NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
Introduction in Psychiatric Nursing
Basic Brain Anatomy- what do the different part of brain control?
Hypothalamus? Neurons/ synapse- pg. 51
Hypothalamus: Regulates temperature, blood pressure, perspiration, libido, hunger, thirst, and circadian
rhythms, such as sleep and wakefulness. Hypothalamic neurohormones, often called releasing hormones,
direct the secretion of hormones from the anterior pituitary gland.
Neurons: The brain is composed of a vast network of more than 100 billion interconnected nerve cells
(neurons) and the supporting cells that surround these neurons. An essential feature of neurons is their
ability to initiate signals and conduct an electrical impulse from one end of the cell to the other called
neurotransmission.
Synapse: This transmitter then diffuses across a narrow space, or synapse, to an adjacent postsynaptic
neuron, where it attaches to specialized receptors on the cell surface and either inhibits or excites the
postsynaptic neuron.
Understand milieu therapy- can you describe it in a clinical setting?
Milieu therapy: group therapy with similar illnesses involved. Promotes productive activity, self-respect,
and individual responsibility. Uses total environment to treat. Enforces boundaries. Inpatient rehab.
Describe the difference between mental health and mental illness
Mental Health: A successful performance of mental functions, resulting in the ability to engage in
productive activities, enjoy fulfilling relationships, and adapt to change and cope with adversity.
Mental Illness: Are medical conditions that affect a person’s thinking, feeling, mood, ability to relate to
others, and daily functioning. Basically, mental illness can be seen as the result of a chain of events that
include flawed biological, psychological, social, and cultural processes.
Maslow’s Hierarchy of needs (pg 31)
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
•Physiological needs. The most basic needs are the physiological drives,
including the need for food, oxygen, water, sleep, sex, and a constant body
temperature. If all the needs were deprived, this level would take priority.
•Safety needs. Once physiological needs are met, the safety needs emerge.
They include security, protection, freedom from fear/anxiety/chaos, and the
need for law, order, and limits.
•Belongingness and love needs. People have a need for an intimate
relationship, love, affection, and belonging and will seek to overcome
feelings of loneliness and alienation. Maslow stresses the importance of
having a family and a home and being part of identifiable groups.
•Esteem needs. People need to have a high self-regard and have it reflected
to them from others. If self-esteem needs are met, we feel confident, valued,
and valuable. When self-esteem is compromised, we feel inferior, worthless,
and helpless.
•Self-actualization. We are preset to strive to be everything that we are
capable of becoming. Maslow said, “What a man can be, he must be.” What
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
we are capable of becoming is highly individual—an artist must paint, a
writer must write, and a healer must heal. The drive to satisfy this need is
felt as a sort of restlessness, a sense that something is missing. It is up to
each person to choose a path that will result in inner peace and fulfillment.
Peplau’s Theory of Interpersonal Relations
Peplau’s Theory of Interpersonal Relations: emphasized that the nature of the nurse to patient
relationship strongly influenced the outcome for the patient.
Freud- what did he contribute to psychiatric setting?
Sigmund Freud (1856 to 1939), an Austrian neurologist, is 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. Freud (1961)
identified three layers of mental activity: the conscious, the preconscious, and the unconscious mind.
One of Freud's later and widely known constructs concerns the intrapsychic struggle that occurs within
the brain among the id, the ego, and the superego.
