NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
5 A/ of integrating best evidence into clinical practices include:
Asking, acquiring, appraising, applying, assessing
Mental health recovery model: is one of helping people w/ psychiatric disabilities effectively manage
their symptoms, reduce psychosocial disability, and find a meaningful life in community of their
choosing.
Introduction in Psychiatric Nursing
Basic Brain Anatomy- what do the different part of brain control?
Hypothalamus? Neurons/ synapse- pg. 51
Hypothalamus: physiological functions (temp regulation, thirst, hunger, sleep, mood, sex
drive, and the release of other hormones w/in the body). Houses the pituitary gland.
Neurons: (located in spinal cord) fiber projects outside the spinal cord to directly or
indirectly control effector organs, mainly muscles and glands.
Synapse: permits a neuron to pass an electrical or chemical signal to another neuron.
Milieu therapy: Creating a SAFE, structured inpt/outpt setting where the mentally ill can test new
behaviors and coping mechanisms w/ others.
Climate is essential to healing: paint color, relaxed environments are conducive to the healing
process
Florence Nightingale believe that the environment helps heal
Describe the difference between mental health and mental illness
Mental health: person’s condition w/ regard to their psychological and emotional well-being
Mental illness: wide range of mental health conditions – disorders that affect your mood,
thinking, and behavior. Ex: depression, anxiety disorder, schizophrenia, etc.
Maslow’s Hierarchy of needs
Physiological needs- most basic needs (food, oxygen, water, sleep)
Safety needs- security, protection, freedom of fear, anxiety & chaos.
Belongingness and love needs- intimate relationships, love, affection, & belonging. Maslow
stresses the importance of having a family and a home and being part of an identifiable group.
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Esteem needs- high self-regard; need to feel confident, valued & valuable.
Self-actualization- hard-wired to be everything we are capable of becoming
Self-transcendence- “seeks to further a cause beyond the self and to experience a communion
beyond the boundaries of the self through peak experiences”
Peplau’s Theory of Interpersonal Relations
Using the interpersonal environment as a therapeutic tool for healing and in reduction of
anxiety. Sitting quietly beside a new father who has recently lost his job and attempted
suicide and does not want to talk.
Freud- what did he contribute to psychiatric setting- unconscious thoughts
Considered the “father of psychiatry.” His work was based on psychoanalytic theory, in
which Freud claims that most psychological disturbances are the result of early trauma or
incidents that are often not remembered or recognized. The assumption is made that in
healthy individuals, the ego is able to realistically evaluate situations, limit the id’s
primitive impulses, and keep the superego from becoming too rigid and obsessive.
o ID - the primitive, pleasure-seeking part (according to Freud, predominantly
sexual pleasure) of our personalities that lurks in the unconscious mind.
o EGO - our sense of self and acts as an intermediary between the id and the world
by using ego defense mechanisms, such as repression, denial, and rationalization
o SUPEREGO – assigned to those processes that Freud referred to as our
conscience (our sense of what is right or wrong) and is greatly influenced by our
parents’ or caregivers’ moral and ethical stances.
Erickson’s
Trust vs Mistrust (Infant 0-1.5) trust developed if caregivers give affection, love, care, attn, &
reliability. (Feeding)
Autonomy vs Shame (toddlers 1.5-3) kids need to develop a sense of personal control (Toilet
training)
Initiative vs Guilt (Children 3-6) children need to have power to explore their environment & not
receive disapproval from parents. (Exploration)
Industry vs Inferiority (school aged kids 6-12) Kids dealing w/ new social & academic demands.
Success leads to a sense of competence. (School)
Identity vs role confusion (teens 12-20) teens need to develop self-identity and personal identity
to stay true to themselves. (Social relationships)
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Intimacy & Solidarity vs Isolation (young adults 20-30) young adults need to form intimate, loving
relationships. (Relationships)
Generativity vs Self-absorption (adults 30-65) Need to create/nurture things by having children
(Work & Parenthood)
Integrity vs Despair (elderly 65+) need to look back and feel fulfilled by accomplishments; have
wisdom and no regrets (Reflection on life)
Therapeutic Communication: goal directed, professional, scientifically based. The goal is to get
information so that you can plan care for the pt.
