NUR 2488 Mental Health latest 2022-2023 graded A
• Introduction in Psychiatric Nursing
• Basic Brain Anatomy- what do the
different part of brain control?
o Frontal Lobe: Thought Processes & Voluntary
Movement (decision making)
o Temporal Lobe: Auditory Processes (language,
speech, connects to Limbic system)
o Occipital Lobe: Vision (interprets visual images)
o Parietal Lobe: Sensory & Motor (L/R orientation,
reading, math, proprioception)
o Hypothalamus: maintains homeostasis, regulates
BP, Temp, libido, hunger, thirst, and sleep/wake
cycles.
o Cerebellum: Balance, Skeletal Muscle Coordination
o Neurons: Nerves that translate electrical impulses into
chemical signals released at the synapse
▪ Synapse- (pg. 51)- The space between neurons in
which neurotransmitters are released and either
inhibit/excite the
adjacent neuron. The 4 NT’s are dopamine,
norepinephrine, serotonin and acetylcholine.
• Milieu Therapy: Creating a SAFE, structured
inpatient/outpatient setting where the mentally ill can test
new behaviors and coping mechanisms with others.
o Creating a SAFE, structured inpatient/outpatient setting
where patients with mental illness can test new
behaviors and interactions.
o Climate is essential to healing: paint color,
relaxed environments are conducive to the healing
process.
o Florence Nightingale believed that the environment helps
heal
• Maslow’s Hierarchy of needs
o Basic Needs: food, oxygen, water, sleep, sex, and a
constant body temperature. If all the needs were
deprived, this level would take priority.
o Safety Needs: Security, protection, freedom from
fear/anxiety/chaos, and the need for law, order, and
limits.
o Belonging and Love Needs: intimate relationship,
love, affection, and belonging, having a family and
a home and being part of identifiable groups.
o Esteem Needs: If self-esteem needs are met, we feel
confident, valued, and valuable. When self-esteem is
compromised, we feel inferior, worthless, and helpless.
o Self-actualization: Reaching our full potential to feel
inner peace and fulfillment.
,NUR 2488 Mental Health latest 2022-2023 graded A
• Peplau’s Theory of Interpersonal Relations
o Created the Nurse-Patient Partnership increasing
individual and family roles in recovery. (Based off of
Sullivan’s Interpersonal Theory). Relationships greatly
influence recovery
• Freud- what did he contribute to
psychiatric setting? (Unconscious thoughts)
o Id – unconscious mind, instincts (this is dominant)
o Ego – sense of self, use of defense mechanisms
o Superego – our conscious and is greatly
influenced by our parents morals and
ethical stances
o Erickson’s
▪ Trust vs. Mistrust (infant 0- 1 ½) trust
developed if caregivers give affection, love,
care, attention, and reliability. (Feeding)
▪ Autonomy vs. Shame (toddlers 1 ½ - 3)
kids need to develop a sense of personal
control. (Toilet Training)
▪ Initiative vs. Guilt (children 3-6) children need
to have power to explore their environment and
not receive disapproval from parents.
(Exploration)
▪ Industry vs. Inferiority: (school aged kids 6-
12) Kids dealing with new social and academic
demands. Success leads to a sense of
competence. (School)
▪ Identity vs. Role Confusion (teens 12-20)
Teens need to develop self-identity and personal
identity to stay true to themselves. (Social
Relationships)
▪ Intimacy & Solidarity vs. Isolation (young
adults 20- 30) Young Adults need to form
intimate, loving relationships. (Relationships)
▪ Generativity vs. Self-Absorption: (adults 30-
65) Need to create/nurture things by having
children. (Work & Parenthood)
, NUR 2488 Mental Health latest 2022-2023 graded A
▪ Integrity vs. Despair (elderly 65+) Need to
look back and feel fulfilled by accomplishments;
have wisdom and no regrets (Reflection on Life)
o Sullivan
▪ Personalities are influenced during childhood and
mostly by the MOTHER. (Page 31 in book for more
information)
• Therapeutic Communication
• Therapeutic Communication: goal directed, professional,
scientifically based. Goal is to get information so that you can
plan care for the patient.
o Active Listening
▪ Clarifying: promotes understanding of the
patient’s statement
▪ Restating: repeating the same key words the
patient has just spoken to echo their feelings. (Ex: If
a patient remarks, “My life is empty…it has no
meaning,” additional information may be gained by
restating, “Your life has no meaning?”)
▪ Reflecting: helps people understand their own
thoughts better; summarizes (Ex: For example, to
reflect a patient's feelings about his or her life, a
good beginning might be, “You sound as if you have
had many disappointments.”)
▪ Exploring: use of open-ended questions or
statements to allow the patient to express
thoughts/feelings. (Ex: “Tell me more…”, “Give me
an example of…”)
• Communication Technique Examples in
Different Scenarios
o For Suicidal Patients: “These thoughts are very
serious Mr. Adams. I do not want any harm to come to
you. Can you tell me what you were feeling and if
there were any circumstances that led you to this
decision?”
o For Patients who start Crying: Stay with your
patient and reinforce that it is all right to cry & offer
tissues. “You seem upset, what are you thinking right
now?”
o For Patients who say they “don’t want to talk”:
“Its alright. I would like to spend time with you. We don’t
have to talk.” Or reapproach at a later time, “Our 5
minutes is up. I will be back at 10am and spend another 5
minutes with you.”
