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