NR 326 Exam 1 Notes from class

What are the two primary Psychological adaptation to stress?

- Anxiety

- Grief

What are the types of Grief?

- Mild

- Moderate

- Severe

What are some feelings associated with Mild grief?

- Feelings of Sadness

What type of disappointments are associated with Mild grief?

- Life's everyday disappointments

What type of response is associated with Moderate Grief?

- Neurotic responses

What type of disorders are associated with Moderate Grief?

- Cyclothymic disorders

What is Severe Grief associated with?

- Severe Depression

What must be met for mental health to be in good standing?

- Maslow's Hierarchy of needs

What does Maslow's Hierarchy of Needs include at the physiological needs level?

- Food

- Shelter

- Water

- Security

What are the levels of Maslow's Hierarchy of Needs? (listed top to bottom)

- Self-actualization

- Esteem

- Love/ Belonging

- Safety needs

- Physiological needs

What does Maslow's Hierarchy of Needs include at the Safety needs level?

Personal security

- Employment

- Resources

- Health

- Property

What does Maslow's Hierarchy of Needs include at the Love/ Belonging level?

- Friendships

- Intimacy

- Family

- Sense of connection

What does Maslow's Hierarchy of Needs include at the Esteem level?

- Respect

- Self-esteem

- Status

-Recognition

- Strength

- Freedom

What does Maslow's Hierarchy of Needs include at the Self-Actualizatoin level?

- Desire to become the most that one can be!

aka

- Achieving one's full potential!

What are the 6 indicators of REFLECTION of mental health?

- Positive attitude towards self

- Growth/ development

- Integration

- Autonomy

- Perception of reality

- Environment mastery

What is the definition of mental health?

- The SUCCESSFUL ADAPTATION of stressors from INTERNAL to EXTERNAL as evidenced by THOUGHTS, FEELINGS, and BEHAVIORS that are age-appropriate and congruent w/ local and cultural norms

What is the definition of Mental ILLNESS?

- MALADAPTIVE RESPONSE to stressors from the internal to the external environment as evidenced by thoughts, feelings, and behaviors that are INCONGRUENT w/ local and cultural norms

What does mental illness interfere with?

- Social

- Occupational

- Physical functioning

What influences mental illness?

- The individuals Culture

How does the individuals culture influence mental illness?

- affects how individuals view mental illness

What are some view points that a culture might hold on mental illness?

- Incomprehensibility

- Cultural relativity

What is the definition of psychological adaptations to stress?

- All individuals exhibit characteristics associated w/ both Mental health and mental illness at any given time

What is the definition of anxiety?

- A feelin of discomfort and apprehension r/t to fear of impending danger

How does low levels of anxiety impact the individual?

- Are adaptive qualities that can provide motivation for survival!

When is severe anxiety problematic?

- When individuals are unable to prevent their response from escalating to a level that interferes w/ the ability to meet basic needs.

Who created the four levels of anxiety?

- Peplau

What is enhances during mild anxiety?

- Learning is enhanced

What can occur to the person who is experiencing mild anxiety?

- person can function optimally

How is mild anxiety satisfied?

- via the individual employing any number of coping behaviors to satisfy their needs

What occurs to the perceptual field during Mild-to-Moderate Anxiety?

- Perceptual fields BEGINS to diminish

Who identified a number of defense mechanisms for dealing with Mild-to-Moderate Anxiety?

- Anna Freud

What are the ego defense mechanisms for dealing with Mild-to-Moderate Anxiety?

- Compensation

- Denial

- Displacement

- Identification

- Intellectualization

- Rationalization

- Reaction formation

- Regression

- Sublimination

What does displacement mean as a defense mechanism?

- The Transfer of feelings from one target to another that is considered less threatening or that is neutral

What is an example of Displacement defense mechanisms?

- A patient is angry w/ his physician, does not express it, but becomes verbally abusive w/ the nurse

What does Compensation mean as a defense mechanism?

- Covering up a real or perceived weakness by emphasizing a trait considered more desirable

What is an example of Compensation defense mechanism?

- A physically disabled boy unable to participate in football, so he compensates by becoming a great scholar

What does Rationalization mean as a defense mechanism?

- Attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors

What is an example of Rationalization defense mechanisms?

- A patient tells the rehab nurse. "I drink b/c it's the only way I can deal w/ my bad marriage and my worse job"

What does Denial mean as a defense mechanism?

- Refusing to acknowledge the existence of a real situation or the feelings associated with it?

What is an example of denial as a defense mechanism?

- A women drinks ETOH every day and cannot stop, failing to acknowledge that she has a problem

What does Reaction Formation mean as a defense mechanism?

- Preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors

What is an example of Reaction Formation defense mechanisms?

- A student hates nursing and only attended nursing school to please her parents. During career day, she speaks to prospective students about the excellence of nursing as a career

What does Regression mean as a defense mechanism?

- Retreating in response to stress to an earlier level of development and the comfort measures associated w/ that level of functioning

What is an example of Regression defense mechanisms?

- When a 2-year-old is hospitalized for tonsillitis. He will drink only from a bottle, even though his mother states he has been drinking from a cup for 6 months

What does Identification mean as a defense mechanism?

- An attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires

What is an example of identification defense mechanisms?

- A teenager ho requires lengthy rehab after an accident and decides to become a PT as a result of his experiences

What does Repression mean as a defense mechanism?

- Involuntarily blocking unpleasant feelings and experiences from one's awareness

What is an example of Repression defense mechanisms?

