NUR 222 Mental Health PP Review
Mental health week 1 PP
Characteristics of Mentally Healthy
• Views reality based on objective data
• Accepting all your strengths and weaknesses
• Establish relationships
• Takes time to be alone and have privacy
Mental illness changes from cultures and can be individualized.
- need to adjust to the culture
Mental illness has no cure. Uses medications and therapies.
Resilience: idea of bouncing back
- process of adjusting
- person has optimism
DSM 5
Psychiatrist or psychologist will use it
- doesn’t have interventions and doesn’t indicate any pharmacological treatments. (we
would use NANDA)
It Establishes diagnosis criteria, planning, and implementing
ICD 10: international classification of diagnosis
- Coding for the disease so insurance companies use it to bill.
- Works with the DSM 5 for coding of Si/Sx
Goal as a mental health RN:
- Safety is priority
- Being present and available to the Pt
- Body language
- sit with hands crossed is a negative impression
- Warm (smiling, using gentle tone, don’t overly smile)
- Empathy (ability to perceive situation) NOT sympathy!
- Respect
- Positioning (both feet on floor, hands present on table, lean forward to show
engagement)
- Good eye contact
- RN there to listen but cannot give advice and never ask why questions
Check on Pt every 15 minutes to assess and make sure they are alive
Milieu (the environment)
- want them to be in milieu
- want them out of their room and participate in activities (be in the day room)
- there you can ensure safety
,NUR 222 Mental Health PP Review
- use to socialize and to assess mental status
Prevention strategies
-primary: before problem manifestations
- Ex. education, teaching, school and talking to students
- Secondary: reducing prevalence
- Ex. screenings
- Tertiary: preventing progression to more severe course
- Ex. suicide precautions to prevent more from occurring
Defense mechanisms
• help cope with anxiety
• Transference: when a Pt is reminded of someone they know
o Ex. RN talking to a Pt and it reminds them of their sister and they hate their sister
• Counter transference: Pt reminds the RN of someone the RN knows
THEORISTS:
FREUD: PSYCHOANALYTIC THEORY
Everything happens in childhood
Conscious: part of mind that is compared to tip of iceberg
• Everything person is aware of thoughts, feelings, emotions
Preconscious: aware and but can retrieve it later
• Suppress and deal with it later on.
Unconscious: Repressed memories
• Trauma that happened in childhood
Psychosexual Development (OAPLG)
• Oral:
o Age 0-18 months
o MOUTH: swallowing, sucking, etc.
• Anal:
o Age 18 months- 3 y.o.
o Withholding or expelling feces
o Independence and control
• Phallic
o Age 3-6 y.o.
o Masturbation: penis/clitoris
o Identify with parents
• Latent
o Age 6-12 y.o.
o Little to no sexual motivation present
,NUR 222 Mental Health PP Review
o Identifies with same sex peers
o Suppressed sexuality
• Genital
o Age 12- 20 (adulthood)
o Sexual intercourse
Ego Development
• ID: “pleasure principle” “I need it now” “Go getter”
o Present at birth
o Assists individual to decrease immediately the anxiety based on primal needs
o Ex) Calling out in pain
• EGO: “Reality principle”
o 4 months to 6 months
o Experience outside world then ADAPTS and RESPONDS to it.
