Mental Health Nursing Principles
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Questions and Answers

What was the primary way institutions raised money during the Middle Ages?

  • By hosting charity events
  • By selling herbs and medicine
  • By offering free treatment to the poor
  • By charging visitors to view the residents (correct)

    • What was a significant change during the Renaissance and the Reformation?

  • A rise in the number of institutions for the mentally ill
  • The closing of many Catholic institutions (correct)
  • The development of new treatments for mental illnesses
  • An improvement in the treatment of the mentally ill

    • What percentage of adults in the United States received treatment for a mental health problem in 2018?

  • 25.5%
  • 18.1% (correct)
  • 10.1%
  • 36.8%

    • Who is credited with establishing the first psychiatric hospital in the United States?

    <p>Dr. Benjamin Rush</p> Signup and view all the answers

    What was the primary belief about mental illness during medieval times?

    <p>It was a punishment for sins committed</p> Signup and view all the answers

    What was the term used to describe the view of illness that believed it was an imbalance of humors based on the fundamental elements of the world?

    <p>The humoral theory</p> Signup and view all the answers

    What was Dr. Philippe Pinel's approach to caring for the mentally ill?

    <p>He advocated humane care and maintenance of case history and conversation records</p> Signup and view all the answers

    What was a major concern in the institutions established during the 18th and 19th centuries?

    <p>Overcrowding and bureaucracy</p> Signup and view all the answers

    What was the treatment for mental illness during ancient times?

    <p>Magical treatments such as spells, potions, noises, or sacrifices</p> Signup and view all the answers

    What is the estimated percentage of people in the United States who will develop a mental health disorder in their lifetime?

    <p>60%</p> Signup and view all the answers

    What was the result of Dorothea Dix's efforts?

    <p>Millions of dollars were raised for the development of mental hospitals</p> Signup and view all the answers

    What was the focus of the Committee for Mental Hygiene established in 1909?

    <p>Prevention of mental illness and removal of the stigma of mental illness</p> Signup and view all the answers

    What is the origin of the term 'bedlam'?

    <p>From the Bethlehem Royal Hospital</p> Signup and view all the answers

    Who wrote A Mind That Found Itself, a book that described the inhumane treatment of the mentally ill?

    <p>Clifford Beers</p> Signup and view all the answers

    What is a common pattern of behaviors that are often seen in individuals with mental illness?

    <p>Conspicuous, threatening, and disruptive of relationships</p> Signup and view all the answers

    What was a significant development in the 1950s in psychiatric medicine?

    <p>The introduction of psychotherapeutic drugs</p> Signup and view all the answers

    What is a potential negative influence on mental health?

    <p>Poverty</p> Signup and view all the answers

    What is the main purpose of a nurse when encountering patients with mental health concerns?

    <p>To provide emotional support</p> Signup and view all the answers

    What is the estimated number of people who actually have a mental health disorder compared to those who receive treatment?

    <p>Three times as many</p> Signup and view all the answers

    What was the primary goal of mental health care during the deinstitutionalization movement?

    <p>To return the individual to the home environment as soon as possible</p> Signup and view all the answers

    What was the outcome of the severe fiscal cuts in 1981?

    <p>Rapid deinstitutionalization</p> Signup and view all the answers

    What is the primary focus of the holistic health movement?

    <p>Meeting the emotional needs of individuals</p> Signup and view all the answers

    What is the role of the nurse in promoting mental health?

    <p>To assess the patient's emotional state</p> Signup and view all the answers

    What is the significance of the Mental Health Care Systems Act of 1980?

    <p>It was the most comprehensive mental health care bill in US history</p> Signup and view all the answers

    What is the goal of community-based mental health care?

    <p>To provide a support system within the community</p> Signup and view all the answers

    What is the significance of Martha Mitchell's appointment to the President's Commission on Mental Health?

    <p>She was a nurse educator and clinical specialist</p> Signup and view all the answers

    What is the primary goal of nursing interventions in mental health care?

    <p>To help patients use their inner healing capacity</p> Signup and view all the answers

    What is the significance of the increase in national funding in 2018?

    <p>It supported research and services for substance abuse, veterans, and jail diversion</p> Signup and view all the answers

    What is the role of the nurse in creating a positive environment for patients?

    <p>To create an environment that allows for a positive experience</p> Signup and view all the answers

    What is the characteristic of an individual at the midpoint on the mental health continuum?

    <p>Adequate coping skills and problem-solving ability</p> Signup and view all the answers

    What is the result of continued stressor exposure on an individual's mental health?

    <p>Deterioration of mental health</p> Signup and view all the answers

    What is the primary component of mental health that determines a person's placement on the mental health continuum?

    <p>All of the above</p> Signup and view all the answers

    What is the term used to describe the consistent set of attitudes and behaviors particular to an individual?

    <p>Personality</p> Signup and view all the answers

    What is the primary influence on personality development?

    <p>Interaction between genetics and environment</p> Signup and view all the answers

    What is the characteristic of an individual at the illness end of the mental health continuum?

