Studied by 9 people
The heart of psychiatric care.
Patient care
Psychiatric nursing involves what?
Implementation of a specialized set of skills
Promoting mental health
providing support to individuals facing mental health challenges.
Psychiatric nurses often work in collaboration with?
PPS
Psychiatric physician
Psychologist
Social Workers
understanding the physiological basis of behavior.
involves the study of the structure and function of the nervous system, including the brain, spinal cord, and nerves.
Neuroanatomy
Understanding the complex process of neurotransmission is essential for comprehending the mechanisms underlying various psychiatric disorders.
Neurotransmission
Refers to the brain's ability to adapt and reorganize itself, which is significant in the context of recovery and rehabilitation for individuals with mental health conditions.
Neuroplasticity
Types of stressors
acute
episodic acute
chronic
The body’s response to stress involves intricate physiological changes, including the release of stress hormones and activation of the sympathetic nervous system.
Physiological Responses
What are the effective coping strategies/ mechanism that plays a pivotal role in managing stress and promoting mental well-being?
mindfulness
physical activity
social support
Factors such as high stress levels, pollution, and limited access to green spaces
Urban Mental Health
face distinct mental health challenges, including social isolation, limited access to healthcare facilities, and economic factors.
Rural Mental Health
Give two (2) state of mental health
Urban Mental Health
Rural Mental Health
What are the therapeutic models in Nursing Practice
Psychoanalytic Model
Developmental Model
Interpersonal Model
Cognitive Model
emphasizes the importance of early childhood experiences and the unconscious mind in shaping behavior and mental health.
Psychoanalytic Model
it focuses on the impact of developmental stages on mental health, highlighting the significance of milestones and challenges at different life stages.
Developmental Model
it explores how individuals' relationships and social interactions influence their mental well-being.
Interpersonal Model
it examines the role of thoughts and beliefs in shaping emotions and behaviors, offering insight into therapeutic interventions
Cognitive Model
What are the Diagnosis and Statistical Manual of Mental Disorders (DSM)?
Evolving Criteria
Multiaxial evaluation
Global Impact
The DSM undergoes revisions to incorporate advancements in the understanding of mental health, ensuring that diagnostic criteria align with current knowledge and research.
Evolving Criteria
The multiaxial system in the DSM facilitates a comprehensive evaluation of various factors contributing to an individual's mental health, encompassing clinical, psychosocial, and environmental aspects.
Multiaxial Evaluation
The DSM's global influence extends beyond clinical settings, shaping policies, research initiatives, and public awareness of mental health conditions.
Global Impact
State of complete physical, mental, and social wellness, not merely the absence of disease (WHO).
Mental Health
State of emotional, psychological, and social wellness evidenced by:
satisfying interpersonal relationships
effective behavior and coping
a positive self-concept
emotional stability
Historically viewed as possession by demons, punishment for religious or social transgressions, weakness of will or spirit, and violation of social norms.
Mental Illness
is “a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom” (American Psychological Association [APA]).
Mental disorder
Mental Health Ability to:
Be flexible
Be successful
Form close relationship
Make appropriate judgments
Solve problems
Cope with daily stress
Have a positive sense of self
Mental Health impaired ability to:
to think
to feel
coping with reality
form strong personal relationships
to make sound judgments
to adapt
What are the factors influencing mental health?
Individuals
Interpersonal
Social/Culture
Person’s biologic makeup, autonomy and independence, self -esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities.
Individual
Effective communication, ability to help others, intimacy, and a balance of separateness and connectedness.
Interpersonal
A sense of community, access to adequate resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive, yet realistic, view of one’s world.
SOCIAL/ CULTURAL
What are the General Criteria to Diagnose Mental Disorders?
Dissatisfaction with one’s characteristics, abilities, and accomplishments
Ineffective or unsatisfying relationships
Dissatisfaction with one’s place in the world
Lack of personal growth
People believed that the mentally ill were possessed by demons who invaded the human body as a form of punishment
Treatment was designed to drive out demons.
Primitive times
sickness represented displeasure of the gods and punishment for sins and wrongdoing
treatments included starving, purging, and bloodletting.
Ancient times
an Egyptian writing wherein mental disorders were mentioned as being dependent upon evil spirits
description of senile deterioration, alcoholism, and hysteria was obvious in those writings.
EBERS PAPYRUS 1560 BC
It contains the first classification of mental disorder.
Vedas or works of wisdom (Hindus)
Contained instructions and qualifications for the nurse
Sushruta samhita
E.g. cool headed, pleasant, kind-spoken, strong and attentive to the needs of the sick, and indefatigable following the doctor’s instructions.
Sushruta samhita
First to regard the brain as the central organ of intellectual activity and mental disorder as an illness of that organ.
Alcmaeon (5th Century BC)
emphasized the natural causes of diseases
known as the Father of Medicine
Hippocrates (460-370 BC)
Expressed the psychosomatic viewpoint that the body and mind were inseparable.
Plato (427–347 BC)
Attempted to relate mental disorders to physical disorders - developed his theory that the amounts of blood, water, and yellow and black bile in the body controlled the emotions.
