NUR 1174 Behavioral Health Nursing Terminology

Client

Used by the instructor and suggests an autonomous person who has freedom of choice in seeking and selecting assistance.

Mental Health Client

NO longer passive recipient of services but an active participant who assumes responsibility for his/her choices and also for consequences of those choices.

Family

Social system composed of two or more persons who co-exist within the context of some expectations of reciprocal affection and/or mutual responsibility. Don't have to live together, or be related, in order to be consider this.

Group

Collection of persons who come together in some way that makes them interdependent.

Psychosis (Psychotic Behavior)

Individual lost the ability to recognize reality and experiences hallucinations and/or delusions, thus being unable to deal with life's demands.

Neurosis (Neurotic Behavior)

Chronic lifetime pattern of poor decision making, poor problem solving, lack of insight, maladaptive behavior, distoritons of reality and a heavy reliance on defense mechanisms.

Decompensation

Relapse, return of psychotic symptoms. When client has return of acute psychiatric symptoms, he/she is said to have decompensated. Many clients who this are admitted to an inpatient unit for treatment.

Borderline Personality Disorder

Characterized by pattern of intense and chaotic relationships with affective instability, fluctuating an extreme attitudes regarding other people, impulsivity, direct and indirect self-destructive behavior, and lack of clear or certain sense of identity, life plan, or values.

Histrionic

Dramatic presentation of oneself with pervasive and excessive emotionality in order to seek attention, love, and admiration.

Passive-Agressive

Type of non-assertive behavior in which one expresses resistance to demands by sly, devious, and underhanded actions rather than being directly assertive. Ex. Being chronically late for staff meetings in response to not wanting to attend them.

Dual Diagnosis

Coexistence of a psychiatric disorder with substance abuse. Some professionals in the field of mental retardation loosely use the term for coexistence of a psychiatric disorder with mental retardation.

Psychotropic Medications

Pharmacological agents used in the treatment of emotional problems or mental illnesses. Main classifications of drugs are: antidepressants, anti maniac, and mood stabilizers; anti anxiety and sedative-hypnotics; antipsychotics and antiparkinson agents; and stimulants.

Decanoate (or Deport) Preparations

Long-acting injectable (IM or SC) medications and is used frequently as Prolixin and Haldol.

Noncompliance

Conscious set of behaviors associated with not following recommended health care activities, such as not talking physician-ordered medications. Not afford treatment, not understanding the needed for the treatment, minimizing the seriousness of the problem, or a way of asserting control.

Anhedonia

Loss of pleasure and interest in activities previously enjoyed.

Splitting

Inability to tolerate ambiguity. Categorizing people, events, or ideas as: all good or all bad, right or wrong, black or white. Person diagnosed with BPD (Borderline Personality Disorder).

Withdrawal

The processes of retreating from society and relationships, usually indicated by aloofness, lack of interest in social activities, and difficulty in communicating with others.

Congruence

Consistency of agreement between verbal and nonverbal behavior.

Incongruence

Lack of consistency between verbal and nonverbal behavior.

Improverishment (or Improverished)

A state in which a person lacks problem-solving abilities, emotional stability, financial resources, and/or emotional support to maintain oneself on a day-to-day basis.

Boundaries

Physical and psychological space individuals identify as their own; sometimes referred to as "limits." They can be flexible (healthy), rigid or inflexible (unhealthy), loose (unhealthy), or enmeshed (unhealthy).

Enmeshed Boundaries (Enmeshment)

Exaggerated connectedness among family members; over-investment, over-involvement, and lack of differentiation between individuals. It occurs when two or more persons' interactions are so blended together that neither can be sure where one stops and the other begins.

Time Out

Removing or disengaging a person from a situation so that he/she might regain self-control and/or not hurt self and/or others.

Seclusion

A type of time-out in which a person who is acting out is isolated in a sparsely furnished room which may or may not be locked.

De-Escalation

The act of decreasing overwhelming emotions related to anxiety, fear, anger, and/or frustration.

Malingering

A conscious effort to deceive others, often to financial gain, by pretending physical or psychiatric symptoms.

Person who abuses alcohol or drugs

A neutral descriptive term which may promote empowerment and a sense of hopefulness and optimism for the future (much preferred to "victim" which denotes a sense of powerlessness, helplessness, and hopelessness for the future.)

Adult Survivor of Childhood (physical abuse, sexual abuse, incest, rape, etc.)

A neutral descriptive term.

Positive Symptoms

Frequently seen symptoms in persons with schizophrenia. An excess or distortion of normal human functions, hallucinations, delusions, disorganized thinking and speech, disorganized behavior, plus many others.

