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60 Cards in this Set
- Front
- Back
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The first priority for any psychiatric patient is______________.
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Client Safety.
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In borderline personality, clients often experience chronic suicidal ideas. Therefore, the challenge for the nurse lies in____________.
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determining when suicidal ideas are likely to be translated into action
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It is not uncommon for borderline personalities to engage in what behaviors?
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cutting, burning, self-inflicted injuries; nurse can engage client in a no-self-harm contract to avoid this
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The idea behind no-self-harm contracts is that the client....
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is making a promise to themselves, not the nurse.
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The idea behind nursing interventions for borderline personalities is to help clients________________ and engage in __________________________.
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cope and control emotions, cognitive restructuring techniques
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If a borderline personality injures themselves, it is important to...
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deflect attention away from the actual physical act
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The nurse must use _________ and ________ in the nurse/client relationship.
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structure and limit setting (avoid giving client unlimited amount of access)
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In social relationships, borderline personalities have no concept of_____________.
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personal boundaries or realistic expectations of relationships
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Keeping a ____________ for borderline personalities helps them gain awareness of feelings.
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Journal
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What is cognitive restructuring?
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helps clients to recognize negative thoughts and feelings and replace with positive emotions.
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Borderline personalities have a real problem when they have what kind of time?
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Unstructured time, nurse must minimize unstructured time with activities
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When has treatment been effective in borderline personalities?
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When clients experience fewer crises less frequently over time.
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What is histrionic personality disorder?
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excessive emotion and attention seeking
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Feedback for histrionic people should focus on_______________.
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appropriate alternatives (when you embrace and kiss other people upon meeting them, they might interpret your behavior in a sexual manner, it would be more appropriate to...)
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Narcissistic personalities blame their problems on____________-
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The faults of others.
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Goal of nursing in narcissistic patients is to gain ____________.
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client cooperation, set limits on rude behavior, and explains expectations of client.
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In order for any pt to trust the nurse, the nurse must establish__________.
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a therapeutic nurse/patient relationship.
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In the initial stage of the nurse-client relationship, the nurse establishes ________ with the client to help the client feel safe and respected.
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Trust. Nurse must listen closely, make frequent visits, empathetic, understanding
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Using _________ statements in client interaction often puts client on the defensive.
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"why"
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What is compensation?
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overachieving in one area to offset deficiencies in another area
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What is conversion?
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Expression of emotional conflict through development of a physical symptom (i.e. blindness) and is totally unconcerned about the loss.
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What is denial?
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failure to acknowledge an unbearable condition or change behavior (ie. diabetic eating chocolate)
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What is displacement?
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ventilating feelings toward persons less threatening than one who aroused the feelings. (Mark yelling at me for something his boss did to make him mad)
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What is dissociation?
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dealing with emotional conflict by altering consciousness or identity (amnesia)
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What is fixation?
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failure to engage in proper age-appropriate behavior due to unsuccessful completion of developmental tasks (i.e. undelay of gratification)
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What is identification?
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modeling actions/opinions of others while searching for identity.
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What is intellectualization?
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Separation of emotions from painful situation (no emotions when discussing terrifying accident)
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What is introjection?
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accepting another person's attitudes as own (i.e. Aaron Young to a T)
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What is projection?
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unconscious blaming of unacceptable ideas/thoughts to an external object (a gay man beats a gay man)
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What is rationalization?
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Excusing one's own behavior to avoid guilt, responsibility, etc. (blaming teacher for failure)
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What is reaction formation?
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Acting opposite of what one thinks/feels (person who despises boss speaks well of him to others)
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What is regression?
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Moving back to previous developmental stage.
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What is repression?
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excluding painful/anxiety provoking thoughts from awareness (no memory from a mugging yesterday)
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What is resistance?
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antagonistic behavior toward remembering/processing anxiety producing information (nurse too busy to talk to dying pt)
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What is sublimation?
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Substituting an acceptable activity for an impulse that is unacceptable (chewing on hard candy instead of smoking)
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What is substitution?
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replacing desired object with one more readily available (woman who wants kids opens a daycare)
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What is suppression?
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conscious exclusion of unaccept. thoughts/feelings from awareness (student decides not to think about parent dying to study for test.)
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What is undoing?
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exhibiting acceptable behavior to make up for non-acceptable behavior (cheats on spouse brings roses to her)
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What happens in trust vs. mistrust (infant)?
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views world as safe/reliable, relationships nurturing and dependable
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What happens in intimacy vs. isolation (young adult)?
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works to form adult, loving relationships and attachments
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What happend in initiative vs. guilt? (prschool)
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development of conscience, managing conflict and anxiety
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What happens in identity vs. role confusion (adolescence?)
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forming sense of love and belonging
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What happens in Generativity vs. stagnation?
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Being creative and productive
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What happens in ego integrity vs. despair?
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accepting resp. for one's self and life
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What happens in industry vs. inferiority?
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confidence in own abilities, taking pleasure in accomplishments
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What happens in autonomy vs. shame and doubt?
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achieving sense of control and free will.
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What illnesses are anti-psychotics used to treat?
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schizophrenia and bi-polar
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What is the action of anti-psychotics?
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dopamine blocker
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Thorazine, Serentil, and Geodon are contraindicated in people with what condition?
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prolongation of QT interval
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When giving Clozapine, what is the primary concern?
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Low WBC counts
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When giving anti-psychotics, what do you give to decrease EPS symptoms?
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Cogentin
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What is dystonia?
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muscle rigidity, stiffness, diff swalling, possible respiratory distress
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What do you give if a client has a dystonic reaction?
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Benadryl, cogentin, ativan or valium
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During the first 1-2 weeks of therapy, what condition can form?
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Neruroleptic Malignant Syndrome.
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What are the hallmarks of NPS?
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rigidity, high gever, unsable BP, diaphoresis, delerium, high Creatinine
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What illnesses do anti-depressants target?
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anxiety/depression
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What are some symptoms of serotonin syndrome?
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agitation, sweating, fever, tachycardia, hypotension, rigidity
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What type of approach do you take with a client who has paranoid personality disorder?
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formal, business-like, keep commitments, straightforward, formulate plan of care with client, help them to validate ideas b4 taking action
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Schizoid personalities are people who are ___________ from social relationships.
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detached, indifferent, no pleasureable activities
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People with antisocial disorder are lacking with what behaviors?
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lack of insight, inability to delay gratification, are impulsive
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