o delays the ID, relaxes the ID and keeps it in check
o Goal is to maintain harmony between ID and SUPEREGO
o Ex) Client exhibits the ability to assert himself or herself with anger or aggression
• SUPEREGO: “Perfection principle” Always seeks perfection
o Internalizes values and morals set forth by primary care givers
o Assists “EGO” to control the impulses of “ID”
o Begins when rewarded or punished for “good” or “bad”
ERIKSON: PSYCHOSOCIAL THEORY
• Trust vs. Mistrust
• Autonomy vs. Shame and Doubt
• Initiative vs. Guilt
• Industry vs. Inferiority
o Age 6-11
• Identity vs. Role Confusion
o 12-18
o Adolescence, when puberty starts
• Intimacy vs. Isolation
o 18-40
o Young adulthood
• Generativity vs. Stagnation
o 40-65- self absorption “I lived with the scar so long worse than cancer”
o Middle adulthood
• Ego integrity vs. Despair
o 65+
o Old age
, NUR 222 Mental Health PP Review
• An individual CAN get stuck in a stage and not be able to move on
PEPLAU: NURSING THEORY *INFLUENCED BY SULLIVAN* RESPECT THE PATIENT AND BELIEVE
IN THEIR NEEDS*
• Nurses should be aware of their behavior and FOCUS on the pt behavior
• MOTHER of psychiatric (mental health) nursing
• RESPECT THE PATIENT
• Promotes the nurse-client relationship
• Applies interpersonal theory to nursing practice
• The nurse is
o A resource person
o A counselor
o A teacher
o A leader
o A technical expert
o A surrogate
SULLIVAN: INTERPERSONAL THEORY *ANXIETIES AND NEEDS*
• Individual behavior and personality development are the DIRECT results of interpersonal
relationships
• Infancy
• Childhood
• Juvenile
• Preadolescence
• Early adolescence
• Late adolescence
MAHLER: OBJECT REALTIONS THEORY
• Birth to 36 months
• Separation-individuation process of the infant from the maternal figure
• Autistic phase
• Symbiotic phase
• Separation-Individuation phase
• Aids the clients level of individuation from primary caregivers
WATSON: 7 ASSUMPTIONS ABOUT THE SCIENCE OF CARING (Behaviorism theory)
• Curing disease is the domain of medicine
• Caring is the domain of nursing
• Her 7 assumptions allows the nurse to deliver integrated holistic care
• Tested a 9 month old who loved animals. If sees white fur, then will become scared
LEININGER: THEORY OR CULTURAL CAREDIVERSITY AND UNIVERSALITY
Mental health week 1 PP
Characteristics of Mentally Healthy
• Views reality based on objective data
• Accepting all your strengths and weaknesses
• Establish relationships
• Takes time to be alone and have privacy
Mental illness changes from cultures and can be individualized.
- need to adjust to the culture
Mental illness has no cure. Uses medications and therapies.
Resilience: idea of bouncing back
- process of adjusting
- person has optimism
DSM 5
Psychiatrist or psychologist will use it
- doesn’t have interventions and doesn’t indicate any pharmacological treatments. (we
would use NANDA)
It Establishes diagnosis criteria, planning, and implementing
ICD 10: international classification of diagnosis
- Coding for the disease so insurance companies use it to bill.
- Works with the DSM 5 for coding of Si/Sx
Goal as a mental health RN:
- Safety is priority
- Being present and available to the Pt
- Body language
- sit with hands crossed is a negative impression
- Warm (smiling, using gentle tone, don’t overly smile)
- Empathy (ability to perceive situation) NOT sympathy!
- Respect
- Positioning (both feet on floor, hands present on table, lean forward to show
engagement)
- Good eye contact
- RN there to listen but cannot give advice and never ask why questions
Check on Pt every 15 minutes to assess and make sure they are alive
Milieu (the environment)
- want them to be in milieu
- want them out of their room and participate in activities (be in the day room)
- there you can ensure safety
,NUR 222 Mental Health PP Review
- use to socialize and to assess mental status
Prevention strategies
-primary: before problem manifestations
- Ex. education, teaching, school and talking to students
- Secondary: reducing prevalence
- Ex. screenings
- Tertiary: preventing progression to more severe course
- Ex. suicide precautions to prevent more from occurring
Defense mechanisms
• help cope with anxiety
• Transference: when a Pt is reminded of someone they know
o Ex. RN talking to a Pt and it reminds them of their sister and they hate their sister
• Counter transference: Pt reminds the RN of someone the RN knows
THEORISTS:
FREUD: PSYCHOANALYTIC THEORY
Everything happens in childhood
Conscious: part of mind that is compared to tip of iceberg
• Everything person is aware of thoughts, feelings, emotions
Preconscious: aware and but can retrieve it later
• Suppress and deal with it later on.