Contraband

Items not permitted in certain locations (inpatient mental health unit, jail, etc.) but may fairly easy to smuggle in (such as weapons, items that could be made into weapons, street drugs, cigarettes, lighters and matches, etc.)

Electroconvulsive Therapy (ECT)

A treatment in which electric current is applied to the brain through electrodes placed on the temples.

1:1

A nurse-client interaction that involves one nurse and one client.

Transference

An unconscious response by clients or patients in which they experience feelings and attitudes toward a nurse (or other health care professional) that were originally associated with significant figures in their early life.

Countertransference

An emotional response by the nurse (or other HCP) that is generated by a client's qualities and is inappropriate to the therapeutic relationships or inappropriate in the degree of emotional intensity.

Five Levels of Suicide Behavior

Suicidal: Ideation, threats, gestures, attempts, and completed suicide.

Suicidal Ideation

Direct or indirect thoughts or fantasies of suicide or self-injurous acts expressed verbally or through writing or artwork without definite intent or action expressed. May be veiled or expressed symbolically.

Suicidal Threats

Direct verbal or written expressions of intent to commit suicide but without action.

Suicide Gestures

Self-directed actions that result in no injury or minor injury, but were done in such way that others would interpret the acts as suicidal behavior (ex. minor scratches on the wrist with a plastic knife).

Suicide Attempts

Serious self-directed actions that may be result in minor or major injury by persons who intend to end their lives or cause serious harm to themselves.

Completed Suicide

Death of a person by his/her own means.

Self-Injury

AKA self abuse, self-directed aggression, self-harm, self-inflicted injury, and self-mutilation. An injury done to oneself without the aid of another person and the injury is severe enough for tissue damage.

Voluntary Admission (or Commitment)

An admission in which a person agrees to the need for psychiatric treatment and admission (to either an inpatient facility or an outpatient program) and voluntarily signs and voluntarily admission form. Note that the client's discharge must be ordered upon by the client's admitting psychiatrist, or a judge, and will not occur "on demand" from the client. Approx. 2/3 of all psychiatric admissions are officially identified as voluntary.

Involuntary Admission (or Commitment)

An admission in which a person does not agree to the need for psychiatric treatment and admission (to either an inpatient facility or an outpatient program) and refuses to sign a voluntary admission form.

Two Ways used Involuntary Admission

Ordered by a judge of the court due to display of recent psychiatric symptoms that may cause injury to the person or others.

OR

Initiated by a case manager, family member, police officer, or friend due to acute psychiatric symptoms and is taken to a psychiatric facility where the person is assessed and admitted on an "emergency admission".

Both admission are time-limited w/ court hearing scheduled usually within tree working days

1. Client to appeal the need for continued admission if so desired (w/ or w/out legal representation).

2. The psychiatric team to present the need (or lack of need) for continuous hospitalization.

3. The judge to review the facts and make a decision for the need (or lack of need) for further psychiatric hospitalization.

Extrapyramidal Symptoms (EPS)

The general term for a variety of motor responses, such as tremors, that can occur as side effects of antipsychotic medications.

Psychomotor Agitation

Excessive motor activity assoc. w/ a feeling of inner tension. This activity is usually nonproductive and repetitious and consists of such behavior as pacing, fidgeting, wringing of the hands, pulling of clothes, and inability to sit still.

Psychomotor Retardation

Extreme slowdown of physical movements when posture slumps, speech is slowed, and digestion becomes sluggish.

Bizarre Behavior

Activity that the person's culture would regard as totally odd, unusual, or strange.

Avolition

Inability to initiate and persist in goal-directed activity.

Echopraxia

Imitating the movements of another person.

Acting Out

Observable behaviors that are performed on an unconscious level to reduce anxiety and tension. Ex. Excessive screaming, hitting, cursing, verbally defiant language.

Pressured Speech

A monologue using intense, uninteruppted words and ignoring anyone else's attempts to enter into the conversation.

Guarded (or Suspicious)

Displays of behavior related to being cautious, reserved, or suspicious such as looking over one's shoulder, closely watching what one says, and scanning the environment with one's eyes.

Apathy (or Apathetic)

Indifference or lack of interest in the environment.

Mood

An individual's sustained emotional tone, which sigificantly influences behavior, personality, and perception. 16 different emotions of this.

Sad Mood

A feeling of unhappiness or a feeling of being "down in the dumps" in relation to every day disappointment in life. These episodes are short-lived as the individual adapts to the loss, change, or failure (real or perceived) that has been experienced.

Depressed Mood

A sustained emotional sadness or feeling of "emptiness".

Elevated (or Elated) Mood

An exaggerated feeling of well-being.

Euphoric (or Expansive) Mood or Euphoria

Lack of restraint in expressing one's feelings, frequently with an overvaluation of one's significance or importance.

