaptive example

Back 14

A woman whose husband dies 3 years ago keeps his clothes in the closet and talks about him in the present tense

Front 15

Displacement

Back 15

transferring emotions to something non-threatening, this is an Intermediate Defense Mechanism

Front 16

Displacement maladaptive example

Back 16

A child who is unable to acknowledge fear of his father becomes fearful of animals

Front 17

Dissociation

Back 17

A disruption in the usually integrated functions of consciousness, memory, identity, of perception of the environment. It may result in separation of feeling and thought.

Front 18

Dissociation maladaptive example

Back 18

As a result of an abusive childhood and the need to separate from it;s realities, a woman finds herself perpetually in a world where she feels disconnected from reality

Front 19

Projection

Back 19

rejecting unacceptable personal traits and attributes them to another (blaming)

Front 20

Projection maladaptive example

Back 20

A woman who has repressed an attraction toward other women refuses to socialize. She fears other women will make homosexual advances toward her.

Front 21

Rationalization

Back 21

justifying unreasonable ideas, actions, or feelings through “acceptable” explanations. An Intermediate Defense Mechanism

Front 22

Rationalization maladaptive use

Back 22

A man who thinks his son was fathered by another man excuses his malicious treatment of the boy by saying, "He is lazy and disobedient," when that is not the case

Front 23

Reaction formation

Back 23

overcompensation, an Intermediate Defense Mechanism

Front 24

Reaction formation maladaptive use

Back 24

A woman who has unconscious hostility toward her daughter is overprotective and hovers over her to protect her from harm, interfering with her normal growth and development... or "What a beautiful baby!"

Front 25

Regression

Back 25

behaving at a less mature level, an Immature Defense Mechanism

Front 26

Regression maladaptive use

Back 26

A man who loses a promotion starts complaining to others, hand in sloppy work, misses appointments, and coms in late for meetings

Front 27

Repression

Back 27

bury memories of stress unconsciously, an Intermediate Defense Mechanism

Front 28

Repression maladaptive use

Back 28

A woman is unable to enjoy sex after having pushed out of awareness a traumatic sexual incident from childhood

Front 29

Splitting

Back 29

inability to combine the (+) and (-) aspects of people, an Immature Defense Mechanism

Front 30

Splitting maladaptive use

Back 30

A 26 y/o F has difficulty maintaining close relationships. Despite the fact that she can initially find many positive qualities about new acquaintances, eventually she becomes disillusioned when they turn out to be flawed

Front 31

Sublimation

Back 31

substituting constructive activity for unacceptable impulses, a Healthy Defense Mechanism

Front 32

Sublimation maladaptive use

Back 32

None- it is always constructive

Front 33

Suppression

Back 33

deciding to ignore stressor temporarily, an Intermediate Defense Mechanism

Front 34

Suppression maladaptive use

Back 34

A woman who feels a lump in her breast shortly before leaving for a 3 week vacation puts the information in the back of her mind until after returning from her vacation

Front 35

Undoing

Back 35

When a person makes up for an act, an Intermediate Defense Mechanism

Front 36

Undoing maladaptive use

Back 36

A man with rigid, moralistic beliefs and repressed sexuality is driven to wash his hands to gain composure when around attractive women

Front 37

Altruism

Back 37

stressors met by meeting the needs of others, a Healthy Defense Mechanism

Front 38

Humor

Back 38

deal with stressors by finding the humor in them, a Healthy Defense Mechanism

Front 39

Acting out behaviors

Back 39

Behaviors that originate on an unconscious level to reduce anxiety and tension. Anxiety is displaced from one situation to another in the form of observable responses

Front 40

Passive aggression

Back 40

indirect aggression against others often through procrastination or inefficiency
. ie- making "mistakes", forgetting

Front 41

Rosa is pacing up and down and can only concentrate on her cat. She has a headache and is nauseated. What is her level of anxiety?

Back 41

Severe

Front 42

Your patient is in the ED after a car accident. He is confused and keeps leaving his room to wander about. What should you do?

Back 42

Remain calm and stay with the person, minimize environmental stimuli, use simple clear statements, set limits to keep person safe, medication may be needed

Front 43

A woman really dislikes babies but she always pays lots of attention to her friends’ children. This is an example of:

Back 43

Reaction formation or overcompensation

Front 44

A man is reprimanded by his boss for poor work. He goes home and yells at his children. This is an example of?

Back 44

Displacement

Front 45

Parents of a cancer victim raise money for cancer research. This is:

Back 45

Altruism

Front 46

Theories help us explain _____. They also help us design methods of addressing those _____.

