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90 Cards in this Set
- Front
- Back
What is the goal of treatment in mental health?
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To treat in the least restrictictive environment.
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What are some sites of mental health care?
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Hospital, crisis stabilization unit, outpatient setting, home, free standing psych hospitals.
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Name the members of the interdisciplinary team.
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Patient, Nurse, Psychiatrist (physician), Social Worker, Clinical Psychologist, Pastoral Counselor, Occupational Therapist, Physical Therapist.
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What does the case manager do?
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Makes sure the patient shows up for appointments, takes meds, etc.
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What is a community mental health agency?
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Where people go who are medicated but not hospitalized. Counseling is available, job training, alcohol/drug rehab.
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What are 3 patient hospitalization goals?
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Stabilize behavior
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What is the role of the physician in the interdisciplinary team?
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Serves as leader of the team. Responsible for diagnosis and treatment of mental disorders. Performs psychotherapy, prescribes medication.
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What is the role of the nurse in the interdisciplinary team?
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Provides ongoing assessment of clients condition, mental & physical. Manages the therapeutic milieu. Administers meds. Assists clients w/ therapeutic activities as required.
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What is the role of the social worker in the interdisciplinary team?
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Conducts therapy. Concerned w/ client's social needs, such as placement, financial support, community requirements. Works with client and family to meet discharge needs.
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What is the role of the clinical psychologist in the interdisciplinary team?
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Conducts individual, group and family therapy. Administers, interprets & evaluates psychological tests.
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Steps in the Interdisciplinary Treatment Plan.
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Initial assessment is made by the admitting psychiatrist, nurse, ets. A treatment plan is initiated in the first 8 hours. The IDT Plan is reviewed w/in 24 hours.
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What is the number one priority for the nurse managing the milieu?
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Safety
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Some properties of a social relationship.
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Non-threatening
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Some properties of an intimate relationship.
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More involved
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Some properties of a therapeutic relationship.
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Nurse-client
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The basis of all therapeutic relationships
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Caring
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Elements of the Jaharia window
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Know yourself, Others know you, Things hidden from others, Things hidden from self
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What is rapport?
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Establishing a comfortable relationship with the client. Sharing, talking.
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What is trust?
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People willing to expose themselves to others. Information is confidential.
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What is respect?
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Unconditional regard for the person regardless of their behavior or inappropriate ways of dealing with life.
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What is genuineness?
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Truthfulness, not fake.
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What is empathy?
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The ability to walk in someone else's shoes and know where they're coming from.
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What are some types of boundaries?
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Flexible, rigid, diffuse, loose, enmeshed,
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4 Stages of a therapeutic encounter.
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Preinteraction
Orientation Working Termination |
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What is transference?
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When a current relationship triggers an old relationship memory. (You remind the client of someone)
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What is countertransference?
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When the patient reminds the nurse of someone.
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What are the 2 components of communication?
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The sender and the receiver contribute.
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3 types of communication
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Verbal (speech)
Non-verbal (body language) Paralanguage (tone of voice, etc.) |
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Name 6 listening skills
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Be on same level (sit with client)
Maintain good eye contact Maintain proper distance Sit open to the client Don't use a table Keep non-judgmental face |
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Technique - Reflecting content and feeling
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Is there something you'd like to talk about?
Share with me how your pass went. Where would you like to begin? |
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Technique - Exploring
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C: I'm confused about this
N: You're confused? C: My brother has the nerve to ask me for money. N: Asking for money makes you angry? |
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Technique - Exploring
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And then?
Tell me about it? |
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Technique - observe feelings
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You sound very upset with this situation. You appear tense.
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Technique - using silence
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Encourage a person to speak by waiting.
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Technique - offering self
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I'll stay with you a little while
I would like to sit with you for a while. |
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Technique - Restating
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C: I have so much to do. I take care of the house and 3 kids. I work part-time. How can you expect me to fit in 30 minutes for relaxation exercises?
N: It's hard for you to see how you could fit one more activity into your busy day. |
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Technique - giving information
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May name is...
Visiting hours are... My purpose in being here is... I'm taking you to the... |
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Technique - Clarifying
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I'm not sure that I follow.
