Psychotic Disorders: Initial Plan of Care for a Client Who Has Schizophrenia (RN QSEN - Patient-
centered Care, Active Learning Template - System Disorder, RM MH RN 10.0 Chp 15)
Provide a structured, safe environment (milieu) for the client to decrease anxiety and to distract
the client from constant thinking about hallucinations
Promote therapeutic communication to lower anxiety, decrease defensive patterns, and
encourage participation in the milieu.
Program of assertive community treatment (PACT): Intensive case management and
interprofessional team approach to assist clients with community-living needs.
Depressive Disorders: Priority Findings to Share with Treatment Team (RN QSEN - Teamwork
and Collaboration, Active Learning Template - System Disorder, RM MH RN 10.0 Chp 13)
Suicide risk: Assess the client’s risk for suicide and implement appropriate safety precautions.
Self-care: Monitor the client’s ability to perform activities of daily living and encourage
independence as much as possible.
Communication: Make observations rather than asking direct questions, which can cause
anxiety in the client. For example, the nurse might say, “I noticed that you attended the unit
group meeting today,” rather than asking, “Did you enjoy the group meeting
Legal and Ethical Issues: Right to Refuse Treatment (RN QSEN - Patient-centered Care, Active
Learning Template - Basic Concept, RM MH RN 10.0 Chp 2)
Freedom from harm related to physical or pharmacological restraint, seclusion, and any physical
or mental abuse or neglect
A psychiatric advance directive that includes the client’s treatment preferences if an involuntary
admission is necessary
Provision of care with the least restrictive interventions necessary to meet the client’s needs
without allowing him to be a threat to himself or others
Sexual Assault: Communicating with a Client (RN QSEN - Safety , Active Learning Template -
Basic Concept, RM MH RN 10.0 Chp 33)
Perform a self-assessment. It is vital that the nurse who works with the client who has been
sexually assaulted be empathetic, objective, and nonjudgmental. If the nurse feels emotional
about the assault due to some event or person in his own past, it can be better to allow another
nurse to care for the client.
Perform an initial and ongoing assessment of the client’s level of anxiety, coping mechanisms,
and available support systems. The nurse should also assess for indications of emotional and/or
physical trauma.
Provide a private environment for an examination with a specially trained nurse-advocate, if
available. A sexual assault nurse examiner (SANE) is a specially trained nurse who performs such
examinations and collects forensic evidence.
Brain Stimulation Therapies: Transcranial Magnetic Stimulation (Active Learning Template -
Therapeutic Procedure, RM
MH RN 10.0 Chp 10)
This study source was downloaded by 100000831988016 from CourseHero.com on 04-20-2022 07:11:31 GMT -05:00
https://www.coursehero.com/file/42597964/ATI-proctored-mental-healthdocx/
, TMS is a noninvasive therapy that uses magnetic pulsations to stimulate the cerebral cortex of
the brain
TMS is approved by the United States Food and Drug Administration (FDA) for the treatment of
major depressive disorder for clients who are not responsive to pharmacological treatment.
TMS is commonly prescribed daily for a period of 4 to 6 weeks.●TMS can be performed as an
outpatient procedure.●The TMS procedure lasts 30 to 40 min.●A noninvasive electromagnet is
placed on the client’s scalp, allowing the magnetic pulsations to pass through.●The client is alert
during the procedure.●Clients might feel a tapping or knocking sensation in the head, scalp skin
contraction, and tightening of the jaw muscles during the procedure.
Common adverse effects include mild discomfort or a tingling sensation at the site of the
electromagnet and headaches.●Monitor for lightheadedness after the procedure.●Seizures are
a rare but potential complication.●TMS is not associated with systemic adverse effects or
neurologic deficits.
Suicide: Risk Factors for Suicide (Active Learning Template - Basic Concept, RM MH RN 10.0
Chp 30)
While females are more likely to attempt suicide, adolescent, middle, and older adult males are
more likely to have a completed suicide. Other individuals at increased risk for suicide include
active military personnel/veterans; those who are lesbian, gay, bisexual, or transgender; and
people who have a comorbid mental illness, such as depressive disorders, substance use
disorders, schizophrenia, bipolar disorder, and personality disorders.
OLDER ADULT CLIENTS: Untreated depression●Loss of employment and finances●Feelings of
isolation, powerlessness●Prior attempts at suicide (older adult clients are more likely to
succeed)●Change in functional ability●Alcohol or other substance use disorder●Loss of loved
ones.
BIOLOGICAL FACTORS●Family history of suicide●Physical disorders, such as AIDS, cancer,
cardiovascular disease, stroke, chronic kidney disease, cirrhosis, dementia, epilepsy, head injury,
Huntington’s disease, and multiple sclerosis.
ENVIRONMENTAL FACTORS●Access to lethal methods, such as firearms●Lack of access to
adequate mental health care●Unemployment.
Medications for Psychotic Disorders: Assessment Tools to Determine Adverse Effects of
Medication (Active Learning Template - Medication, RM MH RN 10.0 Chp 24).
Abnormal Involuntary Movement Scale (AIMS): This tool is used to monitor involuntary
movements and tardive dyskinesia in clients who take antipsychotic medication.
World Health Organization Disability Assessment Schedule (WHODAS): This scale helps to
determine the client’s level of global functioning.
Mental Health Issues of Children and Adolescents: Behavioral Management of Autism
Spectrum Disorder (RN QSEN - Patient-centered Care, Active Learning Template - System
Disorder, RM MH RN 10.0 Chp 28)
Encourage parents to participate in the child’s care and treatment plan as much as possible.
Use short, concise, and developmentally appropriate communication.