Unconscious: Repressed memories
• Trauma that happened in childhood
Psychosexual Development (OAPLG)
• Oral:
o Age 0-18 months
o MOUTH: swallowing, sucking, etc.
• Anal:
o Age 18 months- 3 y.o.
o Withholding or expelling feces
o Independence and control
• Phallic
o Age 3-6 y.o.
o Masturbation: penis/clitoris
o Identify with parents
• Latent
o Age 6-12 y.o.
o Little to no sexual motivation present
,NUR 222 Mental Health PP Review
o Identifies with same sex peers
o Suppressed sexuality
• Genital
o Age 12- 20 (adulthood)
o Sexual intercourse
Ego Development
• ID: “pleasure principle” “I need it now” “Go getter”
o Present at birth
o Assists individual to decrease immediately the anxiety based on primal needs
o Ex) Calling out in pain
• EGO: “Reality principle”
o 4 months to 6 months
o Experience outside world then ADAPTS and RESPONDS to it.
o delays the ID, relaxes the ID and keeps it in check
o Goal is to maintain harmony between ID and SUPEREGO
o Ex) Client exhibits the ability to assert himself or herself with anger or aggression
• SUPEREGO: “Perfection principle” Always seeks perfection
o Internalizes values and morals set forth by primary care givers
o Assists “EGO” to control the impulses of “ID”
o Begins when rewarded or punished for “good” or “bad”
ERIKSON: PSYCHOSOCIAL THEORY
• Trust vs. Mistrust
• Autonomy vs. Shame and Doubt
• Initiative vs. Guilt
• Industry vs. Inferiority
o Age 6-11
• Identity vs. Role Confusion
o 12-18
o Adolescence, when puberty starts
• Intimacy vs. Isolation
o 18-40
o Young adulthood
• Generativity vs. Stagnation
o 40-65- self absorption “I lived with the scar so long worse than cancer”
o Middle adulthood
• Ego integrity vs. Despair
o 65+
o Old age
, NUR 222 Mental Health PP Review
• An individual CAN get stuck in a stage and not be able to move on
PEPLAU: NURSING THEORY *INFLUENCED BY SULLIVAN* RESPECT THE PATIENT AND BELIEVE
IN THEIR NEEDS*
• Nurses should be aware of their behavior and FOCUS on the pt behavior
• MOTHER of psychiatric (mental health) nursing
• RESPECT THE PATIENT
• Promotes the nurse-client relationship
• Applies interpersonal theory to nursing practice
• The nurse is
o A resource person
o A counselor
o A teacher
o A leader
o A technical expert
o A surrogate
SULLIVAN: INTERPERSONAL THEORY *ANXIETIES AND NEEDS*
• Individual behavior and personality development are the DIRECT results of interpersonal
relationships
• Infancy
• Childhood
• Juvenile
• Preadolescence
• Early adolescence
• Late adolescence
MAHLER: OBJECT REALTIONS THEORY
• Birth to 36 months
• Separation-individuation process of the infant from the maternal figure
• Autistic phase
• Symbiotic phase
• Separation-Individuation phase
• Aids the clients level of individuation from primary caregivers
WATSON: 7 ASSUMPTIONS ABOUT THE SCIENCE OF CARING (Behaviorism theory)
• Curing disease is the domain of medicine
• Caring is the domain of nursing
• Her 7 assumptions allows the nurse to deliver integrated holistic care
• Tested a 9 month old who loved animals. If sees white fur, then will become scared
LEININGER: THEORY OR CULTURAL CAREDIVERSITY AND UNIVERSALITY
