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Hello Class of 2007, Welcome to our blog community. This is our area to share information, resources, ask and answer questions. You will have fellow students, past students, and many other assets available to you through this site. Everyone is encouraged to discuss and problem solve here. Check back frequently as we post sample questions and links to relevant sites. We are on the same journey, let's discover it together.
Hello Class of 2007, Welcome to our blog community. This is our area to share information, resources, ask and answer questions. You will have fellow students, past students, and many other assets available to you through this site. Everyone is encouraged to discuss and problem solve here. Check back frequently as we post sample questions and links to relevant sites. We are on the same journey, let's discover it together.
2 comments:
1. The DSM-IV-TR is used to diagnose a psychiatric disorder. It also allows clinicians to make a more holistic and realistic assessment of their clients and this allow for more comprehensive and appropriate interventions. DSM-IV-TR is also how they bill insurance carriers.
2. STAGE 1) Oral-Sensory- Trust vs. Mistrust
STAGE 2) Muscular-Anal- Autonomy vs. Shame/Doubt
STAGE 3) Locomotor- Initiative vs. Guilt
STAGE 4) Latency- Industry vs. Inferiority
STAGE 5) Adolescence- Identity vs. Role Confusion
STAGE 6) Young Adulthood- Intimacy vs. Isolation
STAGE 7) Middle Adulthood- Generativity vs. Stagnation
STAGE 8) Maturity- EgoIntegrity vs. Despair
3. Needs Hierarchy Physiological needs, Psychological needs, Meta-needs. Needs are fulfilled by and through other humans. A person does the best he/she can at the time. With adequate understandable information, a person will make good decisions. Man has a higher nature. The Physiological needs are met first then the Psychological need and last are the Meta-needs..
4. There are 4 major techniques or methods used in operant conditioning. They result from combining the two major purposes of operant conditioning (increasing or decreasing the probability that a specific behavior will occur in the future), the types of stimuli used (positive/pleasant or negative/aversive), and the action taken (adding or removing the stimulus). It is through operant conditioning that voluntary responses are learned. Operant conditioning is active. Reinforcement and Punishment are the basics for operant conditioning.
5. Cognitive Therapy- active, directive, time-limited, structured approach used to treat a variety of psychiatric disorders. Based on the underlying theoretical principle that how people feel and behave is largely determined by the way in which they think about the world and their place in it. Therapeutic techniques are designed to identify, reality test, and correct distorted conceptualizations and the dysfunctional beliefs underlying these cognitions. Basically it helps clients to change the way that they think, which reduces symptoms.
6. The nurse has a legal duty to document and report any abuse. It is also important to follow the channels of communication in an organization to protect the safety of the clients.
7. Goals of Managed Care = Coordinated efficient care to control costs, Appropriate utilization of care resources, Increased access to preventive care, Maintenance and improvement of quality care. The goal of managed care is to provide coordination of all health services at the appropriate level of care, with an emphasis on preventive care, to control costs.
8. “Milieu” is the physical and social environment of an individual. Milieu therapy focuses on manipulation of the environment both physical and social to effect positive change. The nurse’s role is to make sure that clear, consistent communication is practiced; physical safety and comfort are maintained; everyone is treated with respect; and all individuals are encouraged to take responsibility for their own decision making and growth.
9. Unless a court order is given the patient has the right to refuse treatment. When this happens the nurse must document it thoroughly and notify the clients dr. of the event. The state may override a clients right when the client poses a danger to self or others.
10. Social or informal time= is spontaneous, Meets personal needs of both, Confidentiality may or may not be observed and listener may not be objective. Therapeutic or Formal time= is Patient-centered, Planned and Directed by professional, Meets patient’s needs, Listener objective and Information shared with health team
11.)
12.)If a client does not speak english the nurse should provide a professional interpreter. pg.106
13.)this is called somatization it is where psychological (emotional) distress is experienced as physical problem. "type of culture?"
14.) false imprisonment is an act with the intent to confine a person to a specific area. The use of seclusion or restraint that is not defensible as being necessary and in the the client's best interest results in FI. EG: If a client was voluntarily admitted and wanted to leae the facility and the nurse prohibits the client from leaving.
15. Exceptions to rule: 1. Duty to warn and protect 3rd parties- Tarasoff ruling 2. Child and Elder Abuse Reporting Statutes.
16. The behavior leading to restraint or seclusion and the time the client is placed in and released from restraint must be documented; the client in restraint must be assessed at regular and frequent intervals (e.g. every 15-30 min) for physical needs (food, hydration, toileting) safety and comfort and these observations must be documented (every 15-30 min).
17.
1) Conduct 1-1 nursing observation and interaction 24hr/day. (never let client out of staff's sight)
2) Maintain arm's length at all times.
3) Chart Client's whereabouts and record mood, verbatim statements, and behavior every 15-30 min/protocol.
4) Ensure that meal trays contain no glass or metal silverware.
5) During the observation when client is sleeping, hads should always be in view, not under bed covers.
6) Carefully observe client swallow each dose of medication.
7) The nurse and M.D. should explain to the client what they will be doing and why; both document this in the chart.
18. Assessment of suicide potential.
*"You have said you're depressed . Tell me what that is like for you?"
*" When you feel depressed, what thoughts go through your mind?"
19. Ex: More requests by the client for assistance, which causes increased dependency on the nurse.
Nurse's keeping secrets about the nurse-client relationship. Table 10-3 Pg 166.
-Overhelping
-Controlling
-Narcissisim
20. Client: "Could you ask the doctor to let me have a pass for the wkd?"
Nurse: "Your doctor will be on the unit this afternoon. I'll let her know that you would like to speak with her."
21. The nurse-client relationship is lost. The nurse has stepped out of the professional role.
22. Pg 103 Table 7-3
23. Low histamine= depression.
24. Assertiveness is a learned behavior that includes standing up for one's rights w/o violating the rights of others. Assertiveness training has proved to be successful way to lower stress, anxiety, and conflict resulting from stressful interpresonal relaionships, although some may find initial training and practice itself to be somewhat stressful.
25.
26. Aggressively espressing feelings is exemplified more by venting frustration on workers or subordinates, boring friends with emotional minutiae, etc. Voice gets louder, interrupts others, B/P increases, stress increases. Passive- May suffer increased levels of anxiety, discomfort, and depression or develop physical problems.
27. Defense Mechanisms On that list she passed out.
28. You can help the client focus and solve problems problems with the use of specific communication techniques such as employing open-ended questions, giving broad openings, exploring and seeking clarification. These techniques can be useful to a client experiencing mild to moderate anxiety. Also by providing a calm presence, recognizing the anxious person's distress, and being willing to listen. Pg. 215
Clients experiencing severe to panic anxiety levels are out of control, so they need to know that they are safe from their own impulses. Firm, short and simple statements are useful. Reinforcing commonalities in the environment and pointing out reality when there are distortionscan also be useful interventions for severely anxious persons. Pg 216
29. "Show of force"- moving the client to a quieter enviornment, the use of medications and restraints.
Great job Liana!
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