ATI Capstone Content Review: Mental Health - Tips of the Week

ATI Capstone Content Review: Mental Health - Tips of the Week All clients should have a Mental Status Exam, which includes: Level of consciousness Physical appearance Behavior Cognitive and intellectual abilities The nurse conducts the MSE as part of his or her routine and ongoing data collection of the client. Changes in Mental Status should be investigated further and the provider notified. Tools such as the mini-mental status examination (MMSE) and the Glasgow Coma Scale may be used as part of the MSE. There are two types of mental health hospitalizations: Voluntary commitment and involuntary or civil commitment. Involuntary commitment is against the client’s will. Despite that, unless proven otherwise, clients are still considered competent and have the right to refuse treatment. Use the following communication tips when answering questions on NCLEX: * If the client is anxious or depressed – use open-ended, supportive statements * If the client is suicidal – use direct, yes or no questions to assess suicide risk * If the client is panicked – use gentle guidance and direction * If the client is confused – provide reality orientation * If the client has delusions / hallucinations / paranoia – acknowledge these, but don’t reinforce * If the client has obsessive / compulsive behavior – communicate AFTER the compulsive behavior * If the client has a personality or cognitive disorder – be calm and matter-of-fact Therapeutic strategies for mental health illnesses and disorders can include medications, talk and behavior therapy, and / or brain stimulation. Clients undergoing care for mental health disorders may feel pressure to deny behavior or issues to appear ‘normal’. The nurse should always carefully collect data regarding each individual to ensure optimal response to therapies. Nurses may use strategies such as communication skills, orienting clients, offering self-care assistance, administering medications, modeling appropriate behavior, encouraging development, and monitoring health conditions when working in mental health nursing. The most common type of brain stimulation therapy is electronconvulsive therapy (ECT). ECT is generally performed for major depressive disorders, schizophrenia, or acute manic disorders. Most clients receive therapy three times a week for two to three weeks. Prior to ECT, carefully screen the client for any home medication use. Lithium, MAOIs, and all seizure threshold medications should be discontinued two weeks prior to ECT. Before therapy, obtain baseline vital signs and ensure that an IV catheter is in place. Administer ordered medications. Monitor vital signs continuously throughout the treatment, and after the ECT session is completed. After therapy, reorient the client as short-term memory loss is common. A headache may be present after ECT. Anxiety disorders are common mental health disorders. Generalized Anxiety Disorder, Panic Disorder, Phobias, Obsessive Compulsive Disorder, and Posttraumatic stress disorder (PTSD) are all considered types of anxiety disorders. Assist the health care team by collecting data on the client related to risk factors, triggers, and responses. Anxiety that is left untreated may become severe and lead to panic-level and severe behavior changes. Defense mechanisms may be healthy or unhealthy. The nurse should assist the client in developing healthy defense mechanisms such as altruism, sublimation, humor, and suppression. Safety should be ensured for all clients in the mental health setting. For clients on suicide precautions , there should be no access to sharp or harmful objects, …………………………..CONTINUED………………………………………………