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Related Flashcards
Related Topics
Cards In This Set
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Electroconvulsive Therapy: Informed Consent
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- Use therapeutic communication prior to the procedure and throughout the course of ECT tx
- The provider discusses the procedure (including all risks and benefits, as well as a description of the procedure) with the client, and informed consent is obtained - The nurse also asks the client and his family about their understanding and knowledge of the procedure and redirects the client to the provider for clarification as necessary |
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Basic Mental Health Concepts: Client Confidentially
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- Client's right to privacy is protected by the HIPPA
- It is important to gain an understanding of the federal law and of various state laws as they relate to confidentiality in specific health care facilities -Information about the clinet, verbal and in writing, must only be shared with those who are responsible for implementing the client's tx plan -Information may be shared with other persons not involoved in the client tx plan by client consent only -Specific mental heal issues include disclosing HIV status, the duty to warn and protect third parties, and the reporting of child and elder abuse |
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Creating and Maintaining a Therapeutic and Safe Environmetn: Documenting the Use of Restraints
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-Precipitating events and behavior of the client prior to seclusion or restraint
-Alternative actions taken to avoid seclusion or restraint -the time treatment began - The client's current behavior, what foods or fluids were offered and taken, needs provided for, and vital signs -Medication administration |
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Chemical and Other Dependencies: Readiness for Treatment
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- Encourage attendance at self-help groups
-Reinforce teaching with clients and families about codependent behaviors -Defense mechanism of denial is commonly used by clients who have problems with drug abuse or dependency. Frequently denial prevents a clinet from obtaining help w/substance or process abuse or dependency -Participation in dependency despite continuing associated problems - Continued use in the presence of related physical or psychological problems that are acknowledged by clients |
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Anxiety and Defense Mechanisms: Managing Anxiety
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- Provide a calm presence, recognizing the client's distress
-Evaluate past coping mechanisms -Explore alternatives to problem situations -Encourage participation in activities, such as exercise, that may temporarily relieve feelings of inner tension -Use active listening to demonstrate willingness to help |
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Creating and Maintaining a Therapeutic and Safe Environment: Priority Nursing Care
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- Consistently focus on the client's ideas, experiences, and feelings
- Identify and explore the client's needs and problems - Discuss problem-solving alternatives with the client - Help to develop the client's stregths and new coping skills -Encourage positive behavior change in the client - Assist the client to develop a sense of autonomy and self-reliance |
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Medications for Substance Abuse: Alcohol Withdrawl
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- Symptoms usually start within 4-12 hr of the last intake of alcohol, peak after 24-48hr, and then subside, unless alcohol withdrawal delirium occurs
-Common symptoms include N&V, tremors, restlessness and inability to sleep, depressed mood or irritability, increased HR, BP, RR, and temp; diaphoresis and tonic-clonic seizures may occur, particularly in those prone to seizures. Illusions may also occur -Alcohol withdrawal delirium amy occur 2-3 days after cessation of alcohol and last 2-3 days. This is considered a medical emergency. Symptoms include severe disorientation, psychotic symptoms(hallucinations), severe hypertension, cardiac dysrhythmias, and delirium. This type of withdrawal may progress to death - Naltrexone is a pure opiod antagonist that suppresses the craving and pleasurable effects of alcohol - Acamprosate decreases unpleasant effects resulting form abstinence (anxiety and restlessness) |
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Anxiety and Defense Mechanisms: Recognizing Client Use of Displacement
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- Shifting feelings related to an object, person, or situation to another less threatening object, person, or situation
-A person who is angry about losing his job destroys his child's favorite toy - Displacement is an intermediate defense -Individuals may use defense mechanisms as a way to manage conflict in response to anxiety. - Defense mechanisms are reversible and can be adaptive, as well as maladaptive |
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Group and Family Therapy: Adaptation to Role Change
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- Members of a group can take on a number of roles
- Maintenance roles: members who take on these roles tend to help maintain the purpose and process of the group - Task roles: members take on various tasks within the group process - Individual roles: These roles tend to prevent teamwork because individuals take on roles to promote their own agenda - A child taking care of an sick elderly parent - A father taking on the mothers role after the mother has left the family - A child taking on the role of a parent when the parent is a drug addict |
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Anxiety Disorders: Recognizing Somatization
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- Anxiety can be mild: restlessness, increased motivation, and irritability
- Moderate: agitation, muscle tightness -Severe: inability to function, ritualistic behavior, unresponsive - Panic: distorted perception or hallucinations, loss of rational thought, immobility |
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Bipolar Disorders: Recognizing Behavioral Manifestations
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- Manic: Persistent elevated mood; afitation and irritability; dislike of interference and intolerance of criticism; increase in talking and activities; flight of ideas
- Depressive: flat, blunted or labile affect; teafulness or crying; lack of energy; anhedonia; physical finding of discomfort or pain |
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Bipolar Disorders: Relapse
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- Use of substances(alcohol, drugs of abuse, caffeine) can lead to an episode of mania
- Sleep disturbances may come before, be associated with, or be brought on by an episode of mania - Anxiety disorders - Eating disorders -ADHD |
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Schizophrenia: Recognizing Symptoms
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- Paranoid: Hallucinations and delusions; other-directed violence may occur
-Disorganized: Loose association; bizarre mannerisms; incoherent speech; hallucinations and delusions may be present -Catatonic: Withdraw stage-pyschomotor retardation; waxy flexibility; extreme self-care needs; Excited Stage- constant movement, unusual posturing, and incoherent speech; self-care needs; danger to self or others -Residual: anergia, anhedonia, or avolition; withdrawal from social activities; impaired role function; speech problems; odd behavior -Undifferentiated: any positive or megative symptoms may be present |
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Creating and Maintaining a Therapeutic and Safe Environment: Appropriate Techniques
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- Purposeful and goal-directed
- Well-defined with clear boundaries -Characterized by an interpersonal process that is safe, confidential, reliable, and consistent - Milieu therapy creates an environment that is supportive, therapeutic, and safe - Therapeutic nurse-client relationship is foundational to mental health nursing care |
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Effective Communication: Planning the Orientation Phase
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- Minimize distractions
- Provide for privacy - Identify mutually agreed-upon client outcomes - Set priorities according to the client's needs - Plan for adequate time for interventions |