This study source was downloaded by 100000831988016 from CourseHero.com on 04-20-2022 07:11:31 GMT -05:00
https://www.coursehero.com/file/42597964/ATI-proctored-mental-healthdocx/
centered Care, Active Learning Template - System Disorder, RM MH RN 10.0 Chp 15)
Provide a structured, safe environment (milieu) for the client to decrease anxiety and to distract
the client from constant thinking about hallucinations
Promote therapeutic communication to lower anxiety, decrease defensive patterns, and
encourage participation in the milieu.
Program of assertive community treatment (PACT): Intensive case management and
interprofessional team approach to assist clients with community-living needs.
Depressive Disorders: Priority Findings to Share with Treatment Team (RN QSEN - Teamwork
and Collaboration, Active Learning Template - System Disorder, RM MH RN 10.0 Chp 13)
Suicide risk: Assess the client’s risk for suicide and implement appropriate safety precautions.
Self-care: Monitor the client’s ability to perform activities of daily living and encourage
independence as much as possible.
Communication: Make observations rather than asking direct questions, which can cause
anxiety in the client. For example, the nurse might say, “I noticed that you attended the unit
group meeting today,” rather than asking, “Did you enjoy the group meeting
Legal and Ethical Issues: Right to Refuse Treatment (RN QSEN - Patient-centered Care, Active
Learning Template - Basic Concept, RM MH RN 10.0 Chp 2)
Freedom from harm related to physical or pharmacological restraint, seclusion, and any physical
or mental abuse or neglect
A psychiatric advance directive that includes the client’s treatment preferences if an involuntary
admission is necessary
Provision of care with the least restrictive interventions necessary to meet the client’s needs
without allowing him to be a threat to himself or others
Sexual Assault: Communicating with a Client (RN QSEN - Safety , Active Learning Template -
Basic Concept, RM MH RN 10.0 Chp 33)
Perform a self-assessment. It is vital that the nurse who works with the client who has been
sexually assaulted be empathetic, objective, and nonjudgmental. If the nurse feels emotional
about the assault due to some event or person in his own past, it can be better to allow another
nurse to care for the client.
Perform an initial and ongoing assessment of the client’s level of anxiety, coping mechanisms,
and available support systems. The nurse should also assess for indications of emotional and/or
physical trauma.
Provide a private environment for an examination with a specially trained nurse-advocate, if
available. A sexual assault nurse examiner (SANE) is a specially trained nurse who performs such
examinations and collects forensic evidence.
Brain Stimulation Therapies: Transcranial Magnetic Stimulation (Active Learning Template -
Therapeutic Procedure, RM
MH RN 10.0 Chp 10)
This study source was downloaded by 100000831988016 from CourseHero.com on 04-20-2022 07:11:31 GMT -05:00
https://www.coursehero.com/file/42597964/ATI-proctored-mental-healthdocx/
, TMS is a noninvasive therapy that uses magnetic pulsations to stimulate the cerebral cortex of
the brain
TMS is approved by the United States Food and Drug Administration (FDA) for the treatment of
major depressive disorder for clients who are not responsive to pharmacological treatment.
TMS is commonly prescribed daily for a period of 4 to 6 weeks.●TMS can be performed as an
outpatient procedure.●The TMS procedure lasts 30 to 40 min.●A noninvasive electromagnet is
placed on the client’s scalp, allowing the magnetic pulsations to pass through.●The client is alert
during the procedure.●Clients might feel a tapping or knocking sensation in the head, scalp skin
contraction, and tightening of the jaw muscles during the procedure.
Common adverse effects include mild discomfort or a tingling sensation at the site of the
electromagnet and headaches.●Monitor for lightheadedness after the procedure.●Seizures are
a rare but potential complication.●TMS is not associated with systemic adverse effects or
neurologic deficits.
Suicide: Risk Factors for Suicide (Active Learning Template - Basic Concept, RM MH RN 10.0
Chp 30)
While females are more likely to attempt suicide, adolescent, middle, and older adult males are
more likely to have a completed suicide. Other individuals at increased risk for suicide include
active military personnel/veterans; those who are lesbian, gay, bisexual, or transgender; and
people who have a comorbid mental illness, such as depressive disorders, substance use
disorders, schizophrenia, bipolar disorder, and personality disorders.
OLDER ADULT CLIENTS: Untreated depression●Loss of employment and finances●Feelings of
isolation, powerlessness●Prior attempts at suicide (older adult clients are more likely to
succeed)●Change in functional ability●Alcohol or other substance use disorder●Loss of loved
ones.
BIOLOGICAL FACTORS●Family history of suicide●Physical disorders, such as AIDS, cancer,
cardiovascular disease, stroke, chronic kidney disease, cirrhosis, dementia, epilepsy, head injury,
Huntington’s disease, and multiple sclerosis.
ENVIRONMENTAL FACTORS●Access to lethal methods, such as firearms●Lack of access to
adequate mental health care●Unemployment.
Medications for Psychotic Disorders: Assessment Tools to Determine Adverse Effects of
Medication (Active Learning Template - Medication, RM MH RN 10.0 Chp 24).
Abnormal Involuntary Movement Scale (AIMS): This tool is used to monitor involuntary
movements and tardive dyskinesia in clients who take antipsychotic medication.
World Health Organization Disability Assessment Schedule (WHODAS): This scale helps to
determine the client’s level of global functioning.
Mental Health Issues of Children and Adolescents: Behavioral Management of Autism
Spectrum Disorder (RN QSEN - Patient-centered Care, Active Learning Template - System
Disorder, RM MH RN 10.0 Chp 28)
Encourage parents to participate in the child’s care and treatment plan as much as possible.
Use short, concise, and developmentally appropriate communication.
This study source was downloaded by 100000831988016 from CourseHero.com on 04-20-2022 07:11:31 GMT -05:00
https://www.coursehero.com/file/42597964/ATI-proctored-mental-healthdocx/
