MENTAL HEALTH ATI TEST REMEDIATION

Mental Health ATI test Remediation- I had a lot of remediation to do so I typed it. I hope that is okay. 1. Management of Care: a. Collaboration with interdisciplinary team i. Depressive disorders: Priority findings to share with treatment team 1. Vegetative findings: Changing in eating patterns (anorexia in MDD, but over eating in PMDD), change in bowel habits, sleep disturbances, decreased interest in sexual activity. 2. Anhedonia. (lack of pleasure in things they used to love to do). 3. Lack of hygiene, poor grooming, Social isolation, no interaction, slowed speech, looks sad, blunted affect, possible self-harming. b. Confidentiality/Information Security. i. Legal and Ethical Issues: Client confidentiality -Chapter 2 1. If you heard someone talking about a patient/ violating their privacy; immediately take action and stop the violation 2. Only if the patient says it is okay should the nurse share information with someone else who is not involved in treatment plan. 3. HIPPA, knowing and understanding the federal law and state laws because they relate to confidentiality in health care facilities. ii. Creating and Maintaining a therapeutic and Safe Environment: Developing a therapeutic nurse-client relationship-Chapter 5 1. Assist the patient to develop autonomy and self-reliance 2. Identify needs and problems of patient, as well as talk about problem-solving skills, help them develop strengths and new coping skills. 3. Be encouraging, genuineness, empathize with them. c. Establishing Priorities i. Legal and Ethical Issues: Right to Refuse treatment -Chapter 2 1. Document about the restraints every 15 to 30 minutes, including events and behavior prior to restraints, actions that were taken to try about avoid restraints or seclusion, time, current behavior, if things were offered and taken: food, water, vitals, time released from restraints 2. Know the federal, state, and facility policies on use of restraints. 3. A nurse can use restraints or seclusion without first getting a provider’s written prescription if it is an emergency situation. Once you initiate restraints, the nurse should get a written prescription within 15-30 minutes. d. Health Promotion and Maintenance i. Aging Process: Brain Stimulation Therapies: Transcranial Magnetic Stimulation-Chapter 10 This study source was downloaded by from CourseH on :41:58 GMT -05:00 MENTAL HEALTH ATI TEST REMEDIATION 1. TMS is noninvasive therapy using magnetic pulsations to stimulate the cerebral cortex of the brain. It is used to treat Major depressive disorder in patient who do not respond to pharmacological treatment. 2. Considerations: TMS is prescribed daily for a period of 4-6 weeks, it is an outpatient procedure and it takes about 30-40 Minutes. The patient may feel tapping/ knocking sensation in head, scalp skin contraction, tightening of jaw muscle when the procedure is taking place. 3. Complications: Adverse effects: mild discomfort, tingling sensation at site, headache. Monitor for lightheadedness after, and Seizures. e. Psychosocial integrity i. Abuse/Neglect: Family and community violence: Interviewing a child when abuse is suspected. – Chapter 32 1. Assess for unusual bruising in areas that are not seen on a normal day such as abdomen, back, and buttock. 2. Assess for unusual fractures like forearm spiral fracture, arm or wrist fractures. Multiple fractures or fractures that are not healed correctly are also signs. 3. If needed, have the parent step out of the room so you can interview the kid on their own to ask questions. ii. Crisis Interventions: Suicide: Determining a client’s risk for suicide. – Chapter 30 1. Older adult clients: 15-40 are more likely to fall into depression because it is not treated right, loss of employment or finances, feeling isolated, prior attempts of suicide, change in functional abilities, loss of loved one, substance use/alcohol disorder. 2. Biological factors: Family history, physical disorders or diseases, 3. Psychosocial factors: sense of hopelessness, intense emotions, poor interpersonal relationships at home, school, work, no friends, developmental stressors. 4. Cultural factors: American Indian and Alaskans ethic groups have highest rate of suicide. iii. Mental Health Concepts: Personality Disorders: Identifying Manifestations of Antisocial personality disorder. -Chapter 16 1. Cluster B (Dramatic, emotional, or erratic traits) Lack of empathy, failure to accept personal responsibility 2. Sense of entitlement, manipulative, impulsive, and seductive. 3. Verbally charming and engaging, repeated unlawful actions. iv. Manifestations of Borderline personality disorder. 1. Cluster B (dramatic, emotional, or erratic traits) instability of affect, identify and relationships. 