Loading presentation...

Present Remotely

Send the link below via email or IM

Copy

Present to your audience

Start remote presentation

  • Invited audience members will follow you as you navigate and present
  • People invited to a presentation do not need a Prezi account
  • This link expires 10 minutes after you close the presentation
  • A maximum of 30 users can follow your presentation
  • Learn more about this feature in our knowledge base article

Do you really want to delete this prezi?

Neither you, nor the coeditors you shared it with will be able to recover it again.

DeleteCancel

Make your likes visible on Facebook?

Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.

No, thanks

Psychiatric MH week 7

No description
by

Maribeth McKinney

on 16 March 2013

Comments (0)

Please log in to add your comment.

Report abuse

Transcript of Psychiatric MH week 7

ANS: C
Trust is frequently an issue because the child or adolescent may never have had a trusting relationship with an adult. In this patient’s situation, the trust she once had in her parents has been shattered, robbing her of feelings of security. Only the key relates to the therapeutic alliance.
 
DIF: Cognitive Level: Application REF: Text Pages: 634-645
TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity The nurse provides health education for an adult with sleep deprivation. Which instruction has the highest priority?
A. “It’s important to limit your driving to short periods. Sleep deprivation increases your risks for serious accidents.”
B. “Sleep deprivation is usually a self-limiting health problem. See your doctor if it lasts more than a year.”
C. “Turn the radio on with a soft volume as you prepare for bed each evening. It will help you relax.”
D. “Three glasses of wine each evening helps many patients who suffer from sleep deprivation.” Question??? A patient tells a nurse, “The others won’t give me my pain meds early, but you are more understanding, you know what it’s like to be in pain, and you don’t want to see your patients suffer. Could you find a way to get me my pill now? I won’t tell anyone.” Which response by the nurse would be most therapeutic?
A. “I’m not comfortable doing that,” then ignore subsequent requests for early meds.
B. “I’ll have to check with your doctor about that; I will get back to you after I do.”
C. “It would be unsafe to give the medicine early; none of us will do that.”
D. “I understand that you have pain, but giving medicine too soon would not be safe.” Sample Q ANS: C
Conduct disorders are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. The patient’s clinical manifestations do not coincide with criteria of the other disorders.
 
DIF: Cognitive Level: Application REF: Text Pages: 642-643
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 10. A 15-year-old is referred to the mental health clinic by juvenile court after an arrest for vandalism and running away from home six times. The teen has been physically abusive to the mother and defiant to the father. The adolescent’s problem is most consistent with criteria for:
A. attention-deficit hyperactivity disorder.
B. adolescent depression.
C. conduct disorder.
D. autistic disorder.  Motor and verbal tics
Causes marked distress
Causes significant impairment in:
Social functioning
Occupational functioning
Average age of onset of motor tics is 7 years of age; can appear as early as 2 years of age Tourette’s Disorder Most frequently diagnosed mood
disorders:
Major depressive disorder
Dysthymic disorder
Bipolar disorder Mood Disorders Anxiety is part of normal development
Anxiety is a problem when:
An individual fails to move beyond the fears associated with a particular problem
It interferes with normal functioning over an extended period of time
Two anxiety disorders of children and adolescents:
Separation anxiety disorder
Posttraumatic stress disorder Anxiety Disorders Autistic disorder
Asperger’s disorder
Rett’s disorder
Conduct Disorder
Oppositional Defiant Disorder
Pervasive Developmental Disorders
Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders Pervasive Developmental Disorders Attention deficit hyperactivity disorder (ADHD)
Juvenile-onset bipolar disorder
Oppositional defiant disorder
Conduct disorders
Childhood depression
Conduct or oppositional disorders
Anxiety disorders Comorbidities Epidemiology
One in five children and adolescents in the United States has a major mental illness.
Two-thirds of all young people with mental health problems are not getting treatment. Chapter 28 Disorder of children and adolescents ANS: B
The corporate accountant is likely to work long hours and have significant stress associated with work demands. Compounded by travel, these factors are likely to precipitate unstable sleep patterns and inadequate sleep time. The retiree and lawn care worker engage in physical activity during the day, which will promote natural fatigue and sleep. The parent’s sleep is unlikely to be disturbed; teenagers sleep through the night.
 
