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;
104 Cards in this Set
- Front
- Back
|
What is MHW? |
Mental Health Worker |
|
|
What is MHN? |
Mental Health Nurse |
|
|
What is RPN? |
Registered Psychiatric Nurse |
|
|
Define Mental Illness |
A mental illness is a health problem that signifcantly affects how a person feels, thinks, behaves, and interacts with other people. |
|
|
How is mental illness diagnosed? |
It is diagnosed according to standardised criteria. The term mental disorder is also used to refer to these health problems |
|
|
What is another term for mental illness? |
Mental disorder |
|
|
Define mental health |
A state of complete physical, mental and social well‐being, and not merely the absence of disease |
|
|
What is the annual cost of mental health in Australia? |
20 billion dollars |
|
|
What percentage of Australians will have a mental disorder in any 12 month period? |
1 in 5 or 20% |
|
|
What percentage of Australians will have ONE mental disorder in any 12 month period? |
11.5% |
|
|
What percentage of Australians will have TWO OR MORE mental disorders in any 12 month period? |
8.5% |
|
|
What age range is usually when the peak onset of a mental illness occurs? |
Between 18‐24 years of age |
|
|
What is the estimated percentage of mentally ill homeless people? |
Estimated at 85% |
|
|
What age does most mental illness occur before? |
75% happens before the age of 24 years of age |
|
|
How many people per day commit suicide in Australia? |
6 people per day commit suicide in Australia (a further 30 attempt) |
|
|
What was Australia's suicide rate in 2010-2011? |
2,282 people |
|
|
What is the percentage of a lifetime prevalence for mental illness? (Ages 16‐85yrs) |
45% |
|
|
How many mental illnesses are there approx? |
260 |
|
|
What is MSE? |
Mental State Exam |
|
|
Why do we call a mental health patient a client? |
Consumer or client |
|
|
What is the most common mental illness? |
Anxiety disorders |
|
|
What % of Australians suffer psychotic illness ? |
3% |
|
|
What % of Australians suffer from an eating disorder? |
2% |
|
|
What % of Australians suffer from a substance use disorder? |
5% |
|
|
What is the annual cost of mental illness in Australia? |
Approx $20 Billion |
|
|
What % of the homeless are estimated to be mentally ill? |
85% |
|
|
What percentage of young Aussies say they are unhappy with their lives? |
25%/ 1 in 4 |
|
|
What % PA of Aussies are severely mentally ill? |
2-3% or 600,000 Aussies |
|
|
What % PA of Aussies are moderately mentally ill? |
4-6% or 1 million |
|
|
What % of Aussies are mildly mentally ill? |
9-12% or 2million |
|
|
What is recovery? |
Being able to live a life without mental illness affecting the individual. Having a meaningful life. |
|
|
What are some traditional concepts of mental illness? |
- Degenerative - Medicinal treatment - Not going to be successful/ independant/ living - Consumers are passive recipients of care |
|
|
What are some contemporary concepts of mental illness? |
- Recovery is non-linear - Treatment in community is best practice - Need for balance of symptom reduction and acceptable medication regimes agreed upon by the patient - Inability to return to pre-morbid levels is NOT failure |
|
|
What are some things to include in a recovery framework? |
- Culture of hope - Promoting autonomy and self-motivation - Collaborative partnerships - Meaningful engagement - Focus on strengths - Holistic and personalised care - Involvement of family, carers, support people and significant others - Community participation and citizenship - Responsiveness to diversity - Reflection and learning |
|
|
What makes recovery work? |
- Right help at right time for right duration - No judgement - Help everyone equally - Holistic approach - Treat client with respect, dignity and equality - Advocate consumer to take on competent roles - Protect rights - Provide support only when necessary - Encourage use of support services - Educate them on services access - Workers much support core values |
|
|
What is the first point of call for support for clients? |
Family, friends and carers |
|
|
What are some contributing factors to mental health and wellbeing? |
- Individual attributes and behaviours - Social and economic circumstances - Environmental factors |
|
|
Why are protective factors important? |
- Moderate the impact of stress and symptoms on holistic parts of a consumers life - Reduce development/exacerbation/relapses - Resilience in the face of adversity. |
|
|
What is a therapeutic relationship? |
"One which a pt feels comfortable being open and honest with the nurse and is linked to the development of a productive and positive pt outcome" |
