Lecture 2 Mental Health

An interconnected and independent set of individuals who come together for a shared purpose is called a _____.

Any group of people who meet for personal growth and psychological development is called a _____ group.

The Characteristics of the group are determined by:

1. The size and defined _____

2. Degree of ___ among members.

3. Rules, boundaries and ____ (what is said in group_.

4. The _____ which is the underlying dynamics among group members.

group; therapeutic; purpose; similarity; content; process

Advantages of therapeutic groups include:

1. Engaging _____ patients simultaneously

2. Participants benefiting from_______ from nurse leader and peers

3. Relatively a _____setting bc it is a group setting instead of one on one.

4. Promote feeling ______ and makes them feel not alone in their problems.

Disadvantages:

1. There are ____ constraints as patients may only get a couple minutes instead of an entire session one on one.

2. Concerns with ____ issues which is built on trust

3. Dealing w a ____ member.

4. Cohesiveness may bind group (friend groups) members together and encourage ____ behavior

5. Not all patients benefit from group treatment.

multiple; feedback; safe; belonging; time; trust; disruptive; unacceptable

A group in which a range of differences exists among members is called a ______ group.

A group in which all members share central traits is called a _____ group.

A ______ group is a group in which membership is restricted.

A group in which new members are added as a others leave is called an ___ group.

A ______ is an individual or a small group that is isolated within a larger group and functions separately

heterogenous; homogenous; closed; open; subgroup

Yalom’s therapeutic curative factors include:

1. The instillation of ____ in which the leader shares optimism and successes of group TXT and members share their ______.

2. Universality in which members realize that are not ___ with their problems, feelings, or thoughts.

3. Imparting of info in which participants receive formal ____ by the leader or advice from peers.

4. _____ in which members gain/profit from giving support to others and leading to improved self ____.

5. Corrective recapitulation of the primary family group in which members ____ patterns of behavior in the group that they learned in thier families with feedback from the leader/peers, they _____ about their own behavior.

hope; improvements; alone; teaching; altruism; esteem; repeat; learn

When planning a group:

1. Name an ____ of the group

2. Determine the types of patients or _____ of members for inclusion

3. The group schedule

4. The physical ____ configuration which determines how participants ___ with another and can be limited by the size of the group

5. The description of leader and member _____

6. Methods/means of _____ outcomes of the group like how do we know we are successful.

objective; diagnoses; setting; interact; responsibilities; evaluating

Phases of group development include:

1. The ____ phase in which the group is forming. The ___ of the group is states and leader’s role is structure an atmosphere of respect, confidentiality, and ____.

2. The ____ phase in which the leader’s role is to encourage a focus on a problem solving that is ___ with the purpose

3. The ___ phase in which the leader’s role is to encourage the members to ___ on progress they have made and identigy post termination goals.

orientation; purpose; trust; working; consistent; termination; reflect

Tuckman identified 5 stages of group development:

1. The ____ phase takes part in the orientation phase in which members are positive and ____. Some may be ____ as they don’t fully understand the work the team will do. Others may be ___ abt whats to come.

2. The ____ phase which takes place in the working phase. Members start to push boundaries and ____ arise b/w team members. Some may be uncomfy, frustrated, or overwhelmed and some may challenge the leader’s _____. Roles and group goals are _____.

3. The ____ phase takes place in the working phase. Members start to ___ their differences, appreciate each other’s strengths, and ___ the leader’s authority. Roles become ____ and members freely share info and provide ___ feedback.

4. The ____ phase takes place in the working phase and now members can now work to achieve the group’s goal.

forming; polite; anxious; excited; storming; conflicts; authority; clarified; norming; resolve; challenge; defined; performing

An ____ leader exerts control over the group and does not encourage much interaction among members. This may be used if there are ___ limited constraints.

A _____ leader supports extensive group interaction In the process of problem solving.

A _____ ____ leader allows the group members to behave in any way they choose and does not attempt to control the direction of the group. This may be used if ____ is required.

autocratic; time; democratic; laissez faire; brainstorming

The ____ is essentially the vibe of the space.

Movement along the continuum in care is ____ and can go in either direction.

