Foundations of Mental Health 2023 test bank with verified questions and answers

Art and Science of Mental Health Nursing Art - using yourself to advance health and wellbeing o your client. Science - Using theory and knowledge to advance wellness in the client. -Psychology -Environment Theory -Spirituality (Not religion) -Biological Theory -Sociocultural Theory Holism -Think genetics and susceptibility -Focus on WHOLE portion of the patient (Both strengths and weaknesses). Basics Mental health - The ability to adapt to stressors in an appropriate manner. Mental illness - Maladaptive responses tp stressors that interfere with social, occupational, and/or physical functioning. ***Must understand the culture of our patients. Theory of Adaptation Alarm stage - First encounter a stressor. -Fight or flight --Activation of sympathetic nervous system --Release epinephrine --Body prepares to FLEE or Confront stressor Resistance stage Body continues to be in hyperalert state. -Parasympathetic nervous system emerges to maintain body function while in fight or flight response -HR, RR, and blood sugar levels remain elevated. Exhaustion stage Body can only maintain state of stress for such a long time. -If stress is not dealt with, the body begins to decompensate. ----Increased susceptibility to infection/disease and possibly death. Stress & Coping Stress - Anything that causes disequilibrium between internal and external demands and an individual's ability to cope with the demands Coping - Response to address the stressor and maintain wellbeing. -Adaptive coping - Strategies to deal with stress that maintain the integrity of the individual and preserve self esteem -Maladaptive coping - Coping strategies that are ineffective in resolving conflict, deplete resources, and increase personal vulnerability (Smoking, drinking, substance abuse, exaggerating coping mechanisms). Stress Presence of a stressor + Predisposing factors (biological, sociological, an psychological) Appraisal of stressor (Subconscious) -Cognitive appraisal (harm, loss, threat, or challenge) Coping strategies available to the person -Coping mechanisms Coping -Adaptive coping leads to integrated function, supports growth and learning, and leads to achievement -Maladaptive stressors block integrated functioning and prevent growth -Decreased autonomy -Interfere with mastery of environment Emotional Responses to Stress (Peplau's stages) Mild Anxiety -Not problematic -Learning is enhanced and can be optimal. Moderate Anxiety -Begin to get tunnel vision with stressor -Less aware of environmental stimuli -Decrease in cognitive functioning -Impaired problem solving ability -Muscular tension, restlessness. Severe Anxiety -Focus on one detail or inability to focus and distracted by many details -Feelings of dread or terror -Cannot be redirected -Confused -Restless -Increased HR, RR, sweating, and chest pain Panic -Cannot focus on any detail -Loss of touch with reality -Irrational -High risk for injury to self or others -May have hallucinations or immobility (Catatonia) -Impaired cognition Reactions to Different Levels of Anxiety Mild Anxiety: eating, sleeping, yawning, drinking, exercise, and smoking. Moderate Anxiety: -Defense mechanism: compensation, denial, displacement, identification, isolation, and projection. -Psycho-physiological: H/A, anorexia, arthritis, colitis, ulcers, asthma, pain. Severe Anxiety: -Psychoneurotic: phobia, obsession, compulsions. hypochondriasis, conversion disorder. Panic Anxiety: -Psychotic: severe paranoia, thought disorders, schizophrenia. Grief Response to LOSS (May not be loss to you but is loss to the client). 5 Stages of Loss (Kubler-Ross) 1. Denial -Protective reaction -Allows the individual time to become organized and employ more adaptive coping strategies ovr the long term. 2. Anger -Characterized by envy towards others and resentment -Directed towards self, other, or God. -May fantasize or overdramatize loss. 3. Bargaining -Attempt to reverse or postpone loss -With God -May feel guilty and focus on things they wish they did prior to the loss 4. Depression -Person begins to realize and experience full extent of the loss -DIFFERENT FROM DEPRESSIVE DISORDER -Emotional state of sadness 5. Acceptance -Feeling of peace -Acknowledge of the loss as reality and the meaning of the loss in terms of moving forwards Culture Differ in: -Communication --Language, speed, paralanguage, and gestures -Spatial relations --Territoriality --Density --Distance -Social organization --Concept of families and social groups -Time --Some cultures do not have concept of time -Environment --Culture effects how we perceive and interact with our environment -Biological --Nutritional deficiencies --Processing differences --Susceptibility to disease Cultural Issues Incomprehensibility - Not understanding a culture so you perceive it as abnormal or a mental illness. Cultural Relativity - Own culture is the norm Ethnocentrism - Own culture is superior Xenophobia - Fear of others from different cultures Nurses and Culture Knowledge - helps understand cultural differences. -Need to understand self first before we can help others understand who the are. Sensitivity - respect and honor differences between cultures -The clients values and beliefs do not have to change bc they differ from ours. -If they are maladaptive, we