Psychiatric-Mental Health Nursing Review

Comprehensive Question and Answer practice flashcards covering anxiety disorders, psychiatric theories, suicide risk assessment, mental health definitions, and therapeutic relationships.

How are acute anxiety and chronic anxiety classified?

Acute anxiety is referred to as state anxiety, whereas chronic anxiety is referred to as trait anxiety.

What is Generalized Anxiety Disorder (GAD)?

A disorder involving chronic and excessive worry or anxiety on more days than not for $6+$ months that interferes with daily functioning and relationships.

What is the typical duration and nature of a panic attack?

A discrete period of intense anxiety or terror without real accompanying danger, typically lasting $5\text{--}20$ minutes.

What diagnostic criteria define Panic Disorder?

Recurrent panic attacks without a medical cause, accompanied by $1+$ month of persistent concern or worry about future attacks and their consequences.

What are the core characteristics of Body Dysmorphic Disorder?

Preoccupation with an imagined defective body part, obsessive thinking, compulsive behavior, and fear of rejection driven by feelings of disgust, shame, and depression.

How do Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) differ in timeline?

ASD symptoms occur soon after a traumatic event and last within $1$ month; PTSD occurs when ASD symptoms persist past $1$ month with functional impairment.

Which neurotransmitters are primarily involved in the etiology of anxiety disorders?

Norepinephrine, Serotonin, and Gamma-aminobutyric acid (GABA).

What agent is administered to reverse a Benzodiazepine overdose?

Flumazenil (Romazicon).

How does Buspirone (BuSpar) differ from Benzodiazepines?

It lacks muscle-relaxant, anticonvulsant, and sedative-hypnotic properties, does not interact with CNS depressants, is not effective for panic disorder or withdrawal, and takes several weeks to achieve full antianxiety effects.

What are the components and operating principles of Freud's personality structure?

The Id operates on the pleasure principle (reflex action, primary process); the Ego acts as a problem solver and reality tester using the reality principle; the Superego represents the moral component and ethical values.

According to Freud's Psychoanalytic Theory, what levels of human mind awareness are represented in the mental iceberg model?

The Conscious level (thoughts, perceptions), Preconscious level (memories, stored knowledge), and Unconscious level (fears, irrational wishes, immoral urges, selfish needs, violent motives, shameful experiences, unacceptable sexual desires).

What is the difference between transference and countertransference?

Transference occurs when a patient unconsciously displaces feelings and behaviors from past significant figures onto the nurse. Countertransference occurs when the nurse displaces feelings and behaviors from their past onto the patient.

What are Erikson's Eight Stages of Development?

Infant (Trust vs. Mistrust), Toddler (Autonomy vs. Shame/Doubt), Preschooler (Initiative vs. Guilt), School-Age Child (Industry vs. Inferiority), Adolescent (Identity vs. Role Confusion), Young Adult (Intimacy vs. Isolation), Middle-Age Adult (Generativity vs. Stagnation), Older Adult (Integrity vs. Despair).

What is the ABCD approach in Ellis's Rational Emotive Behavior Therapy (REBT)?

A = Antecedent/activating event, B = Belief about the event, C = Consequence of belief, D = Refute/dispute the false or irrational belief.

What are the five levels of human needs in Maslow's Hierarchy, starting from the base?

Physiological needs (air, water, food, shelter, sleep), Safety needs (security, employment, health), Love and belonging (friendship, intimacy, family), Esteem (respect, status, recognition), and Self-actualization (desire to become the most that one can be).

What key prevalence statistics characterize suicide in the United States according to 2021 data?

Suicide was the 11th leading cause of death with 48,183 deaths and 1.7 million attempts; White males accounted for 69.7% of completed suicides, averaging 132 suicides daily (1 every 10.9 minutes).

What does the mnemonic IS PATH WARM stand for in assessing suicide risk?

Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood Changes.

What are overt versus covert verbal statements regarding suicide?

Overt statements directly state intent (e.g., 'I wish I were dead'), whereas covert statements indirectly communicate intent (e.g., 'I won't be a problem much longer').

What protocol requirements apply to nursing care during an active suicide crisis period?

Institutional suicide precautions, milieu management, direct observation, documenting client activity every 15 minutes (or facility protocol), and encouraging expression of feelings and problem-solving alternatives.

How are Mental Health and Mental Illness defined by official guidelines?

Mental Health (USDHHS): Successful performance of mental function resulting in productive activities, fulfilling relationships, and ability to adapt/cope. Mental Illness (NAMI): Medical conditions affecting thinking, feeling, mood, ability to relate to others, and daily functioning.

What continuum stages lie between Well-being and Mental Illness?

Well-being (occasional stress, no impairment) transitions to Mental Health Problems (mild/moderate distress, temporary impairment) and then to Mental Illness (marked distress, moderate to disabling or chronic impairment).

What factors influence overall mental health according to the biological, psychological, and sociocultural model?

Biologic (prenatal/perinatal events, health, nutrition, neuroanatomy), Psychological (interactions, IQ, self-concept, coping skills), and Sociocultural (family stability, housing, economics, religion, values/beliefs).

What is the Diathesis-Stress Model of mental illness?

An explanation stating that mental disorders result from a combination of a biological genetic predisposition (diathesis) and environmental trauma or stressors (stress).

How do Basic Level RNs and Advanced Practice RNs (APRN) differ in psychiatric nursing scope of practice?

Basic RNs handle assessment, case management, milieu management, medication administration/teaching, crisis intervention, and supportive counseling. APRNs additionally formulate diagnoses, order/interpret labs, prescribe medications, and conduct individual, group, or family therapy.

What is HCAHPS and what nursing action most influences its scores?

Hospital Consumer Assessment of Healthcare Providers & Systems; 'Nurse Communication' is the factor with the greatest impact on patient satisfaction and rating.

How do social relationships differ from therapeutic nurse-patient relationships?

Social relationships are mutual, initiated for friendship, involve superficial communication, and give/receive advice. Therapeutic relationships are strictly centered on patient needs, maintain clear boundaries, and focus on patient problem-solving and growth.

What are the three phases of Peplau's Nurse-Patient Relationship Model?

Orientation Phase (establishing rapport, contract, confidentiality, termination terms), Working Phase (gathering data, promoting problem-solving, behavioral change, self-esteem), and Termination Phase (summarizing goals achieved, evaluating new coping strategies).

What core nurse behaviors promote patient growth in a therapeutic relationship?

Genuineness, Empathy (not sympathy), Positive Regard, Attending, and helping patients develop resources.