It ranges from least restrictive to most _____. The least being you’re primary care and you’re most being a ____ hospital.

milieu; fluid; acute; state

The informal functioinal group member roles include:

1. The ___ roles which keeps the group focused on its main purpose and gets the work done.

2. The ____ roles which keeps the group together. They help each person feel ____ and included and create a sense of group ____.

3. The ___ roles whic have nothing to do w helping the group but instead relate to specific _____, personal agendas, and desires for having needs met by shifting group’s focus to htem.

task; maintenance; worthwhile; cohesion; individual; personalities

A primary intervention occurs ____ any problem manifests and seeks to ___ the incidence/reate of new cases.

A secondary intervention is essentially ____ and is aimed at reducing the prevalence of psychiatric disorders. This allows for early ______ of problems, screening, and prompt/effective TXT are hallmarks.

The tertiary prevention inclures TXT of disease w/ a focus on preventing ____ to a severe course, disability, or even death.

before; reduce; screening; identification; progression

The roles of nurses in outpatient settings include:

1. Strong problem solving and ___ skills

2. ____ competence

3. Flexibility and knowledge of ____ resources

4. Autonomy

5. Promoting recovery and ____ of TXT

clinical; cultural; community; continuity

Patient’s rights:

1. Hospitalized patients _____ their rights as citizens.

2. BUT the patient’s need for safety must be _____ against patient’s rights as a citizen.

3. Mental health facilities have ______ statements of patient’s rights and applicable state laws

Teamwork and collaboration:

1. Members of each discipline are responsible for gathering data and_____ in the planning of care.

2. TXT plan provides a ______ for patient’s care during hospital stay. Discharge is planned from the moment they are ____.

3. Nurse’s role is often to ___ planned meetings.

4. For standardization in treatment and improve outcomes, inpatient units use ____ _____.

retain; balanced; written; participating; guideline; admitted; lead; clinical pathways

The overall environment and interactions within the environment is called the therapeutic ___.

Managing behavior crises:

1. Behavioral crises can lead to patient ____ toward self/others and can escalate through predictable stages.

2. Use crisis prevention and management techniques

3. Special teams for _____

4. The use of seclusion, ____, and emergency meds are the actions of ___ resort. The types of restraints include ____ (holding the body, ____ (straps, mittens), and chemical. Only used for safety.

Safety needs to be identified and ____ interventions begin in admission.

The goal in designing psychiatrics units is provide a therpauetic and aesthetically which balances the need for ____ bc some patients are at a risk for ___ or violence.

milieu; violence; deescalation; restraints; last; physical; mechanical; individualized; safety; suicide

Nurses are frequent targets of violence because they have the most _____ patient contact.

Violence is most frequent in:

1. The ____ health units

2. The ______ departments

3. The ____ units.

Co-morbidites include:

1. PTSD and ____ abuse disorder.

2. A substance and mental health disorder is called a ____ diagnosis.

3. They can ____ with depression, anxiety, psychosis, and personality disorders.

direct; mental; emergency; geriatric; substance; dual; coexist

Etiology of mental health disorders include:

1. Biological factors like the ____ of the brain. The ____ helps you to remember. Neurotransmitters and ____ due to genetics.

2. Psychological factors include:

   1. The behaviorial theory, in which you behavior is a ___ response

   2. The social learning theory in which you ___ others.

areas; hippocampus; predisposition; learned; imitate

______ _____ includes knowledge of personal responses to anger and aggression. Also be aware of your own personal and cultural ____.

A self-assessment promotes ____ responses to patient anger and aggression. Without this, nursing interventions are marked by ____ and emotion-based responses.

self awareness; norms; calm; impulsive

Basic considerations for ensuring safety

1. No ____ earrings or necklaces

2. Allow only ____ person to interact with the aggressive person

3. Know your environment and the placement of ____ or hazards

4. Do not stand directly in ____ of the doorway (pt. might feel trapped) and encourage the patient to ____ down

5. Provide ____ to the escalating patient, do not ignore escalating anger

6. Avoid confrontation, keep security in the _____ until they are needed

dangling; one; obstacles; front; sit; feedback; background

Psychosocial Interventions for Anger Control:

1. Establish___ and rapport with the patient

2. Use a ___ and reassuring approach

3. Speak to the patient ____ and in short sentences using a ____ calm voice

4. Clarify behavioral ______ for expression of anger

5. Encourage the patient to seek_______ from nursing staff during periods of increasing tension

trust; calm; slowly; low; expectations; assistance

Pharmacological interventions may be used if the patient is showing ___ signs of anxiety and agitation. These are usually ___ meds to relieve symptoms.

