Mental Health Exam 1: Ch. 1,2,5,6,7,8,9
Stigma
➢ negative attitudes about mental illness and Tx
➢ Found globally in cultures
➢ Creates barriers
DSM-5 - Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
➢ Official medical guidelines of the American Psychiatric Association for diagnosing
psychiatric disorders
➢ Based on specific criteria influenced by multiprofessional clinical field trials
➢ Nurses use the DSM-5-TR to plan, implement, and evaluate care for clients who have
mental health disorders
➢ gives the criteria used to diagnose each mental disorder. It is the official guideline for
diagnosing psychiatric disorders
➢ classifies disorders people have rather than people themselves
ICD-10 CM - International Classification of Diseases, 10e
➢ Clinical descriptions of mental and behavior disorders
○ 2 broad classifications
■ Alphabetical Index (terms and their codes)
■ Tabular List (codes divided into chapters based on body system or
condition).
○ Subclassifications
■ Index of Diseases and Injury
■ Index of External Causes
■ Table of Neoplasms
■ Index of Drugs and Chemicals.
The North American Nursing Diagnosis Association International (NANDA-I)
➢ Provides standardized nursing diagnoses
➢ identifies diagnostic statements regarding human responses to actual or potential health
problems
Nursing Outcomes Classification (NOC)
➢ Source of standardized outcomes, definitions of these outcomes, and measuring scales
Nursing Interventions Classification (NIC)
➢ Identifies seven domains of nursing intervention
Cultural competence
, ➢ nurses adjust their practice to meet patients’ cultural beliefs, practices, needs, &
preferences. EVERY INDIVIDUAL is unique and has different needs
➢ Cultural competence requires ongoing effort. Culture is dynamic, diversified, and
changing.
➢ Must be prepared to gain cultural knowledge and determine nursing care measures that
clients find acceptable and helpful.
Transference - refers to unconscious feelings a client has toward the health care workers that
were originally held toward significant others in his or her life
➢ may be positive or negative.
➢ It is positive if the client is motivated to work with the nurse toward their recovery and
the meaningful work of recovery.
➢ It is negative if the client directs anger or painful emotions toward the health care team
member.
➢ The nurse will need to explore the client's response.
BEHAVIORS:
➢ Client expects exclusive services from the nurse, such as extra session time
➢ Client demonstrates jealousy, anger, hostility or extreme affection for the nurse or for the
nurse's time or attention
➢ Client compares the nurse to a former authority figure
IMPLICATIONS:
➢ A nurse should be aware of transference by a client and reiterate their role as nurse and
attempt to redirect the client toward goals of treatment.
Countertransference - Countertransference refers to unconscious feelings that the health care
worker has toward the client
BEHAVIORS:
➢ Nurse overly identifies with client
➢ Nurse competes with client
➢ Nurse argues or expresses intense emotions toward client
➢ Nurse is overly or underly involved with the client
IMPLICATIONS:
A nurse should be aware that clients who induce very strong personal feelings can become
objects of countertransference. The nurse may need a supervisor or peers for support in
responding objectively to the client.
Freud - Developed Psychoanalysis
➢ Psychoanalysis
, ○ A therapeutic process of assessing unconscious thoughts and feelings, and
resolving conflict by talking to a psychoanalyst. Clients attend many sessions over
the course of months to years.
Levels of awareness
➢ Conscious. The conscious part of the mind is the tip of the iceberg. It contains all the
material a person is aware of at any one time, including perceptions, memories, thoughts,
fantasies, and feelings.
➢ Preconscious. Just below the surface of awareness is the preconscious, which contains
material that can be retrieved rather easily through conscious effort.
➢ Unconscious. The unconscious includes all repressed memories, passions, and
unacceptable urges lying deep below the surface. Memories and emotions associated with
trauma may be stored in the unconscious because the individual finds it too painful to
deal with them.
Personality structure
Id: Unconscious and impulsive
➢ source of all drives, instincts, reflexes and
needs
➢ Lacks the ability to problem solve
➢ Illogical
➢ Example: hungry, screaming infant
Ego: the “I”, personal identity, deals w/ reality,
mediator
➢ Problem solver
➢ Reality tester
➢ Attempts to navigate the outside world
Superego: moral component of personality
Defense mechanisms
➢ Operate on unconscious level
➢ Deny, falsify, or distort reality to make it less threatening
➢ Role is to decrease anxiety
➢ Unconscious level
➢ Change reality to decrease threat
➢ We can’t live without them
○ Rationalization, projection, displacement, repression….
