NUR 2488 Mental Health Nursing Final Exam

 Introduction in Psychiatric Nursing  Basic Brain Anatomy- what do the different part of brain control? o Frontal Lobe: Thought Processes & Voluntary Movement (decision making) o Temporal Lobe: Auditory Processes (language, speech, connects to Limbic system) o Occipital Lobe: Vision (interprets visual images) o Parietal Lobe: Sensory & Motor (L/R orientation, reading, math, proprioception) o Hypothalamus: maintains homeostasis, regulates BP, Temp, libido, hunger, thirst, and sleep/wake cycles. o Cerebellum: Balance, Skeletal Muscle Coordination o Neurons: Nerves that translate electrical impulses into chemical signals released at the synapse  Synapse- (pg. 51)- The space between neurons in which neurotransmitters are released and either inhibit/excite the adjacent neuron. The 4 NT’s are dopamine, norepinephrine, serotonin and acetylcholine.  Milieu Therapy: Creating a SAFE, structured inpatient/outpatient setting where the mentally ill can test new behaviors and coping mechanisms with others. o Creating a SAFE, structured inpatient/outpatient setting where patients with mental illness can test new behaviors and interactions. o Climate is essential to healing: paint color, relaxed environments are conducive to the healing process. o Florence Nightingale believed that the environment helps heal  Maslow’s Hierarchy of needs o Basic Needs: food, oxygen, water, sleep, sex, and a constant body temperature. If all the needs were deprived, this level would take priority. o Safety Needs: Security, protection, freedom from fear/anxiety/chaos, and the need for law, order, and limits. o Belonging and Love Needs: intimate relationship, love, affection, and belonging, having a family and a home and being part of identifiable groups. o Esteem Needs: If self-esteem needs are met, we feel confident, valued, and valuable. When self-esteem is compromised, we feel inferior, worthless, and helpless. o Self-actualization: Reaching our full potential to feel inner peace and fulfillment. NUR 2488 Mental Health Nursing Final Exam Key Concepts  Peplau’s Theory of Interpersonal Relations o Created the Nurse-Patient Partnership increasing individual and family roles in recovery. (Based off of Sullivan’s Interpersonal Theory). Relationships greatly influence recovery  Freud- what did he contribute to psychiatric setting? (Unconscious thoughts) o Id – unconscious mind, instincts (this is dominant) o Ego – sense of self, use of defense mechanisms o Superego – our conscious and is greatly influenced by our parents morals and ethical stances o Erickson’s  Trust vs. Mistrust (infant 0- 1 ½) trust developed if caregivers give affection, love, care, attention, and reliability. (Feeding)  Autonomy vs. Shame (toddlers 1 ½ - 3) kids need to develop a sense of personal control. (Toilet Training)  Initiative vs. Guilt (children 3-6) children need to have power to explore their environment and not receive disapproval from parents. (Exploration)  Industry vs. Inferiority: (school aged kids 6-12) Kids dealing with new social and academic demands. Success leads to a sense of competence. (School)  Identity vs. Role Confusion (teens 12-20) Teens need to develop self-identity and personal identity to stay true to themselves. (Social Relationships)  Intimacy & Solidarity vs. Isolation (young adults 20- 30) Young Adults need to form intimate, loving relationships. (Relationships)  Generativity vs. Self-Absorption: (adults 30-65) Need to create/nurture things by having children. (Work & Parenthood) NUR 2488 Mental Health Nursing Final Exam Key Concepts  Integrity vs. Despair (elderly 65+) Need to look back and feel fulfilled by accomplishments; have wisdom and no regrets (Reflection on Life) o Sullivan  Personalities are influenced during childhood and mostly by the MOTHER. (Page 31 in book for more information)  Therapeutic Communication  Therapeutic Communication: goal directed, professional, scientifically based. Goal is to get information so that you can plan care for the patient. o Active Listening  Clarifying: promotes understanding of the patient’s statement  Restating: repeating the same key words the patient has just spoken to echo their feelings. (Ex: If a patient remarks, “My life is empty…it has no meaning,” additional information may be gained by restating, “Your life has no meaning?”)  Reflecting: helps people understand their own thoughts better; summarizes (Ex: For example, to reflect a patient's feelings about his or her life, a good beginning might be, “You sound as if you have had many disappointments.”)  Exploring: use of open-ended questions or statements to allow the patient to express thoughts/feelings. (Ex: “Tell me more…”, “Give me an example of…”)  Communication Technique Examples in Different Scenarios o For Suicidal Patients: “These thoughts are very serious Mr. Adams. I do not want any harm to come to you. Can you tell me what you were feeling and if there were any circumstances that led you to this decision?” o For Patients who start Crying: Stay with your patient and reinforce that it is all right to cry & offer tissues. “You seem upset, what are you thinking right now?” o For Patients who say they “don’t want to talk”: “Its alright. I would like to spend time with you. We don’t have to talk.” Or reapproach at a later time, “Our 5 minutes is up. I will be back at 10am and spend another 5 minutes with you.” o For Patients who ask the nurse to keep a secret: Nurses cannot make such promises, as it may be important to share that information with other staff for safety reasons. “I cannot make