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116 Cards in this Set
- Front
- Back
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Signs of Mental Health
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Functionality
Satisfactory Relationships Realistic Perception Ability to cope with stress and anxiety Self-Control |
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Signs of a mental illness
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DEFICITS IN FUNCTIONING
Culturally based Distored perceptions Physical Characteristics |
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PHYSICAL CHARACTERISTICS: (NEXT 11 SLIDES)
Appearance |
Approirate dress for climate or age
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Attitude
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Angry, sad, hostile
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Speech
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Quality or quantity
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Behavior
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eye contact, what they are doing
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Mood
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temperment
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AFFECT
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What you as the nurse sees...
Objective! |
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Thought process
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racing or blocked
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Thought content
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Approiriate reality, they think they are rich...
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Perceptions
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Hallicunations
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Insight
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Do they understand that they have an illness?
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Vegetative profile
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Mental/Coma status
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The classification system used to DX 5 axes
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DSM IV
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1st axis is the for _____ clinical dx including bipolar or szcherpherina
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Major Dx
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2nd Axis is for the ______ diagnosis which includes mental retardation or personality disorder
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Secondary
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3rd axis is for ______ medical condition
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General
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$th axis is _______ and environmental issues including being homeless
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Psychosocial
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5th axis is GAF which stands for ____- _________ ___ ________ which states that 100 is most functioning and 50 or lower is usally pt in psycho ward
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Global Assessment of functioning
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Nursing interventions includes active _______, anger _____, assertivesness training, behavior ________, body image enhancement or caregiver support.
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Listening
Control Management |
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More nursing interventions include:
Communication enhancement Delusion ________ Eating disorder Management Grief Work Hallinuation Management _____ control therapy Mileu therapy |
Management
Impulse |
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Delusion is a _____ fixed belief, while a hallination is due to the _____
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False
Senses |
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Impulse control training is when you begin to ____ sbout ways that worked in the past
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Talk
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Milieu therapy is when you ask...
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Are you safe?
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More nursing interventions include:
Mood Managment Role _________ Spiritual support Substance abuse treatment ______ prevention Teaching |
Enhancement
Suicide |
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Almost 1/3 of people admitted to the ward have an _____ ____ problem also
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Substance abuse
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Treatment modalities include Psycholotherapy, ______________, social services, art/music therapy, OT/RT and _________________
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Pharmocogical
ECT |
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The best way to treat is to use 2 types of modalities which are:
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Psychotherapy and Pharmacological
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Main side effect of ECT is
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Memory Loss
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A _________ gives the Dx
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Psychiatrist
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Admission is giving ONLY when there is an ___________ danger to hurt themselves or someone else or cannot take care of themselves
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IMMEDIATE
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2 ways to get into ward is by -
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voluntary and involuntary
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If you are admitted involuntary you have either a ECO or TDO...which is
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Emergency Custody Order
Temporary Detention Order |
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NGRI stands for
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Not guilty by reason of insanity
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The McNaughten test is when the person did not know the ____ or _____ of the act
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Nature or Quality
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The _________- _______ Act is when a person is impulsably driven to perform an act and it HAS TO LACK PREMEDIATION
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Irresistible impulse act
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The American Law Institutes Test lacks to appreciate ____ illness and they cannot conform to law
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Wrong
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When a patient is _____ is the only time that you can medicate against their will
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Violent
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The behavior of one family member effects all, so the family has to ____ goals for change
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Set
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These kind of families produce these things:
open to others permeable boundaries clear communication and generational lines power shared between parents autonomous thing and behavior warm and caring emotions values and beliefs |
Optimal or Functional Families
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_______ family communication includes:
Discounting (put downs) scapegoating (blaming others) Triangling passive -aggression |
Dysfunctional Families
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Autocratic Group Therapy
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Focus on leader, with low moral
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Democratice Group therapy
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Focuses on member
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Lassierez Faire Group therapy
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Anything goes, low moral
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Content oriented group
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works on goals
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Process oriented group
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focuses on relationships
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Mid-range group
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combo of content and process
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Educational groups
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How to take care of yourself
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Pavlov gave an ________ response ex: classical conditioning
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Unconscious
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Skinner gave the ____ response ex: operant conditioning
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Operant
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Cognitive behavioral deals with the pts interpretation of ______
ex: picture of cat looking at lion |
Self
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These are goals of ______ therapy:
Cost effective Increase coping Task oriented homework practical changes |
Cognitive
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Psychoanalytical model of treatment was developed by _____.
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Frued
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Freuds based thisto _____ a persons reality
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Distort
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Freud is based on:
Unconscious factors Treatment traces patterns to _______ Repression keeps experiences out of conciousness Id, Ego and Superego Stages of development |
Childhood
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Aviodance of disagreeable realties by ignoring or refusing to reconize them
"Important one" |
Denial
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Attributing one's thoughts or impulses to another person
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Projection
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Offering a socially acceptable or apprently logical explanation to justify or make acceptable otherwise unacceptable impulses, feelings, behaviors or motives
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Rationalization
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Intense identification in which a person incorporates qualities or values of another person or group into his own ego structure.
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Introjection
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Freuds defense mechanisms is based on a person denial that they have a _______
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problem
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Shift of emotion from a person or object to another
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Displacement
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Development of conscious attitudes and beahvior patterns that are opposite to what one really feels or would like to do
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Reaction formation
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Conscious counterpart of repression in which it intentional exculsion of material from consciousness.
