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192 Cards in this Set

  • Front
  • Back
Attending
Therapeutic benefit of being available & present for pt's.
Clinical algorithms
Written plan or "map" identifying predetermined times that specific nursing & med interventions will be implemented. Step by step guidelines
Clinical practice guidelines
Medical guideline-document w/ aim of guiding decisions & criteria re/ diagnosis, mgmt, & tx in specific areas of healthcare.
Patient advocacy
Protection, promotion, & optimization of health & abilities, prevention of illness & injury, alleviation of suffering through diagnosis & tx of human response, & advocacy in care of individuals, families, communities, and populations.
Caring
Displaying kindness and concern for others; work or practice of looking after those unable to care for themselves
Clinical/critical pathways
Map of preferred treatment/intervention activities. Outlines types of information needed to make decisions, the timelines for applying that information, and what action needs to be taken by whom.
Evidence-based practice
Care that integrates latest & best available research.
Recovery model
Conceptual model of psych illness stresses hope, living a full and productive life, and eventual recovery.
Culture-related syndromes
Sets of S/S common in limited # of cultures but virtually nonexistent in most other cultural groups.
Multi-axial system
Forces a diagnostician to consider a broad range of information.
Stigma
Negative attitudes or behaviors toward a person or group, based on belief that they possess negative traits.
DSM
Diagnostic and Statistical Manual of Mental Disorders: classification of mental disorders that includes descriptions of diagnostic categories.
Resiliency
The ability to adapt and cope, which helps people face tragedies, loss, trauma, and severe stress.
GAF
Global Assessment of Functioning
Elopement
Escape or leaving a psych treatment facility w/o medical authorization or recommendation.
Occupational therapist
Treat pts w/ injuries, illnesses, disabilities thru everyday activities. Help pts develop, recover, improve skills needed for ADL’s & working.
Psychologist
Therapist who evaluates, diagnoses, treats, and studies behavior and mental processes.
Social worker
Individual organizes work intended to advance social conditions of community, & especially disadvantaged- provide psych counseling, guidance, and assistance, especially in the form of social services.
Mental health parity
Recognition by health insurance companies that mental illnesses are debilitating & in need of proper tx as physical illness.
Psychiatrist
Med practitioner specializing in the diagnosis and treatment of mental illness.
Recreational therapist
Therapy based on engagement in rec activities (sports or music) to enhance functioning, independence, well-being of individuals affected w/ disabling condition
Therapeutic milieu
Therapeutic setting focuses on control of environment of individual.
Assault
Intentional threat designed to make victim fearful; produces reasonable apprehension of harm.
Battery
Harmful or offensive touching of another person.
Fidelity
Doing no wrong to the pt.
Involuntary commitment
Admission to psych facility w/o pt's consent.
Justice
Duty to distribute resources/care equally
Veracity
Duty to communicate truthfully
Writ of Habeas Corpus
Formal written order to "free the person".
Riese
Court ruled that absent judicial determination of incompetence, antipsychotic drugs cannot be given to involuntarily committed mental patients in non-emergency situations w/o informed consent.
Autonomy
Respecting the rights of others
Beneficence
Duty to promote the good of others
Informed consent
Person provided w/basic understanding of risks, benefits, alternatives & receiving tx voluntarily
Least restrictive alternate doctrine
Mandates that the least restrictive and least disruptive means be used to achieve a specific purpose.
Malpractice
Act or omission that breaches duty of due care and results in or responsible for person's injuries.
Voluntary admission
Inpatient care sought by the patient or the patient's guardian through a written application to the facility.
Duty to warn
Obligation may result in breach of confidentiality on part of health care worker to warn 3rd parties when may be in danger f/ pt.
Duty to protect
Ethical & legal obligations of health care workers to protect pts f/ physically harming themselves/ others.
Tarasoff
Ca court decision imposes duty on therapist to warn person/persons when therapist aware pt presents risk of harm to specific person/persons.