- A trauma victim is unable to remember anything about the traumatic event

What does Intellectualization mean as a defense mechanism?

- An attempt to avoid expressing actual emotions associated w/ a stressful situation by utilizing the intellectual processes of logic, reasoning and analysis

What is an example of intellectualization defense mechanisms?

- A woman's husband is being transferred w/ his job to a city far away from her parents. She hides anxiety by explaining to her parents the advantages associated w/ the move

What does Sublimation mean as a defense mechanism?

- Rechanneling of drives and impulses that are personally or socially unacceptable into activities that are constructive

What is an example of sublimation defense mechanisms?

- A mother whose son was killed by a drunk driver channels her anger/ energy into being the president of the local chapter of Mothers Against Drunk Driving

What does Introjection mean as a defense mechanism?

- Integrating the beliefs and values of another individual into one's own ego structure.

What is an example of introjection defense mechnanisms?

- Children integrate their parents' value system into the process of conscience formation. A child says to a friend, "Don't cheat. It is wrong"

What does suppression mean as a defense mechanism?

- The voluntary blocking of unpleasant feelings and experiences form one's awareness

What is an example of suppression defense mechanisms?

- "I don't want to think about that now. I'll think about that tomorrow"

What does Isolation mean as a defense mechanism?

- Separating a thought or memory from the feeling, tone, or emotion associated w/ it

What is an example of isolation defense mechanisms?

- A young woman describes being attacked and rapid w/o showing any emotion

What does Undoing mean as a defense mechanism?

- Symbolically negating or canceling out an experience that one finds intolerable

What is an example of Undoing defense mechanisms?

- A man is nervous about his new job and yells at his wife. On his way home, he stops and buys some flowers

What does Projection mean as a defense mechanism?

- Attributing feelings or impulses unacceptable to one's self to another person

What is an example of Projection defense mechanisms?

- A man who is addicted to ETOH blames his wife for his excessive drinking.

How does mild anxiety impact learning?

- it enhances learning for sure!

What occurs to the pupils with moderate to severe anxiety?

- Pupils become dilated

What occurs to the face with moderate to severe anxiety?

- Flushing of the face occurs

What occurs to the Expression with moderate to severe anxiety?

- Patient will have a tight expression

What occurs to the energy levels with moderate to severe anxiety?

- Patient will become lethargic

What occurs to feeling a patient will feel with moderate to severe anxiety?

- Patient will feel DIZZY

What is the nurses priority with panic attacks?

- Never leave the patient alone (SAFETY)

What occurs to reality with Panic attacks?

- Patient may lose contact w/ reality

What occurs to the adaptation to the environment with Panic attacks?

- patient will not be able to process what is happening in the environment

What does psychosis mean?

- A significant thought disturbance in which reality is impaired

What occurs to the speech with Psychosis?

- Disorganized speech

What occurs to behavior w/ Psychosis?

- Catatonic behaviors occurs

What does catatonic behaviors entail?

- Agitation

- Confusion

- Restlessness

What might a patient experience with psychosis?

- Delusions

- Hallucinations

What is the definition of Grief?

- The Subjective feeling of sorrow and sadness accompanied by emotional, physical, and social responses to the loss of a loved person or thing

What feelings occur w/ Grief?

- Sadness

- Anger

- Helplessness

- Hopelessness

- Guilt

- Despair

What is considered to be a loss with grief?

- Anything of value can be considered a loss

What is Anticipatory grief?

- The Experience of Grief before the actual loss occurs

How is Anticipatory grief a good thing?

- B/c it may shorten the period of Grief response

What is the length of grief based off of?

- It is based entirely off the individual

What is the most common complication of grief with ELDERLY folks?

- Bereavement overload

What does Bereavement overload mean?

- When grief occurs for more than one loss or multiple losses PRIOR to Grief being dealt with

What is the biggest contributor to lengthening the response of Grief?

- Guilt

What are the 5 stages of Grief?

- Denial

- Anger

- Bargaining

- Depression

- Acceptance

What is the Denial Stage of Grief?

- A stage of shock and disbelief

- Patient does not belief the loss occurred

What is the Anger Stage of Grief?

- Envy/ Resentment towards individuals not impacted in order to reverse or postpone the loss

What is the Bargaining Stage of Grief?

- an attempt to change the reality of loss with God

What is the Depression Stage of Grief?

- The full impact of the loss is experienced

How is the patient during the depression stage of Grief?

- They are in quiet desperation and disengagement

What is the acceptance Stage of Grief?

- When feeling of peace regarding the loss has occurred

What occurs to the organization of a person when the mourning process is resolved?

- Individual is able to regain a sense of organization

What occurs to the person when the mourning process has been resolved?

- Individual redefines his/her life in absence of the loss

What might a person pursue when the mourning process has been resolved?

- New interests

- New hobbies

What occurs to the sleep with Delay/Inhibited/Prolonged grief?

- Sleeping disorders can occur

What emotions are caused by Delay/Inhibited/Prolonged Grief?

- Anxiety

- Depression

What might a patient experiencing Delay/Inhibited/Prolonged Grief develop?

- Phobias/ Fears

- Mental illnesses

What occurs to hunger as a patient deals with Delay/Inhibited/Prolonged Grief?

- Anorexia may develop and Hunger may decrease

What does Prolonged Grief mean?

- Intense preoccupation w/ memories of the Lost entity for MULTIPLE YEARS after the loss has occurred