What would you say is the main point of what you said? |
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Technique - Presenting reality
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I see no one else in this room.
That sound was a car backfiring. I don't hear any voices other than yours and mine. |
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Technique - summarizing
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Have I got this straight?
You've said that... During the past hour you and I have discussed... |
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Technique - Making observations
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Good morning, Mr. Jones.
I see you showered this morning. |
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Technique - Encouraging continuation
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Yes.
Uh Hum. I follow what you said. Nodding. |
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What is an assessment?
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A collection/interpretation of data.
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How often is a mental status exam done?
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Every shift
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Words that can be used for appearance.
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clean, showered, dirty, odor, slumped, upright, dressed gaudy, etc.
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Motor activity assessment.
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Observe gait
Lithium gives ataxic gait (unbalanced) observe body activity (tremors, calm) |
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Speech assessment
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Observe how thought processes are coming together. Observe quantity and quality.
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Poverty of speech
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Client talks very little.
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Pressured speech
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Client talks very fast, under force. Seen in manic depressive people.
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Retarded speech
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Very slow speech. Seen in depressed people.
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Hesitant speech
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Client speaks slowly and stops occasionally.
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Blocking
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Client stops in mid-sentence. Loses train of thought. May indicate problems in thought process.
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Mood
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Sustained emotion over time
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Affect
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Facial expression
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Congruence
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Mood and affect match
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Incongruence
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Mood and affect don't match.
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Labile mood
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Mood changes frequently
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Behavior style
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cooperative, hostile, suspicious, guarded, friendly.
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Degree of interaction
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Withdrawn, quiet, talkative, seclusiveness, inwardly focused. Pay attention to who they interact with.
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Thought processes
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Organized
Loose - disorganized thoughts Word salad - sentences mixed up Tangential thinking - change topics |
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Flow of thought
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Normal, rapid (zooming), Racing thoughts - common in hypo manic or manic patients.
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Flight of ideas
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Many thoughts being said rapidly. Disorganized thoughts.
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Content
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Compare what the client says to reality. Reality is fluid - dependes on culture.
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Delusion
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A fixed belief that is not grounded in reality.
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How do we judge reality?
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Against common beliefs
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Religious Grandiosity
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Client believes they're God
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Somatic delusions
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Delusions of the body
(bugs inside, empty inside) |
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3 main types of mental illness
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Depression
Schizophrenia Mania |
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Illusion
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Data is interpreted incorrectly (magic)
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Hallucination
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Brain gets data that isn't there.
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Dementia quality
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Common to have visual hallucinations.
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Delirium quality
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Very common to have visual hallucinations.
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Schizophrenia quality
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Common to have auditory hallucinations.
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Psychosis
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Serious psychiatric disturbances characterized by the presence of delusions or hallucinations and the impairment of interpersonal functioning and relationship to the external world.
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Test for long term memory
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Who was the last president?
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What type of memory is lost in dementia?
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Short term memory is lost. Long term memory may remain intact.
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Concrete thinking
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Taking info. exactly how it is said. (Stole a base)
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Abstract thinking
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Take words and infer from them. Occurs at around age 8 or 9.
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Test for judgement.
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Letter under mailbox. What would you do if you won the lottery?
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What are some vegetative symptoms?
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Physical functions such as sleep, appetite, libido, excretory functions.
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6 factors that increase risk of suicide.
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Suicidal ideations
Suicidal gestures Family history Drugs/alcohol No support system Own a gun |
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Self concept
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Overall feeling of self. Body image, self esteem, personal identity.
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Spiritual life
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What gives meaning to your life. What helps you through trouble?
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Religion
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An organized group who share common beliefs.
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Aftercare Plans
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Where will the client go after they leave? Transportation, finances?
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Medical category Axis I
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Clinical psychiatric disorders. Include drug/alcohol problems - dual diagnosis.
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Medical Category Axis II
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Personality disorder and mental retardation.
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Medical category Axis III
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Significant medical conditions that impact recovery (diabetes, hypertension)
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Medical Category Axis IV
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Psychosocial/environmental problems.
Stressors - homelessness, divorce, children leaving home, etc. |
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Medical Category Axis V
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Global Assessment of Functioning GAF Scale of 1-100
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