Abstract thinking
The ability to conceptualize ideas.
Blunted affect
Lack of emotional reactivity
Circumstantial thinking
Too much information; excessive amt. of details; A pattern of speech characterized by indirectness and delay before the person gets to the point or answers a question; the person gets caught up in countless details and explanations.
Delusions
False belief held to be true even w/ evidence to contrary.
Flight of ideas
Continuous flow of speech- person jumps rapidly from one topic to another. Sometimes listener can keep up w/ changes; other times, necessary to listen for themes in incessant talking. Themes often include grandiose & fantasized evaluation of personal sexual prowess, business ability, artistic talents and so forth.
Ideas of reference
The false impression that outside events have special meaning for oneself.
Judgment
The ability to make logical, rational decisions.
Loose associations
Pattern of thinking haphazard, illogical, confused & connections in thought interrupted; seen primarily in schizophrenic disorders.
QSEN
Quality & Safety Education for Nurses
Thought broadcasting
Delusional belief that others can hear or are aware of an individual's thoughts.
Thought withdrawal
Believe missing thoughts w/drawn f/ mind by outside agency
Affect
External manifestation of feeling/emotion manifested in facial expression, tone of voice, body language.
Broad affect
Norm range of body language that matches mood.
Concrete thinking
Thinking grounded in immediate experience rather than abstraction. There is an overemphasis on specific detail as opposed to general and abstract concepts.
Flat affect
Absence or near absence of facial expression.
Hallucinations
Sense perception for which no external stimulus exists. (Hearing voices, seeing people not there)
Insight
Understanding & awareness of reasons for & meaning behind one's motives and behavior
Labile
Rapid shifts in mood: laughing one minute & crying the next; unstable.
MSE
Mental status examination
Tangential thinking
Disturbance in associative thinking- goes off topic. If happens frequently & does not return to topic, interpersonal comm destroyed
Thought insertion
Delusion one's thoughts not one's own but placed into mind by external force.
Word salad
Mixture of words meaningless to listener & to speaker
Congruence
Body language matches mood stated by pt.
Empathy
Ability to get inside another’s world & see things f/other person’s perspective & communicate this to person.
Orientation phase
Phase of nurse-pt relationship which nurse & pt meet, nurse conducts initial interview.
Rapport
Relationship characterized by trust, support, understanding.
Therapeutic relationship
Relationship requiring nurse maximize comm skills, understanding of human behaviors, personal strengths to enhance personal growth in pt. Occurs all clinical settings, not just on psych unit.
Values
Abstract standards represent an ideal, either pos or neg.
Countertransference
The tendency of the nurse (therapist, social worker) to displace onto the patient feelings that are a response to people in the nurse’s past. Strong positive or strong negative reactions to a patient may indicate countertransference.
Genuineness
Honestly felt/ experienced; Sincere
Termination phase
The final, integral phase of the nurse-patient relationship.
Transference
Experiencing of thoughts/ feelings toward person (often therapist) originally held toward sig person in one’s past. Valuable tool by therapists in psychoanalytical therapy.
Working phase
Phase of nurse-pt relationship during which nurse & pt identify/ explore areas causing problems in pt’s life.
Acting out
Originate unconscious-reduce anxiety/ tension. Anxiety displaced f/ 1 sit to another in observable resp (ex anger, crying, violence).
Denial
Escaping unpleasant realities by ignoring existence.
Dissociation
Disruption in integrated functions of consciousness, memory, identity, perception of environment. Result in separation bw feeling & thought. Can manifest in compartmentalizing uncomfortable/ unpleasant aspects of one self.
Passive aggression
Indirect expression of anger or aggressive feelings. May seem passive but motivated by unconscious anger & often triggers anger/ frustration in others. Examples; being late, forgetting, making “mistakes”, acting obtuse.
Rationalization
Justification of illogical/unreasonable ideas, actions, or feelings by development of acceptable explanations that satisfy teller & listener.
