MENTAL HEALTH & PSYCHIATRIC NURSING QUESTIONS & ANSWERS

Self-awareness - ANSWERSfirst and important task that a psychiatric nurse should develop Transference - ANSWERSpatient developing an emotional attitude towards the nurse (patient views nurse as being similar to an imporant person in his/her life) Countertransference - ANSWERSthe healthcare provider's emotional reaction to the client (patient reminds the nurse of someone in his/her life) Coping Mechanism - ANSWERSconscious efforts to indicate/reflect how we adapt to problems Defense Mechanism - ANSWERSefforts performed unconsciously but are not really healthy Trust - ANSWERSmost essential component of a NPR, develops if the nurse is consistent with what he says and does. Rapport - ANSWERSspirit of harmony, cooperation, conveying a positive willingness to deal with patient. Unconditional positive regard - ANSWERSproviding respect by calling out names (not by diagnosis, room numbers), listening attentively to concerns, nonjudgmental, warm, spending time, listen actively with their concerns Setting limits - ANSWERSon the behavior, not on the patient. Conveying that the behavior is not acceptable, we tell them what behavior is considered to be acceptable (alternative). Should be done consistently. Pre-orientation / pre-interaction phase - ANSWERSPhase of the NPR where there is no interaction with the patient yet. The major task is Self-awareness. Orientation / interaction-orientation phase - ANSWERSPhase of the NPR where for the first few days, the nurse must be able to establish some activities (schedules, sessions, goal to accomplish, problems to be resolved, when is the start and end session). The Major task is to establish a mutually agreed contract with the patient. Working phase - ANSWERSlongest yet most productive phase of NPR. Nurse assists the patient in identifying and resolving problems. The major task is the patient being able to identify and resolve his/her problems. Termination phase - ANSWERSPhase of the NPR that is acknowledged in the orientation phase. Assist the client to review what was learned Moving towards independence. Major task is to implement by focusing on future-oriented topics, gradually reduce interaction time, make necessary referrals if not able to overcome feelings of separation, allow verbalization of feelings with separation (lost). Patient is able to have learnings and apply to future relationships. Sigmund Freud - ANSWERSTheorist of Psychosexual Personality Disorder Active Listening - ANSWERSTherapeutic Communication: Listening not only w/ ears but the whole body Establish eye contact, incline body a little bit forward,safe distance (3-6ft) Presenting Reality - ANSWERSTherapeutic communication: Presenting fact as it is in external reality. Therapeutic silence - ANSWERSTherapeutic Communication: Allow client to process feelings, Supportive confrontation - ANSWERSTherapeutic Communication: Citing discrepancy in patient's behavior (usually used in alcoholic clients to promote acceptance) Offering self - ANSWERSTherapeutic communication: Making yourself available for the client. The Nurse/Self is the primary tool. "Let me sit here with you for 5 minutes." Giving feedback/facilitate self-disclosure - ANSWERSTherapeutic communication: share something to the patient Giving recognition - ANSWERSTherapeutic communication: calling the patient using name; Acknowledging accomplishment; Can serve as a reward Collaborating - ANSWERSTherapeutic communication: Work with the patient and not for the patient (Primary reason: working together); Achieve a common goal Stating observation - ANSWERSTherapeutic communication: showing that you are interested; noting what you saw, not what you think you saw; keeps the client aware of what is happening Focusing - ANSWERSTherapeutic Communication: Directing back to the patient; Used when patient has Flight of Ideas (focus on main topic) "Can we focus on the topic?" Broad opening - ANSWERSTherapeutic communication: Good way of starting conversation "What do you want to talk about?" Reflecting - ANSWERSTherapeutic communication: Repeat what the patient said Direct back to the client what he said → patient must answer the question Verbalize feeling implied - Empathy Encourages verbalization of feelings "You seem angry" Shows care, relatability, acknowledge feelings "Iiwan ko naba ang aking asawa?" "Sa tingin mo, mas makakabuti ba sayo kung iiwan mo ang iyong asawa?" Accepting - ANSWERSTherapeutic communication: "Uh huh", "yes", "I follow" (listening, interested); May be interpreted as agreement (on the same page) Restating - ANSWERSTherapeutic communication: Repeating what the patient said Say it again exactly or paraphrase For confirmation "I feel blue." "Are you sad?" "Aalis nako." "Aalis ka na?" General leads - ANSWERSTherapeutic communication: More prompting (encourage the pt. sharing; let the client continue/shows interest) "Go on", "then" Summarizing - ANSWERSTherapeutic communication: Give a gist of what transpired in the conversation (what are done and not done) Give sense of accomplishment to the nurse and patient Giving information - ANSWERSTherapeutic communication: Giving Information Giving a fact that the client needs to know/learn Encouraging description of perception - ANSWERSTherapeutic communication: Letting the client judge his/her experience → for client to have acceptance of reality Reflect/analyze Clarifying - ANSWERSTherapeutic communication: Making clear what is not understood "What do you mean?" Exploring - ANSWERSTherapeutic communication: Know more about the topic; "Tell me more about it" Validating - ANSWERSTherapeutic communication: Check for mutual understanding Check if you understand patient's message "...isn't it?" ("...isn't it you are telling that you hate your mother?") "Are you getting the question?" Placing events in time sequence - ANSWERSTherapeutic communication: "When did this happen?" → organization of thoughts/details Id - ANSWERSthe pleasure, irrational principle