|
|
What is involved in a MSE? |
Records findings between MHW and client recording.... - appearance - speech - motor activity - behaviours - alertness - mood - intelligence - cognition Observe strengths/weaknesses and vital signs |
|
|
What makes an MSE successful? |
- Respect pt - Choose environment/privacy/safety - Set goals - Avoid negative personal judgements - Tune into non-verbal cues - Be mindful of responses - Adopt a conversational approach - Be aware (cognizant) of your non-verbal communication skills (eye contact) |
|
|
How do you start an MSE? |
- Introduce self and designation (RN, student ect) |
|
|
What initial information do you get after introducing yourself etc? |
- Identify person and preferred name - Age / D.O.B - Present address/ phone number - NOK - GP / Psychiatrist - Serology (In case physical illness) - Obs - CT Scan |
|
|
What information is within an MSE? |
- Presenting data - Life events - Socioeconomic - Sexual history - A&OD history - Med history - Psych history - Family history - Forensic history - Work history - Values, spirituality, religious - History from family and previous admissions |
|
|
What is included in MSE regarding general appearance ? |
- First impression of client - Grooming / state of clothing - Weight - Clothing (Appropriateness -> Non judgemental) - Posture - Malodorous? - Age -> younger/older than they say? - Tattoos, nose rings etc (To identify people if they escape) - Glasses, hearing aids etc |
|
|
What is absconding? |
Running away |
|
|
What is in an MSE regarding behaviour? |
- Type and amount of movement (tics, grimace etc) - Hostility, anger, agitation (verbal / physical - are you at risk) - Psychomotor retardation (not moving) or Psych. agitation (restless) - Social skills (positive or unpleasant habits) - Degree of co-operation with interview |
|
|
Define mood |
SUBJECTIVE Is it congruent to what is observed Rate mood 1-10 Consider duration of the mood and does it match expressed topics. |
|
|
What can impact on mood? |
- Appetite (Increase or decrease) - Sleep |
|
|
What is an affect in regard to mood? |
An observable OBJECTIVE visual response (to a mood) |
|
|
What are some types of affects? |
- Appropriate - Restricted - Blunted (VERY restricted) - Inappropriate (doesn't match) - Labile (Changes a lot) |
|
|
What should we look for regarding speech? |
- Rate - Quantity of information - Quality - Volume |
|
|
What are some types of speech? |
- Pressured (in mania) - Rapid - Slow - Spontaneous - Garrulous/loquacious - Talkative - Dramatic - Monotonous - Loud - Whispered - Slurred - Staccato - Spontaneous - Mumbled - Poverty of speech - Disorganised - Latency |
|
|
Define garrulous / loquacious |
Excessively talkative |
|
|
What are the types of quantity of speech? |
Poverty of speech (Too few words) Poverty of content (lacks substance) Voluminous (too many words) |
|
|
What are the types of quality of speech? |
Confabulation |
|
|
What is involved with perception? |
Hallucinations Illusions Depersonalisation De-realisation |
|
|
What is a hallucination? |
A false sensory perception NOT involving external stimuli |
|
|
What is an illusion? |
A misinterpretation of a real external stimuli Usually in alcohol withdrawl |
|
|
What is depersonalisation? |
A feeling you are not yourself |
|
|
What is somatic hallucination? |
Believing something is wrong in your body when there isnt |
|
|
What is kinaesthetic hallucination? |
Not in control of own body, or feel they are being moved when they are not |
|
|
What is de-realisation? |
- Unreality or detached to surroundings / environment Others or surroundings may be seen as 'foggy' or 'dreamlike' |
|
|
What are the most common types of hallucinations? |
Audio and Visual |
|
|
How do you deal with a pt having hallucinations? |
- Do not argue - Trial and error approach (medication is not the first line) - Taking a walk / exercise - Talking to someone - Distraction - Social activity (talking to friend) - Low stimulus environment - Staying with client : emotional support and reality feedback - use of PRN meds anxiolytics / antipsychotics |
|
|
What should you look at regarding a client's thought content? |
Expressed ideas such as : - Risk of harm (self / others) - Antisocial thoughts, fantasies or urges - Phobias (excessive or irrational fears) - Preoccupations (illness/ symptoms) - Obsessions (repetitive, intrusive thoughts, images or impulses - Delusions |
|
|
What are delusions? |
Fixed false beliefs not shared by the general population |
|
|
What are some types of delusions? |
- Grandeur - Persecutory - Paranoid - Somatic - Nihilistic - Erotomanic - Religious |
|
|
What are the types of delusions of control? |