Repression
Unconscious exclusion of unpleasant or unwanted experiences, emotions, or ideas f/ conscious awareness; considered 1st line of psych defense.
Somatization
Tendency to experience & comm psychological distress in form of somatic symptoms & seek med help for them
Undoing
Act or behavior unconsciously designed to make up for or negate previous act/behavior (e.g., bringing boss present after talking about boss unfavorably to co-workers).
Altruism
Principle or practice of unselfish concern for or devotion to welfare of others
Displacement
Transfer of emotions associated w/ particular person, object, or situation to another person, object, or situation.
Projection
Unconscious attributing of one’s own intolerable wishes, emotions, or motivations to another.
Reaction formation
Overcompensationà The process of keeping unacceptable feelings or behaviors out of awareness by developing the opposite emotion or behavior.
Regression
In face of overwhelming anxiety, return to earlier, more comforting (although less mature) way of behaving.
Splitting
Inability to integrate pos & neg qualities of oneself or others into cohesive image. Aspects of the self and of others tend to alternate between opposite poles; for example, either good, loving, worthy and nurturing, or bad, hateful, destructive, rejecting, and worthlessness.
Suppression
Conscious removal from awareness of disturbing situations or feelings; only defense mechanism that operates on a conscious level.
Sublimation
Unconscious process substituting constructive & socially acceptable activities for strong impulses not acceptable in original form, such as strong aggressive or sexual drives.
Automatic thoughts
Rapid, unthinking responses based on schemas.
Behavior therapy
Based on the assumption that changes in maladaptive behavior can occur without insight into the underlying cause.
Cognitive-behavioral therapy
Based on both cognitive psychology and behavioral theory. How people feel and behave is largely determined by the way they think about the world and their place in it.
Defense mechanism
Ward off anxiety by preventing conscious awareness of threatening feelings.
Differentiation
The ability to develop a strong identity and sense of self while at the same time maintaining an emotional connectedness with one’s family of origin.
Ego
Is one’s sense of self and provides such functions as problem solving, mobilization of defense mechanisms, reality testing, and the capability of functioning independently. Mediator between ones primitive drives (id) and the internalized parental and social prohibitions (the superego).
Hierarchy of needs
Maslow conceptualized human motivation as a hierarchy of dynamic processes or needs that are critical for the development of all humans with the ultimate goal of self-transcendence.
Kholberg, Lawrence
6-stage theory of moral development provides framework for evaluating moral decisions. Pre conventional, conventional, post conventional
Multi-generational issues
Various family patterns passed down through the generations.
Operant conditioning
A type of behavior modification in which voluntary behaviors are increased or decreased through reinforcement or punishment.
Piaget
Provided a broad base for cognitive interventions, especially with patient with negative self-views.
Scapegoating
A member of a group or family who becomes the target of others’ aggression but who may not be the actual cause of their hostility or frustration.
Autocratic leadership
Exerts control over the group and does not encourage much interaction among members. Good in emergencies
Boundaries
Those functions that maintain a clear distinction among individuals within a family or group and between family members and the outside world. Boundaries may be clear, diffuse, rigid, or inconsistent.
Clear Boundaries
Balanced flow of energy between members
Diffuse Boundaries
Blending together of roles, thoughts and feelings of individuals- clear distinctions among family members fail to emerge.
Rigid Boundaries
Are those in which the rules and roles are adhered to no matter what.
Cognitive distortions
Inaccurate/ irrational automatic thoughts/ ideas lead to false assumptions & misinterpretations.
Democratic leadership
Supports extensive group interaction in the process of problem solving.
Double bind
Comm contains 2 contradictory messages given by same person at same time, receiver is expected to respond.
Free association
Requires full and honest disclosure of thoughts and feelings as they come to mind.
Id
The source of all primitive drives and instincts and is considered to be the reservoir of all psychic energy.
Laissez-faire leadership
Allows the group members to behave in anyway they choose and does not attempt to control the direction of the group.
