Mental Health Exam 2

Mild Anxiety

• everyday problem, solving leverage

• sees, hears and grasps more information, and problem solving becomes more effective

• physical symptoms may include slight discomfort, restlessness, irritability, or mild relieving behaviors (nail bitting, foot or finger tapping, fidgeting).

Moderate anxiety

• selective inattention

• sympathetic nervous system symptoms begin to kick at this level. The individual may experience tension, a pounding heart, increased pulse and respiratory rates, perspiration, and mild somatic symptoms (gastric discomfort, headache, urinary urgency)

• clear thinking hampered

• problem solving not optimal

sever anxiety

• perceptual field greatly reduced

• difficulty concentrating on enviroment

• confusied and automatic behavior

• somatic symptoms increase (headache, nausea, dizziness, insomnia) often increased

panic

• markedly disturbed behavior - running, shouting, screaming, pacing, or withdrawal. Hallucinations, or false sensory perceptions (seeing people or objects not rally there)

• unable to process reality, impulsivity

symptoms of panic attack

• dizziness

• sweating

• hypertension

• rapid heartbeat

• shortness of breath

  • trembling

nursing interventions for a panic attack

• maintain a calm manner

• remain with the patient

• minimize environmental stimuli if possible

• move to a quieter setting if possible and stay with the parent

• use clear, simple statements and repetition

• use a low pitched voice, speak slowly

• recognize the anxious persons distress

• being willing to listen

nursing process for anti-anxiety meds

• anti-anxiety agents (anxiolytics)

• action: depression oc CNS.

• common: alprazolam (xanax)

• chloridiazepoxide (librium)

• diazepam (valium)

• lorazepam (Ativan)

obsessive compulsive disorders

• trichotillomania and excoriation disorder

  • body-focused repetitive behaviors

  • hair pulling (trichotillomania)

  • skin picking (excoriation disorder)

  • exoriation: picking at skin on face, head, cuticles, back, limbs, hands, and feet to the point of damage

• other compulsive disorders

  • medication or substance-related

  • medical condition related

A patient has a panic attack, which action should be implemented

communicate with simple words and brief messages

Localized amnesia

unable to remember what occured during a specific time

selective amnesia

can recall only a specific aspect of an event

generalized amnesia

Complete loss of memory related to one’s life history

• subtype

• dissociative fugue

Kubler-Ross’s 5 stages

• denial and isolation

• anger

• barganing

• depression

• acceptance

suicide

intentional act of killing oneself by any means

suicide ideation

thinking about killing oneself

suicide attempt

engaging in potentially self injurious behavior with the intention of dead

non-suicidal self injurt

intentional damage to ones own body tissue, without conscious suicidal intent, and for purposes not socially or culturally sanctioned

suicide risk factors

• biological factors: familial, high among twins, low serotonin levels

• cognitive factors: freud: aggression turned inward, menninger’s 3 parts (wish to kill, wish to be killed, wish to doe), aaron beck (central emotional factors of hopelessness

• environmental: family conflicts, low parental monitoring, clusters of suicidal (copycat)

• cultural: religious beliefs, family values, sexual orientation, gender identity, bullying, attitude

• social: relationship, crisis, substance abuse, health problems, financial problems, legal problems, loss of hosing

suicide assessment

• Assessment

  • Verbal and nonverbal clues

    • Overt statements

    • Covert statements/nonverbal cues

• Lethality of suicide plan

• History of attempts

• Family history

• Sudden switch from sad to happy mood

• Social supports

suicide self assessment

• Health professionals may experience:

  • Fear

  • Grief

  • Anger

  • Puzzlement

  • Condemnation of suicidal feelings/ intent

• Acknowledge feelings to team members to avoid

countertransference.

suicidal Application of the Nursing Process

• Nursing Diagnosis

  • Risk for suicide

  • Self-care deficit

  • Impaired sleep

  • Impaired nutritional intake

  • Anxiety

• Outcomes identification

  • Suicide self-restraint

• Planning

suicidal implementation & Evaluation

• Psychosocial interventions

• Health teaching and health promotion

  • Includes prevention efforts

• Case management

• Milieu therapy

• Documentation of care

• Suicide survivors: Postvention

• Evaluation is ongoing

Nonsuicidal Self-Injury

• Clinical Picture

• Epidemiology

• Comorbidity

• Other mental health disorders

• Risk Factors

• Biological factors

• Cognitive factors

• Environmental factors

• Societal factors

Which method of suicide has the highest lethality?

A self-inflicted gunshot wound is considered a high-risk method, or "hard" method. The other examples listed here are lower-risk, or "soft" methods.

Which patient statement does not demonstrate an understanding of a suicide safety plan?

"I will take extra medication if I start getting those self-destructive feelings."