3060 All Comprehensive

DM: Displacement of energy associated with more primitive sexual or aggressive drives into socially acceptable activities

Sublimation

What are these scales used for? Addiction Severity Index (ASI) Recovery Attitude and Treatment Evaluator (RAATE) Brief Drug Abuse Screen Test (B-DAST)

Substance Use Disorders

DM: Replacement of a highly valued, unacceptable object by a less valuable acceptable object

Substitution

Group member role: Keeps group focused and on task Examples: Initiator, evaluator, elaborator, and coordinator

Task

Which stage of group development: Reflect on progress made, acknowledge contributions of each member and the group as a whole. Identify future goals

Termination

Which nurse-client phase? Deal with intense feelings regarding the experience, summarize the goals and objectives achieved, review client's plans for future, and finalize termination

Termination phase

Which stage of group development: Members are encouraged to cooperate with each other, learn conflict resolution, and problem solving

Working

Which nurse-client phase? Maintain relationship, gather further data, promote client's problem-solving skills, self-esteem, and use of language and communication skills, facilitate behavioral change, overcome resistant behaviors, evaluate problems and goals, redefine those as necessary, and promote practice and expression of alternative adaptive behaviors

Working phase

"Free the person"

Writ of habeas corpus

What two words do we avoid in therapeutic communication?

"Why" and "you"

separation anxiety

4 weeks in children, 6 months or more in adults. worry about losing attachment figures or harm coming to them. won't go away from home/ scared to be alone. has STOMACHACHES normal in children from 8-18 months

What are the 3 phases of group development in order?

1. Initial/orientation 2. Working 3. Termination

What are the 3 phases in order of the nurse-client relationship?

1. Orientation 2. Working 3. Termination

What are these scales used for? AIMS Simpson Neurological Rating Scale

Abnormal movements

TC: The helper listens for and describes underlying feelings and behavioral themes (first skill of the second stage)

Additive empathy

"You say you feel _________ (expressed feeling), but it sounds like you also feel ________ (underlying feeling) because ___________ (cause of feeling)."

Additive empathy statement

Countertransference: Withdrawing. Speaking loudly. Using profanity. Asking to be taken off the case

Anger

What are these scales used for? Brief Patient Health Questionnaire (Brief PHQ) GAD-7 Modified Spielberger State Anxiety Scale Hamilton Anxiety Scale

Anxiety

The person is fearful of being harmed, they feel a threat

Assault

Group leadership: Gives structure, controls group, little interaction

Autocratic

Making decisions about care

Autonomy

Countertransference: Feeling sadness.

Helplessness or hopelessness

Causing harm by actual touching

Battery

Family therapy: Focuses on changing behaviors of family members to influence overall patterns of family interactions

Behavioral family therapy

Helping others

Beneficence

What are kinesics?

Body language

Countertransference: Showing inattention. Frequently asking the patient to repeat statement. Making inappropriate responses.

Boredom (indifference)

What is Stage 1 of therapeutic communication?

Building the therapeutic working relationship

What are these scales used for? Mini-Mental State Examination (MMSE) St. Louis University Mental Status Examination (SLUMS) Cognitive Capacity Screening Examination (CCSE) Alzheimer's Disease Rating Scale (ADRS) Memory and Behavior Problem Checklist Functional Assessment Screen Tool (FAST) Global Deterioration Scale (GDS)

Cognitive functioning

DM: Covering up weaknesses by emphasizing a more desirable trait

Compensation

TC: Purposeful questioning (used when there is vagueness) and summarization (offering a summary statement or two) (the fourth and final skill in the first stage)

Concreteness

Protect each others' rights and privacy

Confidentiality

TC: Skill invites the client to examine discrepancies in behavior and is used to solicit deeper patterns (fourth skill of second stage)

Confrontation

"On one hand you feel, say, or do ____ (give behavior), and on the other hand you feel, say, or do (behavior)."

Confrontation statement

What are the structured cerebral abnormalities in one with schizophrenia?

Decreased blood flow to frontal lobe

What is Stage 2 of therapeutic communication?

Deeper Exploration

Alteration in thinking: False, fixed beliefs that can't be corrected by reasoning, not based in reality

Delusion

Group leadership: Encourages sharing, focus is problem solving, extensive interaction

Democratic

DM: An attempt to screen or ignore unacceptable realities by refusing to acknowledge them

Denial

What are these scales used for? Beck Inventory Brief Patient Health Questionnaire (Brief PHQ) GDS (geriatric) Hamilton Depression Scale Zung Self-Report Inventory Patient Health Questionnaire-9 (PHQ-9)

Depression

DM: Transferring of emotional reactions from one object or person to another object or person

Displacement

Schizophrenia is associated w/ increased amounts of what neurotransmitters?

Dopamine and serotonin

What is psychosis-induced polydipsia?

Drinking excessive amounts of water (4-10 liters/day) b/c they have a delusion it will clean them out. Causes a rapid drop in serum sodium levels

What are these scales used for? Eating Disorders Inventory (EDI) Body Attitude Test Diagnostic Survey for Eating Disorders

Eating disorders

TC: The core skill which is used to build rapport and trust between the helper and the client (the first skill used in the first stage)

Empathy

"You feel _________________ because ________________." What kind of statement?

