Mental Health Exam 2 Questions with Correct Answers

Background Correct Answer 1950- first antipsychotic medication was made called Thorazine. Continuum of care Correct Answer decompensation= patient needs higher level of care, and it is when there is deterioration of mental health. Least to most restrictive- primary, specialty, patient-centered medical homes, community mental health centers, psychiatric home care, assertive community treatment, intensive outpatient programs, partial hospitalization programs, emergency care, crisis stabilization/observation units, general and private hospitals, state hospital Outpatient psychiatric mental health services Correct Answer Primary care setting is where many mental health disorders are identified... Screen and provide teaching as necessary... Educate about meds Specialty providers: treat more in-depth cases, typically provide medication as well as therapy (group and individual) They are more experienced workers with specializations including rn's and cnp's Pt centered medical home: Resulted from the ACA.... Integrates care... Primary care AND mental health care in one location. Can coordinate additional services, or resources EX: Hamilton Clinic site and Lapeer community mental health Patient centered medical homes- received strong support from affordable care act of 2010 under president Obama. Five characteristics include: Patient centered care- relationship based on patient and considers the whole person Comprehensive care- all levels such as preventative, acute, and chronic) are addressed. Physicians or APRN's lead the teams Coordination of care- care is coordinated with a broader health system. Improved access- such as people have wide access to providers even after regular hours through emails, reminders, record keeping Systems approach- evidence based care is given through continuous feedback loop of evaluation. Community mental health centers- provides emergency services, community home based services, and outpatient services across life span. Treatments include- med administration, group and individual therapy, family therapy, dual diagnosis with mental health and substance use disorder. They usually give care if the patient is has limited access to private health care. Psychiatric Home care- it is a community based treatment model. Four requirements include: homebound status of the patient, a psychiatric diagnosis for the patient, a skilled psychiatric nurse's care is needed, a care plan based on the orders of the physician a Emergency care services Correct Answer the primary goal is to perform triage and stabilization. It has three models such as: Comprehensive Emergency Service Model- affiliated with Full-service ED, Dedicated clinical space, Specialty staffing, multidisciplinary, Hospital-Based Consultant Model No dedicated space or separate staffing; psychiatric staff on-site or on-call for ED Mobile crisis team model- Stabilization in the field Community based. Triage is determining the severity of the problems and urgency of the response. Stabilization- resolution of the immediate crisis. Prevention strategies in the outpatient care Correct Answer primary prevention- occurs before any problem occurs. It can prevent it or delay the onset of new symptoms. Secondary prevention- we can do screening and early detection that could delay or detect the disease in an early stage. Tertiary prevention- Treatment with a focus on preventing progression, closely related to rehabilitation. Psychiatric nursing in outpatient settings Correct Answer strong problem-solving and clinical skills, flexibility, cultural competence, solid knowledge of community resources, autonomy, and promoting recovery and continuation of treatment. Recovery- is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. What are some factors that can lead to barriers to the needs of patients in the outpatient setting Correct Answer housing adequacy and stability, income and source of income, family & support system, substance abuse history and current use, physical wellbeing. Inpatient care setting Correct Answer crisis/stabilization observation unit- focused on rapid stabilization and shorter stay of 72 hours or less. General hospital and private hospitals State psychiatric hospitals- it serves the most seriously ill patients, forensic care and monitoring as part of their functioning. Admission to inpatient settings- could be voluntary or involuntary. Units could be locked or unlocked to prevent elopement. Admission is reserved based on suicidal, homicidal, significantly disabled, and needing short-term acute care. Admission options- direct admission upon referral, hospital emergency admission or crisis, voluntary or involuntary based on the legal status, patient's rights to medication refusal, restraints, and refusal. Criteria for justification of admission- danger to self, danger to others, and unable to fulfill basic needs. Therapeutic milieu- Surroundings and physical environment. Managing behavioral crises, Safety, Suicide risk, Unit Design Goals of unit design: Promote an environment of safety and empower patients to partner with clinical staff and take ownership of their own health and safety.