For acute symptoms of anger/aggression, anti-anxiety and ___ agents are combined.

Combination of haldol, ativan, and ____ is widely used called B52.

Long term TXT is based on treating ___ psychiatric disorder.

increased; PRN; antipsychotic; benadryl; underlying

The goal of seclusion and/or restraint is the ____ of the patient and/or others.

The involuntary confinement of a patient alone in a room from which the patient is physically prevented from leaving is called _____.

Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the patients ability to move is called a _____.

Once the person

safety; seclusion; restraint

The laws ___ from state to state and nurses must be familiar w their state law which is called the ____ (acronum).

Personal beliefs about what is right and wrong is called ____.

The branch of knowledge and philosophical beliefs about what is right or wrong as a society is called ___. It describes that ___ to be rather than WHAT IS.

The study of specific ethical questions that arise in healthcare is called ____.

vary; NPA; moral; ethics; ought; bioethics

Ethical principles include:

1. Respecting the rights of others to make their own decisions is called ___.

2. The duty to act to promote the health and well-being of others is called ____.

3. Doing no harm to the patient is called ____.

4. Duty to distribute resources or care equally, regardless of personal attributes is called ____.

5. Maintaining loyalty and commitment to the patient and doing no wrong to the patient is called ____.

6. Duty to communicate truthfully is called ____

autonomy; beneficence; nonmaleficence; justice; fidelity; veracity

Voluntary admissions are _____ voluntary admission. It requires a ___ status to be admitted into an inpatient unit.

Involuntary (emergency) committment requires the following certain criteria.

The process by which the courts order a patient committed to a course of outpatient treatment is called a ____ ____ treatment.

The treatment must be ___ and the patient must have some degree of ___ to understand stipulations.

Patient must not present an eminent threat of ___ to self/others.

involuntary community; monitored; competency; danger

A person’s ability to make an informed decision is called _____. This can be ___ in that they can have it one min and not the next.

A legal term related to the degree of mental soundness possessed by a person to perform certain acts is called _____. If they are found to be incompetent, they may be appointed guardians or a ______ which is the person in charge of all their money.

capacity; fluid; competency; fiduciary

An ethical responsibility that prohibits disclosure of privileged information is called ____. This is under the federal law called ____ which was enacted by Bill ___ after his friend, Arthur Ash contracted HIV/AIDs.

Posting confidential info on social _____ is a violation.

We have the duty to ____ potential victims of threats.

confidentiality; HIPAA; clinton; media; warn

A willful or intentional act to violate another person’s rights or property is an _____ ____. It includes:

1. Making someone uncomfortable but not actually touching them which is ____.

A ___ offers much more insight into the family and nature of relationships in a family than a family tree.

genogram

Families are the largest group of ______ for the mentally ill. They ____ each other physically, mentally, emotionally, etc. They exist so humans can ___ and thrive.

The family system is ____ when it fails to perform its necessary functions and starts to ___ individual family members.

caregivers; nourish; develop; dysfunctional; harm

Children living with a single adult of any gender is called a ___ ___ family.

Children living with two unmarried parents who are the biological/adoptive parents to all the family’s other children is called the unmarried biological or ____ family.

Children living w/ two parents who are married to each and are each the biological or adoptive parents to all the children in the family is called the _____ or traditional family.

single parent; adoptive; nuclear

Dysfuntional families often have boundary issues:

____ boundaries are hard to determine where they are and obscure family roles, lines of authority. This can lead to _____ (over-concern or over-involvement).

_____ boundaries exist when rules and roles are completely inflexible. They can lead to _____.

diffuse; enmeshment; rigid; isolation