Mental Health Nursing Clinical Orientation Flashcards

Vocabulary flashcards covering key terms and concepts from the NSC 392 Mental Health Clinical Orientation.

Therapeutic Milieu

The structuring of the social and physical environment to provide therapeutic activities and interactions that promote mental and emotional health.

Maxwell Jones

The individual credited with developing the concept of using community in the psychiatric setting to help patients learn coping skills.

Containment

The first step in Gunderson's milieu treatment guidelines, used when a client enters the system perceiving self as victim or out of control.

Support

A component of Gunderson's milieu treatment that increases a client's self-control and ability to manage their own circumstances.

Structure

A component of Gunderson's milieu treatment that helps shift a client's perception of change from external to internal.

Validation

A component of Gunderson's milieu treatment that, along with support, structure, and involvement, decreases the need for containment.

Involvement

A component of Gunderson's milieu treatment that encourages engagement and decreases the need for containment.

Safe Skills

Interpersonal skills for beginning nurses or students, including acceptance, calmness, observation of affect and behavior, effective praise, compassionate limit setting, verbal prompts, and non-intrusive availability.

Novice Skills

Interpersonal skills for beginning psychiatric nurses, including attending, listening, beginning empathy, processing skills, and pacing before leading.

Advanced Beginner Skills

Interpersonal skills acquired around one year of clinical practice, including constructive confrontation, advanced empathy, advanced limit setting, feedback, influencing, focusing, and modeling interpersonal skills.

Competent Level

The clinical level reached after two years of clinical practice where a nurse utilizes a combination of therapeutic strategies to achieve stated therapeutic goals.

Foundation of Essential Attitudes

Respect and genuineness, which serve as the underlying foundation for the hierarchy of interpersonal skills in psychiatric nursing.

Mood

The pervasive and enduring emotional state of an individual.

Affect

The outward expression of an individual's emotional state.

Thought Process

How the client thinks.

Thought Content

What the client says.

Circumstantial Thinking

A thought process pattern where a client gives tedious, unnecessary details before eventually reaching the point.

Delusion

A fixed, false belief that is not grounded in reality.

Flight of Ideas

A continuous flow of rapid verbalizations where the client switches constantly from one topic to another.

Ideas of Reference

False impressions that external events or actions by others have a special, direct meaning intended specifically for the individual.

Loose Association

Disorganized thinking characterized by lack of smooth flow or logical connection between thoughts.

Tangential Thinking

Wandering off topic during conversation and never returning to the original point or answering the question.

Thought Blocking

A sudden stoppage in the train of thought or in the middle of a sentence.

Thought Broadcasting

The belief that others can hear or know what the person is thinking.

Thought Insertion

The belief that thoughts are being placed or inserted into one's mind by outside people or forces.

Thought Withdrawal

The belief that thoughts are being removed or taken out of one's mind by an outside force.

Word Salad

A chaotic mixture of disconnected words and phrases that lacks logical coherence.

Judgement

The ability to interpret one's environment.

Insight

The ability to understand one's situation and accept responsibility for it.

Self-Concept

How an individual views their personal worth and dignity.

Social Relationships

Relationships focused on sharing mutual ideas, feelings, and experiences, trading advice freely, with no planned time limit or evaluation of interactions.

Therapeutic Relationships

Relationships focused on the client's ideas, feelings, and experiences, offering therapeutic help, active listening, and established time limits with termination in mind.

Denial

Refusal to acknowledge emotion, reality, or a difficult situation.

Repression

Motivated forgetting or pushing uncomfortable thoughts and memories out of conscious awareness.

Projection

Falsely attributing one's own unacceptable feelings, impulses, or traits onto others.

Displacement

Transferring feelings or emotional responses from the original target to another less threatening object or person.

Regression

Retreating to a behavior characteristic of an earlier developmental level or a time when one felt safer.

Sublimation

Channeling unacceptable urges or feelings into constructive, socially acceptable behaviors.

Rationalization

Using cognitive distortions or logical excuses to make an unacceptable feeling or action less threatening.

Reaction Formation

Adopting conscious behaviors and attitudes that are directly opposite of one's true feelings to overcompensate.

Introjection

Incorporating characteristics, values, or traits of another person into one's own identity.

Identification with Aggressor

Adopting the behavior or traits of a person with more power to cope with fear or anxiety.

Help-Rejecting Complaining

Asking for help and then systematically refusing or rejecting all suggestions offered.

Isolation of Affect

Being aware of the details of a painful event while experiencing a complete loss or detachment of associated feelings.

Passive Aggression

Indirectly and unassertively expressing hostility or aggression toward others.

SAD PERSONS: Sex

A risk factor assessment note that men kill themselves three times more often than women, although women make attempts three times more often than men.

SAD PERSONS: Age

A risk factor assessment identifying high-risk suicide groups as individuals 19 years or younger and 45 years or older, especially the elderly (65 or older).

SAD PERSONS: Depression

A risk factor assessment where 35-79% of suicide attempters manifest a depressive syndrome, with hopelessness being a primary predictor.

SAD PERSONS: Previous Attempts

A suicide risk factor noting that roughly 80% of individuals who commit suicide have made previous attempts.

SAD PERSONS: ETOH

A suicide risk factor noting that alcohol is associated with up to 65% of successful suicides, with heavy drug use weighted equally.

SAD PERSONS: Rational Thinking

A suicide risk factor noting that people with functional or organic psychoses are more apt to commit suicide than those in the general population.

Disordered Water Balance

A medical emergency involving potential hippocampal abnormalities with increased ADH levels, leading to excessive thirst, abnormal drinking, and potential motor seizures.

Water Intoxication

A condition caused by rapid ingestion of large fluid amounts resulting in urine specific gravity < 1.005 and serum sodium < 1.35 mEq/L.

Neuroleptic Malignant Syndrome

A rapid-onset emergency characterized by lead pipe muscle rigidity, temperature of 101-103 degrees Fahrenheit, diaphoresis, elevated CPK, and altered consciousness.

Anticholinergic Crisis

A severe reaction caused by overdose or sensitivity to anticholinergic drugs, marked by fever, dry mouth, blurred vision, un-reactive dilated pupils, and delirium.

Serotonin Syndrome

A condition caused by serotonin excess occurring within hours of drug escalation, manifesting as fever, agitation, shivering, diaphoresis, ataxia, diarrhea, and myoclonus.

Hypertensive Crisis

A life-threatening elevation in blood pressure caused by mixing MAOIs with restricted foods/medications, causing explosive occipital/temporal headaches, chest pain, and neck stiffness.

Duty to Warn

The legal requirement established by Tarasoff mandating healthcare professionals to warn identifiable victims when a client poses a serious, explicit threat of harm.

Unintentional Torts

Civil wrongs such as negligence and malpractice involving duty, breach of duty, injury or damage, and causation.

Intentional Torts

Willful and voluntary acts intended to bring about injury or consequences, including assault, battery, and false imprisonment.