Active listening
o Clarifying: promotes understanding of the pt’s statement
o Restating: repeats the same key words the pt has just spoken to echo their feelings (ex: if
a pt remarks, “My life is empty… it has not meaning,” additional info may be gained by
restating, “You life has not meaning?”)
o Reflecting: helps ppl understand their own thoughts better; summarizes (ex: to reflect a
pt’s feelings about his or her life, a good beginning might be “You sound as if you have
had many disappointments.”)
o Exploring: use of open-ended questions or statements to allow the pt to express
thougths/feelings (ex. “Tell me more…”, “Give me an example of…”)
Communication technique ex. In different scenarios
For suicidal pts: “These thoughts are very serious Mr. Adams. I do not want any harm to come to
you. Can you tell me what you were feeling and if there were any circumstances that led you to
this decision?”
For pts who start crying: stay w/ your pt and reinforce that it is all right to cry & offer tissues.
“You seem upset, what are you thinking right now?”
For pts who say the “don’t want to talk”: “Its alright. I would like to spend some time with you.
We don’t have to talk.” Or reapproach at a later time, “Our 5 minutes is up. I will be back at
10am and spend another 5 minutes with you.”
For pts who ask the nurse to keep a secret: nurses cannot make such promises, as it may be
important to share that info w/ other staff for safety reasons. “I cannot make that promise Mr.
Adams as it might be important for me to share it with the other staff.”
Non-Verbal:
o Tone of voice (tone, pitch, intensity, stuttering, silence, pausing)
o Facial expression (frown, smile, grimaces, raises eyebrows, licks lips)
o Posture (slumps over, puts face in hands, taps feet, fidget w/ fingers)
Final Exam
Key Concepts
5 A/ of integrating best evidence into clinical practices include:
Asking, acquiring, appraising, applying, assessing
Mental health recovery model: is one of helping people w/ psychiatric disabilities effectively manage
their symptoms, reduce psychosocial disability, and find a meaningful life in community of their
choosing.
Introduction in Psychiatric Nursing
Basic Brain Anatomy- what do the different part of brain control?
Hypothalamus? Neurons/ synapse- pg. 51
Hypothalamus: physiological functions (temp regulation, thirst, hunger, sleep, mood, sex
drive, and the release of other hormones w/in the body). Houses the pituitary gland.
Neurons: (located in spinal cord) fiber projects outside the spinal cord to directly or
indirectly control effector organs, mainly muscles and glands.
Synapse: permits a neuron to pass an electrical or chemical signal to another neuron.
Milieu therapy: Creating a SAFE, structured inpt/outpt setting where the mentally ill can test new
behaviors and coping mechanisms w/ others.
Climate is essential to healing: paint color, relaxed environments are conducive to the healing
process
Florence Nightingale believe that the environment helps heal
Describe the difference between mental health and mental illness
Mental health: person’s condition w/ regard to their psychological and emotional well-being
Mental illness: wide range of mental health conditions – disorders that affect your mood,
thinking, and behavior. Ex: depression, anxiety disorder, schizophrenia, etc.
Maslow’s Hierarchy of needs
Physiological needs- most basic needs (food, oxygen, water, sleep)
Safety needs- security, protection, freedom of fear, anxiety & chaos.
Belongingness and love needs- intimate relationships, love, affection, & belonging. Maslow
stresses the importance of having a family and a home and being part of an identifiable group.
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Esteem needs- high self-regard; need to feel confident, valued & valuable.
