Exam 1

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servinggod247
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294622
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Exam 1
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2015-02-02 23:51:51
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psych
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psych
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  1. Dont forget to assess...
    spiritual, religious, cultural 

    VERIFY DATA
  2. The assessment establishes the primary problem, a rapport is developed, then
    the patient and nurse agree upon goals and a plan is formed
  3. The NOC
    standardized list of outcomes that provides objective scales for measurement of goals
  4. Nursing Interventions Classification (NIC)
  5. responsibilities of basic level RN
    Coordinate care, health teaching and promotion, milieu therapy, pharm/bilogical/integrative therapies
  6. responsibilities of Advanced Pracitce RN
    Prescriptive authority, psychotherapy, consultation
  7. The six standards
    • 1. Assessment
    • 2. Nursing DX
    • 3. Outcomes
    • 4. Planning
    • 5. Implementation
    • 6. Evaluation
  8. NAMI
    • National Alliance on Mental Illness
    • responsible for recovery approach, putting person in charge of their illness
  9. Increasingly U.S. diversity is driving more focus toward
    cultural assessment
  10. Race is an accurate or inaccurate classification?
    innacurate
  11. Our ____________________ shape our approach to health care and mental care
    cultural beliefs and worldview
  12. Western culture
    • INdividuality/ rugged individualism
    • autonomy/independence/self-reliance
    • mind and body treated separately 
    • goal-future-time oriented
  13. Eastern Culture
    • Interdependence within Family
    • Mind-Body-Spirit more blended
    • Psychological/physical care assessed together
    • Time is more circular
    • Acceptance of what is- the now
  14. Indigenous cultures
    may be more isolated from outside cultures, tend to live in harmony with the environment, accept the cycles of life
  15. enmeshed
    involved in an unpleasent or complicated situation
  16. Enculturation
    The gradual acquisition of the characteristics and norms of a culture or group by a person, another culture, ect
  17. ethnocentrism
    evaluation of other cultures according to preconceptions originating in the standards and customs of one's own culture
  18. Culture bound syndromes
    specific to some groups
  19. Ethnomedicine
    a study or comparison of the traditional medicine practiced by various ethnic groups, and especially by indiginous peoples
  20. At risk groups
    immigrants, refugess, minorities, those in poverty
  21. Acculturation
    a process in which members of one cultural group adopt the beliefs and behaviors of another group
  22. bicultural
    having or combing the cultural attitudes and customs of two nations, peoples, or ethnic groups
  23. Healthy vs unhealthy practice
    Healthy- preserve/maintain, accommodate/negotiate

    Unhelathy- re-pattern/restructure
  24. Bioethics
    healthcare
  25. Ethics
    right/wrong
  26. Beneficence
    do good
  27. Autonomy
    self government
  28. justice
    just behavior or treatment
  29. fidelity
    faithfulness to a person, cause or belief, demonstrated by continuing loyalty and support
  30. veracity
    conformity to facts, accuracy
  31. 14th amendment rights
    life, liberty, property
  32. writ of habeas corpus
    free person

    A court order to a person (prison warden) or agency (institution) holding someone in custody to deliver the imprisoned individual to the court issuing the order
  33. Types of admissions
    • informal
    • voluntary
    • temporary/emergency
    • involuntary
    • long-term involuntary 
    • involuntary outpatient
  34. Discharge from hospital. Type of release depends on type of admission
    Condition

    Unconditional

    Against Medical Advice (AMA)
  35. Patient Rights
    Right to treatment (humane, qualified/sufficient, individualized)

    Right to informed consent vs. implied consent ( o f the nature of their problems, purpose of RX, risks, alternatives, likely sucess, risks of non treatment)

    compentency....right to refuse.....medicate against will
  36. What are the rights of the pt rregarding involuntary admission and directives
  37. What are the rights of the patient regarding restraint/seclusion; failure to protect pt
  38. intentional tort
    torts that describes a civil wrong resulting from an intentional act on the part of the tortfeasor
  39. unintentional tort
    tort that describes a civil wrong resulting from an unintentional act on the part of the tortfeasor
  40. First and foremost for nurses is
    public safety
  41. Community health centers look for
    compliance
  42. Pt do not like how medicine makes them feel because
    • Crave carbs, high calorie beverages
    • More lethargic
    • Lower sexual function
  43. Goals of outpatient care
    • prevention of exacerbation
    • stabilize
  44. Primary prevention
    considering who might be predisposed to a condition; prevention
  45. Secondary prevention
    screening and early identification, promt care
  46. Tertiary prevention
    • current problem
    • stabilize
  47. Positive symptoms
    things that are there that shouldnt be there
  48. Negative symtpoms
    things that arent there that need to be there (communication, insight, judgement, social skills)
  49. Aspects of a Biopsychosocial Assessment
    Must be realistic and individualized