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Suppression
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Acceptance of socially approved substitute goal for a drive whose normal channel of expression is blocked
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Sublimination
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People use symbols rather than direct
ex: giving a rose to show attention |
Symbolism
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Retreat to behavior characteristic of an earlier level of development
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Regression
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Involuntary exclusion of a painful or conflictual thought, impulse or memory from awareness
Ex: Husband doesn't recall hitting wife when pregnant |
Repression
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_____ are important for developing a childs personality
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Parents
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Peplau believed in the theraputic use of _____; self developed w/ primary relationship
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Self
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The existential model of treatment deals with ___ and ____. Rogers gives the unconditional positve regard
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Here and Now
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Mental illness is due to ______ in the brain
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Dysfunction
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Dysfunctions in the brain can be from:
Anatomical _____ Maldistribution of neurotransmitors Malfunction of biochemical pathways |
Abnormality
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Theraputic NPR principles focuses on the ______; it helps them understand behavior, explore problems and develop coping skills
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Client
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Theraputic NPR have mutually determined ____, and the nurse must remember to be accepting and nonjudgemental
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Goals
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Problems with NPR include _____ (missing appts, avoding topics, acting out, superficial talk), ______ (pt feels therapist looking at the as mother father figure and messes us relationship), and ________________ (nurse sees pt as a family member)
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Resistance, Transference, Countertransference
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Some other problems with NPR include _____ violations like:
distance gift-giving use of touch self-disclosure Value clash |
Boundary
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ALWAYS keep personal ______ out of communication
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Values
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3 phases of Therpautic NPR include:
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Orientation
working phase termination |
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The _____ phase is when you are the most active and this is when you give assessment and diagnosis
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Orientation
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The _____ phase is when outcome identification, planning and interventions come into play. This is when the pts talk
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Working
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The ______ phase is when you do your evaluation
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Termination
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Enhancers to theraputic communication include:
reflecting (Youre feeling tense and anxious, is this related to a converation you had last night) Clarifying (I am not sure what you mean) _____-ended questions (What are you thinking about) |
Open
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Ability to enter into the life of another person to accurately percieve his or her current feelings and their meanings and to communicate this understanding to the patient
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Empathy
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Nurse is open, honest, sincere person who is actively involved in the relationship
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Genuineness
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Also called non-possessive warmth or unconditonal positive regard
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Respect
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presentation of alternative ideas
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Suggesting
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Using specific terminology rather than abstractions when discussing the patients feelings, experiences and behavior
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Concreteness
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expression by the nurse of perceived discripences in the patients behavior
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Confrontation
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These are _____ to theraputic communication:
False reassurance minimizing/ belittling "WHY" Advising |
Blockers
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These are also blockers:
Agreeing or disagreeing _____-ended questions providing answerwith the ? Changing the subject Aprroving or disapproving |
Close
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Acute care setting are for _____ stabilization; preventrs self harm or harm to others
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crisis
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These 3 things give good clinical function
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Support, safety and structure
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Mangement of Milieu include:
Maintain theraputic for _____ and growth keep communication open and ______ Safety Communication between shifts |
healing
constructive |
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Psychiatric and medical side effects include: _____ and _____
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Diabetes and obesity
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Milieu does 2 things:
Sets limits on _____ and maladaptive behavior Teaches psychosocial skills |
Disturbing
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5 D's of disturbing behaviors in Milieu:
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Destructiveness
Disorganization Deviancy Dysphoria Dependence |
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Withdrawl from environment, obsessional behaviors, intrusiveness or hyperreligiosity
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Dysphoria
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Partial hospilation is ____ or can be ______
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Days or outpatient
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Partial hospilization is used for ______; to build communication and social skills
problem solving med monitoring education leisure-occupational skills |
Transition
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Treats patients in the community
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Community care setting
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PACT is a community care setting
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Program of assertive community therapy
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These are goals of _____ mental health:
maintance of stability client active in treatment improve ability to function work w/ family and community resources |
Community
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Nursing interventions include:
_____ access & boundaries Negotiate medication adherence Long-Term _______ Assist client in adequate self-care Assist client with services needed in community |
negiotate
Relationships |
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3 types of threats; ____ (get out of my face now), _______ (1 more time and I will...), _____ " last person who brought up my mom is in the cemetarry)
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Direct
Conditional Veiled |
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3 phases of the cycle of violence are; ______ building (abuser blames victim for problem), _____ (actual violence, tension released), _____ (wants to believe abuser is better)
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Tension Building
Expolsion Honeymoon |
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These are ______ about violence:
"Its nobody elses business" She deserves it, "why doesn't she just leave" |
Misonceptions
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Characteristics of a ____ in domestic violence:
Poor impulse control extremely jealous lack of trust in others wide range of insecurities desire for control and power Hx of abuse as a child Drug/alcohol abuse |
Batterer
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Characteristics of the _____ of Domestic Violence:
Low Self-esteem Shameful or guilty depressed helpless or powerless fearful |
Surviover
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You ____ client and provide _____ for surviviors of domestic violence
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Educate
Resources |
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these are all signs of what?
Behavioral extremes fear of parent or caregiver hyperactive, ditractible, irritable lower school performance regression depressed disorganized slef-injourous substance abuse run away sexual acting out |
Child Abuse
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Physical problems in children with sexual abuse include:
STI bleeding soreness, itchness around genital and anus ________ __________ pregnancies |
UTI
Unintended |
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If child abuse is suspected always interview the child _______
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Separte
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20% of _____ are abused
Physical sexual psychological finicial neglect or abandonment |
Elder
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______ factors for elder abuse:
Dependent on others for ADL's physically impaired Self-Neglected Social Isolation Problematic behaviors Females greater at risk |
Risk
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S&S of elder abuse include
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physical injury
anxiety or fear hopelessness depression spiritual distress guilt poor self esteem |
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Characteristics of ______ in elders:
ill-prepared personal life in disarray |
dependent upon survivior for money
abused as child Hx of violence poor coping and communication skills |
