Psych

In the working phase, the nurse:

Encourages and helps the client set goals and take action to meet those goals.

Compassion fatigue may be amplified in certain areas such as:

End of life care, critical care and the Emergency room.

In the termination phase, the nurse:

Evaluates goal achievement with the client.

Serotonin is increased with _______________________ and decreased with ______________________.

Increased with anxiety and decreased with depression.

Four cardinal symptoms of PTSD:

Intrusive reexperiencing of the initial trauma, avoidance (of memory/feelings/people that recall the event) persistent negative alterations in cognitions and mood (fear/guilt/detachment) and alteration and arousal and activity. (irritable, angry outbursts, self-destructive behavior, sleep difficulties)

What benefits can a client get from group therapy?

It provides some structure, boundaries and rules for the client to abide. It provides independence and promotes self-sufficiency. (Also therapeutic curative factors)

Fidelity

Maintaining loyalty and commitment by doing no wrong to the patient. Nsg education.

Autonomy

Patient's right to choose.

The focus of the psychosocial history is the client's:

Perceptions and recollections of current lifestyle and life in general.

3 therapeutic techniques to ALWAYS have are:

Silence, active listening and clarifying techniques.

An OTC herbal treatment known as ____________________ has shown correlation to cardiac problems when used with psych medications.

St John's Wort.

Some insurance companies still won't pay for some mental illness due to:

Stigma

What is stigma and how does it affect people with mental illness?

Stigma is a negative view and can prevent people from seeking help and treatment. Stigma can lead to people being bullied and not receiving quality care. Stigma can lead to intended or unintended discrimination.

What should returning veterans be assessed for besides PTSD?

TBI

Describe the teacher role

Teaching patients relevant information about their health. Examples: Medications, coping skills, and diagnosis information.

What is resiliency?

The ability to bounce back after trauma or severe stress such as a death of a loved one.

A "symmetrical" relationship is:

An equal relationship. Friends, coworkers, etc.

What is important to tell a patient who says they want to kill themselves?

Assess whether the patient has a plan, and if so, gather details. Tell the patient that this is serious and the nurse doesn't want harm to come to the patient and that the information needs to be shared with other staff. After this has been done, the nurse can discuss feelings/circumstances that led up to this decision.

What is the most critical factor for the nurse to determine during crisis intervention?

The client's available situational supports. Personal internal strengths and supportive individuals are critical to the development of a crisis intervention plan.

What to do if your patient asks you to keep a secret?

The nurse CANNOT make this promise. The information may be important to the health and safety of the patient or others.

Antidepressants work by:

Blocking the reuptake of serotonin and norepinephrine.

What is the difference between burnout and compassion fatigue?

Compassion fatigue has a sudden onset. (You should always destress every time you leave your work area.)

Job dissatisfaction, physical and mental health decline, and hopelessness are signs of what?

Compassion fatigue.

When you take on the "Professional" role you know that it is similar to the "Teacher" role and this means:

You teach the client about medications, alteration, diagnosis. You also implement critical thinking skills to come up with ways of coping. You are always observing the patient and responding to them appropriately. You socialize with your client to encourage their own socialization and talking and you are sure to be aware of your facial expressions. Tattoos are hidden and you are dressed modestly.

T/F People can have SMI (Severe Mental Illness) such as Schizophrenia and Bipolar and still live a productive and successful life.

True

When do symptoms of PTSD usually begin occurring?

Within a few months after the trauma, but delay of months or years is not uncommon.

In the orientation phase, the nurse and client meet and get to know each other. During this phase what will the nurse do?

Work to establish trust, prioritizes the client's problems and clarifies the client and nurse roles.

How long does a person need to have symptoms of PTSD before a diagnosis can be made?

1 month.

What is important to remember if you use a bibliography or punching bag as a nursing intervention for a patient?

A bibliography and punching bag may need a Doctor's order. You also need to stay with your patient while they use a punching bag.

A nurse is caring for a client who is angry and agitated. What is the best approach for the nurse to take with this patient?

A calm, consistent approach. A calming approach can decrease agitation.

What therapeutic curative factor is especially important for clients with personality disorders and why?

Existential Factor-The client is assisted in taking direction of their own life and encouraged to take responsibility of their own behavior. It encourages the "here and now."

A person who is mentally healthy is not able to:

Experience joy, accept and give love, able to control their behavior and take responsibility for their choices. A person can think clearly in order to problem solve, has insight and can have healthy relationships. They know their purpose in life and what gives them hope (spirituality) and they're able to work and be productive. They can adapt to stress and can cope with adversity.

Benzodiazepines facilitate the transmission of:

GABA

GAF is:

Global Assessment Function

The counselor role entails:

Helping the patient integrate facts and feelings about their alterations. You use therapeutic communication techniques.

A client is admitted into the mental health unit involuntarily. What course of action should the nurse take in order to prevent legal complications?

The nurse should file with the court within 96 hours of the initial detention.

The nurse may feel anxious, uncomfortable or responsible when the patient begins to cry. How should the nurse respond to patient crying?