Review table 3-2 (pg 28)
TABLE 3-2 DEVELOPMENT OF PERSONALITY ACCORDING TO FREUD, SULLIVAN, AND
ERIKSON∗
FREUD SULLIVAN ERIKSON
Oral—birth to 1½ years Infancy—birth to 1½ years Infancy—birth to 1½ years
Mothering object relieves tension
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
FREUD SULLIVAN ERIKSON
Pleasure-pain principle through empathic intervention and
tenderness, leading to decreased
Id, the instinctive and primitive mind, is anxiety and increased satisfaction
dominant and security; mother becomes Trust vs. mistrust
symbolized “good mother”
Demanding, impulsive, irrational, asocial, Egocentric
selfish, trustful, omnipotent, and Goal is biological satisfaction
dependent and psychological security Danger—during second half of first
year, an abrupt and prolonged
Primary thought processes Denial of tension relief creates separation may intensify the natural
anxiety, and mother becomes sense of loss and may lead to a sense
symbolized as “bad mother” of mistrust that may last throughout
Unconscious instincts—source-energy-
life
aim-object
Anxiety in mother yields anxiety
and fear in child via empathy Task—develop a basic sense of trust
Mouth—primary source of pleasure
that leads to hopeTrust requires a
feeling of physical comfort and a
Immediate release of tension/anxiety and These states are experienced by the minimal experience of fear or
immediate gratification through oral child in diffuse-undifferentiated
uncertainty; if this occurs, the child
gratification manner
will extend trust to the world and self
Task—develop a sense of trust that needs Task—learn to count on others for
will be met satisfaction and security to trust
Anal—1½ to 3 years Childhood—1½ to 6 years Early childhood—1½ to 3 years
Reality principle—postpone immediate Muscular maturation and learning to Autonomy vs. shame/doubt
discharge of energy and seek actual object communicate verbally
to satisfy needs Develop confidence in physical and
Learning social skills through mental abilities that leads to the
Learning to defer pleasure consensual validation development of an autonomous will
Gaining satisfaction from tolerating some Beginning to develop self-esteem Danger—development of a deep
tension-mastering impulses via reflected appraisals: sense of shame/doubt if child is
deprived of the opportunity to rebel;
Focus on toilet training—retaining/letting Good me learns to expect defeat in any battle
go; power struggle of wills with those who are bigger
Bad me and stronger
Ego development—functions of the ego
include problem-solving skills, Not me Task—gain self-control of and
perception, ability to mediate id impulses independence within the
environment
Levels of awareness
Task—delay immediate gratification
Awareness
Final Exam
Key Concepts
Introduction in Psychiatric Nursing
Basic Brain Anatomy- what do the different part of brain control?
Hypothalamus? Neurons/ synapse- pg. 51
Hypothalamus: Regulates temperature, blood pressure, perspiration, libido, hunger, thirst, and circadian
rhythms, such as sleep and wakefulness. Hypothalamic neurohormones, often called releasing hormones,
direct the secretion of hormones from the anterior pituitary gland.
Neurons: The brain is composed of a vast network of more than 100 billion interconnected nerve cells
(neurons) and the supporting cells that surround these neurons. An essential feature of neurons is their
ability to initiate signals and conduct an electrical impulse from one end of the cell to the other called
neurotransmission.
Synapse: This transmitter then diffuses across a narrow space, or synapse, to an adjacent postsynaptic
neuron, where it attaches to specialized receptors on the cell surface and either inhibits or excites the
postsynaptic neuron.
Understand milieu therapy- can you describe it in a clinical setting?
Milieu therapy: group therapy with similar illnesses involved. Promotes productive activity, self-respect,
and individual responsibility. Uses total environment to treat. Enforces boundaries. Inpatient rehab.
Describe the difference between mental health and mental illness
Mental Health: A successful performance of mental functions, resulting in the ability to engage in
productive activities, enjoy fulfilling relationships, and adapt to change and cope with adversity.
Mental Illness: Are medical conditions that affect a person’s thinking, feeling, mood, ability to relate to
others, and daily functioning. Basically, mental illness can be seen as the result of a chain of events that
include flawed biological, psychological, social, and cultural processes.
Maslow’s Hierarchy of needs (pg 31)
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
•Physiological needs. The most basic needs are the physiological drives,
including the need for food, oxygen, water, sleep, sex, and a constant body
temperature. If all the needs were deprived, this level would take priority.
•Safety needs. Once physiological needs are met, the safety needs emerge.
They include security, protection, freedom from fear/anxiety/chaos, and the
need for law, order, and limits.
