NUR 305 Exam 1
Evolution of Mental Health Care - answer- ancient times: sickness was indication of
displeasure of dieties
- Time of Hippocrates/Aristotle: priests provide counseling work to mentally ill
- Early Christians: perform exorcisms, if not successful--> ostracized or killed
- medieval area: contaminated environ. thought to cause mental disorder. Removed
from "sick" environment -->asylum
- renaissance: mental illness caused by demons. Locked in prison
Recovery Model - answer-*most important goal* for individuals w/ mental disorder
- treatment is based on belief that mental illness and emotion issues are treatable,
recovery is an expectation
What are the components of recovery? - answer- hope
- self direction
- individualized/person centered
- empowerment
- holistic
- nonlinear
- strength based
- peer support
- respect
- responsibility
Deinstitutionalization - answer- release of those confined to mental institutions for long
periods of time
- Dorothea Dix believed instituatlization was contributing to the illness
Public Stigma - answer- stereotypes leading to prejudice and discrimination
- ex: being dangerous, unpredictable, unable to function independently, immoral
Self- Stigma - answer- when negative steroetypes are internalized by ppl w/ mental
illness
- they begin to believe they are unpredictable
- think they cannot bceome productive members of society
- think they may have caused their illness
- low self esteem
Epidemiology - answer*prevelance, incidence, rate*
^know those
- prevalence: total # w/ the disiroder in a population @ a given time
,- incidence: rate including only new causes occuring w/i a defined period of time
- Rate: cases in population/total cases and non cases
DSM 5 Axis Classification System - answer- new updated classification system
- single axis
- physical and psychiatric Dxs are BOTH considered medical Dxs. No boundaries
separating one disorder from another (ex: Aspergers and Autism-> no combined)
What is involved in a mental status exam for nursing assessment? - answer- General
Observations
- Orientation
- Mood/Affect
- Speech
- Thought Process
- Cognition/Intellectual Performance
(OOMASTC)
Mental Status Exam: Mood/Affect (define the two) - answer= mood: overall emotions
that a patient expresses
- affect: persons capacity to vary outward emotional expression (can be observed in
facial expressions, vocal fluctations, and gestures)
What are some different moods - answereuthymic: normal
euphoric
labile: changeable
dysphoric: depressed
What does the nurse check for during a mental status exam with thought process? -
answer- assesses for rapid change of ideas, inaility to get to the point, loose/no
connectsion among ideas and words, rhyming/repetition, unheard words
How can the nurse measure cognition and intellectual performance during a mental
status exam when testing for: Attention and Concentration - answer- start w/ 100,
substract 7 until reaching 65
How can the nurse measure cognition and intellectual performance during a mental
status exam when testing for: Abstric reasoning/comprehension - answer- give them a
proverb to interpret
How to conduct a psychosocial assessment? - answer1) Mental Status Exam
2) Behavioral Responses (depressed ptnt may cry, anxious person may twist hair)
3) Risk Factor Assessment (risk to patients safety, risk for developing disorder,...)
(where suicidal/assualtive/homicide is addressed)
Competency - answer- degree to which apatient can understand and appreciate the
information given during the consent process
, - cognitive ability to process info @ a specific time
What are some assessment areas for competence? - answer1) communicate choices:
Patient should be able to repeat what they have heard
2) Understand relevant info: patient should be able to paraphrase treatment
3) Appreciate situation and its consequences: patient shoul dbe able to discuss
disorder, need for treatment, and likely outcome
4) use of logical though process to compare risks/benefits: patient should be able to
discuss logical reasons for treatment
What are some examples of commitment criteria? - answer1) mentally disorderd
2) harm to self/others
3) unable to take care of self
What are some examples of Committment Codes - answer- 1013: 48 hours of
committment (Sat/Sun count)
- 1014: 5 days of committment (Sat/Sunday don't count)
- 2013/2014: same as 1013 and 1014 but for substance abuse
What are some types of treatment when somebody is committed? - answer- voluntary
admission: person retains full rights, free to leave @ any time
- Involuntary Committment: court ordered, w/o persons consent, possible right to refuse
treatment, provision for emergency hospitalization for 48-92 hours
Requires Nursing documentation - answer- observations of subjective/objective
physical, psychological and socal responses
- interventions iplemented and patients response
- observations of meds theraputic and side effects
- evaluation of outcomes and interventions
Duty to warn - answer- judgement that the patient has harmed someone or is about to
injure someone
- based on: Tarasoff vs. Regents of University of California
Assault
Battery - answer- threat to inflict bodily injury
- intentional/unpermitted contact with another
Medical Battery
False imprisonment - answer- treating w/o informed consent
- not discharing a voluntarily committed person upon request
