The Basics
What are the levels of Maslow's Hierarchy of Needs
Physiological (food, water, shelter)
safety
love and belonging
esteem
self-actualization
NonTherapeutic Communication Techniques
-excessive questioning
-giving approval or disapproval
-asking why questions
-giving advice
What are the different levels of anxiety?
-Mild
-Moderate
-Severe
-Panic
Bipolar Type 1
•Episodes of severe mania and depression
•Manic phases last for at least 7 days (every day, most of the day) OR by mania symptoms that are so severe the person requires medical care or hospitalization
What is schizophrenia
-chronic mental illness marked by severely impaired thinking, emotions, behaviors and affects
-patients may have enhanced perception of sounds, colors, and other features of the environment
What are patient rights
-right to treatment
-right to refuse treatment
-right to informed consent
-rights regarding advanced directives
-rights regarding restraint & seclusion
-rights regarding confidentiality
How does a nurse build therapeutic relationships?
Focus on Patient Needs
Remain Consistent
Establish Trust
Actively Listen
Medications used to treat anxiety
Gabapentin (Neurontin), Vistaril (Hydroxyzine), Paxil (Paroxetine), Benzodiazepines, Buspirone (BuSpar)
Bipolar Types 2
•One or more hypomanic episodes
•One or more major depressive episodes
•Do not experience manic episodes
Phases of Schizophrenia
1. Acute Phase: Positive and negative symptom
2. Stabilization Phase: Acute symptoms are less severe
3. Maintenance Phase: Remission of symptoms
Components of a Mental Health Assessment
-Mood
-Affect
-Appearance
-Attitude
-Behavior
-Speech
-Thought Content & Process
-Cognitive Ability
Blurring of Roles in the Nurse-Patient Relationship
relationship slips into social context
nurse's needs met at expense of patient
countertransference: nurse displaces feelings related to people in nurse’s past onto patient
What are Eustress & Distress
Eustress: positive & beneficial stress. helps provide us with energy and motivation to meet our responsibilities sand achieve our goals. (graduating, getting married)
Distress: a continuous experience of feeling overwhelmed, oppressed, and behind in our responsibilities (financial trouble, chronic illness)
Cyclothymic Disorder
Symptoms of hypomania alternate with symptoms of mild to moderate depression for at least 2 years.
cause social and occupational impairment.
irritable hypomanic episodes
Negative Symptoms of Schizophrenia
Affect: emotion, facial expression (flat)
Ambivalence: conflicted feelings
Alogia: short or lack of response, rambling
Anhedonia: cannot experience pleasure
Associality: decreased desire for social contact
Defense Mechanism Examples
-denial (ignoring existence of problem)
-compensation (emphasizing strengths)
-displacement (transferring emotions onto someone/something else)
-rationalization (justifying actions/thoughts)
-regression (reverting to earlier stages)
What are 5 Therapeutic Communication Techniques
-Open-Ended Questions
-Active Listening
-Using Silence
-Paraphrasing
-Reflecting
Symptoms of Depression
-feeling sad, hopeless, irritable
-lack of energy
-loss of interest in activities
-difficulty sleeping
-self-doubt
-feelings of emptiness & worthlessness
Symptoms of Mania
-feeling very happy
-talking very quickly
-full of energy
-high self importance
-delusions, hallucinations, disturbed thinking
-difficulty sleeping
Positive Symptoms of Schizophrenia
Hallucinations
Delusions
Disorganized Speech
Bizarre behavior
Legal Responsibility for Nurses
-Patient Rights & Confidentiality
-Rights of Medication Administration
-Reporting Obligations
-Duty to Advocate for Patients
Aspects of NonVerbal Communication
Tone of voice
Emphasis on certain words
Physical appearance
Facial expressions
Body posture
Amount of eye contact
Hand gestures
Priority Assessment in Depression
Suicidal Thoughts / Ideation
Priority Interventions for Bipolar Disorder
•Safety (risk for injury)
•Suicide risk/prevention
•Cognition
•Mood stabilization
•Medication adherence
What is Anosognosia
the inability to realize one is ill