NSG 221 Midterm Exam 2025

NSG 221 Midterm Exam 2025 Mental Health Definition - -A state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability Mental Health Influencing Factors: Individual - -Include a person's biologic makeup, autonomy and independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities Mental Health Influencing Factors: Interpersonal - -Include effective communication, ability to help others, intimacy, and a balance of separateness and connectedness Mental Health Influencing Factors: Social/Cultural - -Include a sense of community, access to adequate resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive, yet realistic, view of one's world Mental Illness Definition - -Disorders that affect mood, behavior, and thinking, such as depression, schizophrenia, anxiety disorders, and addictive disorders. Mental Illness Influencing Factors: Individual - -Include biologic makeup, intolerable or unrealistic worries or fears, inability to distinguish reality from fantasy, intolerance of life's uncertainties, a sense of disharmony in life, and a loss of meaning in one's life Mental Illness Influencing Factors: Interpersonal - -Include ineffective communication, excessive dependency on or withdrawal from relationships, no sense of belonging, inadequate social support, and loss of emotional control Mental Illness Influencing Factors: Social/Cultural - -Include lack of resources, violence, homelessness, poverty, an unwarranted negative view of the world, and discrimination such as stigma, racism, classism, ageism, and sexism Frontal Lobe Function - -Controls the organization of thought, body movement, memories, emotions, and moral behavior. The integration of all this information regulates arousal, focuses attention, and enables problem-solving and decision-making. Abnormalities in the frontal lobes are associated with schizophrenia, ADHD, and dementia Parietal Lobe Function - -Interprets sensations of taste and touch and assist in spatial orientation Temporal Lobe Function - -Center for the senses of smell and hearing and for memory and emotional expression NSG 221 NSG 221 Occipital Lobe Function - -Assist in coordinating language generation and visual interpretation, such as depth perception What system in the brain affects mental health? - -Limbic System (Hippocampus, Amygdala, Cingulate Gyrus) Dopamine Physiological Effect - -Controls complex movements, motivation, cognition; regulates emotional response Norepinephrine Physiological Effect - -Causes changes in attention, learning, and memory, sleep and wakefulness, mood Serotonin Physiological Effect - -Control food intake, sleep and wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions Components of Personality According to Freud: ID - -Innate desires, pleasure-seeking behavior, aggression, and sexual impulses. The ID seeks instant gratification, causes impulsive unthinking behavior, and has no regard for rules or social convention. Components of Personality According to Freud: SUPEREGO - -Moral and ethical concepts, values, and parental and social expectations. It is in direct opposition to the ID. Components of Personality According to Freud: EGO - -Mature and adaptive behavior that allows a person to function successfully in the world. Freud's Stages of Psychosexual Developement: Oral - -Birth-18 months: Major site of tension and gratification is the mouth, lips, and tongue. Includes biting and sucking activities. Id is present at birth. Ego develops gradually from rudimentary structure present at birth. Freud's Stages of Psychosexual Developement: Anal - -18-36 months: Anus and surrounding areas are major source of interest. Voluntary sphincter control acquired. Freud's Stages of Psychosexual Developement: Phallic/Oedipal - -3-5 years: Genital is the focus of interest, stimulation, and excitement. Penis is organ of interest for both sexes. Masturbation is common. Penis envy (wish to possess penis) is seen in girls; oedipal complex (wish to marry opposite-sex parent and be rid of same-sex parent) is seen in boys and girls. Freud's Stages of Psychosexual Developement: Latency - -5-11/13 years: Resolution of oedipal complex. Sexual drive channeled into socially appropriate activities such as school work and sports. Formation of the superego. Final stage of psychosexual development. NSG 221 NSG 221 Freud's Stages of Psychosexual Developement: Genital - -11-13 years: Begins with puberty and the biologic capacity for orgasm; involves the capacity for true intimacy. Erikson's: Trust vs. Mistrust - -Infant: Hope, viewing the world as safe and reliable; relationships as nurturing, stable, and dependable Erikson's: Autonomy vs. Shame and Doubt - -Toddler: Will, achieving a sense of control and free will Erikson's: Initiative vs. Guilt - -Preschool: Purpose, beginning development of a conscience; learning to manage conflict and anxiety Erikson's: Industry vs. Inferiority - -School age: Competence, emerging confidence in own abilities; taking pleasure in accomplishments Erikson's: Identity vs. Role Confusion - -Adolescence: Fidelity, formulating a sense of self and belonging Erikson's: Intimacy vs. Isolation - -Young adult: Love, forming adult, loving relationships, and meaningful attachments to others Erikson's: Generativity vs. Stagnation - -Middle age: Care, being creative and productive; establishing the next generation Erikson's: Ego Integrity vs. Despair - -Maturity: Wisdom, accepting responsibility for oneself and life Piaget: Sensorimotor Stage - -Birth to 2 years: The child develops a sense of self as separate from the environment and the concept of object permanence, that is, tangible objects do not cease to exist just because they are out of sight. He or she begins to form mental images. Piaget: Preoperational Stage - -2 to 6 years: The child develops the ability to express self with language, understands the meaning of symbolic gestures, and begins to classify objects. Piaget: Concrete Operations Stage - -6 to 12 years: The child begins to apply logic to thinking, understands spatiality and reversibility, and is increasingly social and able to apply rules; however, thinking is still concrete. Piaget: Formal Operations Stage - -12 to 15 years and beyond: The child learns to think and reason in abstract terms, further develops logical thinking and reasoning, and achieves cognitive maturity. NSG 221 NSG 221 Peplau's 4 Stages - -1) The orientation phase is directed by the nurse and involves engaging the client in treatment, providing explanations and information, and answering questions. 