Negative reinforcement
Increasing the probability of a behavior by removing unpleasant consequences; it is not punishment.
Peplau
Cont’d work of Sullivan’s interpersonal theory. Developed 1st systematic theoretical framework for psych nursing. Established foundation for professional practice.
Positive reinforcement
The presentation of a reward immediately following a behavior, making the behavior more likely to occur in the future.
Subconscious
Experiences, thoughts, feelings, and desires that are not in immediate awareness but can be recalled to consciousness; often called the preconscious. The subconscious mind helps repress unpleasant thoughts or feelings.
Superego
The internal representative of the values, ideals and moral standards of society. The superego is said to be the moral arm of the personality.
Systematic desensitization- Behavior therapy
behavior modification therapy involves the development of behavioral tasks customized to the pt. specific fears. Pt. is incrementally exposed to the fear.
Modeling- Behavior therapy
Pt learns thru initiation
Aversion- Behavior therapy
Tx of choice when less drastic measures fail. Ex. put bad smell on finger nails if nail biter
Cognitive theory- Beck
How people feel/behave determined by way think. Schemata A + B = C, stimulus + Appraisal = Response, change by A + B + C = D
Affect
The external manifestation of feeling or emotion which s manifested in facial expression, tone of voice, and body language.
Alogia
Poverty of speech; poverty of content of speech
Anhedonia
The inability to experience pleasure
Blocking
A sudden obstruction or interruption in the spontaneous flow of thinking or speaking that is perceived as an absence or deprivation of thought.
Concrete thinking
Thinking grounded in immediate experience rather than abstraction. There is an overemphasis on specific detail as opposed to general and abstract concepts.
Depersonalization
A phenomenon whereby a person experiences a sense of unreality of or estrangement from the self (i.e., one may feel that limbs or extremities have changed, that one is seeing self and events from a distance, or that one is in a dream.
Echolalia
Repeating of the last words spoken by another; mimicry or imitation of the speech of another person.
EPS
Extrapyramidal side effects- a variety of signs and symptoms that are often side effects of the use of certain psychotropic drugs, particularly the phenothiazines. Three reversible eps side effects are acute dystonia, akathisia, and pseudoparkinsonism. A fourth tardive dyskinesia, is the most serious and is not reversible.
Grandiosity
Exaggerated belief in or claims about one’s importance or identity.
Ideas of reference
The false impression that outside events have special meaning for oneself.
Negative symptoms
The absence of something that should be present (e.g., apathy, lack of motivation, anhedonia, poor thought processes).
Neurocognitive symptoms
Causes difficulty with attention, memory and executive functions; impedes ability to manage their own health; generally devastates the person’s quality of life.
Paranoia
A state characterized by the presence of intense and strongly defended irrational suspicions. These ideas cannot be corrected by experience and cannot be modified by facts or reality.
Pseudoparkinsonisms
A medication-induced temporary constellation of symptoms associated with Parkinson’s disease: tremor, reduced accessory movements, impaired gait, and stiffening of muscles.
Tardive dyskinesia
A serious and irreversible side effect of the phenothiazines and related drugs; consists of involuntary tonic muscle spasms typically involving the tongue, fingers, toes, neck, trunk, or pelvis.
Thought insertion
Belief that thoughts of others are being inserted into one’s mind (e.g., “they make me think bad thoughts.”)
Waxy flexibility
Excessive maintenance of posture; i.e., after the arms or legs are placed in a certain position, the individual holds that same position for hours.
Akathesia
Regular rhythmic movements, usually of the lower limbs; constant pacing may also be seen; often noticed in people taking antipsychotic medication.
Anergia
Lack of energy; passivity.
Avolition
Lack of motivation
Blunted affect
Minimal emotional response.
Clang associations
The meaningless rhyming of words, often in a forceful manner.
Delusions
A false belief held to be true even with evidence to the contrary (e.g., the false belief that one is being singled out for harm by others).
Dystonia
Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuroleptic medication, in which it manifests as muscle spasms of the face, head, neck and back.