Stigma
➢ negative attitudes about mental illness and Tx
➢ Found globally in cultures
➢ Creates barriers
DSM-5 - Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
➢ Official medical guidelines of the American Psychiatric Association for diagnosing
psychiatric disorders
➢ Based on specific criteria influenced by multiprofessional clinical field trials
➢ Nurses use the DSM-5-TR to plan, implement, and evaluate care for clients who have
mental health disorders
➢ gives the criteria used to diagnose each mental disorder. It is the official guideline for
diagnosing psychiatric disorders
➢ classifies disorders people have rather than people themselves
ICD-10 CM - International Classification of Diseases, 10e
➢ Clinical descriptions of mental and behavior disorders
○ 2 broad classifications
■ Alphabetical Index (terms and their codes)
■ Tabular List (codes divided into chapters based on body system or
condition).
○ Subclassifications
■ Index of Diseases and Injury
■ Index of External Causes
■ Table of Neoplasms
■ Index of Drugs and Chemicals.
The North American Nursing Diagnosis Association International (NANDA-I)
➢ Provides standardized nursing diagnoses
➢ identifies diagnostic statements regarding human responses to actual or potential health
problems
Nursing Outcomes Classification (NOC)
➢ Source of standardized outcomes, definitions of these outcomes, and measuring scales
Nursing Interventions Classification (NIC)
➢ Identifies seven domains of nursing intervention
Cultural competence
, ➢ nurses adjust their practice to meet patients’ cultural beliefs, practices, needs, &
preferences. EVERY INDIVIDUAL is unique and has different needs
➢ Cultural competence requires ongoing effort. Culture is dynamic, diversified, and
changing.
➢ Must be prepared to gain cultural knowledge and determine nursing care measures that
clients find acceptable and helpful.
Transference - refers to unconscious feelings a client has toward the health care workers that
were originally held toward significant others in his or her life
➢ may be positive or negative.
➢ It is positive if the client is motivated to work with the nurse toward their recovery and
the meaningful work of recovery.
➢ It is negative if the client directs anger or painful emotions toward the health care team
member.
➢ The nurse will need to explore the client's response.
BEHAVIORS:
➢ Client expects exclusive services from the nurse, such as extra session time
➢ Client demonstrates jealousy, anger, hostility or extreme affection for the nurse or for the
nurse's time or attention
➢ Client compares the nurse to a former authority figure
IMPLICATIONS:
➢ A nurse should be aware of transference by a client and reiterate their role as nurse and
attempt to redirect the client toward goals of treatment.
Countertransference - Countertransference refers to unconscious feelings that the health care
worker has toward the client
BEHAVIORS:
➢ Nurse overly identifies with client
➢ Nurse competes with client
➢ Nurse argues or expresses intense emotions toward client
➢ Nurse is overly or underly involved with the client
IMPLICATIONS:
A nurse should be aware that clients who induce very strong personal feelings can become
objects of countertransference. The nurse may need a supervisor or peers for support in
responding objectively to the client.
Freud - Developed Psychoanalysis
➢ Psychoanalysis
, ○ A therapeutic process of assessing unconscious thoughts and feelings, and
resolving conflict by talking to a psychoanalyst. Clients attend many sessions over
the course of months to years.
Levels of awareness
➢ Conscious. The conscious part of the mind is the tip of the iceberg. It contains all the
material a person is aware of at any one time, including perceptions, memories, thoughts,
fantasies, and feelings.
➢ Preconscious. Just below the surface of awareness is the preconscious, which contains
material that can be retrieved rather easily through conscious effort.
➢ Unconscious. The unconscious includes all repressed memories, passions, and
unacceptable urges lying deep below the surface. Memories and emotions associated with
trauma may be stored in the unconscious because the individual finds it too painful to
deal with them.
Personality structure
Id: Unconscious and impulsive
➢ source of all drives, instincts, reflexes and
needs
➢ Lacks the ability to problem solve
➢ Illogical
➢ Example: hungry, screaming infant
Ego: the “I”, personal identity, deals w/ reality,
mediator
➢ Problem solver
➢ Reality tester
➢ Attempts to navigate the outside world
Superego: moral component of personality
Defense mechanisms
➢ Operate on unconscious level
➢ Deny, falsify, or distort reality to make it less threatening
➢ Role is to decrease anxiety
➢ Unconscious level
➢ Change reality to decrease threat
➢ We can’t live without them
○ Rationalization, projection, displacement, repression….
