mental health exam 1

mental health includes

emotional, psychological, and social well being

mental health affects

how we act, feel and think

mental health can determine how we

handle stress, relate to others, and make choices

mental health it ___ % of nclex exam

8-12

hipocrates

first to place in a physical context around 400 bc

first american hospital established in

philadelphia

first american hospital established in philadelphia in

18th century

benjamin rush

father of american psychiatry

dorthea dix

created first system of state asylums and therapeutic care

linda richards

first american psychiatric nurse

1873

1955 was the

incorportation of psychiatric nursing into the curricula in all undergrad programs

some cultures believe that

soul was taken and wellness could only occur if their soul was returned

stigmas: you must be crazy

what we see in TV

mental illness is seen locked up in asylum or wearing straight jackets in padded cell

stigmas: you must be dangerous

patients are seen as not being able to control thoughts and actions

they could suddenly lash out and hurt you

stigmas: self inflected

those with mental health need to stop what theyre doing and act properly

stigmas: different than the rest of us

due to the danger and unpredictability, patients need to be kept seperate from the wider population

mental health “behavioral health”

able to recognize own potential, cope with normal stress, work productively, make contribution to community

traits of good mental health

ability to think rationally, communicate appropriately, learn, grow emotionally, be resilient, have a healthy self esteem

resilience

ability and capacity to secure resources needed to support well being

resilience is characterized by

optimism, sense of mastery, and competency

resilience is essential to

recovery

two responses that happen with a stressor

adaptive response (good) maladaptive response (bad)

predisposing factors

in how we respond and perceive stress

diathesis

biological disposition and genetically vunerable to stress

stress

environmental stress or trauma

diathesis stress model is

most accepted explanation for mental health

diathesis stress model is the combination of

genetic vulnerability and negative environmental stressors

example of diathesis stress model

genetic vulnerability (predisposition) + history of child abuse + current stress

dsm5

diagnostic and statistic manual of mental disorders

dsm5 is the

official medical guidelines of the american psychiatric association for diagnosing psychiatric disorders

the dsm is often referd to as the

bible of psychology

dsm5 contains the

classification of mental disorders that are diagnosed in the united states, including the requirements for diagnosis

in order to include a complete picture of the factors that influence the clients mental health

the 4th edition of the dsm broke down diagnosis and assessment into five axes

axis 1 of dsm

contains clinical disorders such as ANXIETY AND DEPRESSION

axis 2 of dsm

contains mental retardation and personality disorders such as ANTISOCIAL PERSONALITY DISORDER AND OCD

axis 3 of dsm

contains general medical conditions such as CANCER AND ALZHEIMERS that may affect mental illness

axis 4 of dsm

contains environmental and psychosocial stressors that may affect the clients psychological functioning, such as recent divorce, inadequate social support and the death of a parent

axis 5 of dsm

contains global assessment of functioning, which is a NUMERICAL SCALE that measures the level of functioning of the client

1-100

mental illness is defined as

disorders with definable diagnosis

significant dysfunction in mental functioning related to

developmental, biological, and psysiologial disturbances

psychiatric mental health nurses

employ powerful use of self, work with people throughout the life span, employed in variety of settings

role of mental health nurses

establish foundation of trust

promote psychological wellbeing

help find outside resources and support systems

educate!

milieu therapy or management

orienting the patient to the environment, their rights, and responsibilities, activities design for their own personal growth and therapy, and any restrictions or limits to maintan safety

maslows heirarchy of needs

human beings are active participants in life, striving for self actualization

when lower needs are met, higher needs are able to emerge

heirarchy of needs bottom to top

physiological, safety, love/belonging, esteem, self actualization

nanda-1

north american diagnosis association international

nanda-1 describes

nursing diagnosis as a clinical judgement about individual, family, or community resposnes to actual or potential health problems and life processes

future challenges and roles

aging population, increased cultural diversity, expanding technology, patient advocacy, legislative involvment,

