Introduction to Psychiatric-Mental Health Nursing

Comprehensive practice flashcards covering terminology, history, neurobiology, psychotropic medications, somatic treatments, psychosocial theories, and therapeutic interventions from the lecture.

What did the historical term "asylum" refer to when describing institutions for the mentally ill?

A place of safety, refuge, or haven that offered protection.

What is the primary goal of deinstitutionalization?

Moving individuals away from long-term stays in psychiatric hospitals into community-based facilities and services.

Under what condition is it ethically and legally impermissible to discharge a psychiatric inpatient?

When the patient is actively suicidal or homicidal.

What is the primary purpose of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)?

To standardize diagnostic nomenclature, outline criteria and symptoms for disorders, and assist in identifying underlying causes.

How is mental health defined in the lecture?

A state of emotional, psychological, and social wellness evidenced by satisfying relationships, effective behavior and coping, positive self-concept, and emotional stability.

What were the first two psychotropic medications developed in the $1950\text{s}$?

Chlorpromazine (Thorazine) and lithium.

What contribution did Dorothea Dix make to mental health treatment?

She led a crusade for the mentally ill that helped open $32$ state hospitals offering asylum.

What is the primary difference between voluntary admission and involuntary commitment?

Involuntarily committed patients cannot leave the facility at will and require court or judicial evaluation for discharge, whereas voluntary patients may request discharge unless deemed an immediate danger to themselves or others.

What does the term "boarding" mean in psychiatric healthcare?

The practice of keeping patients in the emergency department (ED) while they wait for an open inpatient psychiatric bed.

Approximately how many adults in the United States have a mental illness, and how many of them receive treatment?

Approximately $51.5\text{ million}$ adults have mental illnesses, but only $23\text{ million}$ receive treatment.

Mental health disorders are the leading cause of disability for individuals in which age bracket?

Ages $15$ to $44\text{ years}$.

What does the "revolving door effect" describe in mental health?

Frequent, repeated hospital admissions and quick discharges, often resulting from shortened stays, decompensation, and medication nonadherence.

What is meant by a "dual diagnosis"?

The co-occurrence of a mental health disorder alongside a substance use disorder.

Who was the first American psychiatric nurse?

Linda Richards.

Which nursing theorist developed the framework for the therapeutic nurse-client relationship and interpersonal skills?

Hildegard Peplau.

What is "milieu therapy" on a psychiatric unit?

Therapy conducted within the open, shared community environment of the unit where clients interact and engage in daily structured activities.

What is akathisia?

An extrapyramidal side effect manifested as extreme motor restlessness (described colloquially as "ants in the pants").

What are the common clinical signs of acute dystonia?

Acute muscle rigidity, stiff or protruding tongue, difficulty swallowing, and potential respiratory compromise.

What are the cardinal manifestations of neuroleptic malignant syndrome (NMS)?

Severe muscle rigidity, high fever, unstable body temperature, fluctuating blood pressure, diaphoresis, delirium, and potential progression to coma.

What does an FDA black box warning signify on a psychotropic medication?

A severe warning highlighting serious or life-threatening side effects, such as increased risk of suicidal thoughts during the initial weeks of antidepressant therapy.

What is a depot injection?

A long-acting injectable antipsychotic formulation administered every few weeks or monthly to maintain sustained medication levels.

Which neurotransmitter is found only in the brain and influences sleep, temperature regulation, mood, and food intake?

Serotonin.

What is the primary role of GABA in the central nervous system?

It serves as an inhibitory neurotransmitter that helps balance, calm, and even out neuronal excitation.

For which clinical conditions is electroconvulsive therapy (ECT) typically considered after medication trials fail?

Major depressive disorder, schizophrenia, acute mania, and catatonia.

What physiological event does ECT intentionally induce, and what is its typical duration?

A generalized seizure lasting approximately $15$ to $20\text{ seconds}$.

Which medications must be withheld prior to electroconvulsive therapy because they interfere with seizure induction?

Anticonvulsants (such as valproic acid and carbamazepine) and benzodiazepines.

Why is succinylcholine administered to patients immediately prior to ECT?

To paralyze muscles and prevent physical injuries or fractures during the induced seizure.

What are common post-procedural side effects following electroconvulsive therapy (ECT)?

Temporary confusion and short-term memory loss.

According to Maslow's hierarchy of needs, which category of needs represents the nurse's first priority?

Physiological and biological needs (such as food, hydration, rest, and safety).

In Sigmund Freud's personality theory, what is the role of the ego?

The rational mediator that balances the instinctual, instant-gratification drives of the id with the rigid moral standards of the superego.

What is the difference between transference and countertransference?

Transference is the client projecting personal feelings or past relationships onto the nurse, whereas countertransference is the nurse projecting personal feelings or past relationships onto the client.

What is modeling in psychiatric behavioral therapy?

A technique in which the nurse demonstrates appropriate behavior with the goal of having the client imitate those behaviors.

How does operant conditioning modify client behavior?

By providing positive rewards and reinforcement for positive, desired behaviors.

How does systematic desensitization help alleviate severe anxiety or phobias?

By gradually exposing the client to anxiety-provoking stimuli step by step in a controlled, progressive manner.

How does aversion therapy work when using disulfiram (Antabuse)?

It triggers severe physical illness (flushing, vomiting, diaphoresis) if the client ingests alcohol or comes into contact with alcohol-containing products like vanilla extract or hand sanitizer.

What does the technique of "response prevention" require the client to do?

Delay or resist performing a compulsive ritual (such as compulsive handwashing) to gradually increase anxiety tolerance.

What distinguishes an adventitious crisis from a situational crisis?

An adventitious crisis is caused by unexpected community-wide disasters or violence (such as hurricanes or mass shootings), whereas a situational crisis stems from unanticipated personal life events (such as divorce or sudden job loss).

What is required of nursing staff when managing a client on one-to-one ($1:1$) suicide precautions?

Continuous, direct visual observation of the patient at all times, including in the bathroom and shower.

What is the difference between empathy and sympathy in client care?

Empathy involves understanding and seeing circumstances from the client's perspective while fostering independence, whereas sympathy is simply feeling pity or sorry for the client.

Why is the termination phase often considered the most challenging phase of group therapy?

Clients often develop dependency on the group and may experience feelings of anxiety, abandonment, or loss as the sessions end.

How does the rate of mental illness among the incarcerated population compare to that of the general population?

The rate of mental illness among incarcerated individuals is $5\text{ times}$ greater than in the general population.