Psychiatric Nursing: Stress, Anxiety, Crisis, Theories, Assessment, and Legal/Ethical Issues

Flashcards covering key definitions, theories, models, assessments, and legal/ethical principles from all lecture notes.

Fight-or-flight response

Walter Cannon's early stress-response theory for acute stress, in which the body prepares for a situation that an individual perceives as a threat to survival.

General Adaptation Syndrome (GAS)

Hans Selye's stress model consisting of three stages: the alarm or acute stress stage, the resistance or adaptation stage, and the exhaustion stage.

Four Coping Styles

The baseline areas evaluated in nursing management of stress responses: health-sustaining habits, life satisfactions, social supports, and effective and healthy responses to stress.

Anxiety

Apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat.

Fear

A reaction to a specific danger, distinct from anxiety which is a response to an unspecified or perceived threat.

Mild Anxiety

A level of anxiety that provides everyday problem-solving leverage, allows a person to grasp more information effectively, and presents with vague feelings of mild discomfort, restlessness, impatience, or irritability.

Moderate Anxiety

A level of anxiety characterized by selective inattention and hampered clear thinking, accompanied by concentration difficulties, pacing, somatic headaches/backaches, urinary urgency, and elevated heart and respiratory rates.

Severe Anxiety

A level of anxiety where the perceptual field is greatly reduced, causing confused or automatic behavior, feelings of impending doom, hyperventilation, tachycardia, and an inability to take directions from others.

Panic Level Anxiety

The most extreme level of anxiety characterized by markedly disturbed behavior (running, shouting, screaming), inability to process reality, severe hyperactivity or immobility, dysfunction in speech, dilated pupils, and potential hallucinations or delusions.

Defense Mechanisms

Automatic, unconscious coping styles that protect individuals from anxiety and maintain self-image by blocking feelings, conflicts, and memories.

Altruism

A healthy defense mechanism in which an individual reaches out to others.

Sublimation

A healthy defense mechanism involving the unconscious substitution of acceptable forms of expression for unacceptable feelings or impulses.

AUIO Acronym

A memory tool describing key characteristics of defense mechanisms: Automatic, Unconscious, Individual, and Observable.

Somatic Symptom Disorder

A condition where psychological stress is expressed through vague or exaggerated physical manifestations, and the patient routinely rejects a psychological diagnosis.

Conversion Disorder

A disorder where a patient presents with sensory-motor malfunctioning (such as blindness or paralysis) completely without organic pathology.

La belle indifférence

A distinct, observable lack of emotional concern regarding severe physical deficits, serving as a diagnostic flag for conversion disorder.

Secondary Gains

Unconscious benefits derived from illness or symptoms, such as securing attention or being excused from personal obligations.

Crisis

An acute, time-limited personal struggle for equilibrium (~4–6 weeks) that cannot be managed with an individual's normal coping mechanisms.

Situational Crisis

A type of crisis driven by external, unanticipated events.

Maturational Crisis

A type of crisis driven by internal developmental stages and transitions.

Adventitious Crisis

A crisis resulting from unplanned, accidental, or natural events such as disasters or crimes of violence.

Resilience

The ability and capacity to secure resources needed to support well-being, characterized by emotion regulation and overcoming self-defeating thoughts.

Diathesis-Stress Model

The explanation asserting that most psychiatric disorders result from a combination of a biological predisposition (diathesis) and environmental stressors or trauma (stress).

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)

The official medical guidelines of the American Psychiatric Association for diagnosing psychiatric disorders based on specific multiprofessional clinical criteria.

Freud's Id, Ego, and Superego

The components of personality structure where the Id operates on the pleasure principle, the Ego acts as the problem solver and reality tester, and the Superego represents the moral component.

Rational-Emotive Therapy

Albert Ellis's cognitive therapy aimed at eradicating irrational beliefs and recognizing inaccurate thoughts.

Dialectical Behavioral Therapy (DBT)

A cognitive-behavioral therapy adaptation employing CBT elements alongside mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.

ASMTPO Mnemonic

A psychiatric assessment mnemonic representing Appearance, Speech, Memory/Mood, Thoughts, Perception, and Orientation.

Beneficence

The ethical bioethical principle defining the duty to act to benefit others.

Autonomy

The bioethical principle respecting the rights of others to make their own decisions.

Justice

The bioethical principle defining the duty to distribute resources equally.

Fidelity

The bioethical principle of maintaining loyalty and commitment to the patient.

Veracity

The bioethical principle defining the duty to communicate truthfully.

Nonmaleficence

The bioethical principle defining the duty to do no harm or inflict the least harm possible to achieve a beneficial outcome.

Temporary Emergency Admission

An admission used when a client is unable to make decisions regarding care, with a stay limited to no more than 15 days.

Involuntary Admission

A legal admission initiated due to mental illness, danger to self/others, or severe inability to meet ADLs, limited to 60 days.

Tarasoff v. Regents of University of California (1974)

The landmark legal case establishing that a psychotherapist has a duty to warn and protect a potential victim of potential harm.

Restraint and Seclusion Timeframes

Legal parameters requiring a face-to-face physician exam within 1 hour of application, phone orders valid for up to 4 hours, client assessment every 15 minutes, restraint rotation every 2 hours, and offering food and fluids at least every 2 hours.

Assault

An intentional tort defined as acting in a threatening manner that induces fear of immediate harm.

Battery

An intentional tort defined as touching an individual in an offensive or harmful manner without consent.

False Imprisonment

An intentional tort involving the unauthorized physical, verbal, or chemical confinement of a patient.

Malpractice

Professional negligence defined as an act or omission to act that breaches the duty of due care, directly resulting in personal injury or damage.