psychiatric nursing/psychosocial nursing – Flashcards
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Define the nursing process
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A tool used by the nurse to systematically asses each patients problems,select and carry out specific nursing interventions, and evaluate the effectiveness of these interventions on patient outcomes
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Discuss the assessment step in the nursing process
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holistic and includes data from all members of multidisciplinary team,patient and family.
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What provide an important means of ensuring consistency and continuity of care?
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written patient assessments,care plans,and progress notes
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What is evaluation in nursing process?
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evaluation of patient progress progress is a foundation for discharge planning and for referrals to other services within the continuum of care.
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What are process recordings?
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Learning tools used to clarify communication and facilitate professional growth
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How does the nursing process serve nursing practice?
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patient-centered,goal-directed action that facilitates health promotion,primary prevention,treatment,and rehabilitation.
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Identify the components of assessment as used by psychiatric nurses
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demographic data;admission date;reason for admission;previous psychiatric history;current medical problems and medications;drug and alcohol use or abuse;disturbances in patterns of daily living;culture and spirituality;support systems
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What is a very important component of patient assessment in psychiatric settings?
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mental status examination
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What does the MSE focus on?
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patients current state in terms of thoughts,feelings and behaviors
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List topics to consider when the nurse decides to investigate the specific behavior of a particular patient
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context or situation that precipitated the behavior;patients thoughts at the time;patients feelings then and now;whether the behavior makes sense in that context;whether the behavior was adaptive or dysfunctional;how this episode fits with the total picture of the patient;whether a change is needed
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Explain the arrangements of the components of a well written nursing diagnosis
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risk for actual problems;contributing,causative or etiologic factors;defining characteristics or behavioral outcome
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How is nursing diagnosis statement usually written?
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(problem) related to (contributing factor) as evidenced by(behavioral outcome)
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What question can a nurse ask when checking to ensure that a goal or outcome is properly written?
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what are the patients problems that need addressing and the goals the patient wants to achieve
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Characterize typical psychiatric nursing intervention strategies
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safety;structure;support and symptom management
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For what purpose are nursing progress notes used?
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patients statements and the nurses observations,analyses and plans;also ways of evaluating the effectiveness of treatment plans and progress towards short term and long term outcomes
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Define stress
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A stressor is any event or circumstance that an individual perceives as a threat,loss or danger
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Define anxiety/Peplau's model
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Four levels of anxiety/mild,moderate,severe,and panic
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Describe coping mechanisms
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adaptive,palliative,maladaptive and dysfunctional
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Define crises
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A crisis results in a period of severe disorganization that is caused by failure of an individuals usual coping mechanisms,the lack of usual resources, or both
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Discuss crisis intervention strategies
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crisis intervention strategies concentrate on the immediate precipitant as well as on individuals physical safety and emotional security
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Identify common perceived losses or threats that typically engender anxiety
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Health or the ability to perform and function;self-esteem or self-respect;self-control;control or power over ones life;status or prestige;resources[emotional,physical,financial,spiritual,social,cultural];loved ones;freedom or independence;needs,goals,desires and expectations
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What are objective perceived losses or threats that typically engender anxiety
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resources,loved ones,health
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What are subjective perceived losses or threats that typically engender anxiety
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self-esteem,self-respect,self-control,
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What are maturational perceived losses or threats that typically engender anxiety
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status or prestige,freedom or independance,needs,goals,desires and expectations.
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What are situational perceived losses or threats that typically engender anxiety
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control or power over ones life
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Summarize the psychodynamic,interpersonal, and biologic theories of anxiety
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Freud-ego/id/superego[psychodynamic];Sullivan-how taught early in life[interpersonal];Selye-general adaptation syndrome[biologic model]
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Link the objective symptoms of anxiety with the neurochemical reactions occuring with the general adaptation syndrome.
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tolerating fear and pain during serious injury
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Categorize symptoms reflective of each of the four levels of anxiety
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mild[+1]adaptive;moderate[+2]palliative;severe[+3]fight-flight;panic[+4]disfunctional
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Nursing interventions for mild anxiety
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discuss source of anxiety[steps of learning];problem solve;accept anxiety as natural-tolerate benefit from it
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Nursing interventions for moderate anxiety
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decrease anxiety-ventilation,crying,exercise;refocus attention;use problem solving techniques
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Nursing interventions for severe anxiety
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decrease anxiety,stimuli,and pressure;use kind firm simple directions;use time-out;give IM meds if needed
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Nursing interventions for panic anxiety
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guide firmly or physically take control;give IM meds;order restraints
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List criteria for evaluating adaptive coping mechanisms
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solves the problem that is causing the anxiety,so the anxiety is decreased.pt. is objective,rational and productive
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List criteria for evaluating palliative coping mechanisms
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temporary decrease in anxiety,but doesnt solve the problem,so anxiety returns.temporary relief allows the patient to return to problem solving
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List criteria for evaluating maladaptive coping mechanisms
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unsuccessful attempts to decrease the anxiety without attempting to solve the problem.anxiety remains
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List criteria for evaluating dysfunctional coping mechanisms
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is not successful in reducing anxiety or solving problems.even minimal functioning becomes difficult and new problems begin to develope
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Pharmacokinetic processes
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the absorption,distribution,metabolism,and excretion of drugs
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absorption
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the process whereby drugs leave the GI tract and enter the bloodstream
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bioavai
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