Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
95 Cards in this Set
- Front
- Back
|
Axis I
|
Clinical Disorders (Major depression
|
|
|
Axis II
|
Personality disorders/mental retardation
|
|
|
Axis III
|
General medical condition
|
|
|
Axis IV
|
Psychosocial and Environmental Problems
|
|
|
Axis V
|
Global Assessment of Functioning
|
|
|
Psychoanalytic
|
Freud
|
|
|
Freud Stages of Personality Development
|
Oral, Anal, Phallic, Latency, Genital
|
|
|
Oral
|
birth to 18 months Relief from anxiety through oral gratification
|
|
|
Anal
|
18 months - 3 years Learning independence and control w/focus on the excretory function
|
|
|
Phallic
|
3-6 years Identification with parent of same sex, development of sexual identity
|
|
|
Genital
|
13-20 yrs Libido reawakened as gental organs mature, focus on relationships
|
|
|
Id
|
Locus of instinctual drives-"pleasure principle" Impulsive and irrational
|
|
|
Ego
|
Rational self. Mediator between external world, Id, and the superego
|
|
|
Superego
|
"perfection principle" Internalizes values and morals
|
|
|
Hippocrates
|
Disturbance of 4 body fluids and its disruption. Hot, cold, dry & moisture. Yellow bile, Black Bile, Blood, Phlegm
|
|
|
Aristotle
|
Mind and heart
|
|
|
Greek
|
Breathing bad air. Tx place in temple w/ fresh air, sunshine, pure H20 and listening to waterfall
|
|
|
Roman
|
Mentally ill could not enter into any contracts
|
|
|
Middle Ages
|
Alientation, Seclusion & Confinement Tx-starvation, torture, blood letting, beheadings, hanging, burning & exorcism
|
|
|
1800's
|
Still being tortured & executed for mentally ill
|
|
|
Bethlehem Royal Hospital
|
1st hospital. Patients tortured in public. Spectators paid admission to watch.
|
|
|
Dorthea Dix
|
Crusade for humane care of mentally ill
|
|
|
McLean Hospital, Massachusetts
|
1882, First psychiatric training school for nurses
|
|
|
Clifford Beers
|
1908, wrote book describing his years as psych patient, increased public awareness
|
|
|
Linda Richards
|
1915, First graduate psychiatric nurse in the U.S.
"First Psychiatric Nurse" |
|
|
Battle Fatigue
|
WW2..sleeplessness, battle dreams, anxiety, tremors, loss of appetite. Increased public awareness of mental illness
|
|
|
"Open Door Policy"
|
Phenothiazine therapy led to less violent, more responsive patients..released out of hospitals and treated outpatient.
|
|
|
Community Mental Health Centers Act of 1963
|
"deinstitutionalization movement" Out of huge rural state mental hospitals and into community centers/support services
|
|
|
Protection and Advocacy Bill for Mentally Ill Individuals Act of 1981
|
Bill of Rights for Psychiatric Patients
|
|
|
Mental Illness
|
clinically significant behavioralor psychological syndrome or pattern that occurs in a person and that is associated with present distress or diability. Abnormal response to stressors.
|
|
|
Nursing Malpractice-Negligence
|
1. Failure to act in acceptable way.
2. Failure to conform to standards of care. 3. Approximate causes 4. Actual damage occurs |
|
|
Informed Consent
|
Supports client's right to autonomy and self determination
|
|
|
Involuntary admission
|
Read rights, file petition. Right to court hearing within 72 hours.