    • Housing
    • INcome
    • Family/Support
    • Substance abuse
    • Physical condition
    • Language/cultural barriers
  50. Comprehensive Emergency Department
    Set aside areas for psychiatric treatment
  51. Bipolar 1
    associated with psychosis
  52. Bipolar 2
    hperverbal, moody, but no psychosis
  53. Most common In-patient diagnoses
    • Mood disordres
    • Substance abuse
    • Delerium
    • Dementia
    • Anxiety disorders
    • Schizophrenia
  54. What does a psychiatrist do?
    • MD
    • admits
    • discharges
    • writes ordres
    • perscribes
    • head of team
    • good at therapy
  55. What does a psychologist do?
    • PHD
    • testing
    • good at therapy
  56. What does an APRN do?
    Similar things as psychiatrist but not to full extent
  57. What do social workers do?
    expert as social services such as applying for tencare, finding housing, food sources

    needed for discharge planning
  58. What does occupational therapy do?
    nursing, physical therapy, and social work all into one
  59. Milieu
    • Role model appropriate behavior
    • Set up safe environments
    • Strucutre
    • Rules
    • Appropriate sexual behavior
    • Coping
    • educating
  60. Elopement
    running away
  61. What type of detox is life threatening?
    Alcohol detox

    Must go to medical facility because of seizure risk
  62. Interpersonal process
    between two ore more people
  63. What is needed in therapeutic relationships
    • self awareness
    • boundaries
    • clinical supervision
  64. Typical reactions of transference/countertransference
    • boredom
    • rescue
    • over involvement
    • over indentification
    • anger/annoyance
    • hopeless/sad
    • witholding info
  65. Hildegard Peplau wrote what book
    1952  Interpersonal Relations in Nursing
  66. Four phases of Nurse-Patient relationship according to Peplau
    • Preorientation Phase
    • Orientation Phase
    • Working Phase
    • Termination
  67. Surgeon General 1999
    State of Successful performance of mental function that results in productive activites, fulfilling relationships and the ability to adapt to change/cope with adversity
  68. Is there a middle ground
    YES
  69. McNaughton Rule 1843
    From English Law- Person is innocent by reason of insanity if behavior was due to defect of reason from disease of mind as not to know nature and quality of act, or did not know that it was wrong
  70. Jahadora, Marie, 1958 Six Categories
    • Attitudes toward self
    • Presence of growth/development
    • Personality integration
    • Autonomy
    • Sense of Reality 
    • Mastery Over Environment

    ?Cross Out?
  71. It is difficualt to have a _______ standard
    cultural
  72. Factors Affecting mental health
    • culture/ethnicity
    • resilience
    • physical illness
    • diathesis-stress model
  73. Incidence
    number of new cases in a defined population and time frame
  74. prevalence
    total cases new and already existing
  75. 1 ____ adults dx with mental disorder
    4
  76. ____________ leading cause of disease
    neuropsychiatric disorders
  77. More than ________ of mental illness is depression
    1/3
  78. 5 axis of DSM-5
    • 1. psyciatric dx
    • 2. personality disorders or other developmental disorders
    • 3. medical problems
    • 4. social stresses
    • 5. global assessment of functioning (GAS)
  79. Psychoanalytic theory was developed by
    Freud
  80. What did Freud believe?
    mental illness was largely caused from unresolved childhood conflicts. This is based on his beliefs on his practice in treating people suffering from hysteria.  First focus was on hypnosis
  81. Major Aspects of Freudian Theory
    Talk therapy using catharsis and free association

    ID of levels of awareness ( conscious, preconscious, and unconscious)

    three distinct aspects of personality (ID, EGO, SUPEREGO)
  82. Defense mechanisms are a part of which theory
    Freud's Psychoanalytic theory
  83. Psychosexual development from Freud
    • 0-18 MO: Oral Oral Gratification 
    • 18 MO- 3 YR: Anal Independence/Control 
    • 3-6: Phallic Genital Focus
    • 6-12: Latency Repressed Sexuality 
    • 13-20: Genital pubberty/desire opposite sex
  84. Erik Erikson
    1902-1994

