Download Psych/Mental Health Nursing General Question

Psych/Mental Health Nursing General Question Themes/subject matters:
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Paralanguage: use of vocal effects, such as tone and tempo to convey a message.
Example includes a client being more anxious and speaking louder and faster than
usual.
Holmes and Rahe’s Theory: suggests that all life events (especially significant),
whether positive or negative, causes stress
Flight of Ideas: is a pattern of thinking, characterized by a client changing topics
rapidly. Example: when a client is relaying a past psychiatric history they change
topics rapidly
Abuse and Neglect: lead to poor self concept and role confusion; and are the basis
for unhealthy personal boundaries;
Clients lack of eye contact during interview or assessment: be sure to observe if
this is normal for the clients culture; assess to see if this is normal for the client and
part of their normal behavior patterns
Exploring: is a communication technique designed to get the patient to explore their
feelings; it is used if the nurse asks “Do you want to talk more about it”
Goal in crisis intervention: use problem solving techniques and structured activities
to relief the crisis immediately; the patient is in crisis because they cannot problem
solve and their structure has broken down; This is a priority case/instance.
Clients seeing their chart: tell client they have a right to see their chart, but they
need to speak with their primary care provider; they have the right to see their chart as
long as it is not detrimental to their health
Psychiatric Nursing & Primary Prevention: includes providing sexual education
classes for adolescents; education programs that promote mental health that prevent
future psychiatric episodes
Discussing hypothetical ethical considerations: helps nurse to assess clients mental
status and judgment
Alternative modes of expression: could be play therapy (drawing, puppetry); helps
people express feelings they can’t articulate.
Therapeutic Nurse-Client Relationship: begins with the nurse assessment of their
own self-awareness and understanding in order to fully understand clients and their
condition.
Making Observations: is a communication technique that gives a client feedback
about their attitude and behavior:
Displacement: is a defense mechanism used when the client transfers their feelings
for one person towards another who is less threatening.
Cross-Tolerance: is one drug that a client is using/prescribed/given that lessens their
response to another drug.
Group Therapists: must have a masters degree in psychiatric nursing with
credentials
Self-Acceptance: serves as the basis for healthy relationships with others and is the
main accepted mental health criterion.
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Displacement: when feelings of anger and rejection are discharged or focused in an
indirect way that is considered safe and doesn’t directly harm other people.
Elderly clients reactions to medications: slow metabolism of drugs put elderly
people at higher risk of adverse effects.
18 to 25 developmental task: Postulated by Erikson; it is intimacy vs. isolation
Antisocial personality disorder: it is important to consistently enforce unit and
facility policy; firmness and consistency should be the main part of a careplan with a
patient who has antisocial personality disorder.
Electroconvulsive Therapy (ECT): is indicated for patients with major depression;
it is deemed effective if the patient has/reports a dry mouth; you may need to reorient
client to time/place/person also short term memory loss can occur.
Patient Confidentiality: unless a court order is in place or you have explicit patient
permission, you cannot reveal that a patient is undergoing chemical/substance abuse
treatment; do not violate patient confidentiality
Nurse using self-disclosure: must make sure it is brief and refocus the
conversation/interaction on the patients experiences; self-disclosure needs to be used
to achieve a specific therapeutic goal
Self Mutilation: if you are dealing with a self-mutilating patient it is important to
shift the conversation to from the mutilation to helping the client express their
feelings. Example: “What were you feeling before you hurt yourself”
Ego and Psychosexual Theory: put forth by freud; the ego tests reality and directs
behavior.
Assessing Full Leather Restraints: must be done every 10 to 15 minutes to make
sure patients circulation isn’t impacted and skin and nerve damage is not occurring.
Avoidant Behavior: is a personality disorder; consists of social inhibitions,
hypersensitivity to negative evaluation, fear of criticism, and social ineptitude.
Emergency restraints or seclusion: when a patient is combative or is presents a
danger to self or others; you can restrain the patient but must get a physicians order in
8 hours.
Medication Tolerance: a diminished response to a drug so that more of the drug is
required to achieve the same previous therapeutic effects; this includes substances
like alcohol, morphine, opioids, etc.
Restraining a violent client: first priority is to checking to make sure the restraints
are properly applied (safety); second priority make be bathroom and rest breaks and
water, etc.
A sexually assaulted client sitting quietly in an exam room: may be exhibiting
denial
o Denial is: a protective and adaptive reaction to increased anxiety
Focusing: is used to suggest to that a client may want to explore a specific topic
during group or one-on-one sessions.
Working Phase of the nurse-client relationship: during this phase the client and
RN will evaluate and refine goals set during the orientation phase.
Group Therapy: if client is demanding, interrupting others, and taking up a lot of
group time, the best thing to do is focus the client; example: “Will you briefly
summarize your point because others need time also.”
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Orientation phase: the first task during this phase is to form a contract with a
patient; a contract begins with an exchange of names and an explanation of the roles
and limits of the relationship;
Critical Pathways of Care: provides outcome based guidelines for goal achievement
within a specific length of stay; it is used by all of the care staff; it is essentially a
length of stay and not a specific therapy;
Establishment of Trust and Rapport with a Client: is a priority when dealing with
clients with mental health issues;
Situational low self esteem: is a nursing diagnosis characterized by a client
presenting with complaints/symptoms of fatigue, sensitivity to criticism, feeling selfconsciousness.
Body Dysmorphic Disorder: when a client is diagnosed with this encourage them to
discuss stressful life situations and fears, which helps them focus on the underlying
issues.
Priorities in the therapeutic Setting: client safety in the environment is the most
important priority in the therapeutic setting;
Stimulant withdrawal symptoms and physical tolerance: are characterized by
fatigue, mental depression, and confusion.
Reflecting: is a communication/therapeutic technique; that involves the nurse
referring client statements back to the client to explore;
CNS depressants: can produce an initial and temporary excitatory response when
inhibitory synapses are depressed.
Erotomanic type delusional disorder: is characterized by delusions that another
person loves you and you need to send them gifts, etc. in order to get their attention
Delegation to nursing assistant: it is ok to delegate tasks such as looking for sharp
objects or to place someone on a one-to-one.
Denial: is characterized by an avoidance of reality by ignoring or refusing to
acknowledge a stressful event or unpleasant incident.
Medication abuse: is more prevalent in clients with low self esteem and unresolved
rage; they will search for solace in addictive medications.
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Obsessive Compulsive disorder: when caring for a client with OCD the goal is to
systematically decrease the undesirable behavior; it is important to allow time (or
Focus) for the client to perform their compulsive behavior
Client Experiencing an Anxiety Attack: priority nursing intervention is to stay with
the client and to speak in short sentences;
Potentiating Effect: refers to a drugs ability to increase the potency of another drug
when taken together. Do not mix antianxiety agents and with alcohol or other CNS
depressions
Clients with acute anxiety: it is important not to touch the patient if trust and rapport
has not yet been established; clients with anxiety have an increased heart rate;
Panic Attack: during a panic attack it is important to stay with the client and use
interventions which focus on decreasing anxiety, to reduce environmental stimuli, and
retain calmness and be direct and professional.
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Understanding clients fears: is important to due FIRST so you can intervene
effectively;
Panic Disorder with Agoraphobia: the overall goal is to get the patient to function
in their environment as effectively as possible, so they can begin to resume normal
activities and develop coping mechanisms.