    <p>Loss of contact with reality</p> Signup and view all the answers

    What is the result of an inability to cope with a situation that an individual finds overwhelming?

    <p>Mental illness</p> Signup and view all the answers

    What is the framework provided by Erik Erikson to understand personality development?

    <p>Task mastery</p> Signup and view all the answers

    What is the primary function of the ego in Sigmund Freud's personality development framework?

    <p>To integrate and mediate between the self and the environment</p> Signup and view all the answers

    What is the characteristic of an individual with a positive self-concept?

    <p>Has an assertive communication style</p> Signup and view all the answers

    What is the term used to describe the total of internal and external patterns of adjustment to life?

    <p>Personality</p> Signup and view all the answers

    What level of awareness holds memories, feelings, and thoughts that are not available to the conscious mind?

    <p>Unconscious level</p> Signup and view all the answers

    What is the term for the organizing principle of the self, which includes beliefs, values, and goals in life?

    <p>Personal identity</p> Signup and view all the answers

    What is the term for the assessment one makes about personal worth, comprising thoughts and feelings about oneself?

    <p>Self-esteem</p> Signup and view all the answers

    What is the term for the mental picture of and feelings toward one's body, including feelings about appearance, function, and gender?

    <p>Body image</p> Signup and view all the answers

    What is the term for the expected behavior of an individual in a social position, which can be ascribed or assumed?

    <p>Role performance</p> Signup and view all the answers

    What is the term for the frame of reference used for all that a person knows and experiences, which includes all perceptions and values held?

    <p>Self-concept</p> Signup and view all the answers

    What is the term for the part of the psyche that is in contact with external reality and enables reasoning and good sense?

    <p>Ego</p> Signup and view all the answers

    What is the term for the moralistic censoring force that develops from the ego in response to reward or punishment?

    <p>Superego</p> Signup and view all the answers

    What is the term for the process of growth and development, through which individuals accumulate and process information to form a basic perception of themselves?

    <p>Self-concept development</p> Signup and view all the answers

    What is the primary determinant of whether an individual feels distress in response to a stressor?

    <p>The individual's perception of the stressor</p> Signup and view all the answers

    Which of the following is a characteristic of anxiety?

    <p>A vague feeling of apprehension</p> Signup and view all the answers

    What influences the degree of anxiety experienced by an individual?

    <p>The individual's perception of the stressor, the number of stressors, and the magnitude of change</p> Signup and view all the answers

    What is the result of mild levels of anxiety?

    <p>Promotion of problem-solving and constructive action</p> Signup and view all the answers

    What is the primary focus of mental health nursing?

    <p>The individual's response to the stressor</p> Signup and view all the answers

    What is a common pattern of behavior exhibited in response to anxiety?

    <p>Maladaptive behavior</p> Signup and view all the answers

    What is the role of the nurse in helping a patient develop adaptive patterns of behavior?

    <p>To serve as a resource</p> Signup and view all the answers

    What is the relationship between stress and anxiety?

    <p>Stress can lead to anxiety</p> Signup and view all the answers

    What is the impact of higher levels of anxiety on coping skills?

    <p>They immobilize coping skills</p> Signup and view all the answers

    What is the primary factor that determines an individual's response to a stressful situation or event?

    <p>The individual's learned or conditioned behavior</p> Signup and view all the answers

    What is the primary difference between a moderate and severe anxiety response?

    <p>The feeling of impending danger</p> Signup and view all the answers

    What is the primary goal of motivation in treating emotional problems?

    <p>To help the patient through the stages of recovery quickly</p> Signup and view all the answers

    What is the term used to describe the emotional response to anything that interferes with goal-directed activity?

    <p>Frustration</p> Signup and view all the answers

    What is the term used to describe the ability to adjust to changing life situations by using various strategies?

    <p>Adaptation</p> Signup and view all the answers

    What is the primary purpose of defense mechanisms in coping with anxiety?

    <p>To offer protection to the self from a stressful situation</p> Signup and view all the answers

    What is the term used to describe the process of gathering personal resources or inner drive to complete a task or reach a goal?

    <p>Motivation</p> Signup and view all the answers

    What is the primary reason why anxiety is relieved through various coping and mental mechanisms?

    <p>Because these mechanisms protect individuals from situations perceived as dangerous</p> Signup and view all the answers

    What is the primary consequence of an inability to meet basic needs or role expectations?

    <p>Emotional upheaval</p> Signup and view all the answers

    What is the primary purpose of coping responses in adjusting to stress?

    <p>To reduce anxiety brought on by stress</p> Signup and view all the answers

    What is the primary function of defense mechanisms?

    <p>To block conscious awareness of threatening feelings</p> Signup and view all the answers

    What is an example of compensation?

    <p>A boy who is small in stature and places his emphasis on academics rather than attempting sports</p> Signup and view all the answers

    What is an example of projection?

    <p>A person who attributes their own shortcomings to someone else</p> Signup and view all the answers

    What is the difference between repression and suppression?

    <p>Repression is unconscious, while suppression is conscious</p> Signup and view all the answers

    What is an example of reaction formation?