    Eight stages
  85. What did Margaret Mahler focus on
    Theoires of Child Development

    object relations and separation-individuation
  86. Who thought that Human behavior seeks to decrease anxiety and meet needs and developed interpersonal theories?
    Harry Stack Sullivan
  87. What did peplau develop
    • Therapeutic use of self, empathic linkage, the art of nursing
    • Facilitating change via the nurse-patient relationship
    • Levels of anxiety 
    • Therapeutic milieu
    • The self-system and personal development
  88. Who wrote INterpersonal Relations in Nursing (1952)?
    Peplau
  89. Ivan Pavlov
    Russian

    involuntary conditioned responses
  90. Watson
    • BEhaviorism 
    • Behavior learned through conditioning
  91. Skinner
    Operant conditioning, positive and negative reinforcemtn
  92. Ellis
    • Rational-Emotive Behavior Therapy 
    • Core beliefs, often negative
  93. Beck
    • Cognitive Behavioral THerapy (CBT)
    • feelings and behavior from distorted thinking
  94. Benner
    Focus on caring, teaching, coaching in nurse, pt relationship
  95. Orem
    promotion of self care
  96. Roy
    adaptation to change
  97. Neuman
    stress reduction
  98. Travelbee
    communcation skills in nurse pt relationship
  99. Theories in a gist
    Psychoanalytic – human behavior complex, importance of family of origin, genogram, themes, traumas, root causes…listen.

    Interpersonal – respectful, educative, accepting, trusting.

    Behavioral – concrete method – behavior modification

    Cognitive – thoughts lead to feelings lead to actions

    Humanistic – prioritizing patient needs, positive approach

    Biological – meds, therapies, nutrition, exercise…

    Milieu – role modeling, structured environment, safety…
  100. Monoamines
    Dopamine, norepi, seratonin, histamine
  101. Amino acids
    aminobutyric acid, GABA,
  102. cholinergics
    acetylcholine
  103. peptides
    neuromodulators
  104. Cerebrum lobes
    • Frontal 
    • Parietyal 
    • Temporal 
    • Occipital
  105. What is a big area of psychiatric research now
    the limbic system
  106. The limbic system includes
    parts of the frontal cortex, the basal ganglia, and the brainstem 

    Links these parts
  107. disordres linked to neurotransmitters
    • schizophrenia
    • depression/mood disorders
    • anxiety disorders
  108. Antianciety and hypnotics enhance
    GABA

    • Examples
    • benzodiazepines, short acting sedative hypnotics, melatonin receptor agonists, deoxepin, some antidepressents
  109. Antidepressents aimed at
    correcting deficiencies of neurotransmitters norepi, seratonin, and dopamine

    • Types:
    • Tricylic antidepressents, SSRI, SNRI, SNDI, Monoamine oxidase inhipitors
  110. Mood stablizers
    • (lithium)
    • may affect electrical conductivity- involves sodium and potassium
  111. Anticonvulsant drugs
    • (Depakote)
    • reduce firing rate of high frequency neurons
  112. first gen antipsychotics
    dopamine blockers
  113. second gen antipsychotic
    dopamine and seratonin blockers
  114. Third gen antipsychotic
    dopamine stabilizer (Abilify(
  115. Stimulants
    • (For ADHD)
    • Ritalin
    • Vyvanse
    • Adderall 
    • Concerta
  116. Non stimulants
    Strattera
  117. Cannon
    studied fight or flight response
  118. GAS
    • 1. Alarm
    • 2. Adaptation
    • 3. Exhaustion

    Hans Selye
  119. Eustress
    positive stress
  120. What is interacting
    congruency of content and process
  121. attending behaviors of nurse
    • eye contact
    • body language
    • voice/tone
  122. ADHD (CNS stimulant) med SE
    • CNS stimulation( insomnia, restlessness)
    • weight loss
    • cardiovascular effects
    • hallucinations, paranoia
    • withdrawal reaction 
    • hypersensitivity
  123. Strattera SE
    • appetite suppression, weight loss
    • GI problems
    • sucidal thoughts
    • liver tox
  124. TCA SE
    • orthostatic hypotention
    • anticholinergic effects
    • weight gaine
    • sedation 
    • toxicity 
    • seizures
    • excessive sweating
  125. Altpha Adrenergic Agonist SE
    (Intunic)
    • CNS effects ( sedation, drowsiness, fatigue
    • Cardiovascular
    • Weight gain
  126. Aytypical Antipsychotic SE
    (Risperdal)
    • Diabetes
    • Weight gain
    • high cholesterol 
    • orthostatic hypotension
    • anticholinergic 
    • agitation
    • dizziness
    • sedation 
    • sleep disruption
    • extrapyramidal side effects

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