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149 Cards in this Set

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Hippocrates Believed:
mental disorders were caused by natural causes and needed treatment
Dorothea Dix
retired teacher who worked to improve the care of people with mental illness
Sigmund Freud
(1856-1939)-founder of psychoanalysis.
Clifford W. Beers
contributed to the organization of the mental hygeine movement.
During what decade were psychotherapeutic drugs introduced?
1950's
Psychotherapeutic drugs:
placed emphasis on community based programs.
National Mental Health Act
(1946)-provided federal aid for research, training and community service.
Deinstitutionalization
A social policy where large numbers of people with mental illnesses moved out of state hospitals into the community.
What became of most of the deinstitutionalized once they got out into the community?
They became homeless or were put into nursing homes.
What were the main concepts of deinstitutionalization?
Rehab and long term care with severe mental illnesses.
Nurses role in mental health setting?
To assist patient to understand the cause of his/her illness and help restore health. Select appropriate care sites through triage.
What does triage include for the mentally ill?
Helps determine the level of care and appropriate sites and it includes the assessment of patient, family, home environment and available community and financial resources.
Goal of inpatient hospitalization?
To restore coping ability ASAP!
When are clients hospitalized for their mental illness?
When they are at risk of harming themselves or others or if their environment cannot continue to support them, or if they are emotionally vulnerable and cannot cope.
Advantages of Inpatient hospitalization?
Interventions are planned and predictable and it results in earlier discharge.
What are the five vital questions to ask a mentally ill person?
Any allergies? Are you feeling like hurting yourself or others? Are you hearing or seeing things that others cannot? Why did you come to the hospital and did you come voluntarily? What meds are you taking or supposed to be taking?-when were they last taken?
What are the admission statuses?
Voluntary,emergency hold, transportation hold, district court hold, assessment hold, and court commitment.
What does voluntary mean?
Person comes to the hospital voluntarily.
What does emergency hold mean?
Placed by a physician for 72 hours for evaluation of those who may be dangerous to themselves or others. 72 hours does not include the weekends.
What does transportation hold mean?
Person was placed by police to bring to the hospital in an emergency.
What does district court hold mean?
Placed before a judge before a preliminary hearing.
What does assessment hold mean?
Placed by court to assess if the person is mentally competent to stand trial for a crime.
What does court commitment mean?
Usually to a state, VA hospital, county hospital, chemical dependency treatment or other care facility for treatment.
What does it mean to be admitted under a no-information status?
The person does not want anyone to know they are there and no information is given out to anyone. Flowers and mail are not delivered. High profile clients are admitted under an alias.
When is discharge planning usually started?
ASAP!
Who is a part of the Mental Health Treatment Team?
Psychiatrist, Registered Nurse, LVN/LPN, Psychologist?
What does Milieu mean?
Total environment, the entire environment, regardless if it is therapeutic or not.
What does Milieu Therapy mean?
Turning the client's environment into a therapeutic mechanism.
What does Milieu Therapy focus on?
Focuses on participation of clients and staff at all levels to include adaptive coping, interaction, and relationship skills.
What are the five components of therapeutic milieu?
Containment, structure, support, validation, and involvement.
What are the three major populations that may be treated in outpatient or community settings?
Physically disabled or elderly who need home care, people with non-disabling mental disorders who can still work, and individuals who are psychiatrically disabled.
What does the Community Mental Health Act emphasize?
That a community mental health center should be accessible to the community it serves.
Who do centers serve?
A certain geographic area called a catchment area.
How long do you have to travel to the mental health center?
Up to but not exceeding one hour.
What five basic services does the community mental health center provide?
Inpatient treatment, outpatient treatment, partial hospitalization, emergency services, and consultation and education services to community agencies, groups ot individuals.
What other services may the mental health center provide that aren't basic?
Diagnostic services, rehablititation services, precare and after care, training programs, and research and evaluation.
If the center provides the five basic services plus the "non-basic" services, what are they called?
A Comprehensive Mental Health Center.
