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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
Freud Stages of Personality Development
Oral, Anal, Phallic, Latency, Genital
birth to 18 months Relief from anxiety through oral gratification
18 months - 3 years Learning independence and control w/focus on the excretory function
3-6 years Identification with parent of same sex, development of sexual identity
13-20 yrs Libido reawakened as gental organs mature, focus on relationships
Locus of instinctual drives-"pleasure principle" Impulsive and irrational
Rational self. Mediator between external world, Id, and the superego
"perfection principle" Internalizes values and morals
Disturbance of 4 body fluids and its disruption. Hot, cold, dry & moisture. Yellow bile, Black Bile, Blood, Phlegm
Mind and heart
Breathing bad air. Tx place in temple w/ fresh air, sunshine, pure H20 and listening to waterfall
Mentally ill could not enter into any contracts
Middle Ages
Alientation, Seclusion & Confinement Tx-starvation, torture, blood letting, beheadings, hanging, burning & exorcism
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.
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)
Nurse reminds client of something or someone
Client reminds nurse of something or someone
S-sit squarely facing client
O-Observe an open posture
L-Lean forward toward client
E-Establish eye contact
Interpersonal Theory
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
technical expert
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.
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.
Plans nutritious meals for all clients. Works on consulting basis for clients with specific eatcing disorders.
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.
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.
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
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.
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.
Involuntary blocking unpleasant feelings and experiences from one's awareness. Ex. Accident victim can't remember anything about the accident.
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.
Integrating the beliefs and values of another individual into one's own ego structure. Ex. Children integrate parent's value system to their own.
Symbolically negating or canceling out an experience that ones find intolerable. Ex. Abusive husband buys flowers for wife.
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"
Converts stress to a physical ailment.
Attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors. Ex. I drink because I have a bad job.