Psych Final Mental Illness and Interventions

PTSD

reexperiencing the trauma through dreams or recurrent and intrusive thoughts, avoidance, negative cognition or thoughts, being on guard, or hyperarousal.

PTSD Cues

numbing of general responsiveness and shows persistent signs of increased arousal such as insomnia, hyperarousal or hypervigilance, irritability, or angry outbursts.

They report losing a sense of connection and control over their life

Dissociative

- a subconscious defense mechanism that helps a person protect their emotional self from recognizing the full effects of some horrific or traumatic event by allowing the mind to forget or remove itself from the painful situation or memory

- The nurse can help the client minimize dissociative episodes or flashbacks through grounding techniques and reality orientation.

Panic Disorder

- CBT, medications, lifestyle modifications, and exposure therapy

- approach the conversation with empathy, calmness, and a focus on reducing the client’s anxiety.

Panic attacks can be overwhelming, and your goal is to help the client feel safe, supported, and understood.

OCD

exposure and response prevention

(ERP): exposing the individual to anxiety-provoking situations or thoughts (obsessions) and preventing the compulsive behaviors (or responses) that the person would normally engage in to reduce anxiety

hallucinations

Seeing images that don’t exist at all, seeing a dead person or bugs on a wall that aren’t there.

Delusion intervention

The nurse must avoid openly confronting the delusion or arguing with the client about it.

The nurse must also avoid reinforcing the delusional belief by “playing along” with what the client says.

Mania

a distinct period during which mood is abnormally and persistently elevated, expansive, or irritable

Mania Interventions

The primary treatment for mania involves mood stabilizers (such as lithium or valproate) and antipsychotic medications (such as olanzapine or risperidone) to reduce symptoms.

In some cases, benzodiazepines may be prescribed for agitation

Suicide coping

Engage in Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT) to help manage emotional distress and negative thought patterns.

Suicide

Crisis intervention services, including hotlines and support networks, can provide immediate assistance and reduce the feeling of isolation that often accompanies suicidal thoughts.

Myths about Suicide

- People who talk about suicide won’t actually do it

- Talking about suicide will make someone more likely to attempt it

Verbalizing the implied or clarificatioN

voicing what the client has hinted at or suggested

Suicide Risks

Depression, bipolar, schizophrenia, anxiety, personality disorder

Suicide Assessment

The nurse must determine whether the depressed or hopeless client has suicidal ideation or a lethal plan

Ideation: “Are you thinking about killing yourself?”

Plan: “Do you have a plan to kill yourself?”

Method: “How do you plan to kill yourself?”

Access: “How would you carry out this plan? Do you have access to the means to carry out the plan?”

Where: “Where would you kill yourself?”

When: “When do you plan to kill yourself?”

Timing: “What day or time of day do you plan to kill yourself?”

Depression

persistent feelings of sadness or a lack of interest in daily activities for at least two weeks.

Assessment Steps

Introduction and Establishing a Relationship

Chief Complain

History of Present Illness

Past Psychiatric History

Medical History

Family History

Social History

Mental Status Examination (MSE)

Psychosocial Assessment

Physical Examination

Introduction and Establishing a Relationship

- Building trust and creating a comfortable environment

Chief Complain

- Understanding the primary reason for seeking care

History of Present Illness

- Gather information on the onset, duration, and progression of symptoms

Past Psychiatric History

- Goal: Identify previous psychiatric conditions and treatments

Medical History

- Goal: Identify medical conditions that could impact mental health

Family History

- Goal: Assess for any genetic predisposition to mental health conditions

Social History

- Goal: understand the patient’s lifestyle, environment, and support system

Mental Status Examination (MSE)

- Goal: Assess the patient’s current mental state (appearance, behavior. Speech, mood/affect, thought process, thought content, perception, cognition, insight and judgement, risk assessment)

Psychosocial Assessment

- Goal: understand ho the psychiatric condition impacts daily life

Physical Examination

- Goal: rule out medical conditions affecting psychiatric symptoms

MAOI food

Mature or aged cheeses or dishes made with cheese, such as lasagna or pizza. All cheese is considered aged except cottage cheese, cream cheese, ricotta cheese, and processed cheese slices. Aged meats such as pepperoni, salami, mortadella, summer sausage, beef logs, meat extracts, and similar products. Make sure meat and chicken are fresh and have been properly refrigerated. Italian broad beans (fava), bean curd (tofu), banana peel, overripe fruit, and avocado. All tap beers and microbrewery beer. Drink no more than two cans or bottles of beer (including nonalcoholic beer) or 4 oz of wine per day. Sauerkraut, soy sauce or soybean condiments, or marmite (concentrated yeast). Yogurt, sour cream, peanuts, brewer’s yeast, and monosodium glutamate (MSG).

Borderline Personality Disorder communication

Maintain clear, consistent boundaries, avoid splitting, validate feelings, calm, nonjudgemental, and supportive

Anorexia

focus on building a therapeutic relationship, promoting safe weight gain through structured meal plans, and closely monitoring physical health and lab values.

Nurses use cognitive-behavioral strategies to help the client challenge distorted body image and eating behaviors while encouraging participation in therapy.

Education on nutrition and the health risks of starvation is essential, along with setting realistic goals and creating a relapse prevention plan to support long-term recovery.

Self-monitoring

- a cognitive–behavioral technique designed to help clients manage their own behavior

Somatic

empathetic listening, validation of the patient's concerns, and setting clear boundaries.

The nurse should avoid reinforcing the patient's physical complaints or focusing solely on the symptoms.

Instead, communication should be directed towards exploring feelings and emotional distress, as somatic symptoms are often linked to underlying psychological issues.

Dementia

Psychosocial interventions play a key role in improving the quality of life for individuals with dementia.

These interventions can help individuals maintain cognitive function, reduce behavioral symptoms, promote emotional well-being, and preserve social relationships.

Paranoid Dementia

Delusions of mistrust and fearfulness

How to Avoid Agitation in Dementia

Individualization

Simplicity

Consistency

Involvement

Patience

Individualization

personalized to the person’s specific abilities, preferences, and stage of dementia

Simplicity

tasks and routines should be broken down into simple, manageable steps

Consistency

set regular routine to provide structure and reduce confusion

Involvement

whenever possible, involve the individual in the process of setting and achieving their own goals

Patience

achieving self-care goals may take time, and caregivers should remain flexible and understanding

Dopamine

neurotransmitter located primarily in the brain stem;

has been found to be involved in the control of complex movements, motivation, cognition, and regulation of emotional responses

NMS

potentially fatal, idiosyncratic reaction to an antipsychotic (or neuroleptic) drug

NMS major symptoms

rigidity; high fever; autonomic instability such as unstable blood pressure, diaphoresis, and pallor; delirium; and elevated levels of enzymes, particularly creatine phosphokinase

Pseudoparkinsonism

Bradykinesia, muscle rigidity, tremor, shuffling gait, mask-like facial expression, drooling

Therapeutic Relationship Aspects

Trust

Empathy

Non-judgmental

Acceptance

Self-awareness

Therapeutic Relationship Explained

Trust: The nurse–client relationship requires trust. Trust builds when the client is confident in the nurse, and the nurse’s presence conveys integrity and reliability.

- Empathy is the ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client.

- The nurse who does not become upset or respond negatively to a client’s outbursts, anger, or acting out conveys acceptance to the client.

- This unconditional, nonjudgmental attitude is known as positive regard and implies respect.

- Self-awareness is the process of developing an understanding of one’s values, beliefs, thoughts, feelings, attitudes, motivations, prejudices, strengths, and limitations, and how these qualities affect others