Echopraxia
Mimicry or imitation of the movements of another person
Flat affect
Absence or near absence of facial expression
Hallucination
A sense perception (seeing, hearing, tasting, smelling or touching) for which no external stimulus exists (e.g., hearing voices when none are present).
Illusion
An error in the perception of a sensory stimulus (e.g., a person may mistake polka dots on a pillow for hairy spiders).
Neologisms
A word a person makes up that has meaning only for that person; often part of a delusional system.
Neuroleptic malignant syndrome
A rare and sometimes fatal reaction to high-potancy neuroleptic drugs. S/S include muscle rigidity, fever, and elevated WBC. It is thought to result from dopamine blockage at the basal ganglia and hypothalamus.
Positive symptoms
The presence of something that is not normally present (e.g., hallucinations, delusions, bizarre behavior, paranoia).
Tangential
A disturbance in associative thinking in which the speaker goes off the topic. Whenit happens frequently and the speaker does not return to the topic, interpersonal communication is destroyed.
Thought broadcasting
Belief that one’s thoughts can be heard by others (e.g., “My brain is connected to the world mind. I can control all heads of state through my thoughts.”)
Thought withdrawal
Belief that thoughts have been removed from ones mind by an outside agency (e.g., “The devil takes my thoughts away and leaves me empty.”)
Word salad
A mixture of words meaningless to the listener and to the speaker as well.
Acetylcholine
Stimulates parasympathetic nervous system; role in learning & memory; regulates mood (mania, sexual aggression); affects sexual and aggressive behavior. Receptor sites are Nicotini, muscarinic. Associated w/¯alzheimer’s, ¯huntington’s, ¯parkinsons disease; And ­depression.
Adrenergic
Sympathetic Nervous System
Antagonist
Drugs that block or depress the normal response of a specific receptor by only partly fitting the receptor site.
Antipsychotic
Drugs used to decrease psychotic symptoms (hallucinations, delusions and disorganized thinking) & increase mood and motivation.
Typical antipsychotics
Target the neurotransmitter dopamine.
Atypical antipsychotics
Target dopamine and other neurotransmitters, including serotonin.
Anxiolytic
Antianxiety drug that inhibits anxiety by slowing the limbic system
Depot injection or decanoate injection
Decanoate is a typical antipsychotic medication (brand name Haldol Decanoate; generic haloperidol).
Dystonia
Abnormal muscle tonicity resulting in impaired voluntary movement. May occur as an acute side effect of neuroleptic (antipsychotic) medication, in which it manifests as muscle spasms of the face, head, neck and back.
Extrapyramidal symptoms
Acute dystonia, akathisia, pseudoparkinsonism, tardive dyskinesia (most serious/irreversible).
Glutamate
Receptor sites NMDA & AMPA. Is excitatory; AMPA plays a role in learning and memory. ­NMDA psychosis, ¯NMDA neurotoxicity & Alzheimer’s, ­AMPA improved cognitive & behavioral tasks.
MAOI’s
Monoamine oxidase inhibitors- antidepressants that inhibit monoamine oxidase preventing the breakdown of amines such as serotonin and norepinephrine. TYRAMINE-FREE DIET
Neuroleptic malignant syndrome
NMS- rare and sometimes fatal reaction to high potency neuroleptic drugs. S/S Severe, EPS’s, muscle rigidity, fever, autonomic dysfunction (hypertension, tachycardia, diaphoresis, incontinence), reduces consciousness, and elevated WBC. Results from dopamine blockage at basal ganglia and hypothalamus.
Norepinephrine
Receptor sites are Alpha (1 & 2) and Beta (1&2). Effects mood, attention, & arousal. Stimulates the sympathetic nervous system. Associated with ¯Depression, ­mania, ­anxiety, & ­Schizophrenia.