Aristotle (382–322 BC)
His system consisted of hygienic measures which included attention to diet, bath, friction and methods of keeping the skin pores open
Asclepiades of Bithynia (129 – 40 BC)
world's first and oldest institution to specialize in the mentally ill
variously known as St. Mary Bethlehem, Bethlem Hospital, Bethlehem Hospital and Bedlam
founded as a priority in 1247 and as a hospital in 1330
Middle Ages Bethlem Royal Hospital
English physician who published in 1758 the first lengthy book on the treatment of mental illness.
A Treatise on Madness.
Extending methods of treatment to the poor as well as the affluent, helped raise psychiatry to a respectable specialty
Early modern period William Battie (1704-76)
The creation of asylums as a safe refuge or haven offering protection.
Period of Enlightenment (1790s)
Who is the Father of American Psychiatry?
Benjamin Rush (1745- 1813)
Two (2) approaches of tx of mentally ill:
Physical treatment
Occupational treatment
Initiated the moral treatment of mentally ill individuals
Philippe Pinel (1745- 1826)
English businessman, philanthropist
development of more humane methods in the custody and care of people with mental disorders
York Retreat (1796)
William Tuke (1732 – 1822)
German physician
revived the age-old art of suggestive healing
divine trance
Franz Anton Mesmer (1734-1815)
American activist on behalf of the indigent insane
created the first generation of American mental asylums
19th Century : The Evolution of the Psychiatric Nurse Dorothea Dix (1802-1887)
Nightingale’s Notes on Nursing was published
1859
First training school for nursing of the mentally ill established at Mclean Asylum, Waverly, Massachusetts
1882
first professionally trained American nurse
created the first system for keeping individual medical records for hospitalized patients
Linda Richards (1841- 1930)
Swiss psychiatrist
President of the American Psychiatric Association } Patients could best be understood through consideration of their life situations } need to study a person’s whole environment
20th Century: The Era of Psychiatry Adolf Meyer (1866- 1950)
founder of the American
mental hygiene movement (1908)
a patient himself, experienced and witnessed serious
maltreatment at the hands of the staff A Mind That Found Itself (1908) autobiographical account of his hospitalization and the abuses he suffered.
Clifford Beers (1876-1943)
German psychiatrist who devised a classification of mental disorders
credited with the classification of what was previously considered to be a unitary concept of psychosis, into two distinct forms: Mania Dementia Praecox
Emil Kraepelin (1856-1926)
Also recognized today for having a neurological condition called synesthesia.
“Schizophrenia” was first named by Eugen Bleuler (1857-1939)
challenged society to view human beings objectively
studied the mind, its disorders, and their treatment as no one had before
dev’t of psychoanalysis, psychosexual theories, and neurosis
psychoanalysis as for treatment and a theory of personality development
Sigmund Freud(1856- 1939)
Believed that anxiety interfered with ability to cope & communicate effectively resulting in mental illness -interpersonal theories stimulated the dev’t of multidisciplinary approaches to psychiatric and milieu therapy.
Harry Stack Sullivan (1892-1949)
emphasized the nurse-client relationship as the foundation of nursing practice
Developmental Stages of the Nurse-Client Relationship
Seven Nursing Roles
Hildegard Peplau (1909-1999)
The three purposes of DSM-IV-TR
To provide a standardized nomenclature and language for all mental health professionals
To present defining characteristics or symptoms that differentiate specific diagnoses T
To assist in identifying the underlying causes of disorders.
In what year is the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published by APA?
1952
is a taxonomy published by APA and is used by all mental health professionals.
Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR)
DSM-IV-TR Multiaxial Classification System
Axis I (Clinical Syndrome) - Signs and Symptoms
Axis II (Personality Disorders)
Axis III ( Pathological Disorders)
Axis IV ( Environmental & Psychosocial Stressors)
Axis V (Global Assessment of Functioning)
Identifying all major psychiatric disorders except mental retardation and personality disorders.
Axis I (Clinical Syndrome) - Signs and Symptoms
Mental retardation and personality disorders as well as prominent maladaptive personality features and defense mechanisms.
Axis II (Personality Disorders)
Current medical conditions that are potentially relevant to understanding or managing the person’s mental disorder as well as medical conditions that might contribute to understanding the person.
Axis III ( Pathological Disorders)
Psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders.
Axis IV ( Environmental & Psychosocial Stressors)
Rates the person’s overall psychological functioning on a scale of 0 to 100.
Axis V (Global Assessment of Functioning)
What are the severity of the Psychosocial Stressor Scale for Adults?
None
Mild
Moderate
Severe
Extreme
Catastrophic
Inadequate Information or no Change in Condition
Adult and Children & Adolescents: No acute events may be relevant to the disorders.
Example:
Adult and Children & Adolescent: No enduring circumstances that may be relevant to the disorder.
None
Adult: Broke up with boyfriend or girlfriend; started or graduated from school; child left home.
C&A: Broke up with boyfriend or girlfriend; change of school.
