PMHNP-BC LMR
Priority questions...
Initial action questions... *** 1. ABC's - Airway, Breathing, Circulation
2. Maslow's Hierarchy (physiologic needs first: food, water, warmth, rest)
3. Nursing process (Assessment before intervention). Collect data to support the problem towards a
resolution.
Safety for the patient is.... *** Usually the right answer
Interprofessional collaboration... *** Is encouraged
Culture... *** Is important to be included in all nursing care
SAFETY is... *** a PRIORITY. Reassure the patient they are safe and that it is a priority
Goal of safety is... *** to ensure they are safe and can cope effectively before they leave
No harm contracts... *** Safety/no harm contract or agreement is incorrect
Pseudo dementia and depression *** Can be used simultaneously in exam
Hallmarks of vascular dementia *** Carotid bruits, fundoscopic abnormalities, enlarged cardiac
chambers
Safety starts at... *** Admission or right after the patient is admitted
,Interviewing patients... *** > In a private office with the door open or partially opened.
> Do not interview in their room or dayroom
> Safety over privacy!! People need to have access to help you if patient becomes aggressive
Doll/Toy play in sexualized way *** Report to CPS immediately
Adolescents *** > build therapeutic rapport - what they tell you is confidential unless harmful to self or
others
> No need to interview adolescents with their parents.
Adolescents and relationships *** > If consensual with a different gender of the same age = OK
> If one is older, might need to let parent know
Referring Out *** If there is something you can do before referring them out that is within your scope of
practice - help before referring
Culture expected response to a stressor = *** meaning/context = cultural syndrome = brief supportive
therapy = job/house loss
Cultural Formulation Interviews *** > Clarify meaning of illness or predicament
> Contextualize their situation in their local world
> Empower the patient
Somatic complaints of pain *** understand patient's symptoms based on context
Multicultural population *** > multicultural teaching = ethnospecific assessment parameters
,> Respect
> Native Americans - Highest ethnic suicide rate
> Imbalance between and individuals relationship with the world
Ethnic groups... *** ***Healing stick = teach nurse about cultural competency
> Choose non-confrontational answers
Release of Information (ROI) *** If patient wants you to release information to a traditional healer,
family member, or spiritual leader - this is OK, just need informed consent as it is culturally sensitive.
Cultural Syndromes *** Clusters of symptoms and attributions that tend to co-occur among those is
specific cultural groups, communities, or contexts. Recognized locally as coherent patterns of
experience.
Susto *** > "fright" common folk illness
> Latino population
> Resulting from a shocking, unpleasant, frightening experience causing the soul to leave the body
Susto Symptoms *** > appetite disturbances
> Inadequate or excessive sleep
> troubled sleep or dreams
> sadness
> Lack of motivation
> Feelings of low self worth or dirtiness
Susto somatic symptoms *** > muscle aches and pains
> headache
, > stomach ache
> diarrhea
Ataque de nervios *** > "attack of nerves"
> Puerto Rican population
> Uncontrollable shouting, attacks of crying
> trembling
> heat in the chest rising into the head
> verbal or physical aggression
Mal de ojo *** > "evil eye"
> fatigue
> headache
> weight loss
> exhaustion
> malaise
Empacho *** > "blocked intestine"
> indigestion
> feeling bloated, nausea, vomiting
Mollera caida *** sunken fontanel
"Wind-Cold" *** > Illness - concept in traditional Chinese Medicine describing a pattern of symptoms
associated with an invasion of the body by external pathogenic factors, wind and cold.
Priority questions...
Initial action questions... *** 1. ABC's - Airway, Breathing, Circulation
2. Maslow's Hierarchy (physiologic needs first: food, water, warmth, rest)
3. Nursing process (Assessment before intervention). Collect data to support the problem towards a
resolution.
Safety for the patient is.... *** Usually the right answer
Interprofessional collaboration... *** Is encouraged
Culture... *** Is important to be included in all nursing care
SAFETY is... *** a PRIORITY. Reassure the patient they are safe and that it is a priority
Goal of safety is... *** to ensure they are safe and can cope effectively before they leave
No harm contracts... *** Safety/no harm contract or agreement is incorrect
Pseudo dementia and depression *** Can be used simultaneously in exam
Hallmarks of vascular dementia *** Carotid bruits, fundoscopic abnormalities, enlarged cardiac
chambers
Safety starts at... *** Admission or right after the patient is admitted
,Interviewing patients... *** > In a private office with the door open or partially opened.
> Do not interview in their room or dayroom
> Safety over privacy!! People need to have access to help you if patient becomes aggressive
Doll/Toy play in sexualized way *** Report to CPS immediately
Adolescents *** > build therapeutic rapport - what they tell you is confidential unless harmful to self or
others
> No need to interview adolescents with their parents.
Adolescents and relationships *** > If consensual with a different gender of the same age = OK
> If one is older, might need to let parent know
Referring Out *** If there is something you can do before referring them out that is within your scope of
practice - help before referring
Culture expected response to a stressor = *** meaning/context = cultural syndrome = brief supportive
therapy = job/house loss
Cultural Formulation Interviews *** > Clarify meaning of illness or predicament
> Contextualize their situation in their local world
> Empower the patient
Somatic complaints of pain *** understand patient's symptoms based on context
Multicultural population *** > multicultural teaching = ethnospecific assessment parameters
,> Respect
> Native Americans - Highest ethnic suicide rate
> Imbalance between and individuals relationship with the world
Ethnic groups... *** ***Healing stick = teach nurse about cultural competency
> Choose non-confrontational answers
Release of Information (ROI) *** If patient wants you to release information to a traditional healer,
family member, or spiritual leader - this is OK, just need informed consent as it is culturally sensitive.
Cultural Syndromes *** Clusters of symptoms and attributions that tend to co-occur among those is
specific cultural groups, communities, or contexts. Recognized locally as coherent patterns of
experience.
Susto *** > "fright" common folk illness
> Latino population
> Resulting from a shocking, unpleasant, frightening experience causing the soul to leave the body
Susto Symptoms *** > appetite disturbances
> Inadequate or excessive sleep
> troubled sleep or dreams
> sadness
> Lack of motivation
> Feelings of low self worth or dirtiness
Susto somatic symptoms *** > muscle aches and pains
> headache
, > stomach ache
> diarrhea
Ataque de nervios *** > "attack of nerves"
> Puerto Rican population
> Uncontrollable shouting, attacks of crying
> trembling
> heat in the chest rising into the head
> verbal or physical aggression
Mal de ojo *** > "evil eye"
> fatigue
> headache
> weight loss
> exhaustion
> malaise
Empacho *** > "blocked intestine"
> indigestion
> feeling bloated, nausea, vomiting
Mollera caida *** sunken fontanel
"Wind-Cold" *** > Illness - concept in traditional Chinese Medicine describing a pattern of symptoms
associated with an invasion of the body by external pathogenic factors, wind and cold.