The nurse should stay with the pt and reinforce that its okay to cry. This is a time that feelings may be able to be identified.

A therapeutic nurse/client relationship has a continuous focus on:

The patient's problems and needs.

The fight or flight response is aka

The stress response.

How could the nurse respond to a parent of an adolescent who was recently diagnosed with something new?

"Lets talk about how you're feeling about your child's diagnoses." Initiating conversation about the parent's feeling does not prejudge the parent.

Before discharge of an anxious client, the nurse should teach the family that anxiety can be recognized as what?

A pattern of emotional and behavioral responses to stress.

What are the nursing interventions for a client with cultural and spiritual needs aimed at?

Aimed at helping the client achieve meaning and purpose in life that reinforce hope, peace, contentment, and self-satisfaction.

What is eye casting?

Angry, suspicious, accusatory looks. Ex: The patient's eyes harden with suspicion.

Double messages (Mixed messages) are: How can the nurse respond to these kinds of messages?

Conflicting or confusing messages. Verbal or nonverbal incongruities. Reflect and validate the patient's feelings. Ex: "You say you are upset you did not pass this semester, but I notice that you look more relaxed and less conflicted than you have all term. What do you see as some of the pros and cons of not passing the course this semester?"

"Why" questions imply:

Criticism. It is much more useful to ask what is happening rather than why it is happening. Why questions put the patient on the defense.

Mental health is _____________________ defined.

Culturally

What is the 7th step of the nursing process?

Documentation. Usually one entry per shift is sufficient.

Beneficence

Duty to act so as to benefit/promote the good of others. Spending extra time to help an extremely anxious patient is a beneficent act.

What is an MIW?

Mental Inquest Warrant

Antipsychotics work by blocking specific:

Neurotransmitter receptors.

Psychostimulants increase the release of:

Norepinephrine, serotonin and dopamine.

Signs of compassion fatigue may be as early as:

Nursing school.

And individual who has had exposure to a trauma severe enough to be outside the range of normal human experience can experience: (Childhood physical abuse, torture/kidnap, military combat, sexual abuse, natural disasters, human disasters & severe illness.)

PTSD This can occur in people who have WITNESSED trauma too.

List some examples of Nursing Interventions for a patient experiencing Spiritual Distress.

Prayer, being present, Scripture reading, peaceful environment, meditation, music pastoral care, inspiring hope, active listening, validating pt's thoughts and feelings, sensitive responses to patient beliefs and developing a trusting relationship.

What should you do if the patient asks personal questions?

Remember not to switch roles with the patient. The focus should be on the patient. If the nurse does answer a natural question, do so with one or two words and immediately shift the focus back onto the patient.

Name some nursing interventions for a Dementia/Alzheimers Disease patient:

Reminisce, read with visual aids, sing/whistle/hum, sensory stimulation and namaste care.

What does the nurse recall is a major component of behavior modification?

Rewarding positive behavior. In behavior modification, positive behavior is reinforced and negative behavior is not reinforced or punished.

What is the basic therapeutic tool used by the nurse to foster a client's psychologic coping?

Self. To be therapeutic, the nurse must be present, actively listening and attentive.

Why is it important to assess yourself as a nurse and be self aware?

So you can be aware of any bias or stigma or any irrational beliefs you have. You need to evaluate yourself for compassion fatigue and burnout. Being aware of these things allows you to fix them to ensure the patient gets quality care and is not discriminated or labeled. Knowing your personal triggers and what intensifies your anxiety allows you to better cope with different situations.

Mental health is:

The successful adaptation to stressors from the internal or external environment. Someone who is mentally healthy.

What is the surrogate role?

This is similar to being a patient advocate. You will speak up for the patient but you want the patient to eventually be able to speak up for themselves.

Veracity

To communicate truthfully. Describing the purpose and side effects of psychotropic meds in a truthful and non-misleading way is veracity.

Justice

To distribute resources or care equally regardless of personal attributes.

Role blurring is often a result of unrecognized_________________ or _____________________. Warning signals of boundaries being blurred may be:

Transference or countertransference. OVER HELPING the patient. Doing what they can do for themselves or going beyond the needs/wishes of the patient. Also, CONTROLLING. Assuming control of patients "for their own good."

T/F: Self awareness is considered the most important and essential aspect of a professional nurse.

True.

What is important to know of the pt with PTSD?

Trust is a common concern. Child and spousal abuse may be associated with hyper vigilance and irritability. Chemical abuse may begin as an attempt to reduce anxiety/depression. Exposure to stimuli reminiscent of those associated with the original trauma can cause an exacerbation of the trauma.

Milieu Manager means

Trying to manipulate/keep the environment therapeutic. Arts & crafts, playing cards. This involves keeping the client safe.

A "complementary" relationship is:

Unequal; difference in status of power. "Superior" ex: Teacher/student, RN/patient.

List some ways of therapeutically using "self" for the client.

Walking with, sitting with, watching tv, listening to music, humor (when appropriate)