Mental Health and Therapeutic Communication Overview

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Questions and Answers

What is the primary purpose of conducting a cultural assessment in healthcare?

To determine the patient's physical health needs.

To evaluate the effectiveness of a treatment plan.

To identify cultural beliefs and practices that may impact healthcare decisions. (correct)

To establish a diagnosis for a medical condition.

Which of the following factors can cause an increase in pulse rate?

Medications that stimulate the nervous system (correct)

Consistent physical training

Deep sleep

A state of relaxation and calmness

What is the normal range for adult respiratory rate?

20-30 breaths per minute

15-25 breaths per minute

12-20 breaths per minute (correct)

10-15 breaths per minute

Why is therapeutic communication important during the history-taking process?

To build trust and promote a sense of safety. Signup and view all the answers

Which vital sign measurement is considered most reliable for determining core temperature in infants?

Rectal temperature Signup and view all the answers

Which of the following best describes the difference between mental health and mental illness?

Mental health involves coping with life stresses, whereas mental illness refers to impaired adaptation to stressors. Signup and view all the answers

What is the purpose of using ego defense mechanisms?

To protect the individual from anxiety or distress. Signup and view all the answers

Which technique is NOT considered a therapeutic communication method?

Making value judgments Signup and view all the answers

In managing suicidal patients, which action should be prioritized?

Assessing the patient’s thoughts, intentions, plan, and means. Signup and view all the answers

What is a defining characteristic of Dysthymia?

It is a chronic, milder form of depression lasting for at least two years. Signup and view all the answers

Which medication is commonly used as a mood stabilizer in bipolar disorder?

Lithium Signup and view all the answers

What distinguishes Bipolar I Disorder from Bipolar II Disorder?

Bipolar I is marked by manic episodes; Bipolar II is marked by hypomanic and depressive episodes. Signup and view all the answers

What is NOT a key technique in therapeutic communication?

Using logic to avoid emotions Signup and view all the answers

What is the primary safety concern during manic episodes?

Risk of impulsive behaviors such as hypersexuality Signup and view all the answers

Which of the following are symptoms of schizophrenia?

False beliefs and perception of things not present Signup and view all the answers

What is a common nursing intervention for patients with Body Dysmorphic Disorder?

Provide support and address distorted perceptions Signup and view all the answers

Which characteristic distinguishes delirium from dementia?

Delirium has an acute onset and identifiable causes Signup and view all the answers

For a patient with obsessive-compulsive disorder, what should the nursing care focus on?

Identifying triggers and promoting coping strategies Signup and view all the answers

Which goal is critical when managing eating disorders like anorexia nervosa?

Promoting healthy habits and gradual weight restoration Signup and view all the answers

Which therapy is effective in treating post-traumatic stress disorder (PTSD)?

Eye Movement Desensitization and Reprocessing (EMDR) Signup and view all the answers

Which disorder involves preoccupation with having a serious illness despite negative tests?

Illness Anxiety Disorder Signup and view all the answers

What should nursing care focus on for individuals with Cluster B personality disorders?

Therapeutic alliance and boundary maintenance Signup and view all the answers

What is a common sign of overdose from CNS depressants?

Altered mental status Signup and view all the answers

Which component of health history includes previous surgeries and chronic illnesses?

Past medical history Signup and view all the answers

In a functional assessment, which aspect is evaluated?

Patient's ability to perform daily living activities Signup and view all the answers

What is a key element when monitoring patients taking clozapine?

Check for agranulocytosis Signup and view all the answers

What is an example of a compulsion in obsessive-compulsive disorder?

Repetitive hand washing Signup and view all the answers

Study Notes

Mental Health Overview

Mental health & mental illness exist on a continuum.
Mental health: Coping with normal life stressors.
Mental illness: Inability to adapt to stressors, self-care deficit.

Ego Defense Mechanisms

Unconscious strategies to protect from anxiety/distress.
Denial: Refusal to acknowledge reality.
Displacement: Redirecting emotions to safer targets.
Rationalization: Justifying behaviors.
Intellectualization: Using logic to avoid emotions.
Suppression: Consciously pushing thoughts out of awareness.
Repression: Unconsciously blocking thoughts/memories.

Therapeutic Communication

Purpose: Rapport, info gathering, emotional support.
Key techniques:
- SOLER (Sit squarely, Open posture, Lean forward, Eye contact, Relax).
- Broad openings ("Tell me more about that").
- Offering self ("I am here to listen").
- General leads ("Tell me more," "Go on").
Avoid non-therapeutic techniques (advice, false reassurance, judgment).

Safety Considerations

Prioritize patient safety, especially self-harm/harm to others.
Suicide assessment:
- Ask about thoughts, intentions, plan, and means.
- Risk highest with detailed plan and access to means.

Psychiatric Disorders

Depression

Dysthymia: Chronic, milder depression (2+ years).
Major Depressive Disorder (MDD): More severe, acute, significant impairment.
Nursing care: Safety, suicide monitoring, physical activity encouragement, emotional support.