Back 46

phenomena
phenomena

Front 47

____ ______ is considered the founder of psychiatry.

Back 47

Sigmund Freud

Front 48

PSYCHOANALYTIC THEORY - developed by

Back 48

Freud

Front 49

Freud stages called

Back 49

Psychosexual stages of development

Front 50

Ego

Back 50

Self- reality principal

Front 51

Id

Back 51

Pleasure principal, unconscious urges and desires (I want it and I want it now)

Front 52

Superego

Back 52

Ego ideal, moral guardian (conscience)

Front 53

Freud focused on interpersonal, intrapersonal, or extrapersonal?

Back 53

intrapersonal

Front 54

Therapeutic Model

Back 54

Psychoanalysis Therapy involved “free association,” dream analysis, therapeutic transference, and years of therapy

Front 55

Sullivan

Back 55

Focused on interpersonal relationships, Actively challenge maladaptive behaviors

Front 56

BEHAVIORAL THEORY

Back 56

Pavlov, Watson, Skinner
-All behavior is learned
-works best when directed at specific problem

Front 57

What types of therapies did Behavioral therapy apply?

Back 57

Behavior modification, Systematic desensitization, Aversion therapy, Biofeedback

Front 58

Behavior modification

Back 58

uses operant conditioning to change behavior- used + rewards to get a desired response/behavior

Front 59

Systematic desensitization

Back 59

reverses learned responses by promoting relaxation and gradually facing stressful stimulus (like getting used to an airplane)

Front 60

Aversion therapy

Back 60

negative event paired with something the patient likes (cigarette cessation- puff=shock)

Front 61

Biofeedback

Back 61

learn to control physiological responses

Front 62

COGNITIVE THEORY

Back 62

Beck & Ellis
-Seeks to modify negative thoughts, which lead to dysfunctional behavior
-Schema & automatic thoughts

Front 63

Automatic thoughts

Back 63

All or nothing thinking = thinking in absolutes
Jumping to conclusions = making judgments without proof

Front 64

Schema

Back 64

assumptions about ourselves, others, and the world; Common negative ones are incompetence, abandonment, vulnerability

Front 65

Automatic thoughts AKA

Back 65

cognitive distortions

Front 66

These are rapid responses that just “pop” into people’s heads in response to everyday encounters. Also known as “cognitive distortions.”

Back 66

Automatic thoughts

Front 67

THERAPEUTIC MODEL

Back 67

How you feel or do to what you think *ABC model *talk out negative thoughts and give alternatives to those thoughts

Front 68

Assertiveness and role playing- to learn more positive ways of thinking, Recording dysfunctional thoughts- journals *These are activities that would fall under which model?

Back 68

Therapeutic model

Front 69

ABC model

Back 69

A = activating event
B = belief about the activating event
C = Consequence of belief
D = disputing irrational beliefs

Front 70

BIOLOGICAL MODEL

Back 70

Genetic predisposition, Environmental influences (toxins), Diatheses-stress model

Front 71

Diatheses-stress model

Back 71

biologic and environmental issues together- it is a complex mix of things biologic and environmental issues together- it is a complex mix of things

Front 72

Med therapy and ECT as therapies fall under which model?

Back 72

Biological Model

Front 73

____ described 4 major stages of cognitive development giving clues to how to approach patients at different phases in their life

Back 73

Piaget

Front 74

_______ described the social development of people and gave us the concept of maturational crisis

Back 74

Erickson

Front 75

_______ described a hierarchy of needs. Useful in determining priority but does not translate well to psychiatric care

Back 75

Maslow

Front 76

________ described 3 major stages of moral development.

Back 76

Kohlberg

Front 77

Cognitive Development

Back 77

Piaget- stages of cognitive development, gives clues about how well the person is thinking

Front 78

Psychosocial Development

Back 78

Erickson- has to do with social interactions in the world

Front 79

Humanistic Theory

Back 79

Maslow- hierarchy of needs- helpful to determine priority of needs. Not as helpful in psych care as in med surg.

Front 80

Moral Development

Back 80

Kohlberg- Just know he is a moral theorist

Front 81

Peplau

Back 81

Nurse-patient relationship; work with the patient rather than doing things to them; be aware of internal feelings to avoid role blurring; think of the patient as a person

Front 82

Milieu Therapy

Back 82

designed for the hospital- hospital environment needs to have a healthy social structure- to support healthy/normal behavior

Front 83

Types of groups in the hospital

Back 83

Groups include community meetings, improve social interaction, education, decrease social isolation, support groups, self-help groups, medication education, health education, etc.

Front 84

Do groups benefit Everyone?

Back 84

Patients with distortions of reality do not do well, whereas people who feel isolated often benefit from the sense of not being alone.

Front 85

Group Leader Roles

Back 85

Autocratic, Democratic, Laissez-faire

Front 86

Who leads groups?

