Week 2 Lecture- Behavioral Health

What are the 3 major categories that influence a client's response to illness?

Individual, interpersonal, and cultural factors

How does developmental level affect a client's response to illness?

It affects coping skills, emotional responses, ability to express feelings, and understanding of illness.

Why may younger clients struggle during illness or stress?

They may have difficulty expressing thoughts and feelings.

What can happen when stress or illness occurs early in life?

It may lead to poorer outcomes later.

According to Erikson, how can unresolved developmental stages affect a person?

They may have poorer coping skills and difficulty with stress.

A patient has trouble handling stress because they never developed independence and self-esteem. Which theory helps explain this?

Erikson's psychosocial development theory

What does biologic makeup include?

Genetics and physical health

How does poor physical health affect coping?

It can worsen anxiety, depression, and adaptation to stress.

Why might some ethnic groups require lower psychiatric medication doses?

Some groups metabolize medications more slowly.

What is self-efficacy?

Belief that one's abilities and efforts can influence life events.

A client says, "I know I can manage my illness if I try." What concept does this demonstrate?

Self-efficacy

What are the 3 components of hardiness?

Commitment, control, and challenge

A client adapts positively during stressful situations and sees change as growth. Which trait are they showing?

Hardiness

What is resilience?

The ability to respond to stress in a healthy manner.

What is resourcefulness?

Learned ability to solve problems and manage challenges.

A patient successfully adjusts after losing their spouse. What concept does this demonstrate?

Resilience

What are examples of spirituality?

Religion, belief in God, meaning in life, cultural beliefs, connection with nature

How can spirituality help clients?

Provides support, hope, strength, and coping assistance

How should the nurse assess spirituality?

Ask respectfully: "How can I support your spiritual or religious practices?"

What are interpersonal factors?

Social support, belonging, family relationships, community involvement

What does a sense of belonging include?

Feeling valued and accepted

True or False: Family support is always beneficial.

False

How can unhealthy family systems affect clients?

Increase stress, conflict, or enable maladaptive behaviors

What is culture?

Learned beliefs, values, behaviors, customs, and ways of thinking

How does culture influence healthcare?

It affects health beliefs, illness behaviors, and treatment decisions.

What are the 6 cultural phenomena nurses assess?

Communication, space, social organization, time orientation, environmental control, biologic variations

A nurse is unsure about a client's cultural preference. What should the nurse do?

Ask the client directly and respectfully.

What is an important principle of culturally competent nursing care?

Avoid assumptions and use the client as the best source of information.

What must nurses recognize in themselves to provide unbiased care?

Personal biases

True or False: Hardiness and resilience are cultural factors.

False

What is the purpose of a psychosocial assessment?

To assess emotional state, mental capacity, and behavioral functioning

Why is psychosocial assessment important?

It provides baseline information, guides care, and evaluates progress.

What nurse behaviors are important during psychosocial assessment?

Calm, direct, nonjudgmental, objective communication

What type of environment is best for psychosocial assessment?

Quiet, safe, private, and comfortable

Why may family input be helpful during assessment?

They may provide information about behavior and functioning.

What information is included in psychosocial history?

Age, culture, spirituality, developmental stage, psychiatric history

What is flight of ideas?

Rapid shifting between topics

Flight of ideas is commonly seen in what disorder?

Mania

What is thought blocking?

Sudden interruption in thought

Thought blocking is commonly associated with what disorders?

Schizophrenia and severe anxiety

What is perseveration?

Repeating the same response repeatedly

What is word salad?

Incomprehensible mixture of words

Word salad is commonly seen in what condition?

Severe psychosis

What areas are assessed in sensorium and intellectual functioning?

Orientation, memory, concentration, abstract thinking

What 4 things are assessed during orientation?

Person, place, time, and situation

What is judgment?

Ability to make safe decisions

What is insight?

Understanding one's condition or behavior

What does self-concept assessment include?