DIF: Cognitive Level: Application REF: Text Pages: 460-461
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance A nurse cares for these four patients. Which patient has the highest risk for problems with sleep physiology?
A. Retiree who volunteers twice a week for Habitat for Humanity
B. Corporate accountant who travels frequently
C. Parent with three teenagers
D. Lawn care worker  Question??? Insomnia related to another mental disorder
Hypersomnia related to another mental disorder
Major depressive disorder
Anxiety disorders
Schizophrenia Sleep Disorders Related to
Other Mental Disorders ANS: B
Even when a behavior is maladaptive or ineffective, it usually represents our best effort to cope, given the coping skills and resources available to us at that time. For people with personality disorders, coping overall is usually less effective and more rigid than for other persons, but it too represents each person’s best efforts to cope with the circumstances at that moment. Recovery from many medical and psychiatric disorders, including personality disorders, can be slow and involve periods of relapse or regression. However, that does not mean that personality disorders do not improve or that these patients are at the mercy of others’ actions. Like everyone else, they can learn to cope and be resilient under stress. What looks like improvement is not necessarily manipulation instead.
 
DIF: Cognitive Level: Application REF: Text Page: 446
TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity Answer 3. A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend, who breaks off their relationship. Although she has not self-injured in over 2 months, she makes repeated lacerations on her forearm. Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?
A. People with personality disorders rarely achieve lasting improvement.
B. However dysfunctional, most behavior is the person’s best effort to cope.
C. People with personality disorders are at the mercy of others’ actions.
D. What appears to be improvement can be manipulation instead. Sample Q Anxious or fearful behavior
Rigid patterns of social shyness
Examples
Avoidant PD
Dependent PD
Obsessive-compulsive PD Cluster C Personality Disorders Dramatic, emotional, erratic behavior
Problems with impulse control
Examples
Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD Cluster B Personality Disorders Cluster A :
Eccentric and Odd behavior
Unusual level of suspiciousness
Magical thinking
Cognitive impairment
Examples:
Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder Personality Disorder ANS: C
Although all the questions might be appropriate to ask, only the correct response focuses on the patient’s eating patterns. The distracters focus on distortions in body image and explore the patient’s feelings about weight.
 
DIF: Cognitive Level: Application REF: Text Pages: 346, 349-350
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
  Answer A patient referred to the eating disorders clinic lost 35 pounds over 3 months. To assess eating patterns, the nurse should ask:
a. “Do you often feel fat?”
b. “Who plans the family meals?”
c. “What do you eat in a typical day?”
d. “What do you think about your present weight?” Sample Q Anorexia Nervosa

Bulimia nervosa

Binge eating disorder Eating Disorder Week 7
Chapters 16,19,20,&28 Psychiatric Mental Health Nursing A nurse works with an adolescent who is moody and withdrawn because the teen’s parents are divorcing. Establishing a therapeutic alliance is a priority because:
A. focusing on the strengths of an individual increases the individual’s self-esteem.
B. the adolescent should express feelings and not keep them internalized.
C. acceptance and trust convey feelings of security to the adolescent.
D. therapeutic activities provide an outlet for tension.  Sample Q. ANS: B
The corporate accountant is likely to work long hours and have significant stress associated with work demands. Compounded by travel, these factors are likely to precipitate unstable sleep patterns and inadequate sleep time. The retiree and lawn care worker engage in physical activity during the day, which will promote natural fatigue and sleep. The parent’s sleep is unlikely to be disturbed; teenagers sleep through the night.
 
DIF: Cognitive Level: Application REF: Text Pages: 460-461
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance Answer Dyssomnias
Primary insomnia
Primary hypersomnia
Narcolepsy
Breathing-related sleep disorders
Circadian rhythm disorders
Dyssomnias not otherwise specified
Restless legs syndrome
(Box 20-1) Primary Sleep Disorders Sleep deprivation – discrepancy between hours of sleep obtained and hours of sleep required for optimal functioning
Implications for
Health
Safety
Quality of life Chapter 20 Sleep Disorder
Answer D
Empathetic mirroring, wherein the nurse reflects back to the patient an understanding of the patient’s distress or situation in a neutral manner that does not judge it, helps elicit a more positive response to the limit that is being set. The other options would not be nontherapeutic, but they lack the empathetic mirroring component that tends to elicit a more positive response from the patient.
 
DIF: Cognitive Level: Analysis REF: Text Pages: 449-450, 452
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity Answer
Full transcript