Behavioral health quiz 1:chp. 1-8

Chapter 1

100

Bioethics

Beneficence: 

Autonomy:

Justice: 

Fidelity:

Veracity:

• Bioethics is a more specific term that refers to the ethical questions that arise in health care.

• Beneficence: The duty to act so as to benefit or promote the good of others. Example: Spending extra time to help calm an extremely anxious patient

• Autonomy: Respecting the rights of others to make their own decisions. Example; Acknowledging the patient’s right to refuse medication

• Justice: The duty to distribute resources or care equally, regardless of personal attributes.  Example: evoting equal attention to both a friendly patient and a patient who will not speak or make eye contact

• Fidelity (nonmaleficence): Maintaining loyalty and commitment to the patient and doing no wrong to the patient. Example: Maintaining expertise in nursing skill through nursing education

• Veracity: One’s duty to communicate truthfully; Example Describing the purpose and side effects of psychotropic medications in a truthful and non-misleading way

200

Pt centered care:

• Care is evidenced by empathetic understanding, actions, patience on another’s behalf

300

• How nurses advocate for pts:

Ethical

• The nurse must take appropriate action when the rights/ best interests of the pt is in jeopardy

400

• Evidence based practice

• Clinical decision making that synthesizes:

• 
  

  • Best available research evidence

  • Clinical expertise

  • Patient preferences

500

• 5 A’s vs RECOVERY MODEL 

• Ask a question

• Acquire the literature

• Appraise the literature

• Apply the evidence

• Assess the performance 

• Scientific evidence for psychologic and physiologic tx

• Neurobiology of psychiatric disorders

• 1990- “Decade of the Brain”

• -Recovery model:
  Consumers as partners

  • Mental health care: consumer and family driven

  • Focus on increasing consumer resilience, coping, and facilitating recovery

  • Individualized plan of care, consumer centered and recovery oriented 

CHAPTER 2

100

• Cultural competence:

• All people:

• 
  

  • Different backgrounds/ cultures

  • Grow intellectually and emotionally at different rates

  • Choose to or choose not to evaluate their behaviors

  • Grow within themselves

  • Have or have no spiritual beliefs

200

• Stigma of mental illness:

• Major barrier to mental health tx and recovery

• Have harmful effects on the individual/ family 

• Include:

• 
  

  • Stereotyping, labeling, separating, and status loss or discrimination in a context of power imbalance, social isolation, and reduced opportunities 

300

• DSM 5 (used/ application):

• Provides standard language/ criteria

• Focuses on research/ clinical observation 

• Used to:

• 
  

  • Assess

  • Diagnose

  • Plan care

  • Global system of the person’s functioning 

400

• Mental Health Parity Act of 1996:

• U.S. insurers must offer the same benefits at the same level of coverage for mental illness as for other conditions

• Equal coverage improved with the Affordable Care Act (ACA)

CHAPTER 3

100

Freud- Psychoanalytic Theory

• Id: Primitive, pleasure-seeking, impulsive

• Ego: Problem solver, reality tester

• Superego: Moral component

200

Levels of awareness:

-Conscious mind:current awareness, thoughts, beliefs, and feelings

-Preconscious mind:below the surface, not currently the subject of our attention, but accessible 

-Unconscious mind: biggest chunk, seat of primitive feelings, drives, and memories, especially those that are unbearable and traumatic 

300

Transference

•  occurs as the pt projects intense feelings onto the therapist related to unfinished work from previous relationships 

400

• Interpersonal Theory

• Behavioral Theory:

• Humanistic Theory:

• Interpersonal Theory:

  • Purpose of all behavior is to get needs met through interpersonal interactions and to decrease or avoid anxiety

• Behavioral Theory:

• Pavlov- dog salivation, classical conditioning

  • Watson- behavior can be learned

  • Skinner- positive/ negative  reinforcement

• Humanistic Theory: Consists of Maslow's hierarchy of needs 

500

Maslow Hierarchy: Bottom to top

VS 

• Therapeutic Model of care:

 

• Physiological needs

• safety needs, belonging/ love needs

•  esteem needs

• Self-actualization

• self-transcendence

  • Therapeutic Model of care:

  • Existential Base:

    • Emphasis on self-awareness, emphasis on the present

  • Therapist as Facilitator: Genuineness, empathy, respect

  • Carl Rogers’ Person- Centered Therapy

    • People have innate self-actualizing tendencies 

CHAPTER 4

100

cognitive behavioral therapy vs. cognitive distortions 

• Cognitive Behavioral Therapy (CBT):

• 
  

  • Seeks to modify negative thoughts that lead to dysfunctional emotions and actions

  • Once maladaptive patterns are identified, they can be replaced with rational thoughts 

• Cognitive distortions- exaggerated or irrational thought pattern 

200

• Seclusion vs restraints 

• Seclusion

  • Involuntary confined alone in a room, the pt is physically prevented from leaving

  • Used if the pt presents a clear/ present danger to self or others, escape risk 

  • Q15 checks

• Restraints

  • Is any materials, physical or mechanical device, or material or equipment that restricts freedom of movement

  • Least restrictive is always tried first!

  • Used if the pt presents a clear/ present danger to self or others, escape risk 

  • Q15 checks 

300

aggression/ anger/ violence 

• Aggression:

  • Anger’s motor counterpart

  • Goal-directed action or behavior that results in a verbal or physical attack

  • May be appropriate:

    • Self-protective, protecting self/ family

  • Is hostility that arouses thoughts of attack and/or a disposition to behave aggressively 

• Anger: Emotional response to a frustration of desires, threat to one’s needs, or a challenge

  • Normal, not always a logical human emotion 

• Violence:

  • The unjust, unwarranted, or unlawful display of verbal threats, intimidation, or physical force with the intent to cause damage, injury, or death 

  • Stages of the violence cycle:

    • Preassaultive stage- de-escalation approaches 

    • Assaultive stage- meds, seclusion, restraint

    • Post-assaultive stage- seclusion, restraint

400

• De-escalation 

• Emphasize that you are on the pt’s side

• Appear calm/ in control

• Personal safety 

• Set clear, consistent and enforceable limits

• nurse/ pt should sit at a 45 degree angle

• Acknowledge the pts needs whether rational/ irrational, possible/impossible

500

• Affordable Care Act (ACA)

• Inability of insurance companies to deny a person coverage because of pre-existing conditions or rescind or take away insurance for health/ mental health-related reasons 

CHAPTER 5, 6, 8

100

Different types of hospital settings:

200

• Patient rights

• Right to refuse teaching!

• Right to withhold consent!

• Right to withdraw consent at any time!

• The right of a pt who is mentally ill to refuse tx with psychotropic drugs has been debated in the courts!

• Reporting of abuse to children/ elderly 

• Situations in which health care professionals can break pt confidentiality:

  • Duty to warn/ protect third parties 

300

Active listening:

Communicating across cultures:

Nonverbal communication:

• Active listening:

  • Observing the pt’s nonverbal behaviors

  • listening/ understanding the pt’s verbal message

  • Listening for “false notes”  (inconsistency)

  • Provide feedback

• Communicating across cultures: Communication styles, use of eye contact, perception of touch, and cultural filters

• Nonverbal communication: people will pay more attention to this. Any body gestures such as facial expressions, body posture, hand movements, etc 

400

Effective communication with pts

• Appropriate, sensitive use of silence

• Active listening

500

• Clarifying techniques:

• Paraphrasing, restarting, reflection of feelings, exploring, projective questions (“What if..”)

  • Projective questions- can help people to imagine conflicts, thoughts, values, feelings, and behaviors they might have in certain situations