Evolution of Mental Health Care - answer- ancient times: sickness was indication of
displeasure of dieties
- Time of Hippocrates/Aristotle: priests provide counseling work to mentally ill
- Early Christians: perform exorcisms, if not successful--> ostracized or killed
- medieval area: contaminated environ. thought to cause mental disorder. Removed
from "sick" environment -->asylum
- renaissance: mental illness caused by demons. Locked in prison
Recovery Model - answer-*most important goal* for individuals w/ mental disorder
- treatment is based on belief that mental illness and emotion issues are treatable,
recovery is an expectation
What are the components of recovery? - answer- hope
- self direction
- individualized/person centered
- empowerment
- holistic
- nonlinear
- strength based
- peer support
- respect
- responsibility
Deinstitutionalization - answer- release of those confined to mental institutions for long
periods of time
- Dorothea Dix believed instituatlization was contributing to the illness
Public Stigma - answer- stereotypes leading to prejudice and discrimination
- ex: being dangerous, unpredictable, unable to function independently, immoral
Self- Stigma - answer- when negative steroetypes are internalized by ppl w/ mental
illness
- they begin to believe they are unpredictable
- think they cannot bceome productive members of society
- think they may have caused their illness
- low self esteem
Epidemiology - answer*prevelance, incidence, rate*
^know those
- prevalence: total # w/ the disiroder in a population @ a given time
,- incidence: rate including only new causes occuring w/i a defined period of time
- Rate: cases in population/total cases and non cases
DSM 5 Axis Classification System - answer- new updated classification system
- single axis
- physical and psychiatric Dxs are BOTH considered medical Dxs. No boundaries
separating one disorder from another (ex: Aspergers and Autism-> no combined)
What is involved in a mental status exam for nursing assessment? - answer- General
Observations
- Orientation
- Mood/Affect
- Speech
- Thought Process
- Cognition/Intellectual Performance
(OOMASTC)
Mental Status Exam: Mood/Affect (define the two) - answer= mood: overall emotions
that a patient expresses
- affect: persons capacity to vary outward emotional expression (can be observed in
facial expressions, vocal fluctations, and gestures)
What are some different moods - answereuthymic: normal
euphoric
labile: changeable
dysphoric: depressed
What does the nurse check for during a mental status exam with thought process? -
answer- assesses for rapid change of ideas, inaility to get to the point, loose/no
connectsion among ideas and words, rhyming/repetition, unheard words
How can the nurse measure cognition and intellectual performance during a mental
status exam when testing for: Attention and Concentration - answer- start w/ 100,
substract 7 until reaching 65
How can the nurse measure cognition and intellectual performance during a mental
status exam when testing for: Abstric reasoning/comprehension - answer- give them a
proverb to interpret
How to conduct a psychosocial assessment? - answer1) Mental Status Exam
2) Behavioral Responses (depressed ptnt may cry, anxious person may twist hair)
3) Risk Factor Assessment (risk to patients safety, risk for developing disorder,...)
(where suicidal/assualtive/homicide is addressed)
Competency - answer- degree to which apatient can understand and appreciate the
information given during the consent process
, - cognitive ability to process info @ a specific time
What are some assessment areas for competence? - answer1) communicate choices:
Patient should be able to repeat what they have heard
2) Understand relevant info: patient should be able to paraphrase treatment
3) Appreciate situation and its consequences: patient shoul dbe able to discuss
disorder, need for treatment, and likely outcome
4) use of logical though process to compare risks/benefits: patient should be able to
discuss logical reasons for treatment
What are some examples of commitment criteria? - answer1) mentally disorderd
2) harm to self/others
3) unable to take care of self
What are some examples of Committment Codes - answer- 1013: 48 hours of
committment (Sat/Sun count)
- 1014: 5 days of committment (Sat/Sunday don't count)
- 2013/2014: same as 1013 and 1014 but for substance abuse
What are some types of treatment when somebody is committed? - answer- voluntary
admission: person retains full rights, free to leave @ any time
- Involuntary Committment: court ordered, w/o persons consent, possible right to refuse
treatment, provision for emergency hospitalization for 48-92 hours
Requires Nursing documentation - answer- observations of subjective/objective
physical, psychological and socal responses
- interventions iplemented and patients response
- observations of meds theraputic and side effects
- evaluation of outcomes and interventions
Duty to warn - answer- judgement that the patient has harmed someone or is about to
injure someone
- based on: Tarasoff vs. Regents of University of California
Assault
Battery - answer- threat to inflict bodily injury
- intentional/unpermitted contact with another
Medical Battery
False imprisonment - answer- treating w/o informed consent
- not discharing a voluntarily committed person upon request