|
|
|
Restraints
|
Orders must be reissued:
<9 yo. q hour 9-17 yo q 2h >18 yo q 4h |
|
|
Conditions Essential to Development of a Therapeutic Relationship
|
Rapport, Trust, Respect, Genuineness, Empathy
|
|
|
Phases of a Therapeutic Nurse-Client Relationship
|
Pre-interaction: Obtain information
Orientation (introductory) Working Termination |
|
|
Transference
|
Nurse reminds client of something or someone
|
|
|
Countertransference
|
Client reminds nurse of something or someone
|
|
|
SOLER
|
S-sit squarely facing client
O-Observe an open posture L-Lean forward toward client E-Establish eye contact R-Relax |
|
|
Interpersonal Theory
|
Sullivan
Infancy, childhood, juvenile, preadolescence, Early adolescence, late adolescence |
|
|
Trust vs Mistrust
|
birth to 18 months
|
|
|
Autonomy vs shame and doubt
|
18 months to 3 years
|
|
|
Initiative vs guilt
|
3-6 years
|
|
|
Industry vs inferiority
|
6-12 years
|
|
|
Identity vs role confusion
|
12-20 years
|
|
|
Intimacy vs isolation
|
20-30 years
|
|
|
Generativity vs stagnation
|
30-65 years
|
|
|
Ego integrity vs despair
|
65 years - death
|
|
|
Theory of object relations
|
Phase I: Austic phase
Phase II: Symbiotic phase Phase III: Seperation-individuation |
|
|
Peplau Nursing Model Roles
|
Resource person
counselor teacher leader technical expert surrogate |
|
|
Peplau Four stages of development
|
Stage 1: Learning to count on others
Stage 2: Learning to delay satisfaction Stage 3: Identifying oneself Stage 4: Developing skills in participation |
|
|
Limbic system
|
"emotional brain" associated with fear and anxiety; anger and aggression; love, joy and hope; sexuality and social behavior
|
|
|
Acetylcholine Functions
|
Implicated in sleep, arousal, pain perception, coordination of movement, memory acquisition and retention
|
|
|
Possible implications of acetylcholine for Mental Illness
|
Role in disorders of motor behavior and memory (Parkinson's, Huntington's, Alzheimer's) Increased levels associated with depression
|
|
|
Norepinepherine (monoamine)Functions
|
Role in regulation of mood, in cognition and perception, cardiovascular functioning and in sleep and arousal
|
|
|
Possible implications of Norepinepherine for Mental Illness
|
Implicated in mood disorders such as depression and mania, anxiety states, schizophrenia. Increased levels lead to mania, anxiety states and schizophrenia. Decreased in depression
|
|
|
Dopamine functions
|
Regulation of movements and coordination, emotionsand voluntary decision making ability
|
|
|
Possible implications of Dopamine for mental illness
|
Decreased levels implicated in Parkinson's and depression. Increased are associated with mania and schizophrenia
|
|
|
Serotonin functions
|
Play role in sleep and arousal, libido, appetite, mood, aggression and pain perception
|
|
|
Possible implications of Serotonin for mental illness
|
Increased levels implicated in schizophrenia and anxiety states. Decreased levels have been associated with depression
|
|
|
Milieu Therapy
|
Manipulate the environment so that all aspects of the client's hospital experience are considered therapeutic.
|
|
|
Psychiatrist
|
Leader of Interdisciplinary team. Responsible for dx and tx of mental disorders. Performs psychotherapy, prescribes medication.
|
|
|
Clinical psychologist
|
Conducts individual, group and family therapy. Administers, interprets and evaluates psychological tests that assist in the diagnostic process.
|
|
|
Psychiatric Clinical Nurse Specialist
|
Conducts individual, group, and family therapy. Presents educational programs for nursing staff
|
|
|
Psychiatric nurse
|
Provides ongoing assessment of client condition, both mentally and physcially. Manages the therapeutic milieu on a 24-hour basis. Adminsters meds. Focus on one-one relationship development
|
|
|
Mental health technician/psychiatric aide
|
Functions under supervision of psych nurse. Provides assistance to clients to fulfill ADLs.
|
|
|
Psychiatric Social Worker
|
Conducts individual, group, and family therapy. Concerned with client's social needs such as placement, financial support and community requirements. Works with family, client to ensure discharge requirements are fulfilled.
