Mental Health Rights
Communication
Schizophrenia
Bipolar
Pharm
100
A 30 male has been admitted to API. The wife would like to set up a meeting to discuss the plan of care. What is the first thing that needs to be done before the staff discusses the plan of care?
Obtain consent from the patient to discuss his POC and mental health/health status.
100
None therapeutic communication techniques.
•Direct Questions
•WHY???? / Probing
•Value judgments
•Agreeing / Disagreeing (with false belief /misperception)
•Talking unnecessarily
•False Reassurance
•Avoiding
•Blaming
100
Positive symptoms are like adding something to the person’s experience such as hallucinations, delusions, paranoia, etc. What cause of Positive Symptoms in Schizophrenia.
Hyperactivity of dopamine
100
A family member wants to understand how this happened to their son. New dx of bipolar disorder what is the nurse's best response.
Chemical imbalance in the brain.
100
The nurse now observes a patient shuffling their feet, a mask-like face, and drooling after starting a new medication for schizophrenia. Which term does the nurse use to describe the patient response to the medication?
Pseudoparkinsonism
200
What are the rights of a mental health client?
Rights to privacy and confidentiality
Right to informed consent
Right to keep personal items
Right to habeas corpus
Right to enter into a legal contract
200
Phases of nurse Therapeutic relationship
Pre orientation (planning for 1st encounter)
orientation
Working phase
Termination
200
A patient diagnosed with paranoid schizophrenia tells the nurse, “I have to get away. The aliens are coming to take me to space”. Which is the best response for the nurse to make?
A. “It must be frightening to think something is going to take you to away.”
B. "What aliens are you talking about?"
C. "I see the Aliens lets run and hide together."
D. “You are safe here. This is a locked unit, and no one can get in.”
A. “It must be frightening to think something is going to take you to away.”
This response focuses on the client's feelings and neither directly supports the delusion nor denies the client's experience.
200
A patient is sitting in the corner laughing than suddenly crying followed by screaming and ending with a big smile. What mood is this person presenting with.
Labile
Rapid and exaggerated change in moods.
200
The client has major depressive disorder and was suicidal. The client has been on the new anti depressive for 3 weeks. What should the nurse look out for?
Determine if the client has a plan for suicide.
The client may have more energy. Medication takes 2-6 weeks to take effect.
300
What rights can a patient with mental illness be denied?
Wear own clothing
Keep & spend money
See visitors each day
Have access to storage space
Keep & use personal possessions
Receive mail & unopened correspondence
Access to telephone
To have letter-writing materials
300
When does termination phase start.
During orientation phase
Plans start to be put in place getting patient ready for termination.
300
Positive and negative symptoms of schizophrenia.
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300
A patient with acute mania has not been home for days. What is this patient at risk for.
Risk for injury
During mania, some people may do things without thought for the consequences, like spending too much money or taking risks with their physical safety. In this situation, being in a busy street, patient is potentially at risk for physical injury.
300
A patient is on Risperdal and the nurse has concern the client may be experiencing neuroleptic malignant syndrome due to muscle stiffness, trouble swallowing, and increased temp. What is the appropriate nursing action?
Notify the MD stat
Neuroleptic malignant syndrome (NMS) is a life-threatening syndrome associated with virtually every neuroleptic agent but is more commonly reported with the typical antipsychotics. Classic clinical characteristics include mental status changes, fever, muscle rigidity, and autonomic instability.
400
Grounds for a psychiatric hold
Danger to self
Danger to others
Grave disability
400
Social Vs Therapeutic communication
Social both parties' needs are met. Therapeutic only pt needs are met.
Giving advice is done by both parties. Not Therapeutic to give advice ( NO advice)
Problems are addressed with a solution both parties implement. Therapeutic ssolutionaddressed and patient implements.
400
A patient diagnosed with schizophrenia tells the nurse, "The staff is watching me through the air vents. I can't even go to the bathroom. Be careful they are watching you too. Which response by the nurse would be most therapeutic?
A. "It is against the law for the staff to watch you."
B. "Oh no do you think they saw me go to the bathroom? "
C. "You sound worried about your privacy'"
D. "You sound like you are having another episode due to a decline in your mental health."
C. "You sound worried about your privacy'"
It is important not to challenge the patient’s beliefs, even if they are unrealistic. Challenging undermines the patient’s trust in the nurse. The nurse should try to understand the underlying feelings or thoughts the patient’s message conveys. The correct response uses the therapeutic technique of reflection.
400
I am the world's best and most prosperous attorney; everyone wants me to work for them.
What type of delusion is this
Grandiose delusion
unfounded or inaccurate beliefs that one has special powers, wealth, mission, or identity
400
when should you draw a Lithium level?
8-12 hours after dose.
500
A nurse tells a patient we must put these restraints on you to protect you. This is an example of
Beneficence
All treatment must be for the clients good.
500
"everyone is trying to hurt me " Best response by nurse.
"Feeling that people want to hurt you must be scary"
focus on the feelings the patient is expressing. This strategy prevents arguing about the reality of delusional beliefs. Such arguments increases anxiety.
500
A patient who was admitted for schizophrenia is scared to take a shower and states that there is poison in the shower water. Which nursing action is most appropriate?
1. force pt to take a shower because there is no poison.
2. Provide the patient with equipment for a sponge bath.
3. Let them not bathe it is their right to be dirty.
4. Check the water quality and show the pt the results.
Provide the pt with equipment for a sponge bath.
500
A patient at breakfast starts to get loud and yelling at people sitting next to him at the breakfast table.
What should the nurse do
Assist the client to a calmer location.
Remove the client from the environment so others do not have to experience the behavior.
500
A client was prescribed antidepressant medication 1 week ago and "states that the medication is not working." Which statement by the nurse would be most appropriate?
A. "we will need to change your medication."
B. "Tell me why you do not think it is working."
C. "It can take a few weeks for the medication to start working. "
D. "You think your medication is not helping you."
C. "It can take a few for the medication to start working."