o For Patients who ask the nurse to keep a secret:
Nurses cannot make such promises, as it may be
important to share that information with other staff for
safety reasons. “I cannot make
• Introduction in Psychiatric Nursing
• Basic Brain Anatomy- what do the
different part of brain control?
o Frontal Lobe: Thought Processes & Voluntary
Movement (decision making)
o Temporal Lobe: Auditory Processes (language,
speech, connects to Limbic system)
o Occipital Lobe: Vision (interprets visual images)
o Parietal Lobe: Sensory & Motor (L/R orientation,
reading, math, proprioception)
o Hypothalamus: maintains homeostasis, regulates
BP, Temp, libido, hunger, thirst, and sleep/wake
cycles.
o Cerebellum: Balance, Skeletal Muscle Coordination
o Neurons: Nerves that translate electrical impulses into
chemical signals released at the synapse
▪ Synapse- (pg. 51)- The space between neurons in
which neurotransmitters are released and either
inhibit/excite the
adjacent neuron. The 4 NT’s are dopamine,
norepinephrine, serotonin and acetylcholine.
• Milieu Therapy: Creating a SAFE, structured
inpatient/outpatient setting where the mentally ill can test
new behaviors and coping mechanisms with others.
o Creating a SAFE, structured inpatient/outpatient setting
where patients with mental illness can test new
behaviors and interactions.
o Climate is essential to healing: paint color,
relaxed environments are conducive to the healing
process.
o Florence Nightingale believed that the environment helps
heal
• Maslow’s Hierarchy of needs
o Basic Needs: food, oxygen, water, sleep, sex, and a
constant body temperature. If all the needs were
deprived, this level would take priority.
o Safety Needs: Security, protection, freedom from
fear/anxiety/chaos, and the need for law, order, and
limits.
o Belonging and Love Needs: intimate relationship,
love, affection, and belonging, having a family and
a home and being part of identifiable groups.
o Esteem Needs: If self-esteem needs are met, we feel
confident, valued, and valuable. When self-esteem is
compromised, we feel inferior, worthless, and helpless.
o Self-actualization: Reaching our full potential to feel
inner peace and fulfillment.
,NUR 2488 Mental Health latest 2022-2023 graded A
• Peplau’s Theory of Interpersonal Relations
o Created the Nurse-Patient Partnership increasing
individual and family roles in recovery. (Based off of
Sullivan’s Interpersonal Theory). Relationships greatly
influence recovery
• Freud- what did he contribute to
psychiatric setting? (Unconscious thoughts)
o Id – unconscious mind, instincts (this is dominant)
o Ego – sense of self, use of defense mechanisms
o Superego – our conscious and is greatly
influenced by our parents morals and
ethical stances
o Erickson’s
▪ Trust vs. Mistrust (infant 0- 1 ½) trust
developed if caregivers give affection, love,
care, attention, and reliability. (Feeding)
▪ Autonomy vs. Shame (toddlers 1 ½ - 3)
kids need to develop a sense of personal
control. (Toilet Training)
▪ Initiative vs. Guilt (children 3-6) children need
to have power to explore their environment and
not receive disapproval from parents.
(Exploration)
▪ Industry vs. Inferiority: (school aged kids 6-
12) Kids dealing with new social and academic
demands. Success leads to a sense of
competence. (School)
▪ Identity vs. Role Confusion (teens 12-20)
Teens need to develop self-identity and personal
identity to stay true to themselves. (Social
Relationships)
▪ Intimacy & Solidarity vs. Isolation (young
adults 20- 30) Young Adults need to form
intimate, loving relationships. (Relationships)
▪ Generativity vs. Self-Absorption: (adults 30-
65) Need to create/nurture things by having
children. (Work & Parenthood)
, NUR 2488 Mental Health latest 2022-2023 graded A
▪ Integrity vs. Despair (elderly 65+) Need to
look back and feel fulfilled by accomplishments;
have wisdom and no regrets (Reflection on Life)
o Sullivan
▪ Personalities are influenced during childhood and
mostly by the MOTHER. (Page 31 in book for more
information)
• Therapeutic Communication
• Therapeutic Communication: goal directed, professional,
scientifically based. Goal is to get information so that you can
plan care for the patient.
o Active Listening
▪ Clarifying: promotes understanding of the
patient’s statement
▪ Restating: repeating the same key words the
patient has just spoken to echo their feelings. (Ex: If
a patient remarks, “My life is empty…it has no
meaning,” additional information may be gained by
restating, “Your life has no meaning?”)
▪ Reflecting: helps people understand their own
thoughts better; summarizes (Ex: For example, to
reflect a patient's feelings about his or her life, a
good beginning might be, “You sound as if you have
had many disappointments.”)
▪ Exploring: use of open-ended questions or
statements to allow the patient to express
thoughts/feelings. (Ex: “Tell me more…”, “Give me
an example of…”)
• Communication Technique Examples in
Different Scenarios
o For Suicidal Patients: “These thoughts are very
serious Mr. Adams. I do not want any harm to come to
you. Can you tell me what you were feeling and if
there were any circumstances that led you to this
decision?”
o For Patients who start Crying: Stay with your
patient and reinforce that it is all right to cry & offer
tissues. “You seem upset, what are you thinking right
now?”
o For Patients who say they “don’t want to talk”:
“Its alright. I would like to spend time with you. We don’t
have to talk.” Or reapproach at a later time, “Our 5
minutes is up. I will be back at 10am and spend another 5
minutes with you.”
o For Patients who ask the nurse to keep a secret:
Nurses cannot make such promises, as it may be
important to share that information with other staff for
safety reasons. “I cannot make
