nuts&bolts of psych

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  1. Definition of mental health:
    A state of psychological and emotional well being.
  2. A mentally healthy person:
    Strives to achieve balance in physical, emotional, social and spiritual spheres.

    Able to cope effectively with normal stresses in life and function productively to meet individual, family and community needs.
  3. Two types of communication:

  4. Communication that takes place between the nurse and client and the focus in on the client's thoughts, feelings, behavior, roles and expectations.
    Therapeutic communication
  5. Nurse's role in therapeutic communication:
    • Uses active listening
    • Help client as they work to explore their feelings, understand and gain insight into their mental illness
    • Assist them as they work to change.
  6. *Goals of therapeutic communication:
    • Establish rapport
    • Actively listen
    • Gain client's perspective
    • Explore client's thought's and feelings
    • Guide client toward problem solving
  7. The main compontent in communication is:
    therapeutic communication
  8. Communication that is......

    - less goal oriented
    - more superficial
    - does not involve the expectation of helping the client regarding emotional concerns
    Social communication
  9. Nurse and client discussing their favorite movies.
  10. Discussion is about medication side effects.
  11. Discussion is about issues related to grief.
  12. While watching television they are discussing the weather.
  13. Client is describing issues of concern related to her children.
  14. Open-ended questions
    Restating and reflecting
    Asking for elaboration
    Seeking clarification
    Offering self
    Making observation

    Are these therapeutic or non therapeutic communication?
  15. Advising
    Belittling feelings
    Changing the subject

    Are these therapeutic or non therapeutic communication?
    non therapeutic
  16. Non-verbal aspects of communication:
    • Proxemics
    • Active listening
    • Observation
    • Body language
    • Eye contact
    • Silence
    • Touch
  17. What is the physical distance between communicators?
  18. Space that is...
    Up to 18 inches
    Parents and children
    Threatening to invade this space
    Intimate space
  19. Space that is...
    18 inches - 4 feet
    Comfortable for family and friends conversing
    Personal space
  20. Space that is....
    9-12 feet
    Social, work and business
    Social-consultative space
  21. Space that is...
    Up to 12-25 feet
    Speaker to audience, small groups
    Public space
  22. Refraining from other internal mental activities and concentrating exclusively on what is being said.
    Active listening
  23. Nonverbal indicators of active listening:
    • Position facing client
    • Open posture
    • Leaning forward toward client
    • Establishment of eye contact
    • Relaxed body language
  24. S
    • S - Sit squarely, face client
    • O- Observe open posture, arms and legs uncrossed
    • L - Lean forward
    • E- Eye contact
    • R - Relax!
  25. Watching the speaker's nonverbal actions as he or she communicates.
    Active observation
  26. Touch used to examine or perform procedures.
    Functional-professional touch
  27. Greetings, handshakes, gentle guiding of someone.
    Social-polite touch
  28. A hug as a greeting, when an arm is thrown around another person.
  29. Between lovers, close relatives
  30. Between lovers
  31. Touch should not be perceived as invasive or inappropriate.
    Ask permission!
  32. Relationship that is directed toward improving the client's well-being.
    Therapeutic relationship
  33. Phases of therapeutic relationship:

    Phase I: ____

    Phase II: ____

    Phase III: _____
    Phase I - Orientation

    Phase II - Working

    Phase III - Termination
  34. Initial phase that involves assessment and analysis.
    Phase I.
  35. Which phase?

    Nurse establishes trust
    Nurse assess client
    Nursing diagnosis is formed
    Goals are established
    Phase I - Orientation
  36. Working phase involves planning outcomes and applying interventions to help the client achieve their goals.
    Phase II - Working
  37. Which phase?

    Nurse encourages expression of problems, thoughts and feelings.
    Collaboration and mutual problem solving
    Coping techniques are taught/recognized
    Adaptive behaviors are implemented
    Phase II - Working
  38. Which phase is the termination of resolution is the endpoint of the relationship.
    Phase III - Termination
  39. Which phase?

    Problems should be solved
    Nurse evaluated outcomes for entire relationship
    Mutual agreement
    Does client show regression?
    Phase III - Termination
  40. Nursing roles in therapeutic communication:
    • Teacher
    • Caregiver
    • Advocate
    • Parent surrogate
  41. The purpose of the nurse client relationship in therapeutic relationship is to:
    Create a safe climate where the client feels free to express themselves and try out new ways to cope.
  42. When the client experiences an emotions reaction toward the nurse based on past experiences.
  43. When the nurse responds to the client with feelings based on feelings from their past.
  44. Signs the relationship has become inappropriate:
    • Secretive
    • Phone calls outside of hours
    • Makes exceptions for client
    • Gift giving
    • Touching / over doing
    • Extended sessions
    • Body language
  45. Considering the client as a person or individual or biopsychosocial being.
    Holistic care (Nursing Model)
  46. Viewed as a characteristic of mentally healthy people involving control, commitment and challenge.
  47. Individual factors affecting response to therapy:
    • Age, Developmental
    • Genetics, Familial tendencies
  48. The essence of a persons being and his or her beliefs about the meaning of life and purpose of living self awareness is very important
  49. Forms of spirituality:
    • Belief in God/higher power
    • Practice of religion
    • Cultural beliefs and practices
    • Relationship with the environment
  50. *Spirituality should serve as:
    A source of comfort during stressful or traumatic times.
  51. Clients with mental illnesses may believe that they are demon possessed that God has abandoned them, or they haven't prayed hard enough
    This is when it's not a comfort.
  52. Freud's belief that faith and religious beliefs were a universal obsessive neurosis
  53. Keeping a person's faith completely separate from their mental illness.
  54. Combines a person's spirituality with their treatment plan.
  55. Interpersonal factors of spirituality:
    • Sense of belonging - "value" and fit
    • Social networks
    • Social support
    • Family support
  56. To have culturally competent nursing care you must:
    Have respect for the individual regardless of cultural differences.
  57. Theoretical concepts:
    • Attempts to explain human behavior
    • Suggests how normal development occurs from theorist's perspective
    • Suggests strategies for interventions for working with clients.
  58. Humanistic Framework:
    • Shifted away from viewing the individual as a neurotic, impulsive or repressed being.
    • Frued
    • Views human nature as positive and growth orientated
    • Focus is here and now
  59. Client centered Therapy:
    Person can become fully functioning when they are unconditionally valued.
  60. Theory of human motivation:
    Abraham Maslow
  61. Human needs that are organized according to levels or a hierarchy in which individuals move on to higher needs as lower, more basic needs are met.

    Focuses on total person

    Emphasizes health rather than illness or problems.
  62. Maslow's Hierarchy of Needs:
    Physiologic needs - basic needs to sustain life - air food water

    Safety and security - need to establish security, stability and consistency out of the chaos of lie

    Love and belonging (top of pyramid) - referse to an individuals desire for acceptance and belonging to others
  63. Maslows:

    When basic needs are met, health and growth will follow.
  64. Represents the "loftiest" need describing self awareness and the desire to become the best that one can become.
  65. Interpersonal theory of nursing:
    Hildegarde Peplau
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nuts&bolts of psych
nuts&bolts of psych
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