Back 86

Basic RN level

Front 87

Member roles in groups

Back 87

Task roles, Maintenance roles, Individual roles

Front 88

What is a task role?

Back 88

serve to leep the group focused on it's main purpose and get the work done (energizer, coordinator, recorder)

Front 89

What is a Maintenance role?

Back 89

function to keep the group together, help each person feel worthwhile, and create a sense of group cohesion (harmonizer, encourager, follower)

Front 90

What is an Individual role?

Back 90

these have nothing to do with helping the group but instead relate to specific personalities, personal agendas, and a desire to have needs met by shifting the group's focus to them (blocker, aggressor, dominator)

Front 91

Families teach about management

Back 91

issues of power, financial management

Front 92

Families teach about Boundaries

Back 92

how members are separated from one another, relating to one another and how close and distant we should be to certain people/situations, how to talk to elders, personal space, etc.

Front 93

Emmeshed

Back 93

way to involved with one another and not enough boundaries- feel that one person knows what other members are thinking, etc., smothered.

Front 94

Families teach about Communication

Back 94

ways to relaying messages; clear and direct best- how to speak, how to get your point across. When communication is messed up causes resentment and manipulation.

Front 95

Double Bind Messages

Back 95

one person gives permission for an act but in next sentence makes person feel guilty about doing said act

Front 96

Families give emotional support

Back 96

affection versus anger- people coming from angry atmosphere leads to a negative angry person

Front 97

Genograms key will include

Back 97

Male/Female
Identified Pt
Death, miscarriage, divorce
Relationship lines: close, close/conflictual, conflictual, and distant

Front 98

cognitive-behavioral therapy

Back 98

based on learning theory; focuses on changing cognition and behavior

Front 99

free association

Back 99

A psychoanalytic technique for investigation of the unconscious mind, in which a relaxed subject reports all passing thoughts without reservation (Freud)

Front 100

Defense Mechanism

Back 100

A mental process (e.g., repression or projection) initiated, typically unconsciously, to avoid conscious conflict or anxiety. (Freud)

Front 101

Negative reinforcement

Back 101

A type of operant conditioning, The removal of an unpleasant consequence following a desired behavior

Front 102

Positive reinforcement

Back 102

An instrumental or operant conditioning procedure in which the behavior is followed by a positive stimulus or reinforcer

Front 103

Operant conditioning

Back 103

Also called learning by reinforcement or behaviour modification. Focuses on rewards and punishments and the effect that they have on behaviour.

Front 104

Subconscience

Back 104

Experiences, thoughts, feelings, and desires that are not in immediate awareness but can be recalled to consciousness.

Front 105

5 functions of the family?

Back 105

Management
Boundaries
Communication
Emotional Support
Socialization

Front 106

Types of boundaries in the family

Back 106

Clear boundaries = well understood separation
Enmeshed = blurred boundaries, interfere with each other too much, mind reading
Rigid = too strict and don’t adapt to new situations

Front 107

Dysfunctional types of family communication?

Back 107

Double bind messages, manipulation

Front 108

Differentiation

Back 108

refers to the ability of the individual to establish a unique identity while remaining emotionally connected to the family of origin

Front 109

Family Systems Theory

Back 109

Aims to decrease emotional reactivity and encourage differentiation among individual family members

Front 110

Genogram

Back 110

A systematic diagram of the three-genereational relationships within a family system

Front 111

Multigenerational Issues

Back 111

various family patterns passed down through the generations

Front 112

Nuclear Family

Back 112

A family that includes a parent or parents and the children under the parents care

Front 113

Scapegoating

Back 113

A member of the group or family who becomes the target of others' aggression but who may not be the actual cause of their hostility or frustration

Front 114

Phases of group?

Back 114

Same as nurse/pt- orientation, working, and termination ohases

Front 115

Conflict

Back 115

open disagreement among members (positive conflict resolution within a group is key to successful outcomes)

Front 116

feedback

Back 116

letting group members know how they affect each other

Front 117

closed group

Back 117

a group in which membership is restricted; no new members are added when others leave

Front 118

group norms

Back 118

expectations for behavior in the group that develop over time and provide structure for members (starting on time, not interrupting)

Front 119

group process

Back 119

the dynamics of interaction among the members (Who talks to whom, facial expressions, body language)

Front 120

open groups

Back 120

a group in which new members are added as others leave

Front 121

Psycho-educational groups

Back 121

groups set up to increase knowledge or skills about a specific somatic or psychological subject and allow members to communicate emotional concerns

Front 122

Support groups and Self-help groups

Back 122

are structured for the purpose of providing patients with the opportunity to maintain or enhance personal and social functioning through cooperation and shared understanding of life's challenges

Front 123

Catharsis

Back 123

Intense feelings, as judged by the member, are shared