Pseudoparkinsonisms
A medication-induced temporary constellation of symptoms associated with Parkinson’s disease: masklike face, tremor, reduced accessory movements, impaired/shuffling gait, drooling, stiffening of muscles, stooped posture, and “pill-rolling”.
Reticular activating system
RAS- the part of the brain stem that mediates alertness, arousal, and motivation; serves to filter out repetitive stimuli to prevent overload.
Reuptake
The return of neurotransmitters to the presynaptic cell after communication with receptors on the postsynaptic cell.
SPECT scan
Single photon emission computed tomography. Imaging that can detect circulation of cerebrospinal fluid; similar functions to PET.
Tardive dyskinesia
A serious and irreversible side effect of the phenothiazine’s and related drugs; consists of involuntary tonic muscle spasms typically involving the tongue (lip smacking or thrusting), fingers, toes, neck, trunk, or pelvis.
Akathisia
Regular rhythmic movements usually of the lower limbs; rocking; tapping foot; sense of inner restlessness; constant pacing may also be seen; often noticed in people taking antipsychotic medication.
Agonist
A drug or other chemical that can combine with a receptor on a cell to produce a physiologic reaction typical of a naturally occurring substance.
Anticholinergic
Shut-down of the cholinergic nervous system.
Anticholinergic Side Effects
Side effects of neuroleptic and tricyclic antidepressants. S/S include Dry mouth, urinary retention, constipation, blurred vision, dry eyes, inhibition of ejaculation, photosensitivity.
Antidepressant
Drugs predominantly used to elevate mood in people who are depressed.
Basal ganglia
Pockets of integrating gray matter deep within the cerebrum; involved in the regulation of movement, emotions, and basic drives.
Dopamine
Receptor sites D (1-5). Involved in fine muscle movement, integration of emotions & thoughts, decision making; stimulates hypothalamus to release hormones. ­DA associated with Schizophrenia & Mania. ¯DA associated with Parkinson’s and Depression.
Epinephrine
A catecholamine secreted by the adrenal gland and by fibers of the sympathetic nervous system. It is responsible for many of the physical manifestations of fear and anxiety.
GABA
Gamma-Aminobutyric Acid- The major inhibitory neurotransmitter in the central nervous system; Anticonvulsant and muscle relaxing properties; may impair cognition and psychomotor functioning. ¯of GABA associated w/ anxiety disorders, schizophrenia, mania & huntingtons disease. ­ of GABA associated with Anxiety reduction. Receptor sites GABA (A & B).
Limbic system
The part of the brain that is related to emotions and is referred to by some as the “emotional Brain”. It is involved in the mediation of fear and anxiety; anger and aggression; love, joy, and hope; and sexuality and social behavior.
Neuroimagining
Two types are functional (PET & SPECT) and structural (CT & MRI).
Neurotransmitter
A chemical substance that functions as a neural messenger. Neurotransmitters are released from the axon terminal of the presynaptic neuron when stimulated by an electrical impulse.
PET scan
Imaging that looks at how brain is working. Can detect possible schizophrenia, Mood disorders and Adult ADHD by looking at the Oxygen utilization, glucose metabolism, blood flow and neurotransmitter/receptor interaction.
Psychotropic drugs
Drugs that have an effect on psychic function, behavior or experience.
Receptors
Protein molecules located within or on the outer membrane of cells of various tissues, such as neurons, muscle, and blood vessels. A receptor receives chemical stimulation that causes a chemical reaction resulting in either stimulation or inhibition of the activity of the cell.
Serotonin syndrome
S/S= hyperactivity or restlessness; tachycardia; Fever; elevated blood pressure; altered mental states (delirium); irrationality, mood swings, hostility; seizures; myoclonus, incoordination, tonic rigidity; Abdominal pain, diarrhea, bloating; apnea. (my book 265).
Synapse
The gap between the membrane of one neuron and the membrane of another neuron. The synapse is the point at which the transmission of the nerve impulse occurs.
Therapeutic index
The ratio of the therapeutic dose of a drug and the toxic dose of a drug.