in recent years, a greater emphasis has been placed on

study of the organic basis for psychiatric illness

function and activities of the brain

maintenance of homeostasis

regulation of ANS and hormones

control of biological drives and behavior

cycle of sleep and wakefullness

cellular composition of the brain

neurons (86million)

respond to stimuli

conduct electrical impulses

release chemicals-neurotransmitters

neurotransmitters

keep our functioning, managing everything from breathing to heartbeat to learning and concentration levels

neurotransmitters can affect various psychological functions such as

fear, mood, pleasure, and joy

common neurotransmitters in the body

serotonin, dompamine, glutamate, epinephrine, norepinephrine, endorphines

neurons can release more than one

chemical at the same time

core of brain

regulates internal organs and vital functions

hypothalamus

basic drives and link between thought and emotion and function of internal organs

brainstem

processing center for sensory information

function of cerebrum

mental activityes, conscious sense of being, muscle movement, emotional status, memory, language, communication

structured imaging techniques

CT and MRI scans

function imaging techniques

PET, SPECT

PET scan

o2, glucose, blood flow, N/T receptors in actions

SPECT: single photon emission computed tomography

increase or decrease of d2, d3 receptors, utilization of glucose, abnormalities in limbic system and temporal lobes

disturbances of mental function

environment, genes, altered neurons, neurotransmitters, norepinephrine, serotonin, dopamine, glutamate, GABA

happy hormones

dopamine, serotonin, endorphins, oxytocin

serotonin

sun produces vitamin d which increases serotonin

endorphins

runners high, laughter, pleasant aromas, dark chocolate

oxytocin

breast feeding, be in love, orgasm, hugging, showing love to people or animals

implications for psychiatric illness

when stressed, immune system in suppressed resulting in supression of lymphocyte proliferation and function

certain neurochemicals may influence immune system: positives for teh immune system

growth hormone, testosterone, epinephrine and norepinephrine, serotonin

psychotropics target

neurons, neurotransmitters, and receptors

delusions and hallucinations are caused by

overactive dopamine

antipsychotic drugs block

D2 receptors for dopamine

sedative and tranq were popular in

1800s

barbiturates and amphetamines were popular in

early 1900s

antipsychotics and thorazine were popular in

1950s

mood stablilizers and lithum

still used

barbiturates

combination of urea and malonic acid that is used as sedative

example of babiturates

sodium amytal, pentobarbital, butalbital, phenobarbital, brevital

pentobarbital is used for

short acting seizures, insomnia

butalbital is used for

migraines

phenobarbital is used for

long acting seizures

brevital is used for

anesthesia (short acting)

jimi hendrix overdosed on

barbiturates

classification of psychotropic drugs

anxiolytics, ssri and snri, maois and tcas, typical first gen, atypical second gen, mood stablizers, adhd meds, meds for alzheimers

antianxiety and hypnotic drugs: benzodizepines

diazepam, clonazepam, alprazolam, lorazepam

buspar is not a

benzo, decreases anxiety

neurotransmitter y-amniobutryic acid (gaba) plays a role in

modulating neuronal excitability and anxiety

decreased levels are associated with anxiety

benzos

valium, klonopin, xanax, ativan

anticonvulsants decrease

neuron excitement

benzos replaced barbiturates for

anxiety

hypnotic sleep drugs

short acting sedative hypnotic sleep agents (z hypnotics)

z hypnotics

zolpidem, zaleplon, eszopiclone

melatonin receptor agonists

ramelteon, doxepin, buspirone

4 categories of antidepressnats

tcas, maois, ssris, snris

tcas

tricyclic antidepressants

increase levels of norepinephrine and seratonin and block the action of acetycholine

examples of tcas

nortriptyline, amitryptyline, imipramine

maois

monamine oxidase inhibitors

maois are used to prevent

monamine oxidase from destroying norephinephrine, seratonin, and dopamine from the brain

maois are not as popular because

interactions with food and other medications