Psych Mental Health Nursing Practice Flashcards

A complete set of 150 vocabulary flashcards covering basic psych mental health nursing concepts, including communication techniques, therapeutic relationship phases, psychiatric disorders, and safety priorities.

Goal of the therapeutic nurse-patient relationship

Promote patient growth, coping, and safety.

Therapeutic use of self

Purposeful use of personality and communication to promote healing.

Therapeutic vs social relationship

Therapeutic is patient-focused, goal-directed, and time-limited; social meets mutual needs.

Peplau's four phases

Preorientation, Orientation, Working, Termination.

Orientation phase priority

Establish trust, define roles, identify goals.

Working phase focus

Promote insight, behavior change, and problem-solving.

Termination phase

Review progress and prepare for ending the relationship.

Preorientation phase

Nurse self-prepares before meeting the client.

Transference

Client unconsciously transfers feelings about another person onto the nurse.

Countertransference

Nurse's personal feelings interfere with care.

Best communication technique

Use open-ended questions.

Purpose of therapeutic silence

Allows time for reflection and expression.

Reflection

Direct the client's feelings back to them.

Clarification

Ensure accurate understanding.

Restating

Repeating the main idea to encourage discussion.

Reason to avoid 'why' questions

They can make clients feel defensive.

Reason to avoid false reassurance

It minimizes the client's feelings.

Giving advice

Nontherapeutic.

Action when client asks personal question

Briefly redirect the focus to the client.

Best response to a delusion

Acknowledge feelings without arguing or reinforcing.

Best response to hallucinations

Assess the experience and focus on safety.

Priority with command hallucinations

Assess intent to act and protect safety.

First priority for suicidal client

Assess plan, intent, means, and ensure safety.

Antidepressants onset of action

Usually several weeks for full effect.

Mood vs affect

Mood is reported; affect is observed.

Insight

Awareness of one's condition.

Judgment

Ability to make safe decisions.

MSE assesses

Current cognitive and emotional functioning.

Psychosocial assessment components

Support systems, coping, culture, spirituality, history.

Purpose of cultural assessment

Avoid incorrect assumptions about behavior.

Eye contact significance

Depends on cultural norms.

Therapeutic boundary

Professional limits that protect client and nurse.

Boundary violation example

Meeting socially outside care.

Aggressive client priority

Maintain safety and set clear limits.

Limit setting characteristics

Clear, calm, specific, and consistent.

Fight-or-flight system

Sympathetic nervous system.

Relaxation technique

Deep breathing.

Guided imagery

Uses mental images to reduce anxiety.

Progressive muscle relaxation

Alternately tense and relax muscle groups.

Depression hallmark

Persistent sadness or loss of interest.

Highest priority in depression

Suicide assessment.

Significance of hopelessness

Increased suicide risk.

Schizophrenia positive symptom example

Hallucinations or delusions.

Schizophrenia negative symptom example

Flat affect or social withdrawal.

Delusion

False fixed belief.

Hallucination

False sensory perception.

ODD hallmark

Defiant behavior toward authority.

Conduct disorder hallmark

Violation of others' rights and social rules.

IED (Intermittent Explosive Disorder) hallmark

Recurrent impulsive aggressive outbursts.

Safety question on psych exams

Safety always takes priority over all other needs.

Components of a suicide assessment

Ideation, plan, intent, means, and previous attempts.

Highest suicide risk factor

A specific plan with available means.

Priority after identifying suicide risk

Stay with the client and initiate safety precautions.

Rationale for monitoring after starting antidepressants

Energy may improve before mood, increasing suicide risk.

Best response to 'I want to die.'

Explore suicidal thoughts directly and assess risk.

Therapeutic response to hopelessness

Acknowledge feelings and encourage expression.

Reason to avoid changing the subject

It blocks therapeutic communication.

Empathy

Understanding the client's feelings without taking them on.

Sympathy vs empathy

Sympathy shares feelings; empathy understands feelings.

Congruent communication

Verbal and nonverbal messages match.

Incongruent communication

Words and behaviors conflict.

Best seating during interview

At eye level with personal space respected.

First step of the clinical interview

Establish rapport and explain purpose.

Best type of initial question

Broad, open-ended.

Purpose of observing appearance

Provides clues about mental status.

Flight of ideas

Rapid shifting between loosely connected thoughts.

Tangential speech

Never returns to the original topic.

Circumstantial speech

Eventually answers after unnecessary detail.

Thought blocking

Sudden interruption in thought.

Loose associations

Illogical flow of ideas.

Illusion

Misinterpretation of a real stimulus.

Delusion of persecution

False belief of being harmed or followed.

Delusion of grandeur

False belief of exaggerated importance.

Most common hallucinations in schizophrenia

Auditory hallucinations.

Priority if voices command violence

Protect client and others immediately.

Reality-based response

Present reality without arguing.

Reason not to validate a delusion

It reinforces false beliefs.

Appropriate affect

Matches the situation.

Flat affect

Minimal emotional expression.

Blunted affect

Reduced emotional expression.

Lab values and psych symptoms relationship

Consider a medical cause before assuming psychiatric illness.

Significance of elevated BUN/creatinine

A medical condition contributing to altered mental status.

Nursing diagnosis priority rule

Safety before coping or education.

Most therapeutic phrase

'Tell me more about that.'

Active listening

Giving full attention using verbal and nonverbal cues.

Purpose of summarizing

Review and organize key points.

Giving approval

Nontherapeutic.

Defending

Nontherapeutic.

Minimizing feelings

Nontherapeutic.

Conduct disorder nursing priority

Consistent limits and safety.

ODD nursing approach

Remain calm and avoid power struggles.

Behavior contracts

Promote accountability and consistency.

Mood stabilizer examples

Valproate or carbamazepine.

Lamotrigine classification

Mood stabilizer/anticonvulsant.

Medication role in ODD

Behavioral therapy is primary; medication is not used alone.

Fight-or-flight signs

$\uparrow$HR, $\uparrow$BP, $\uparrow$RR, $\uparrow$alertness.

Parasympathetic response

Rest and digest.

Healthy coping example

Exercise or deep breathing.

Ineffective coping example

Substance misuse.

Psych nursing priority rule

Ask: 'What is the safest and most therapeutic response?'