2) The identification phase begins when the client works interdependently with the nurse, expresses feelings, and begins to feel stronger. 3) In the exploitation phase, the client makes full use of the services offered. 4) In the resolution phase, the client no longer needs professional services and gives up dependent behavior. The relationship ends. RN Role Functions - --Stranger: offering the client the same acceptance and courtesy that the nurse would to any stranger. -Resource person: providing specific answers to questions within a larger context -Teacher: helping the client learn either formally or informally -Leader: offering direction to the client or group -Surrogate: serving as a substitute for another, such as a parent or sibling -Counselor: promoting experiences leading to health for the client, such as expression of feelings What is classical conditioning? - -Ivan Pavlov: a learning process that occurs when two stimuli are repeatedly paired: a response which is at first elicited by the second stimulus is eventually elicited by the first stimulus alone. What is operant conditioning? - -B.F. Skinner: people learn their behaviors from their history or past experiences, particularly those experiences that were repeatedly reinforced Maslow's Hierarchy of Needs - -1) Physiologic needs: food, water, sleep, shelter, sexual expression, and freedom from pain 2) Safety and security: protection, security, and freedom from harm or threatened deprivation 3) Love and belonging needs: enduring intimacy, friendship, and acceptance 4) Esteem needs: the need for self-respect and esteem from others 5) Self-actualization: the need for beauty, truth, and justice. Existential Therapy: Rational Emotive Therapy - -Therapist: Albert Ellis A cognitive therapy using confrontation of "irrational beliefs" that prevent the individual from accepting responsibility for self and behavior Existential Therapy: Logotherapy - -Therapist: Viktor E. Frankl NSG 221 NSG 221 A therapy designed to help individuals assume personal responsibility (the search for meaning [logos] in life is a central theme) Existential Therapy: Gestalt Therapy - -Therapist: Frederick S. Perls A therapy focusing on the identification of feelings in the here and now, which leads to self-acceptance Existential Therapy: Reality Therapy - -Therapist: William Glasser Therapeutic focus is need for identity through responsible behavior; individuals are challenged to examine ways in which their behavior thwarts their attempts to achieve life goals Many existential therapists use cognitive therapy. What is it? - -It focuses on immediate thought processing—how a person perceives or interprets their experience and determines how they feels and behave. T/F: You should stop taking your psychopharmacological medication once you feel better - -False - Don't stop taking your medication even if your symptoms improve Major adverse drug reactions for psychopharmacological medications - -Suicidal tendencies, serotonin syndrome, EPS, increased portal hypertension (MAOIs-avoid foods with tyramine (aged food, wine, meats, cheeses)) Neurotransmitter target for antipsychotics - -Decreases dopamine Neurotransmitter target for anti-anxiety medications - -Increases norepinephrine and GABA Neurotransmitter target for antidepressants - -Increases norepinephrine and serotonin What is involuntary hospitalization/civil commitment? - -Curtails the client's right to freedom (the ability to leave the hospital when he or she wishes). All other client rights remain intact. Clients hospitalized against their will under these conditions are committed to a facility for psychiatric care until they no longer pose a danger to themselves or to anyone else. Confidentiality Exception - -Mental health clinicians may have a duty to warn identifiable third parties of threats made by clients, even if these threats were discussed during therapy sessions otherwise protected by privilege. Maturational Crises Definition - -Sometimes called developmental crises: are predictable events in the normal course of life, such as leaving home for the first time, getting married, having a baby, and beginning a career. NSG 221 NSG 221 Situational Crises Definition - -Unanticipated or sudden events that threaten the individual's integrity, such as the death of a loved one, loss of a job, and physical or emotional illness in the individual or family member. Adventitious Crises Definition - -Sometimes called social crises: include natural disasters like floods, earthquakes, or hurricanes; war; terrorist attacks; riots; and violent crimes such as rape or murder. Tort Definition - -A wrongful act that results in injury, loss, or damage. Torts may be either unintentional or intentional. Negligence Definition - -An unintentional tort that involves causing harm by failing to do what a reasonable and prudent person would do in similar circumstances Malpractice Definition - -A type of negligence that refers specifically to professionals such as nurses and physicians. Intentional Tort: Assault - -Any action that causes a person to fear being touched in a way that is offensive, insulting, or physically injurious without consent or authority. Intentional Tort: Battery - -Involves harmful or unwarranted contact with a client; actual harm or injury may or may not have occurred Intentional Tort: False Imprisionment - -The unjustifiable detention of a client, such as the inappropriate use of restraint or seclusion. Standards of Care Definition - -Nurses are expected to meet standards of care, meaning the care they provide to clients meets set expectations and is what any nurse in a similar situation would do. Utilitarianism - -A theory that bases decisions on "the greatest good for the greatest number." Decisions based on utilitarianism consider which action would produce the greatest benefit for the most people. Deontology - -A theory that says decisions should be based on whether an action is morally right with no regard for the result or consequences. Principles used as guides for decision-making in deontology include autonomy, beneficence, nonmaleficence, justice, veracity, and fidelity What is Individual Psychotherapy? - -A method of bringing about change in a person by exploring his or her feelings, attitudes, thinking, and behavior. It involves a one-to-one relationship between the therapist and the client. What is group therapy? - -Clients participate in sessions with a group of people. The members share a common purpose and are expect