•Belongingness and love needs. People have a need for an intimate
relationship, love, affection, and belonging and will seek to overcome
feelings of loneliness and alienation. Maslow stresses the importance of
having a family and a home and being part of identifiable groups.
•Esteem needs. People need to have a high self-regard and have it reflected
to them from others. If self-esteem needs are met, we feel confident, valued,
and valuable. When self-esteem is compromised, we feel inferior, worthless,
and helpless.
•Self-actualization. We are preset to strive to be everything that we are
capable of becoming. Maslow said, “What a man can be, he must be.” What
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
we are capable of becoming is highly individual—an artist must paint, a
writer must write, and a healer must heal. The drive to satisfy this need is
felt as a sort of restlessness, a sense that something is missing. It is up to
each person to choose a path that will result in inner peace and fulfillment.
Peplau’s Theory of Interpersonal Relations
Peplau’s Theory of Interpersonal Relations: emphasized that the nature of the nurse to patient
relationship strongly influenced the outcome for the patient.
Freud- what did he contribute to psychiatric setting?
Sigmund Freud (1856 to 1939), an Austrian neurologist, is 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. Freud (1961)
identified three layers of mental activity: the conscious, the preconscious, and the unconscious mind.
One of Freud's later and widely known constructs concerns the intrapsychic struggle that occurs within
the brain among the id, the ego, and the superego.
Review table 3-2 (pg 28)
TABLE 3-2 DEVELOPMENT OF PERSONALITY ACCORDING TO FREUD, SULLIVAN, AND
ERIKSON∗
FREUD SULLIVAN ERIKSON
Oral—birth to 1½ years Infancy—birth to 1½ years Infancy—birth to 1½ years
Mothering object relieves tension
, NUR 2488 Mental Health Nursing
Final Exam
Key Concepts
FREUD SULLIVAN ERIKSON
Pleasure-pain principle through empathic intervention and
tenderness, leading to decreased
Id, the instinctive and primitive mind, is anxiety and increased satisfaction
dominant and security; mother becomes Trust vs. mistrust
symbolized “good mother”
Demanding, impulsive, irrational, asocial, Egocentric
selfish, trustful, omnipotent, and Goal is biological satisfaction
dependent and psychological security Danger—during second half of first
year, an abrupt and prolonged
Primary thought processes Denial of tension relief creates separation may intensify the natural
anxiety, and mother becomes sense of loss and may lead to a sense
symbolized as “bad mother” of mistrust that may last throughout
Unconscious instincts—source-energy-
life
aim-object
Anxiety in mother yields anxiety
and fear in child via empathy Task—develop a basic sense of trust
Mouth—primary source of pleasure
that leads to hopeTrust requires a
feeling of physical comfort and a
Immediate release of tension/anxiety and These states are experienced by the minimal experience of fear or
immediate gratification through oral child in diffuse-undifferentiated
uncertainty; if this occurs, the child
gratification manner
will extend trust to the world and self
Task—develop a sense of trust that needs Task—learn to count on others for
will be met satisfaction and security to trust
Anal—1½ to 3 years Childhood—1½ to 6 years Early childhood—1½ to 3 years
Reality principle—postpone immediate Muscular maturation and learning to Autonomy vs. shame/doubt
discharge of energy and seek actual object communicate verbally
to satisfy needs Develop confidence in physical and
Learning social skills through mental abilities that leads to the
Learning to defer pleasure consensual validation development of an autonomous will
Gaining satisfaction from tolerating some Beginning to develop self-esteem Danger—development of a deep
tension-mastering impulses via reflected appraisals: sense of shame/doubt if child is
deprived of the opportunity to rebel;
Focus on toilet training—retaining/letting Good me learns to expect defeat in any battle
go; power struggle of wills with those who are bigger
Bad me and stronger
Ego development—functions of the ego
include problem-solving skills, Not me Task—gain self-control of and
perception, ability to mediate id impulses independence within the
environment
Levels of awareness
Task—delay immediate gratification
Awareness
