Mental Health Nursing Study Group 1 (Weeks 1, 2, and 3)

Flashcards covering core concepts from Mental Health Study Group 1, including stress models, history of stigma, communication, therapeutic relationships, MSE, and milieu therapy.

How does the World Health Organization (WHO) define mental well-being?

Mental well-being allows a person to cope with life stresses, realize abilities, learn/work well, and contribute to the community.

What key components are involved in mental health according to the lecture notes?

Successful mental activity, productive daily activities, fulfilling relationships, ability to adapt to change, ability to cope with stress, and congruence with local/cultural norms.

What are the key characteristics of a mental health illness?

Symptoms disrupt the person's ability to function for a significant period; may affect emotions, thinking, and behavior; can involve maladaptive responses to internal/external stressors; and interfere with social, occupational, and/or physical functioning.

What is meant by the concept of 'incomprehensibility' in mental health?

How understandable the behavior is to others.

What does 'cultural relativity' mean regarding mental health and illness?

Behaviors must be considered within a cultural context.

How is stress defined in the lecture notes?

A state of disequilibrium occurring when there is disharmony between demands from the internal/external environment and the individual's ability to cope with those demands.

What are the three stages of Hans Selye's General Adaptation Syndrome (GAS)?

1. Alarm Reaction
2. Resistance
3. Exhaustion

What happens during the Alarm Reaction stage of General Adaptation Syndrome?

A stressor occurs and the fight-or-flight response begins.

What happens during the Resistance stage of General Adaptation Syndrome?

Initial defenses are activated and the person attempts to adapt to the stressor.

What happens during the Exhaustion stage of General Adaptation Syndrome?

Prolonged stress continues and adaptive energy becomes depleted.

What characterizes the freeze stress response?

It is a fear response dominated by the parasympathetic system where a person may feel paralyzed, unable to respond, disconnected from the body, or dissociated.

Who is recognized as the 'Mother of Psychiatric Nursing'?

Hildegard Peplau.

What are Peplau's Four Levels of Anxiety?

Mild, Moderate, Severe, and Panic.

What are the five Kübler-Ross stages of grief?

Denial, Anger, Bargaining, Depression, and Acceptance.

What is the distinction between anticipatory grief and complicated grief?

Anticipatory grief occurs before the actual loss. Complicated grief is a maladaptive response that may be prolonged, delayed/inhibited, and/or distorted.

Which historical figure is associated with the Moral Treatment era (1790–1900)?

Dorothea Dix.

What treatments were commonly used during the Premoral Era of mental health?

Jailing, separation, chaining, and trephining.

What were the key historical treatments used during the Institutionalized Period (1900-1955)?

Hydrotherapy, lobotomy, barbiturates, insulin shock, isolation, 'shock treatments', and psychoanalysis/Freud.

What was the significance of the National Mental Health Act passed in 1946?

It provided grants to develop mental health programs outside state hospitals.

What major medication development contributed significantly to deinstitutionalization in the 1950s?

Chlorpromazine/Thorazine (the first typical antipsychotic).

Which organization publishes the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)?

American Psychiatric Association.

What is the difference between implicit bias and explicit bias?

Implicit bias consists of subconscious attitudes, feelings, prejudices, and stereotypes. Explicit bias occurs when a person is consciously aware of their prejudices and attitudes.

What does the SOLER acronym stand for in active listening?

S — Sit squarely facing the client O — Observe an open posture L — Lean forward E — Establish eye contact R — Relax

What are the four phases of a therapeutic nurse-patient relationship?

1. Pre Orientation
2. Orientation
3. Working
4. Termination

What occurs during the Pre Orientation phase of the therapeutic relationship?

The nurse prepares by exploring their own self-perceptions.

What occurs during the Orientation phase of the therapeutic relationship?

Building the relationship: establishing trust, gathering information, identifying strengths/limitations, establishing collaborative goals, maintaining confidentiality, and exploring feelings.

What occurs during the Working phase of the therapeutic relationship?

Promoting change: identifying problems and problem-solving.

What occurs during the Termination phase of the therapeutic relationship?

Closure: evaluating goal attainment and therapeutically ending the relationship.

What is transference in psychiatric nursing?

When the patient unconsciously transfers feelings from someone in their past onto the nurse (Patient -> Nurse).

What is countertransference in psychiatric nursing?

When the nurse develops behavioral/emotional responses toward the patient that interfere with being therapeutic (Nurse -> Patient).

What are the six steps of the NCSBN Clinical Judgment Model?

1. Recognize cues
2. Analyze cues
3. Prioritize hypotheses
4. Generate solutions
5. Take action
6. Evaluate outcomes

What is the difference between mood and affect?

Mood is the patient's internal emotional state (e.g., elated, depressed, irritable, anxious). Affect is the observable external emotional expression (e.g., labile, blunted/constricted, flat, congruent, incongruent).

What is the difference between thought process and thought content?

Thought Process refers to HOW thoughts are expressed (e.g., tangential, circumstantial). Thought Content refers to WHAT the person is thinking/talking about (e.g., delusions, phobias).

What is the difference between tangential thinking and circumstantial thinking?

Tangential thinking wanders and never returns to the original topic. Circumstantial thinking wanders into unnecessary details but eventually returns to the original topic.

What is the difference between a hallucination and an illusion?

A hallucination is a sensory perception without a corresponding external stimulus. An illusion is a misperception/misinterpretation of a real environmental stimulus.

What crucial elements are NOT assessed in a brief/mini mental status evaluation?

Mood, affect, thought content, judgment, and insight.

What is diagnostic overshadowing?

Attributing a patient's physical symptoms to their mental illness instead of properly evaluating the physical symptoms.

What are the three priority issues for mental health screening?

Trauma, suicide risk, and substance use disorders.

What is the nursing priority when providing trauma-informed care?

Avoiding retraumatization of the patient.

What does the acronym SBIRT stand for in substance use management?

S — Screening BI — Brief Intervention RT — Referral to Treatment

What are the five conditions required for a therapeutic community (milieu)?

1. Containment (Safety and security)
2. Structure (Schedules, activities, expectations)
3. Involvement (Community participation)
4. Support (Empowering rather than punitive)
5. Validation (Active, empathic listening)