Examples:
Adult: Family arguments; job dissatisfaction; trouble with loss; being a single parent.
C&A: Overcrowded living quarters; family arguments.
Mild
C&A: Expelled from school; the birth of a sibling.
Adult: Marriage; marital separation; loss of job; retirement; miscarriage.
Examples:
Adult: Marital disorder; serious financial problem; trouble with loss; being a single person.
C&A: Chronic disabling illness in the parent; chronic parental discord.
Moderate
C&A: Divorce of parents; unwanted pregnancy; arrest.
Adult: Divorce; birth of first child
Examples:
Adult: Unemployment; poverty.
C&A: Harsh or rejecting parents; chronic life-threatening illness in the parent; multiple foster home placements.
Severe
Adult: Death of spouse; serious physical illness diagnosed; victim of rape.
C&A: Sexual or physical abuse; death of a parent.
Examples:
Adult: Serious chronic illness in self or child; ongoing physical or sexual abuse.
C&A: Recurrent sexual or physical abuse
Extreme
Adult: Death of child; suicide of spouse; devastating natural disaster.
C&A: Death of both parents.
Examples:
Adult: Capacity of hostage; concentration camp experience
C&A: Chronic life-threatening illness.
Catastrophic
PSYCHIATRIC–MENTAL HEALTH NURSING: SCOPE AND STANDARDS OF PRACTICE
Standard 1. Assessment
Standard 2. Diagnosis
Standard 3. Outcome Identification
Standard 4. Planning
Standard 5. Implementation
Standard 5a. Coordination of care
Standard 5b. Health Teaching and Health Promotion
Standard 5c. Milieu Therapy
Standard 5d. Pharmacological, Biological, and Integrative Therapies
Standard 5e. Prescriptive Authority and Treatment
Standard 5f. Psychotherapy
Standard 5g. Consultation
Standard 6. Evaluation
Standard 7. Quality of Practice
Standard 8. Education
Standard 9. Professional Practice Evaluation
Standard 10. Collegiality
Standard 11. Collaboration
Standard 12. Ethics
Standard 13. Research
Standard 14. Resource Utilization
Standard 15. Leadership
The psychiatric–mental health registered nurse collects comprehensive health data that is pertinent to the patient’s health of situation.
Standard 1. Assessment
The psychiatric–mental health registered nurse analyzes the assessment data to determine diagnoses of problems, including level of risk.
Standard 2. Diagnosis
The psychiatric–mental health registered nurse identifies expected outcomes for a plan individualized to the patient or the situation.
Standard 3. Outcome Identification
The psychiatric–mental health registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes.
Standard 4. Planning
The psychiatric–mental health registered nurse implements the identified plan.
Standard 5. Implementation
The psychiatric–mental health registered nurse coordinates care delivery.
Standard 5a. Coordination of care
The psychiatric–mental health registered nurse employs strategies to promote health and a safe environment.
Standard 5b. Health Teaching and Health Promotion
The psychiatric–mental health registered nurse provides, structures, and maintains a safe and therapeutic environment in collaboration with patients, families, and other health-care clinicians.
Standard 5c. Milieu Therapy
The psychiatric–mental health registered nurse incorporates knowledge of pharmacological, biologic, and complementary interventions with applied clinical skills to restore the patient’s health and prevent further disability.
Standard 5d. Pharmacological, Biological, and Integrative Therapies
The psychiatric–mental health advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations.
Standard 5e. Prescriptive Authority and Treatment
The psychiatric–mental health advanced practice registered nurse conducts individual, couple, group, and family psychotherapy using evidence-based psychotherapeutic frameworks and nurse– patient therapeutic relationships.
Standard 5f. Psychotherapy
The psychiatric–mental health advanced practice registered nurse provides consultation to influence the identified plan, enhance the abilities of other clinicians to provide services for patients, and effect change.
Standard 5g. Consultation
The psychiatric–mental health registered nurse evaluates progress toward attainment of expected outcomes.
Standard 6. Evaluation
The psychiatric–mental health registered nurse systematically enhances the quality and effectiveness of nursing practice.
Standard 7. Quality of Practice
The psychiatric–mental health registered nurse attains knowledge and competency that reflect current nursing practice.
Standard 8. Education
The psychiatric–mental health registered nurse evaluates one’s own practice in relation to the professional practice standards and guidelines, relevant statues, rules, and regulations.
Standard 9. Professional Practice Evaluation
The psychiatric–mental health registered nurse interacts with and contributes to the professional development of peers and colleagues.
Standard 10. Collegiality
The psychiatric–mental health registered nurse collaborates with patients, family, and others in the conduct of nursing practice.
Standard 11. Collaboration
The psychiatric–mental health registered nurse integrates ethical provisions in all areas of practice.
Standard 12. Ethics
The psychiatric–mental health registered nurse integrates research findings into practice.
Standard 13. Research
The psychiatric–mental health registered nurse considers factors related to safety, effectiveness, cost, and impact on practice in the planning and delivery of nursing services.
Standard 14. Resource Utilization
Note 
Flashcard (69)