Self-actualization- hard-wired to be everything we are capable of becoming
Self-transcendence- “seeks to further a cause beyond the self and to experience a communion
beyond the boundaries of the self through peak experiences”
Peplau’s Theory of Interpersonal Relations
Using the interpersonal environment as a therapeutic tool for healing and in reduction of
anxiety. Sitting quietly beside a new father who has recently lost his job and attempted
suicide and does not want to talk.
Freud- what did he contribute to psychiatric setting- unconscious thoughts
Considered the “father of psychiatry.” His work was based on psychoanalytic theory, in
which Freud claims that most psychological disturbances are the result of early trauma or
incidents that are often not remembered or recognized. The assumption is made that in
healthy individuals, the ego is able to realistically evaluate situations, limit the id’s
primitive impulses, and keep the superego from becoming too rigid and obsessive.
o ID - the primitive, pleasure-seeking part (according to Freud, predominantly
sexual pleasure) of our personalities that lurks in the unconscious mind.
o EGO - our sense of self and acts as an intermediary between the id and the world
by using ego defense mechanisms, such as repression, denial, and rationalization
o SUPEREGO – assigned to those processes that Freud referred to as our
conscience (our sense of what is right or wrong) and is greatly influenced by our
parents’ or caregivers’ moral and ethical stances.
Erickson’s
Trust vs Mistrust (Infant 0-1.5) trust developed if caregivers give affection, love, care, attn, &
reliability. (Feeding)
Autonomy vs Shame (toddlers 1.5-3) kids need to develop a sense of personal control (Toilet
training)
Initiative vs Guilt (Children 3-6) children need to have power to explore their environment & not
receive disapproval from parents. (Exploration)
Industry vs Inferiority (school aged kids 6-12) Kids dealing w/ new social & academic demands.
Success leads to a sense of competence. (School)
Identity vs role confusion (teens 12-20) teens need to develop self-identity and personal identity
to stay true to themselves. (Social relationships)
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Intimacy & Solidarity vs Isolation (young adults 20-30) young adults need to form intimate, loving
relationships. (Relationships)
Generativity vs Self-absorption (adults 30-65) Need to create/nurture things by having children
(Work & Parenthood)
Integrity vs Despair (elderly 65+) need to look back and feel fulfilled by accomplishments; have
wisdom and no regrets (Reflection on life)
Therapeutic Communication: goal directed, professional, scientifically based. The goal is to get
information so that you can plan care for the pt.
Active listening
o Clarifying: promotes understanding of the pt’s statement
o Restating: repeats the same key words the pt has just spoken to echo their feelings (ex: if
a pt remarks, “My life is empty… it has not meaning,” additional info may be gained by
restating, “You life has not meaning?”)
o Reflecting: helps ppl understand their own thoughts better; summarizes (ex: to reflect a
pt’s feelings about his or her life, a good beginning might be “You sound as if you have
had many disappointments.”)
o Exploring: use of open-ended questions or statements to allow the pt to express
thougths/feelings (ex. “Tell me more…”, “Give me an example of…”)
Communication technique ex. In different scenarios
For suicidal pts: “These thoughts are very serious Mr. Adams. I do not want any harm to come to
you. Can you tell me what you were feeling and if there were any circumstances that led you to
this decision?”
For pts who start crying: stay w/ your pt and reinforce that it is all right to cry & offer tissues.
“You seem upset, what are you thinking right now?”
For pts who say the “don’t want to talk”: “Its alright. I would like to spend some time with you.
We don’t have to talk.” Or reapproach at a later time, “Our 5 minutes is up. I will be back at
10am and spend another 5 minutes with you.”
For pts who ask the nurse to keep a secret: nurses cannot make such promises, as it may be
important to share that info w/ other staff for safety reasons. “I cannot make that promise Mr.
Adams as it might be important for me to share it with the other staff.”
Non-Verbal:
o Tone of voice (tone, pitch, intensity, stuttering, silence, pausing)
o Facial expression (frown, smile, grimaces, raises eyebrows, licks lips)
o Posture (slumps over, puts face in hands, taps feet, fidget w/ fingers)
