Mental health (module 5-10)

What is produced by the adrenal glands in the brain as a release of stress

cortisol, epinephrine, and norepinephrine

What reaction does stress create for self-preservation

The "fight or flight" reaction

What happens when the stress threshold is crossed?

The benefits of stress are lost and performance declines

What body systems can be damaged by sustained stress?

Cardiovascular, immune, and nervous system

What are the three stages of General Adaptation Syndrome?

Alarm, resistance, exhaustion

What happens during the alarm stage?

The body responds to a stressor through the hypothalamus activating the sympathetic nervous system

What happens to pupils during the alarm stage

Pupils dilate

What happens to respiratory rate and blood pressure during alarm stage

Increases

What happens to GI mobility during the alarm stage

decreases

What happens during the resistance stage?

The body maintains preparedness and adapts to the stressor

What happens if stress continues during the resistance stage?

The body progresses to the exhaustion stage

What happens during the exhaustion stage?

The body can no longer adapt to continued stress

What can untreated exhaustion lead to?

Severe health consequences or death

What cardiovascular effect can prolong stress

Sustained elevated blood pressure

What disease risk increases with prolonged stress

coronary artery disease

What cardiac complications can prolonged stress cause

Arrhythmias and cardiac damage

How does prolonged stress affect immune function

It suppresses immune function, susceptibility to infections increase

How does prolonged stress affect cognition

It can impair memory and concentration

What happens without proper intervention during the resistance stage?

The patient progresses to exhaustion, where organ systems begin to fail under continued stress

What is a crisis

A psychological state of disequilibrium

Is a crisis a psychiatric diagnosis?

No- it is an acute response to overwhelming stressors

What are examples of natural disasters that can cause crisis?

Hurricanes, floods, earthquakes, wildfires, tsunamis, and tornadoes

What disease-related event can create a crisis?

Pandemic disease outbreaks

What personal events can cause a crisis?

Death of loved ones, divorce, job loss, financial ruin, serious illness diagnosis, and domestic violence

What is the nurse's role during a crisis event?

Provide support through assessment, intervention, and connecting patients with resources

What does "event-triggered" mean in a crisis?

A specific identifiable event or situation exceeds the person's coping capacity

How long does the acute crisis response generally last

Approx 4-6 weeks before resolution / adaptation occurs

Is “crisis” an establish psychiatric diagnosis

No

Is experiencing a crisis considered abnormal

No- it happens to all individuals at some point, and is a normal human response to overwhelming circumstances

What is a crisis precipitant

A stressful event that overwhelms existing coping strategies

How long does the acute crisis phase last

1-2 weeks

How long does the working-through phase typically last

2-4 weeks

How long does the resolution phase last

4-6 weeks

What is the overall crisis timeline

Usually no more than 4-6 weeks

Phase 1 of crisis development

Stressful situation causes anxiety, person attempts to cope based on past experiences

Phase 2 of crisis development

Anxiety builds when previous coping methods do not relieve the stress

Phase 3 of crisis development

Person tries every new coping strategy they can think of

Phase 4 of crisis development

Every coping idea strategy fails, resulting in distress and inability to cope

What are the 3 balancing factors affecting crisis response

• perception of the event

• situational supports

• adequate coping skills

3 categories of emotional crisis

• maturational

• situational

• social/adventitious

What is a maturational crisis

Crisis occurring during normal growth and developmental transitions

Examples of maturational crisis

Marriage, parenthood, retirement, adolescence

Examples of situational crisis

Death of loved one, divorce, job loss

Social/adventitious crisis

Crisis resulting from large scale disaster or catastrophes

Examples of social/adventitious crisis

Earthquakes, floods, terrorism, mass violence

First goal of crisis intervention

Address immediate problems

What are the 3 levels of functioning after crisis

Higher, lower, or the same

What does self-limiting mean in crisis

Natural resolution occurs over time

Why is crisis intervention time-sensitive

There is a window of opportunity for maximum impact

Founder of modern nursing

Florence nightingale

What did nightingales environmental theory focus on

creating healing environments

Who is the “mother of psychiatric nursing”

Hildegard peplau

What is Peplau's theory?

Nursing is an interpersonal, therapeutic process between nurse and patient

What is the primary intervention tool in Peplau's crisis framework?

therapeutic communication

What happens to the perceptual field with moderate anxiety

it decreases (focus on specific details while missing broader picture)

How does moderate anxiety affect information processing?

It decreases

What type of attention occurs with moderate anxiety?

Selective attention

What happens to the perceptual field during severe anxiety?

It is greatly decreased with distorted perceptions

true or false: effective problem solving occur with severe anxiety

false

What type of medication may be offered for severe anxiety?

Prescribed anxiolytic medications (benzos, SSRI’s)

What physical findings can occur during panic?

• Severe shakiness

• Dilated pupils

• Speech dysfunction

• Insomnia

• Hyperventilation

At what anxiety level is learning enhanced?

mild

What is the general nursing approach as anxiety increases?

• Decrease stimulation

• Provide simple/firm directions

• Maintain safety

• Provide calm support

How long is crisis intervention therapy typically provided?

1-6 weeks

What is the goal of crisis intervention therapy?

Immediate stabilization and restoration of coping

What are flexible service delivery options for crisis intervention?

• Home-based

• Office-based

• Hybrid approaches

Clonazepam brand name

Klonopin

Diazepam brand name

Valium

Lorazepam brand name

Ativan

Common antidepressant used for insomnia

Trazodone (desyrel)

Olanzapine brand name

Zyprexa

Risperidone brand name

Risperdal

quetiapine brand name

seroquel

What needs should generally be addressed first during crisis/disaster response?

basic physiological and safety needs

How can debriefing help prevent negative outcomes?

Prevents burnout and secondary trauma