Bipolar Disorder

Bipolar I: Manic episodes (hyperactivity, poor judgment, insomnia).
Bipolar II: Hypomanic & depressive episodes.
Medications: Lithium (mood stabilizer).
- Nursing considerations: Consistent fluid/salt intake, avoid excess caffeine/diuretics, monitor for toxicity (nausea, vomiting, tremors), regular blood levels.
Mania safety: Impulsive behaviors (hypersexuality, poor judgment), priority.
Encourage nutrition (finger foods). Teamwork for management, stress reduction.

Schizophrenia

Symptoms: Major thought disturbances (delusions, hallucinations).
Delusions: False beliefs.
Hallucinations: Perception of non-existent things (auditory).
Medications: Clozapine (monitor for agranulocytosis), antipsychotics.
Nursing care: Present reality, calm/non-judgmental approach.

Body Dysmorphic Disorder

Distortion of body image. Social avoidance due to fear of judgment.
Nursing care: Support, help recognize distorted perception.

Delirium vs. Dementia

Delirium: Acute onset (medications, infections, injuries).
Nursing care: Treat underlying cause.
Dementia: Chronic, progressive, irreversible cognitive decline.
Nursing care: Safety, routine, redirection, family education.

Anxiety Disorders

Therapeutic communication: Calm, simple instructions, avoid overwhelming.
Types:
- Generalized Anxiety Disorder (GAD): Excessive worry, Buspirone may help (but not cure.)
- Phobias: Anxiety from specific stimuli (e.g., agoraphobia).
- Obsessive-Compulsive Disorder (OCD): Obsessions (intrusive thoughts), compulsions (repetitive behaviors).
Nursing care: Identify triggers, encourage coping strategies.

Eating Disorders

Anorexia Nervosa: Fear of weight gain, food avoidance, extreme weight loss.
Bulimia Nervosa: Binge eating, purging.
Binge Eating Disorder: Binge eating, no purging.
Management: Healthy habits, weight restoration (1-2 lbs/week), 1-hour post-meal observation for purging.

Post-Traumatic Stress Disorder (PTSD)

Cause: Unresolved emotional trauma (lack of support/resources).
Treatment: EMDR therapy.
Trauma-informed care: Avoid retraumatization, mindful of patient triggers.

Somatoform and Factitious Disorders

Somatoform: Anxiety manifested as physical symptoms.
Illness Anxiety Disorder: Preoccupation with serious illness, despite negative tests.
Factitious Disorder (Munchausen's Syndrome): Intentionally producing symptoms for attention/sympathy.
Dissociative Identity Disorder: Severe childhood trauma, multiple personalities.

Substance Use and Addiction

CNS depressants (alcohol, benzodiazepines, opioids): Overdose signs (bradypnea, bradycardia, hypotension, altered mental status (AMS)), withdrawal symptoms (tachypnea, tachycardia, hypertension, anxiety, agitation, tremors).
Tolerance & Withdrawal: Tolerance (higher doses for same effect).
Recovery: Accountability, honesty, long-term treatment programs.
RN diversion (substance abuse in nurses): Frequent absences, breaks, medicating for others, higher controlled substance volumes.

Personality Disorders

Clusters of personality disorders (A, B, C), different types within each.
Cluster A: Odd/eccentric (Paranoid, Schizotypal, Schizoid).
Cluster B: Dramatic/erratic (Antisocial, Borderline, Histrionic, Narcissistic).
Cluster C: Anxious/fearful (Avoidant, Dependent).
Management: Therapeutic alliance, boundaries, consistent care.

Physical Assessment (History Taking & Exam)

RN role: Recognize patient cues (subjective & objective changes).
Subjective data (symptoms): Patient reports (pain, dizziness, nausea).
Objective data (signs): Measurable info (vitals, exam findings).
Health history components:
- Chief complaint.
- History of Present Illness (HPI).
- Past medical history.
- Family history.
- Social history.
- Review of systems (ROS).
Purpose of health history: Comprehensive info to guide diagnosis & treatment.
Functional assessment components: ADLs, mobility, self-care, social interactions.
Purpose of functional assessment: Assess independence, potential issues.
Cultural assessment purpose: Identify cultural beliefs & practices affecting care.
SDOH (Social Determinants of Health): Socioeconomic barriers (income, education, access).
Identify important practices: Cultural influences on health decisions.
Use of therapeutic communication: Build trust, gather information, promote safety.
Vital signs:
- Temperature (oral, axillary, rectal - normal ranges). Fever causes.
- Pulse (newborn & adult normal ranges, factors).
- Respirations (count 1 minute - rate, depth, pattern, effort).

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Description

This quiz explores key concepts in mental health, ego defense mechanisms, and therapeutic communication techniques. Understand the continuum of mental health and illness, learn about various defense mechanisms, and master effective communication strategies. Test your knowledge on the essential aspects of mental well-being and support.