case study
Mental Health Final Exam Review
Schizophrenia
-What would be the initial care plan?
-Medication regimen, safety concerns, milieu therapies, set boundaries, establish
trusting relationship, promote therapeutic communication, encourage participation in therapy, social
skill development, psycho education, address hallucinations (It is okay to say “I do not hear what you are
hearing, tell me what you are hearing”)
Anger management
-calm tone of voice, deescalate pt by distractions, seclude and restrain if pt are harming self or
you (new restraints order at least twice a day, restraints must be taken off, skin assessment, take one
restraint off at a time)
How do you know it is time to remove restraints?
-improvement in behavior
-check by conducting assessment, conversation, interview
-Remove restraints one at a time & observe for reoccurrence
Risk factors of aggression
-past hx of aggression, poor impulse control and violence, poor coping skills, commodities that
leads to acts of violence (psychic delusions, commands hallucinations), living in violent environment
Dealing w/ aggressive pt
- responding quickly, remaining calm and in control, encourage pt to express feelings verbally
using therapeutic communication tech, give personal space, maintain eye contact, describe options, give
choices, try walking to calm pt
Pt talking about depression, what would be priority to share w/care team?
-thoughts of suicide, given away belongings, quit job, plan to harm self or others
How do you create and maintain a safe and therapeutic environment?
-trusting relationship, family support, and support groups
What does a therapeutic client and nurse relationship look like?
-rapport, professional, set limits, keep your word
Priority assessment for pt w/delirium?
-medical clearance (fluid and electrolytes)
How do we know pt actually has delirium?
-Delirium can be reversed and can be improved w/O2 or fluids
-Delirium causes: meds, sleep deprivation, nutrition, fluid & electrolytes
-Dementia and Alzheimer’s are irreversible
Transcranial magnetic stimulation: electromagnetics placed on pt scalp allowing magnetic pulsations to
pass through which stimulates the cerebral cortex.
-Indicated for pt who are unresponsive to pharmacological tx for depression
-Non-invasive procedure lasting 30-40mins
-Pt is alert, may feel knocking or tapping sensation on scalp
-May cause light headaches, tingling sensations, discomfort
-Postoperative care: monitor for seizures and TMS
Risk factors for suicide?
-active military personnel and veterans, LGBTQ individuals, substance abuse, age >45,
schizophrenia, lost of loved one
Suicide precautions
-place pt in secluded room, take all belongings, monitor pt at all times
How do we assess a pt to determine if medication is effective?
This study source was downloaded by 100000830772748 from CourseHero.com on 07-19-2022 04:44:58 GMT -05:00
https://www.coursehero.com/file/38356825/Mental-Health-Final-Exam-Reviewdocx/
Mental Health Final Exam Review
Schizophrenia
-What would be the initial care plan?
-Medication regimen, safety concerns, milieu therapies, set boundaries, establish
trusting relationship, promote therapeutic communication, encourage participation in therapy, social
skill development, psycho education, address hallucinations (It is okay to say “I do not hear what you are
hearing, tell me what you are hearing”)
Anger management
-calm tone of voice, deescalate pt by distractions, seclude and restrain if pt are harming self or
you (new restraints order at least twice a day, restraints must be taken off, skin assessment, take one
restraint off at a time)
How do you know it is time to remove restraints?
-improvement in behavior
-check by conducting assessment, conversation, interview
-Remove restraints one at a time & observe for reoccurrence
Risk factors of aggression
-past hx of aggression, poor impulse control and violence, poor coping skills, commodities that
leads to acts of violence (psychic delusions, commands hallucinations), living in violent environment
Dealing w/ aggressive pt
- responding quickly, remaining calm and in control, encourage pt to express feelings verbally
using therapeutic communication tech, give personal space, maintain eye contact, describe options, give
choices, try walking to calm pt
Pt talking about depression, what would be priority to share w/care team?
-thoughts of suicide, given away belongings, quit job, plan to harm self or others
How do you create and maintain a safe and therapeutic environment?
-trusting relationship, family support, and support groups
What does a therapeutic client and nurse relationship look like?
-rapport, professional, set limits, keep your word
Priority assessment for pt w/delirium?
-medical clearance (fluid and electrolytes)
How do we know pt actually has delirium?
-Delirium can be reversed and can be improved w/O2 or fluids
-Delirium causes: meds, sleep deprivation, nutrition, fluid & electrolytes
-Dementia and Alzheimer’s are irreversible
Transcranial magnetic stimulation: electromagnetics placed on pt scalp allowing magnetic pulsations to
pass through which stimulates the cerebral cortex.
-Indicated for pt who are unresponsive to pharmacological tx for depression
-Non-invasive procedure lasting 30-40mins
-Pt is alert, may feel knocking or tapping sensation on scalp
-May cause light headaches, tingling sensations, discomfort
-Postoperative care: monitor for seizures and TMS
Risk factors for suicide?
-active military personnel and veterans, LGBTQ individuals, substance abuse, age >45,
schizophrenia, lost of loved one
Suicide precautions
-place pt in secluded room, take all belongings, monitor pt at all times
How do we assess a pt to determine if medication is effective?
This study source was downloaded by 100000830772748 from CourseHero.com on 07-19-2022 04:44:58 GMT -05:00
https://www.coursehero.com/file/38356825/Mental-Health-Final-Exam-Reviewdocx/