- Thought withdrawal - Thought insertion - Thought broadcasting - Thought control |
|
|
What is an erotomanic? |
is a type of delusion in which the affected person believes that another person, usually a stranger, high-status or famous person, is in love with them. |
|
|
What is a bizarre delusion? |
Unrealistic, unlikely and ridiculous delusions |
|
|
What is a non-bizarre delusion? |
Something possible that could happen |
|
|
What is form of thought? |
How thoughts are connected or expressed? Does it flow? Do they answer/reply with goal directed thinking or are they all over the place? |
|
|
What is formal thought disorder? |
Involves - Flight of ideas - Tangentiality - Circumstantiality |
|
|
What is loosening of associations? |
Poor progression of thoughts, ideas change rapidly and are unconnected Unrelated & unconnected ideas shift from one topic to another |
|
|
What is flight of ideas? |
- Continued flow of accelerated speech which changes abruptly - Can be based on environmental factors or understandable associations - Rapid thinking in its extreme |
|
|
What is tangentiality? |
- Indirect replies to questions in an irrelevant way - Digression may never get back to the topic, client goes "Off on a tangent" |
|
|
What is circumstantiality? |
A delay in reaching the goal due to the inclusion of excessive or irrelevant details |
|
|
What are some formal thought disorders? |
- Word salad - Neologisms - Clanging / Clang association - Punning - Thought blocking - Echolalia |
|
|
What is word salad? |
An incoherent mixture of words or phrases. |
|
|
What is a neologism? |
A newly created word (Like head-shoe for hat) |
|
|
What is clanging? |
words chosen for sound not meaning (Like rhyming) |
|
|
What is punning |
plays on words to sound funny eg/ like a homophone |
|
|
What is thought-blocking |
Abrupt gaps in the flow of thought |
|
|
What is echolalia? |
Imitating word of others; often mocking, repetitive and persistent |
|
|
What is sensorium & cognition? |
- Organic brain functioning and IQ - Insight - judgement - Cognition - Abstract and concrete thinking |
|
|
What is Insight? |
Ability to understand the reasons for and meanings of behaviour and feelings Capacity to gain an understanding of something |
|
|
What is judgement? |
Ability to understand consequences of actions eg/ I slap someone, I know they will be angry Ability to use previous learning in new situations |
|
|
What is involved in cognition? |
- Issues with consciousness usually involve organic brain impatient - Orientation (TPP) - Serial 7's or 3's (count back from 100 in 3's or 7's) |
|
|
What is DSH? |
Deliberate self-harm |
|
|
What do we need to be aware of in risk management and assessment? |
- DSH - Suicide - Interpersonal violence (to other pts or staff) - Property damage (Thrown tv's) - Absconding - Substance misuse - Vulnerability - Medication non-adherence |
|
|
What is a danger to the pt absconding? |
Apparently approx 20% of those pt's commit suicide |
|
|
What is ISOBAR? |
Identification Background Observation Situation Assessment and actions Responsibility and risk management |
|
|
What are the risk categories? |
- Constant (Arms length) Arms length at ALL TIMES One on one (special) 1 on 1 and always within RN vision - Intermittent May be several set times per hour or random lengths of time between observations Negotiated - Low risk pts - Negotiated frequency of engagement |
|
|
What is a code grey |
An aggression call |
|
|
What is a code black |
An aggression call when the pt has a weapon |
|
|
What % of hospital workers have suffered verbal abuse? |
95% |
|
|
What % of hospital workers have suffered physical abuse? |
35-40% |
|
|
Approx how many code greys can happen per year? |
over 13 thousand per year |
|
|
What % of assaults are NOT reported in the hospital? |
Approx 75%` |
|
|
In risk management, what do we need to identify? |
- Observations - Threats - Themes in conversations - Actions - Past history - Conversations with carers - Information provided by services - Thorough and frequent mental state exams |
|
|
In risk management, how do we manage a risk? |
- De-stimulate the area - Therapeutic interventions - Observations (15/60s etc)? - Documntation - Frequent communication between staff - Thorough hand-over - Obtaining guarantees - Restrictive interventions - Medication adherence techniques |
|
|
What is PAMSGOTJIMIR? |
Way to remember the steps of an MSE Perception Affect Mood and memory Speech General appearance Orientation Thought Judgement Insight Memory Intelligence Risk |
|
|
What is BATOMI-PJR? |
A way to remember the steps of a MSE Behaviour and appearance Affect Orientation Mood Perception |