About how much of the homeless population is mentally ill?
Nearly half.
Has home care nursing increased or decreased in the last decade?
It has increased.
What is this shift in response to?
This shift of nursing into the home care fields is in response to insurance programs and managed care programs.
What is the support for the home health client?
Family, Social Network, Social System.
What is the role of the family?
The family is a blood relative of a client or may be individuals who are not related but live in the same home and help support the client.
What is the role of the Social Network?
Social support are people who provide support but do not live in the home with the individual.
What is the Social System?
Individuals, family and social network including the environment of the client.
What is the core value of mental health home care nursing?
To return the individual to a pre-crisis level of functioning within his/her normal social environment.
What is triangulation and should a nurse avoid it?
A social dynamic where conflict begins with two people, but a third person becomes involved. A nurse should avoid triangulation in order to avoid further conflict.
What type of position are physically or mentally ill people in?
Dependant.
What should you do if a client discloses information and asks you not to tell?
You should verbally tell the charge nurse or director of the team and let them decide what to do.
What are the two exceptions to the protected right of confidentiality?
Duty to warn and duty to report child abuse. Never imply that information will be kept from the treatment team.
What are the five goals of psychiatric care?
Sense of control, participation in planning goals and intervention, encouragement to use strengths to deal with weaknesses, sharing observation of their abilities using positive reinforcement, and only positive reinforcement as long as it increases and maintains the positive behavior.
What is the most important goal in psychiatric care?
To help change attitudes.
What attributes do mentally healthy people have?
Purposefulness, accountability, creativity and commitment.
What attributes do mentally UNhealthy people have?
Loneliness, hostility, anxiety and dependence.
How is personality defined in Molsby's?
The composite of the behavioral traits and attitudinal characteristics by which one is recognized as an individual.
What stage serves as the building block for the foundation of personality development?
The infancy stage.
A person's personality forms as a result of interaction between what?
Environment and heredity.
Do newborn children have any concept of morality?
No.
What happens if a child is deprived and neglected and the lack of care continues?
The child will withdraw from reality and will not thrive.
What are values?
Principles and standards that have meaning and worth to an individual, family, group or community.
When does a child normally acquire values?
During their formative years and are the basis of much adult behavior and decision making.
What happens if a child experiences disturbing early experiences and unsatisfiable emotional needs?
It may lead to arrest or fixation of the normal growth of personality.
What is one of the most important processes in influencing personality?
Identification.
What are Maslow's Hierarchy of needs?
Physiologic, safety, love and belonging, esteem, sefl actualization.
What are the levels of awareness?
Conscious, Subconscious, and Unconscious.
What is the role of the Conscious?
Thinking, feelings and actions that a person can control.
What is the role of the Subconscious?
It is just below the immediate awareness, it is the storehouse for the memories.
What is the role of the Unconscious?
Thoughts, feelings, desires and memories that are repressed or closed to immediate awareness are stored here.
What is the ID?
Is the part of the personality concerned with pleasure and gratification of the self. Strives for satisfaction and pleasure.
What is the Ego?
The balance to the id. Mostly in touch with reality and keeps the id under control. Executive branch of personality because it uses reasoning to make decisions.
What is the Superego?
The conscience. The part of the personality that allows us to determine what is right, wrong, good, or bad.
What is the Oral Stage?
Birth to 18 months, focus of pleasure is on the mouth. Sucking and biting are favorite activities.
What is the Anal Stage?
18 months to 3/4 years, focus of pleasure is on the anus. Control of the bladder, rectum and anus provides pleasure and is parent pleasing. "Woohoo you used the potty!"
What is the Phallic Stage?
3-6 years and the focus is on the genitals. Learn sexual identity and awareness of genital area as source of pleasure.
What is the Latency Stage?
6-12 years, quiet stage in sexual development, child learns to socialize.
What are the Freud's four stages of psychosexual development?
Oral, anal, phallic and latency.
Who developed the psychosocial development theory?
Sigmund Freud.
Who developed the psychosocial theory?