Mania

An unstable mood that is elated, expansive, or irritable. Delusions and poor judgement are present. The person experiences marked impairment in social, occupational, and interpersonal functioning.

Hypomania

Elevated mood with symptoms less severe that those of mania. The person does not experience impairment in reality, or do the symptoms markedly impair social, occupational, or interpersonal functioning.

Labile Mood

Unpredictable and rapid mood swings with no apparent stimuli.

Melancholy Mood (or Melancholia)

A severe form of depression when symptoms are exaggerated and interest or pleasure in virtually all activities is lost.

Feelings of Hopelessness (or Despair)

Feelings of discouragement about the future. Common with major depressive disorder and dysthymia.

Feelings of Helplessness

Feelings of imcompetence and inability to help oneself. Common with major depressive disorder and dysthymia.

Feelings of Worthlessness

Feelings of having no value, dignity, worth, or virtue. Common with depressive disorder.

Feelings of Guilt (or Feeling Guilty)

Feelings of remorse from real or imagined offenses.

Anxious Mood (or Anxiety)

Vague diffuse apprehension that is associated with feelings of uncertainty and helplessness in response to the emotional appraisal of a threatening stimulus.

Irritable Mood (or Feelings of Irritability)

Easily annoyed or angered. Responding readily to an abnormal degree, to stimulus.

Fearful Mood (or Feelings of Fear)

Feeling agitation, dread, or terror in response to the intellectual appraisal of a threatening stimulus.

Shameful Mood (or Feelings of Shame)

A painful sense of gilt, degradation, humiliation, regret, dishonor, or disgrace; scandalous or indecent.

Affect

The behavioral expression of emotion. Common types of this is appropriate, inappropriate, and blunted.

Appropriate Affect

Emotion that is congruent with the situation.

Inappropriate Affect

Emotion that in incongruent with the situation.

Blunted Affect (Considered, Flat, or Dull Affect)

Emotions that are diminished in range and intensity; absence of emotion expression.

Form of Thought

What forms of expression does the person used to express himself/herself.

Flight of Ideas

Over-productive speech characterized by rapid shifting form one topic to another and fragmented ideas.

Loose Association (or Associative Looseness)

Lack of a logical relationship between thoughts and ideas that renders speech and thought inexact, vague, and unfocused.

Intellectualization

The excessive use of reasoning, logic, or words to avoid confronting (or experiencing) undesirable impulses, emotions, or situations.

Concrete Thinking

Inability to conceptualize ideas; inability to comprehend abstract words such as love, idealism, faith, patriotism, etc., or abstract phrases such as proverbs. The thinking of persons diagnosed with schizophrenia is usually limited to concrete thinking with no ability for abstract thinking.

Abstract Thinking

The ability to conceptualize ideas (ex. find meaning in proverbs). Persons with schizophrenia usually lack the ability for abstract thinking.

Circumstantiality

Thought and speech associated with excessive and unnecessary detail that is usually relevant to a question and the answer is ultimately provided.

Tangentiality

Similar to circumstantiality but the person never returns to the central point and never answers the question.

Neologisms

Words that have private, symbolic meaning for a person.

Cryptic Language

An abbreviated version of language such as only speaking every 4th word of each thought; often used by persons who used neologisms.

Clang Association

Speech directed by the sounds of words, as in combining words that rhyme rather than using appropriate ones.

Word Salad (Incoherence)

Speech of thinking that is essentially incomprehensible to others because the mixture of words and phrases are meaningless to the listener and the speaker as well; the highest level of thought disorganization.

Perseveration

Continuation repetition of a meaningless word, phrase, or song to an unusual degree; repetition of answers that are not related to successive question asked.

Echolalia

Mimicking or imitating speech of another person.

Thought Blocking

The abrupt stopping in the middle of a sentence or train of thought, sometimes unable to continuous the idea.

Suicidal Ideation

Ideas or thoughts of suicide (see the five levels of suicidal behavior).

Homicidal Ideation

Ideas or thoughts of killing another person.

Obsession

An idea, emotion, or impulse that repetitively and insistently forces itself into consciousness, although it is welcome.

Religiosity

An obsession, preoccupation, or excessive demonstration of religious ideas and behavior.

Magical Thinking

A belief that thinking equates with doing. Characterized by lack of realistic relationship between cause and effect; the belief that one's thoughts or wishes can control other people or events. The belief is not necessarily evil or related to sin or guilt.

Phobia

An irrational fear.

Delusion

A fixed, false belief that cannot be corrected by reasoning even though it is not shared by others and is contraindicated by social reality.

Persecutory or Paranoid

A false sense that others are against them; excessive or extreme irrational suspiciousness and mistrustfulness of others' actions or perceived intentions.