2. Splitting behaviors, manipulation, impulsiveness, and fear of abandonment This study source was downloaded by from CourseH on :41:58 GMT -05:00 3. Self-injurious and suicidal- often accompanied by impulsivity. v. Depressive Disorder: Expected findings in older adult client-Chapter 13 1. Somatic reports: fatigue, GI changes, pain 2. Anhedonia: lack of pleasure in normal activities 3. Anergia: lack of energy, feeling sluggishness or unable to relax or sit still. vi. Anxiety Disorder: Clinical Findings of Posttraumatic stress disorder- Chapter 11 1. Re-experiencing the event with distressing recollection. Like dreams, flashbacks, psychologic and physical distress 2. Persistent avoidance of stimuli that might make them remember something or memories of experiencing the trauma 3. Increased arousal vii. Stress and Defense Mechanisms: Identifying Defense mechanisms -Chapter 4 1. Altruism: dealing with anxiety by reaching out to others, sublimation: dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression, Suppression: voluntarily denying unpleasant thoughts and feelings, Repression: Unconsciously putting unacceptable ides, thoughts, and emotions out of awareness, Regression: Sudden use of childlike behavior that do not correlate with their developmental level 2. Displacement : shifting feelings related to an object, person, or situation to another less threatening object, person or situation, Reaction formation: Overcompensating or demonstrating the opposite behavior of what they are feeling, Undoing: performing an act to make up for prior behavior, Rationalization: creating reasonable and acceptable explanations for unacceptable behavior, Dissociation: Creating a temporary compartmentalization or lack of connection between the persons’ identity, memory, and how they take in the environment around them. 3. Denial : Pretending the truth is not the reality, Compensation: Emphasizing strength to make up for their weaknesses, Identification: characteristics of another individual or group, Intellectualization: Being about to separate emotions and facts when coping with a situation, Conversion: responding to a stressor by unconsciously developing a physical manifestation that is not caused by a physical illness, splitting: Demonstrating inability to reconcile negative and positive attuributes of self or others; having a patient say you are the best one day and then saying I hate you the next, Projection: Projecting thoughts and feelings into another person even when it is not them that you are made at. This study source was downloaded by from CourseH on :41:58 GMT -05:00 viii. Planning care for a client who has paranoid personality disorder-Chapter 16 1. Assess client’s neurological status- determine if there is other issue, disorders, disease that could be contributing. 2. Explaining all procedures clearly and carefully, and their purpose before starting them. 3. Minimize environment stimuli and encourage patient to socialize with others. ix. Bipolar disorder: manifestations of mania-chapter 14 1. Abnormally elevated mood: expansive or irritable, impulsivity, denial of illness 2. Manic episodes last at least a week 3. Increase talking, flight of ideas, attention seeking, neglect of ADLS f. Pharmacological and parenteral therapies i. Adverse effects/contraindications/side effects/interactions: Medications for psychotic disorders: Adverse effects of Thioridazine therapy- Chapter 24 1. Complications: Agranulocytosis and Anticholinergic effects 2. Extrapyramidal side effects: Acute dystonia, Pseudoparkinsonism, Akathisia, Tardive dyskinesia, Neuroendocrine effects, Neuroleptic malignant syndrome, orthostatic hypotension, sedation, severe dysrhythmias, sexual dysfunction, skin effects: Photosensitivity, liver impairment 3. Contraindications: do not give to patients who are in a coma or have parkinson’s disease, liver damage, or severe hypotension, or have dementia. Use caution is patient who have prostate enlargement, heart disorders, kidney disease, or seizure disorder. ii. Medication for substance use disorder: Adverse effects of Disulfiramchapter 26 1. Nausea, vomiting, weakness, sweating, palpitations, and hypotension 2. Acetaldehyde syndrome can progress to respiratory depression, cardiovascular suppression, seizures, and death. 3. Educate the patient about medication; if they ingest any alcohol they will get these symptoms. iii. Expected Actions/Outcomes: Medication for children and adolescents who have mental health issues: Evaluating client understanding of methylphenidate-Chapter 25 1. For patients with depression: improvement in moods, improved sleeping and eating habits, increased interactions with peers 2. Clients who have OCD, Panic, and anxiety disorder: reduced levels of anxiety, increased ability to recognize their symptoms, ability to perform self-care, ability to assume usual role. This study source was downloaded by from CourseH on :41:58 GMT -05:00 3. For patients who have autism spectrum disorder: decreased anger, decreased compulsive behavior. For patient who have ADHD: decreased hyperactivity, ability to pay attention. iv. Medication for substance use disorders: managing alcohol withdrawal- Chapter 26 1. Medications: Benzodiazepines: Chlordiazepoxide, Diazepam, Lorazepam, Oxazepam- decrease risk of seizures, intensity withdrawal manifestations 2. Adjunct medications: Carbamazepine, clonidine, propranolol, atenolol- Decrease seizure: carb, Depression autonomic responsedecrease bp and hr: clonidine, propranolol, atenolol, decrease cravings: propranolol, atenolol 3. Abstinence maintenance: Disulfiram-makes you sick if you ingest alcohol, Naltrexone-suppresses craving and pleasurable effects, Acamprostate-reduces unpleasant effect of abstinence like dysphoria, anxiety, and restlessness v. Substance use and addictive disorder: Medication for Generalized anxiety disorder-Chapter 18 1. SSRI- fluoxetine, paroxetine, citalopram, sertraline 2. Anxiolytic-buspirone 3. Antidepressan-Duloxetine, Venlafaxmine vi. Reduction of risk potential: Laboratory Values: Medications for bipolar disorders: Monitoring client’s laboratory results-chapter 23 1. Monitor blood-leukopenia, anemia, thrombocytopenia 2. Monitor for hypoosmolatiry: indicates water excretion by kidneys, can cause pt who has heart failure to have high risk for fluid overload 3. AST, ALT for liver function This study source was downloaded by from CourseH on :41:58 GMT -05:00 Powered by TCPDF ()