Eric Erickson, a psychoanalyst who developed personality theory from observing children.
How many stages did Eric Erickson organize life into?
8-extending from birth to death.
What two major themes did Eric Erickson's philosophy rest upon?
1. The world gets bigger as we go along, and 2. Failure is cumulative.
What is a common belief among mental health experts about life experiences?
Experiences during the first 20 years of life have the most significant impact on personality.
What is the first stage of life in the psychosocial theory?
Early Infancy- birth to one year, trust vs. mistrust. Nurturing people build trust in newborn.
What is the second stage of life in the psychosocial theory?
Later infancy-1-3 years, autonomy vs. shame. Children view themselves as individuals, seperate from their parents, but still dependent on them.
What is the third stage of life in the psychosocial theory?
Early Childhood-ages 4-5 years, initiative vs. guilt. Ego and superego begin to develop. Child learns assertiveness and can manipulate the environment.
What is the fourth stage of life in the psychosocial theory?
Later Childhood-ages 6-11, industry vs. inferiority. Usually described as the "golden era" of childhood. Creativity and shyness develop. Begin to identify with same sex parents and with other children of same sex.
What is the fifth stage of life in the psychosocial theory?
Puberty and Adolescence-ages 12-20 years, Identity vs. Role Confusion. Decide who we are as individuals seperate from our family and as members of a wider society.
What is the sixth stage of life in the psychosocial theory?
Early Adulthood-ages 20-40 years, intimacy vs. isolation. Develop intimate relationship with another.
What is the seventh stage of life in the psychosocial theory?
Middle Adulthood-ages 40-60 years, generativity vs. stagnation. Focus is on establishing family and guiding the next generation.
What is the eighth and final stage of life in the psychosocial theory?
Late Adulthood-ages 60 and older, integrity vs. despair. Individual accepts own life as fulfilling, if not, he/she becomes fearful of death.
What are some influences on an individual?
Family and social environment.
What role does immediate family have in a person's life?
Into which a child is born, it is the nuclear family or family of origin.
What role does Open family have in a person's life?
Where people can develop as members of society with positive self esteem.
What role does Closed family have in a person's life?
Rigid and don't allow for changes in roles and patterns in the family.
What type of family do most people in psych settings come from?
Closed family.
What position in the home influences the way a person communicates and functions inside a family?
The sibling position.
What is the role of the oldest child in the family?
More responsive to criticism;more resposible;achieves consistently and behavior is more rigid.
What is the role of the youngest child in the family?
Usually more dependent, less achievement oriented and usually very charming.
What is the role of the middle child in the family?
More flexible and independent, easy going.
What are boundaries in the family setting?
Rules that keep the roles seperate from another family member.
What happens when a mentally ill person reenters a family after successful treatment?
Their family role is different and the family may have a hard timeaccepting the new role the successfully treated mentally ill person fills.
What is homeostasis?
A dynamic, ever changing state in which a system constantly works to maintain balance.
What are emotions?
Outward expressions or display of mood or feelings. Powerful motivations of behavior.
When does physiologic alteration often occur?
With a marked change of emotion regardless of whether the feelings are conscious or unconscious, expressed or unexpressed.
What is the fight or flight response a result of?
A result of sympathetic nervous system activation that prepares the body to address a challenge or flee from it.
What is anxiety?
A normal, almost helpful emotion that alerts one to potential danger. An uncomfortable feeling caused by internal conflict.
When is anxiety less likely to form?
When a person feels good about themselves.
What are the levels of anxiety?
Mild, moderate, severe and panic.
What happens in the Mild level of anxiety?
Occurs in the normal experience of everyday living. It increases one's ability to percieve reality. Vague feeling of mild discomfort, impatience and apprehension.
What happens in the Moderate level of anxiety?
Occurs when mild anxiety escalates. Slightly reduced perception and processing of information and selective inattention may occur. Concentration difficulties, tiredness, pacing, and increased heart and respiratory rate.
What happens in the Severe level of anxiety?