may advocate for their change. **Need both to care for patients. Nursing Theories Peplau - Relationship with patient is tool in moving the client forward. Roy - Adapt to environment Orem - Self care Watson - Caring Travelbee - Meaning of oneself and relationship Freud's Psychoanalytic Theory Id: -Operates on pleasure principle -Most primitive Ego: -Begins around 4-6 months -Focus on reality principle -Moderator Superego: -3-6 years -Conscience -Perfection and control -Heavy influence on society Trust vs. Mistrust (0-18 months) Develop trust to mother figure and generalize it to others. Autonomy vs. Shame and Doubt (18 months - 3 years) Gain self control and independence within the environment. Initiative vs. Guilt (3-6 years) Develop sense of purpose and the ability to initiate and direct own activities. Industry vs Inferiority (6-12 years) Achieve sense of self confidence by learning, competing, performing successfully, and receiving recognition from significant others, peers, and acquaintances. Identity vs Role confusion (12-20 years) Integrate tasks of past stages and secure them into a sense of self. Intimacy vs Isolation (20-30 years) To form an intense, lasting relationship or a commitment to another person, cause, or creative effort. Generativity vs. Stagnation (30-65 years) Achieve life goals while considering welfare for future generations. Ego integrity vs. Despair (65 years) Look back and take meaning from both positive and negative events, while achieving a positive sense of self worth. Interpersonal Theory Henry Sullivan -Mental illness arises from interpersonal difficulties. -Therefore, improving interpersonal relationships resolve mental illness --Similar to Peplau Mahler's Theory Of Object Relations Separation Individualization Theory -Infant realizes they are separate from mother Cognitive Theories Piaget: Human intelligence is the individual's ability to adapt psychologically to one's environment Beck: CBT Schemas - thought patterns Ellis Rational Emotive theory - irrational beliefs cause maladaptive behavior Crisis Theory Caplan -Crisis is what brings about mental illness Maslow's Hierarchy of Needs Needs must be filled in order from physiological needs to self-actualization Phillip Pinel French Psychiatrist -Advocated for humane care of the mentally ill William Tuke English Psychiatrist similar to Phillip Pinel -Advocated for human care of the mentally ill -Created Retreat at York, which was first human home for the mentally ill in England. Benjamin Rush*** -First American to undertake psychiatry -Viewed physician-patient relationship as significant factor in patient care. Horace Mann Legislator for Massachesetts -Advocated for financial responsibility of the states for the mentally ill. -Before this, families undertook the financial burden Dorothea DIx School Teacher -In Civil War she took superidtendent of Female Nurses of the Union Army. -**Championed the cause to obtain facilities to care for the mentally ill. -Advocated for nursing to be more of a profession *Clifford Beers* Crusader for the Mentally Ill -Directly impacted the Mental Hygiene Movement which included reforming institutions that care for the mentally ill Linda Richards The first American Psychiatric nurse -Big part in establishing the first school or psychiatric nursing in the Massachusetts -McLean Asylum Emil Kraepelin German Psychiatrist -Created foundation for DSM -Observed patients with mental illness and was able to categorize their symptoms into clusters Hildegard Peplau -Interpersonal relationships in nursing -Psychiatric nurse plays vital role in developing a working relationship with the patient for recovery of mental illness. Asylums in PA PA State Lunatic Hospital -First public health institution in PA -Changed to Harrisburg State Hospital to reflect more humane care State Hospital for the Insane at Danville 2nd public mental health hospital in PA -First mental health hospital in the nation to stop use of mechanical restraints WWII and Mental Health -Changed view on Mental illness -Exposed prevalence of mental illness -Shell shock and Combat exhaustion emerged -Psychiatric services overburdened with increase in mental illness -Increase in focus on mental health nursing National Mental Health act of 1946 Provided funding for education of mental health nurses, psychiatrists, and social workers. -Around the time graduate degrees in mental health nursing came about Community Mental Health Center act of 1963 De-institutionalization of mentally ill and reintegration into community -Struggle with framework Community Mental Health Center act of 1965 Provided funding so communities could establish community mental health centers Goals of Continuum of Care Tx Setting 1. Facilitate stability, continuity, and comprehensiveness of services. 2. Maximize coordination of care. 3. Assist clients to achieve highest level of functioning with the least restrictive environment 4 Dimensions of Life in Recovery 1. Health - Physical and emotional health 2. Home - Stable and safe environment 3. Purpose - Having meaning 4. Community - Relationships and social networks --Ongoing-- TIDAL Model of Recovery Developed by Phil Barker and Poppy Buchanan Barker -Focusing on the process of change like an incoming tide -Process of story telling -Person focused model -People share their story with others