Self-worth, dignity, body image

What should nurses assess regarding roles and relationships?

Role fulfillment, relationship satisfaction, family functioning

What physiologic/self-care factors should nurses assess?

Sleep, eating habits, substance use, medication compliance

What do nurses look for during data analysis?

Patterns, strengths, themes, and needs

Is assessment ongoing or one-time?

Ongoing and dynamic

What do intelligence tests assess?

Cognitive and intellectual functioning

What do personality tests assess?

Self-concept, impulse control, defense mechanisms, reality testing

What is the purpose of the DSM?

Classifies mental disorders and provides diagnostic criteria

What does the Mental Status Examination assess?

Cognitive function, memory, concentration, calculations, writing/drawing

Why is self-awareness important during assessment?

Prevents personal bias from affecting care

What difficult topics may nurses struggle to assess?

Suicide, self-harm, violence, sexual behaviors, homicide

What is always the priority during psychiatric assessment?

Safety

True or False: Asking about suicide increases suicidal thoughts.

False

What suicide assessment question evaluates ideation?

"Are you thinking about killing yourself?"

What suicide assessment question evaluates plan?

"Do you have a plan?"

What suicide assessment question evaluates intent?

"Would you act on these thoughts?"

Why is assessing access important in suicide assessment?

Determines ability to carry out the plan

What are major suicide risk factors?

Previous attempts, depression, hopelessness, isolation, trauma, substance abuse

What are warning signs of suicide?

Giving away possessions, saying goodbye, withdrawal, hopelessness

A depressed client suddenly becomes calm and starts giving away belongings. What should the nurse suspect?

Increased suicide risk

What are nursing priorities for suicidal clients?

Ensure safety, remove harmful objects, stay calm, notify team

Should high-risk suicidal clients be left alone?

No

What are therapeutic responses to suicidal clients?

"I'm glad you told me," "Tell me more," "You are not alone."

What responses should nurses avoid with suicidal clients?

"Everything will be okay" or "You have so much to live for."

What do psychosocial theories explain?

Human behavior, mental wellness, and mental illness

Which theory focuses on unconscious conflict?

Psychoanalytic theory

Who developed psychoanalytic theory?

Sigmund Freud

What are Freud's 3 personality structures?

Id, ego, and superego

Which part of personality follows the pleasure principle?

Id

Which part follows the reality principle?

Ego

Which part represents morality?

Superego

How many psychosexual stages did Freud identify?

Five

What are Freud's psychosexual stages?

Oral, anal, phallic, latency, genital

Who developed psychosocial development theory?

Erik Erikson

What was Erikson's main focus?

Lifespan psychosocial development

Who developed cognitive development theory?

Jean Piaget

What are Piaget's 4 stages?

Sensorimotor, preoperational, concrete operations, formal operations

Who focused on interpersonal relationships?

Harry Stack Sullivan

What is Sullivan's main theory focus?

Social interactions and interpersonal relationships

Who developed the therapeutic nurse-patient relationship theory?

Hildegard Peplau

What are Peplau's 4 anxiety levels?

Mild, moderate, severe, panic

Who developed client-centered therapy?

Carl Rogers

What are Rogers' key concepts?

Empathy, genuineness, unconditional positive regard

Who created the hierarchy of needs?

Abraham Maslow

What is the highest level of Maslow's hierarchy?

Self-actualization

What do behavioral theories focus on?

Learned behaviors and conditioning

What shapes voluntary behavior in operant conditioning?

Rewards, consequences, reinforcement

What is systematic desensitization?

Gradual exposure with relaxation techniques

What disorders commonly use systematic desensitization?

Phobias and anxiety disorders

What does cognitive therapy focus on?

Thoughts and distorted thinking patterns

Rational emotive therapy focuses on what?

Irrational beliefs and automatic thoughts

Automatic thoughts are associated with which therapy?

Rational emotive therapy (RET)

What does existential therapy focus on?

Meaning, purpose, responsibility