Perceptual field is greatly reduced with distorted perceptions. Learning and problem solving are not possible. Confusion, feelings of impending doom, and aimless activity. Cannot take direction from others.
What happens in the Panic level of anxiety?
Characterized by markedly disturbed behavior. Not able to process what is occuring in the environment and may lose touch with reality. Extreme fright and horror, dysfunction in speech, inablity to sleep, delusions, and hallucinations.
What is fear?
A feeling of dread associated with a specific identifiable cause.
What is aggression?
Emotion compounded of frustration, hate or rage.
What is anger?
Inborn emotional reaction to loss or violation. There are six predominant patterns of anger.
Identify the patterns of anger.
Justified, rage, hating anger, resentment, helpless anger, powerlessness.
What is justified anger?
Where a person feels in control and uses the angry feeling to correct what is wrong.
What is rage?
A state of expressed anger where a person loses all control.
What is hating anger?
An intense dislike for a person or situation marked by resentment/hostility or violence.
What is resentment?
A feeling of hostility or dislike as a result of percieved violation.
What is violence?
Unjust or unwarranted exertion of power that is fueled by anger.
What is helpless anger?
The person feels disempowered because they feel they cannot address their anger.
What is hopelessness?
Self perception where the person feels they have no choice or alternatives in their current life situtations.
What is powerlessness?
Self perception that one's own actions cannot change a current negative life situation.
Describe spiritual distress.
A distress within the self that leads one to question the meaning of one's life.
What is GAS?
General Adaptation Syndrome.
What are the three stages of GAS?
Alarm reaction, resistance or adaptation, and exhaustion.
What is the alarm reaction stage of GAS?
The body responds to a stressor and releases adrenaline. Once stress is removed the body goes back to normal.
What is the resistance/adaptation stage of GAS?
The body maintains resistance until the stressor disappears.
What is the exhaustion stage of GAS?
The body runs out of reserves of body energy and immunity and death may occur.
What are defense mechanisms?
Mental pressure valves to help people resolve mental conflicts, reduce anxiety, protect self esteem and maintains a sense of security.
What is Projection?
Unacceptable feelings or impulses transferred to another. Blaming others, "scapegoating".
Bob didn't get a promotion at work when he has been waiting on it for five years, he tells himself it is because his boss doesn't like him. This is an example of:
Projection.
What is Regression?
Emotionally returning to an earlier time in life where there is less stress.
A new baby is brought home and their six year old sister starts wetting herself and refusing to use the potty, this is an example of:
Regression.
What is displacement?
Transferring anger and hostility to another person or object that is percieved to be less threatening.
Tom loses his job without notice and when he gets home he verbally abuses his wife, this is an example of:
Displacement.
Sara began having sex with her boyfriend for the first time but feels bad about it, she spends hours lecturing about the perils of sex, this is an example of:
Reaction formation.
What is reaction formation?
Reacting to an impulse by repressing it and turning it into something else.
What is compensation?
Trying to compensate for a real or imagined weakness by showing a great deal of strength in another area.
Elaine wants to be a model, but feels she isn't attractive enough to be one, so instead she becomes a designer, this is an example of:
Compensation.
What is rationalization?
Logical sounding excuses to cover up thoughts or feelings.
Sam failed his A&P final and said he failed it because the teacher wrote bad questions, this is an example of:
Rationalization.
What is repression?
Unacceptable ideas, impulses, and memories are kept out of consciousness.
Sandra and her mother get into a fight and a week later she forgets her mom's birthday, this is an example of:
Repression.
What is sublimation?
Transforming unacceptable impulses into constructive more acceptable behavior.
A burglar teaches home safety classes, this is an example of:
Sublimation.
What is conversion reaction?
Emotional stress that is converted into physical complaints.
Chandra has nausea the night before the big exam, causing her to miss the exam. The nausea goes away after the scheduled exam, this is an example of:
Conversion Reaction.
What is orientation?
The person's ability to identify who they are, where they are and the date and approximate time.
How do you abbreviate orientation?
Alert and oriented X3.