week 2 concepts answers

Recovery Model

. Less focus on disease and dysfunction and more focus on improving the patient's competencies, not simply alleviating symptoms

Residential care

A place where long-term care is given. Nursing homes would be an example.

Restraint

Any mechanical or chemical device that prevents or reduces movement of the patient's legs, arms, body, or head. Must be an active threat to self or others. Must be physician ordered and time limited. All other de-escalation options must be deemed inadequate

Seclusion

Confining a patient alone in an area or room and preventing them from leaving. Must be an active threat to self or others. Must be physician ordered and time limited. All other de-escalation options must be deemed inadequate

Attachment Theory

Developing safe and secure emotional bonds.

Milieu

Encompasses all aspect of the therapeutic environment. Milieu = environment.

Erikson

Every person passes through eight interrelated stages over the life cycle - failure to complete a stage results in reduced ability to cope

Norms

Expected behavior in the therapeutic setting.

T/F Patients have the right to receive treatment in the last restrictive environment without restraints even if they are a threat to themselves or others?

F: Patient does have right to receive treatment is least restrictive environment. However, if they are presenting an immediate risk to self or others, more restrictive alternatives may be indicated.

T/F Spirituality is not important when taking care of a mentally ill client

F: Spiritually serves as a protective factor for mental health.

T/F Nurses can and should hug and touch the client when attempting to display empathy even if the patient has not given permission

F: Touch should be used with caution and only with patient's permission.

Balance

Gradually allowing independent behaviors in a dependent situation.

Self-help

Groups that provide mental health to individuals. Usually ran by an outsider or someone in the community. Examples include AA meetings.

Maslow

Humans are motivated by unmet needs. The strongest, most fundamental needs placed on the lower level. When lower level needs are met, higher needs can emerge.

Probate court

If involuntary admission past 72 hours is warranted due to patients' severe mental illness, the physician will petition to the probate court for further treatment. If granted, the patient will be probated to the facility until treatment is terminated by the physician and the patient is discharged.

Interpersonal Therapy

Learning effective interpersonal skills by using the nurse/patient relationship as a vehicle for analyzing interpersonal processes and testing new skills.

Freud

Levels of consciousness are central to understanding problems of personality and behavior.

Court-ordered medication

Medication mandated by law through the court process. Patients are unable to refuse the administration of this

outpatient

Occurs in mental health clinics and private offices. Patients can see social workers, psychologists, therapists/counselors, and/or psychiatrists in this level of psychiatric care.

Involuntary status:

Patient admitted against own will after being deemed a risk to self, others, or gravely disabled. Placed on a 72-hour hold. Legally allowing up to 72-hours for observation

Voluntary status

Patient admitted of own volition after being deemed a risk to self, others, or gravely disabled (i.e. not caring for basic needs of self due to mental illness). Signs inpatient consent for treatment. Must be discharged by physician.

Behavioral Therapy

Reinforcement, skills training, response prevention, exposure, and systematic desensitization

Right to Refuse treatment

Rodgers vs Okin

mental illness

Serious conditions which can affect your thinking, mood, and behavior. can affect your ability to relate to others and function each day.

Limit setting

Setting reasonable rules and handing out consequences if they are broken.

Nurse asks, "Have you ever considered going for a massage?"

Suggesting

T/F Even involuntary committed clients have the right to refuse psychiatric medications.

T: Medication may only be forced when patient is deemed an immediate threat to self or others (emergency medication) or medication is court ordered.

Duty to Warn

Tarasoff v Regents of UC

Cognitive Therapy

Teaches individuals to identify automatic thoughts and distortions to help revise and replace these thoughts.

Cannot be held liable reasons of insanity

The McNaghten Rule

Deinstitutionalization

The depopulating and closing of many state mental hospitals after 1955, shifting focus and funding to a more community-based care. Provided aid to the disabled through Supplemental Security Income (SSI) and Social Security disability insurance (SSDI). Brought about change in commitment laws. Has had many unintended consequences including increased demands on emergency departments to provide care to acutely mentally ill individuals, increased demands on general hospital psychiatric units to provide quick admissions and discharges, increased rate of homelessness and incarceration in the severely mentally ill.

Inpatient

The level of care for a patient that is deemed to be a danger to themselves or others or gravely disabled.

safety

The priority of the psychiatric milieu.

Emergency medication

When a patient deemed to be an immediate threat to themselves or others requires medication to assure safety, usually against their will. Other least restrictive interventions must first be attempted and documented (i.e. reduced stimulation, po medication, verbal intervention, active listening, diversion). is physician ordered and time limited, i.e. cannot be a standing order.

Right to treatment

Wyatt vs Stickney

Nurse does not speak, but he/she does maintain eye contact and nod their head when the patient speaks.

active listening

Guardianship

any person who has the authority to care for and make treatment decisions for another person deemed incompetent to care for themselves due to severe mental illness. must provide guardianship paperwork to the facility where the patient is being cared for.

Nurse asks, "What do you mean by..."

clarifying

Multidisciplinary team

coordinates care of the patient and may include physicians; patients or consumers; families; social workers; mental health specialists; psychologists; recreational therapists; spiritual care; occupational therapists; representatives from insurance companies, nursing homes, group homes.

Nurse states, "This must be very painful for you to discuss."

empathy

Nurse states, "Explain more about...."

focusing

"Are you happy today?"

forbidden

"Don't worry about tomorrow."

forbidden

"Everything happens for a reason."

forbidden

"I think you need to sit down."

forbidden

"If I were you, I'd go see a psychiatrist."

forbidden

"Why did you stop taking your medication?"

forbidden

"Why don't you change to a different doctor?

forbidden

"You have to take your medication, or you will not get better."

forbidden

Mental health

includes emotional, psychological, and social well-being. It affects how we think, feel, and act as we cope with life. It also helps determine how we handle stress, relate to others, and make choices and is important at every stage of life

Nurse states, "You seem really upset today."

making observation

Nurse states, "I'll stay with you for a while."

offering self

Nurse is assessing a client and states, "Tell me about your relationship with your husband."

open-ended question

Nurse states, "I know the things you are seeing are real to you; however, I don't see them."

presenting reality

Nurse states, "You say that you are an only child."

restating

Patient states, "I am having trouble with my marriage. My husband doesn't understand me. He comes home from work and sits on the couch. I have to do everything around the house." Nurse sits quietly and listens to patient.

silence

Nurse states, "So far you have said that..."

summarizing

Patient States, "I really want to find ways to relax, but I don't have time for yoga or massages." The nurse states, "On one hand you want to relax, but on the other hand you are saying you don't have time. How do you feel about this conflict

supportive confrontation

T/F It is important for the nurse taking care of a mentally ill client to provide culturally competent care.

true

"Are you saying that you are upset today?"

useful

"It seems as if you are angry today."

useful

"Tell me more about your siblings."

useful

"What are your thoughts?"

useful