NUR 2488 Mental Health Nursing Final Exam Key Concepts

Cognitve behavior theory- Aaron Beck Introduction in Psychiatric Nursing Basic Brain Anatomy- what do the different part of brain control? Hypothalamus? Neurons/ synapse- pg. 51 Understand milieu therapy- can you describe it in a clinical setting? Describe the difference between mental health and mental illness Maslow’s Hierarchy of needs (pg 31) Know scenarios Safety is #1 in terms of what you are doing as a nurse. Self-actualization Physiological ***What is the highest we want to attain in terms of Maslow? Self-actualization.*** ***You walk into Whispering Oaks and find resident with pee all over herself? Maslow- physiolocial/physical.*** Peplau’s Theory of Interpersonal Relations Mother of psychologic theory Freud- what did he contribute to psychiatric setting? Review table 3-2 (pg 38) Therapeutic Communication Empathy-Put yourself in their shoes. Help them talk about the feeling. Active listening-attending to verbal and non-verbal forms of communication. The way you carry on in front of the patient. Be able to given examples of verbal and non-verbal communication. Know it. Review table 8-1, 8-2, 8-3 Phases of the Nurse-Patient Relationships Describe relationship during each phase Preorientation phase: you have not met them yet Orientation Phase: building rapport Working phase: implementation Termination phase: discharge, evaluation, speak about everything that happened up to this phase. ***There will be a lot of question on termination phase.*** Boundaries Review table 9-1 Legal, Ethical, and Cultural Give examples of Negligence, Autonomy, Justice, Beneficence, Fidelity, and Veracity They will be on the exam. Know examples. Rights for Voluntary and Involuntary Admission Know it. Informed Consent Know it. Confidentiality/HIPAA Know it. Health Information Portability and Accountability Act of 1996. Psychiatric Nursing Assessment – priority interventions, nursing dx, etc. (pg 101) Mood Disorders Primary vs. Secondary Depression Review tables 15-2, 15-8 & 15-9 (Foods that interact) First-line treatment for Depression – Can you name them? Patient teaching for Nortriptyline, TCAs vs. SSRIs vs. MAOIs – know examples from classes of meds/benefits/risks/adverse effects/pt. teaching (Review table 15-7) Review box 15-2 Understand when the question is looking for a response that is asking for low or high tyramine Know the foods low and high in tyramine Know the meds Suicidal Ideation – Assessment, Risk Factors & Interventions (pg 437) Table 23-1, 23-2 We are there to help them get their control back. If they commit suicide, that means someone did not do their job. If the patient has to shit, you are going with them! No more privacy. Lithium Levels & Toxicity Serum level: 0.6-1.2 S/S: nausea Table 15-5 Mr. Jones is on lithium, but he loves his Jamaican food with lots of salt and spice. He comes in and says lithium is not working. He tells you what he loves to eat. High salt intake will decrease its effect. Check serum levels every month, 2 hours after last dose. Anything that will cause dehydration (N/V) will increase the serum lithium level. ***Question may not include the word dehydration in it.*** Review table 16-5 Anxiety Disorders Anxiety Levels & Stages Review table 11-1, 11-2, 11-9 & 11-10 Chronic-generalized anxiety. “I’ve had this feeling for months.” Panic-chest pain, panting Severe- Benzodiazepines – commonly given & teaching needed for patients Table 11-4- Understand and Describe Defense Mechanisms Denial Reaction formation-You just go ahead and do something even if you don’t want to, to cope with your anxiety. Example: you do not like animals, yet you want to be a vet. Example: You hate someone but you bring them donuts every time you see them. Example: You do not like your manager, but you always bring her chocolates. Rationalization-Example: Abuse your spouse because they made you. Example: Someone steals because they say their parents did not feed them when they were young. Discuss the benefits of buspirone For maintenance Thought Disorders Positive and Negative Symptoms of Schizophrenia Negative symptom-flat affect EPS/Tardive Dyskinesia- identify and describe Akathisia Tardive dyskinesia (tongue flapping) Serotonin syndrome-no fever Neuroleptic Malignancy Syndrome- be able to describe ***Fever*** The other conditions do not include fever. Review box 17-2, 17-3 Review table 17-8 & 17-9 Personality, Somatoform, and Eating Disorders