NS 320 STUDY GUIDE-DR. RICE-EXAM 1 (MH EXAM)

CHAPTER 2: HISTORICAL AND THEORETICAL CONCEPTS Historical The consideration of mental health and mental illness has its basis in the cultural beliefs of the society in which the behavior takes place. Some cultures are quite liberal in the range of behaviors that are considered acceptable, whereas others have very little tolerance for behaviors that deviate from the cultural norms. Mental Health Maslow and others characterized mentally healthy behaviors as: an appropriate perception of reality; a need for detachment and privacy; independence/autonomy/resistance to enculturation; the ability to achieve satisfactory interpersonal relationships; creativeness; positive attitude towards self. Can you name other behaviors considered mentally healthy in our society? Mental Illness A clinically significant behavior or psychological syndrome or pattern that occurs in a person and that is associated with present distress (painful symptom) or disability (e.g. unable to work) or with significant suffering or possible death or harm to others. Continunum of Mental Health (pg. 25) -“Every One Has a Blue Period” but via friends, family, innate qualities such as resilience and positive coping we can stay in balance. Anxiety (see pg 17-19).....this content for Exam 2 Low levels of anxiety are adaptive and can provide the motivation required for survival. Fears of unknown or fear of impending doom or some bad consequence for us. Peplau cites several levels: Mild seldom a problem/heightened awareness -is associated w/tension experienced in day to day living Moderat less alert/more tense/assistance with problem e solving may be needed/muscular tension and restlessness are evident -less alert to events in environment -attn span and ability to concentrate decrease *increase muscular tension/restlessness evident. Severe focuses on one detail with limited attention span/overt behavior is aimed at relieving anxiety -attn span is extremely diminished -difficulty completing the simplest task NS 320 STUDY GUIDE-DR. RICE-EXAM 1 Page | 2 *H/A, palpitations, insomnia, confusion, dread, horror ALL behavior is aimed at relieving anxiety. Panic most intense state/may experience hallucinations or delusions/characterized by wild or extreme actions... can be life threatening. -cannot focus on even “one” detail in the environment. -misconceptions are common -losing touch with reality is common -hallucinations/delusions -human fxing and contact are ineffective *Can be life threatening Key nursing intervention is to take control of the situation and keep client safe. Ego Defenses Defense mechanisms (Anna Freud) employed by the ego in the face of some biological or psychological threat. Can be maladaptive depending to the degrees the interfere with one’s ability to deal with reality. Know table 2-2 on pg 20. Related Terms: Neurosis (seen with Severe Anxiety) Psychosis (seen with Panic Anxiety) appears as a symptom such as an obsession or phobia. loss of ego boundaries with gross impairment of reality testing. Grief (know Kubler-Ross’s 5 stages --on pg. 24) 1)Denial Shock and disbelief; Reality of loss not acknowledged Protective mechanism........ NO, it can’t be true 2)Anger Envy and resentment towards those not affected by the loss are common WHY me, IT’S not fair 3)Bargainin Ex: God if you help me through this, I promise I will go to g church 4)Depressio Full impact of loss is experienced n 5)Acceptan A feeling of peace regarding the loss ce Anticipatory Grief vs Maladaptive Grief (pg. 25) Anticipator When a loss is anticipated, individuals often begin the y work of grieving before the actual loss occurs. Can decrease the duration and intensity of the mourning NS 320 STUDY GUIDE-DR. RICE-EXAM 1 Page | 3 period Maladaptiv Individual is not able to progress through the stages of e grieving and achieve resolution. -individual may be fixed in the denial stage Prolonged- intense preoccupation with memories of the lost entity for many years Delayed or inhibited- fixed in the denial stage Emotional pain is not experienced, but Anxiety disorders, or sleeping and eating disorders are evident. TEST ?’s Patients learn with MILD anxiety 1. A client hates her mother because of childhood neglect. The nurse determines which client statement represents the use of the defense mechanism of reaction formation? A) “I don’t like to talk about my relationship with my mother.” B) “My mother hates me.” C) “I have a very wonderful mother whom I love very much.” D) “My mom always loved my sister more than she loved me.” DSM-IV-TR Multiaxial Evaluation System • Axis I: Clinical disorders and other conditions that may be a focus of clinical attention • Now Focuses on Axis I with Primary Psych Disorder • Depression, bipolar, schizophrenia Nclex tips Be able to identify mentally healthy behaviors  keep job, good relationships, enjoys life Recognize that clients go to the hospital with threat to self or other or inability to safely care for theirselves; or detox issues; Or drug seeking issues or sometimes just needing a bed if homeless Chapter 8: Therapeutic Communication (9 questions) Therapeutic communication- are specific communication techniques to help nurses provide care to clients requiring psychosocial intervention. Be aware that ones own values, attitudes, and beliefs can influence communication in numerous ways.