|
|
|
Occupational therapist
|
Works with client to develop or redevelop independence in performing ADL
|
|
|
Recreational therapist
|
Use recreational activities to promote clients to redirect their thinking or to rechannel destructive energy in an appropriate manner.
|
|
|
Music therapist
|
Encourages clients in self expression through music.
|
|
|
Dietician
|
Plans nutritious meals for all clients. Works on consulting basis for clients with specific eatcing disorders.
|
|
|
Chaplain
|
Assesses, identifies, and attends to the spiritual needs of clients and their family members. Provides spiritual support and comfort.
|
|
|
General Adaptation Syndrome
|
Physiologic response of a biological system to a change imposted on it.
|
|
|
G.A.S.-Alarm Reaction Stage
|
Fight or flight. Increased HR, BP, R; decreased GI motility, pupil dilation, diaphoresis
|
|
|
G.A.S.-Resistance Stage
|
Adapt to stressors. Ability to adapt dependent on your physical functioning, coping ability of stressors.
|
|
|
G.A.S.-Exhaustion Stage
|
Adaptive ability is exhausted after prolonged exposure to stressors.
|
|
|
Hardiness
|
Clear sends of personal values/goals, Increased interaction with environment, sense of meaningfulness, internal locus of control
|
|
|
Sense of Coherence
|
Enduring tendency to see one's live as ordered, predictable and manageable.
|
|
|
Reticular Activating System
|
network of neurons involved with arousal & consciousness. Functions to maintain wakefulness and alertness.
|
|
|
Levels of Anxiety
|
1. Mild
2. Moderate 3. Severe 4. Panic |
|
|
Mild Anxiety
|
Prepares people for action, sharpens senses, increases motivation for productivity, increases perceptual field, heightened awareness.
|
|
|
Moderate Anxiety
|
Perceptual field diminishes, less alert, attention span and ability to concentrate decreases.
|
|
|
Severe Anxiety
|
Concentration is able to focus on one particular detail only or many extraneous details. Attention span extremely limited. Multiple physical symptoms (headaches, palpitations, insomnia)
|
|
|
Panic Anxiety
|
Most intense state of anxiety. Misperceptions are common, loss of contact with reality may occur. May experience hallucinations or delustions.
|
|
|
Ego Defense Mechanisms
|
Mechanisms employed by the ego to relieve anxiety such as: compensation, denial, displacement, identification, intellectualization, introjection, etc.
|
|
|
Compensation
|
Covering up a real or perceived weakness by emphasizing a traint one considers more desireable. Ex. handicapped boy can't play football, compensates by becoming a great scholar
|
|
|
Denial
|
Refusing to acknowledge the existence of a real situation or the feelings associated with it. Ex. Women drinks alcohol daily, can't stop, refuses to acknowledge there is a problem.
|
|
|
Displacement
|
Transfer of feelings from one target to another that is considered less threatening or that is neutral. Ex. Client angry at doctor, does not express it, yells at nurse instead.
|
|
|
Repression
|
Involuntary blocking unpleasant feelings and experiences from one's awareness. Ex. Accident victim can't remember anything about the accident.
|
|
|
Suppression
|
Voluntary blockage of unpleasant feelings and experiences from one's awareness. Ex. Don't want to think about it, I'll think about it tomorrow.
|
|
|
Introjection
|
Integrating the beliefs and values of another individual into one's own ego structure. Ex. Children integrate parent's value system to their own.
|
|
|
Undoing
|
Symbolically negating or canceling out an experience that ones find intolerable. Ex. Abusive husband buys flowers for wife.
|
|
|
Projection
|
Attributing feelings or impulses unacceptable to one's self to another person. Ex. Feels attraction to someone but says "they're coming on to me"
|
|
|
Conversion
|
Converts stress to a physical ailment.
|
|
|
Rationalization
|
Attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors. Ex. I drink because I have a bad job.
|