Empathy statement

Modeling and Role Modeling Nursing Theory

Erickson, Tomlin, and Swain

What are these scales used for? McMaster Family Assessment Device

Family assessment

TC: Provides information back to the client (third skill of second stage)

Feedback

"May I share something with you?" (get permission) When I (observed behavior), I feel (reactive feeling). I want to (desired behavior). Right now I am (what actually will be done).

Feedback statement

What are these scales used for? BPRS Global Assessment of Functioning Scale (GAF)

General psychiatric assessment

TC: The helper presents as a human being rather than as a role (the third skill in the first stage)

Genuineness

Trivial things blown out of proportion

Ideas of reference

DM: An attempt to manage anxiety by imitating the behavior of someone feared or respected

Identification

What is the second aspect of the skill of additive empathy

Identifying patterns and behavioral themes

TC: This skill brings the relationship to a new level of intensity, creating an opportunity for exploration of the immediate relationship by having "you and me" talk. (Fifth skill of the second stage)

Immediacy

"Right now I sense you expect or want me to ____ (desired action or role)."

Immediacy statement

What is Stage 3 of therapeutic communication?

Implementation

Group member role: Roles interfere with the group's goals Examples: Aggressor, dominator, recognition seeker, help-seeker

Individual

Communication essential information

Informed consent

Which stage of group development: Set up an atmosphere of acceptance, respect, confidentiality, and trust. Help members to feel relaxed

Initial/orientation

Family therapy: Focuses on developing increased self, other and family awareness, among family members

Insight-oriented family therapy

DM: A mechanism by which an emotional response is evaded by use of rational explanations

Intellectualization

A voluntary act performed with the intent to bring about a physical consequence (battery, assault, false imprisonment)

Intentional tort

DM: A form of identification that allows for the acceptance of others norms and values

Introjection

Group leadership: More supportive than structural, encourages creativity, minimal direction

Laissez-faire

What is the onset age of schizophrenia?

Late teens or early twenties

The least drastic measures must be taken

Least restrictive alternative doctrine

Culture Care: Diversity and Universality Theory

Leininger

Group member role: Keeps group cohesive and cooperating Examples: Encourager, compromiser, harmonizer, and gatekeeper

Maintenance

What are these scales used for? Mania Rating Scale

Mania

DM: Not acknowledging the significance of one's behavior

Minimization

Countertransference: Withholding information. Lying

Misuse of honesty

DM: A process in which blame is attached to others

Projection

No harm to others

Non-maleficence

What are these scales used for? Yale-Brown (Y-BOCS)

Obsessive-compulsive behavior

Self-care nursing theory

Orem

Which nurse-client phase? Establish trust, parameters of the relationship. formal or informal contract, confidentiality, and mutual goals. Termination begins.

Orientation phase

Countertransference: Having special agenda, keeping secrets. Increasing self-disclosure. Feeling omnipotent. Experiencing physical attraction.

Over-identification

Countertransference: Coming to work early, leaving late. Ignoring peer suggestions, resisting assistance. Buying the patient clothes or other gifts. Accepting the patient's gifts. Behaving judgmentally at family interventions. Keeping secrets. Calling the patient when off duty

Over-involvement

Human Becoming Nursing Theory

Parse

What is the third aspect of additive empathy?

Personalizing

Added behaviors nor normally seen in a mentally healthy person; a distortion of normal functioning Alteration in thinking Alterations in speech Alterations in perception Alterations in behavior

Positive symptoms

What are these symptoms? Withdrawn from others, change in behavior and personality, depressed, anxious, phobias, obsessions and compulsions, difficulty concentrating, preoccupation w/ religion, preoccupation w/ self

Potential pre-psychotic symptoms

DM: Justification of certain behaviors by faulty logic

Rationalization

DM: People act opposite the way they feel

Reaction formation

DM: Resorting to an earlier, more comfortable level of functioning

Regression

DM: An unconscious mechanism by which threatening thoughts, feelings, and desires are kept from becoming conscious

Repression

Countertransference: Reaching for unattainable goals. Resisting peer feedback and supervisory recommendations. Giving advice.

Rescue

TC: An attitude or value one holds of a client (the second skill in the first stage)

Respect

What are these scales used for? Scale for Assessment of Negative Symptoms (SANS) Brief Psychiatric Rating Scale (BPRS)

Schizophrenia

What are the only 2 disorders that can't be managed without medication?

Schizophrenia and bipolar disorder

"When ___ (triggering event), you choose to ____ (pattern of response), and it leaves you _____ (consequences of behavior)."

Second part of additive empathy statement (patterns and behavioral themes)

TC: Used to deepen the client's awareness, the purpose is to lead the client into exploration of deeper feelings. The helper uses their own life experience to assist in the process (the second skill of the second stage)

Self disclosure

"When I ____ (life experience), I felt (deeper feeling than client had shared), I wonder if that fits for you."

Self disclosure statement

"You feel ____ (self judgement) with yourself because you do not ____ (deficit behavior) and you want to ____ (goal behavior)."

Third part of additive empathy statement (Personalizing)

A civil wrong for which monetary damages may be collected by the injured party (plaintiff) from the wrongdoer (the defendant)

Tort

DM: An action or words designed to cancel some disapproved thoughts, impulses, or acts in which the person relieves guilt by making reparation

Undoing

Negligence and malpractice are examples of this

Unintentional tort

What is the #1 rule in PMHN?

We don't do anything FOR the client, we do everything WITH the client