    <p>A person who is excessively polite to an individual whom they dislike</p> Signup and view all the answers

    What is dissociation?

    <p>Separation and detachment of emotional significance and affect from an idea or situation</p> Signup and view all the answers

    What is an example of regression?

    <p>An 8-year-old who reverts to bedwetting and thumb-sucking while hospitalized</p> Signup and view all the answers

    What is the purpose of rationalization?

    <p>To give untrue, but seemingly more acceptable, reasons for one's behavior</p> Signup and view all the answers

    What is the consequence of using defense mechanisms inappropriately or overusing them?

    <p>The behavior is termed maladaptive</p> Signup and view all the answers

    What is the primary reason for anxiety in hospitalized patients?

    <p>Lack of control and unfamiliar surroundings</p> Signup and view all the answers

    What is the result of unremitting losses in older adults?

    <p>Coping ability decreases</p> Signup and view all the answers

    What is the purpose of reminiscence and life review in older adults?

    <p>To cope with changing life circumstances</p> Signup and view all the answers

    What is a common pattern of behavior in older adults experiencing significant sensory changes?

    <p>Behavioral changes</p> Signup and view all the answers

    What is the primary focus of the healthcare team when meeting the psychosocial needs of patients?

    <p>Considering the patient's emotional state</p> Signup and view all the answers

    What is the result of unrecognized alcoholism in older adults?

    <p>Exacerbation of medical conditions</p> Signup and view all the answers

    What is the purpose of effective patient education?

    <p>To build trust</p> Signup and view all the answers

    What is the result of continued stressor exposure on an individual's mental health?

    <p>Negative impact on mental health</p> Signup and view all the answers

    What is the primary focus of patient support groups?

    <p>Maintaining emotional support</p> Signup and view all the answers

    What is the primary way that mental health is defined?

    <p>The ability to cope with and adjust to the recurrent stresses of everyday living</p> Signup and view all the answers

    Which of the following factors does NOT affect mental health?

    <p>Diet and nutrition</p> Signup and view all the answers

    What is the term for the way a person performs daily activities?

    <p>Behavior</p> Signup and view all the answers

    What is the result of a person's mental health fluctuating along a continuum?

    <p>It varies in accordance with the situation and available support systems</p> Signup and view all the answers

    Which of the following is an example of a positive influence on mental health?

    <p>Inherent adequate coping ability</p> Signup and view all the answers

    What is a characteristic of a mentally healthy individual?

    <p>The ability to enjoy life's activities</p> Signup and view all the answers

    Why do individuals respond differently to changes in daily activities?

    <p>Because of their unique personalities and resources</p> Signup and view all the answers

    What is the primary goal of a nurse when interacting with a patient who is experiencing a crisis?

    <p>To facilitate healthy adaptation by understanding the relationship of stressors, anxiety, and culture to behavior</p> Signup and view all the answers

    What is the range of an individual's mental health?

    <p>Dynamic and fluctuating</p> Signup and view all the answers

    What is a common behavior exhibited by individuals who are experiencing a crisis?

    <p>Denial of the situation</p> Signup and view all the answers

    What is the outcome of an individual's inability to manage a crisis successfully?

    <p>Physical illness or emotional breakdown</p> Signup and view all the answers

    What is the role of the nurse in promoting healthy adaptation in patients who are experiencing a crisis?

    <p>To set attainable short-term goals to enable the patient to be aware of their recovery and rehabilitation</p> Signup and view all the answers

    What is the term used to describe the process of an individual's emotional or situational upheaval that results in extreme or decisive change?

    <p>Identity crisis</p> Signup and view all the answers

    What is the primary focus of a nurse when interacting with patients who are experiencing a crisis?

    <p>To understand the patient's behavior and cultural background</p> Signup and view all the answers

    What is the result of an individual's inability to cope with a situation that they find overwhelming?

    <p>Crisis</p> Signup and view all the answers

    What is the term used to describe the relationship between the patient's past and their interactions with the healthcare system?

    <p>Learned behavior</p> Signup and view all the answers

    What is the goal of the nurse when assisting a patient who is experiencing a crisis?

    <p>To facilitate the patient's successful management of the crisis</p> Signup and view all the answers

    What is the significance of understanding the patient's cultural background in crisis management?

    <p>It helps the nurse to develop a treatment plan that is culturally sensitive</p> Signup and view all the answers

    What is the role of the LPN/LVN in the nursing process?

    <p>To assist the registered nurse in establishing patient problem statements</p> Signup and view all the answers

    What is the outcome of the crisis intervention process?

    <p>The crisis resolves, and the individual returns to a precrisis status or a higher functional level</p> Signup and view all the answers

    What is the purpose of the nursing process in every setting?

    <p>To meet the many needs of patients</p> Signup and view all the answers

    What is the purpose of the assessment of emotional status?

    <p>To evaluate the patient's thinking, mood, and affect</p> Signup and view all the answers

    What is the goal of the nurse during a crisis intervention?

    <p>To decrease the patient's emotional stress and protect the victim</p> Signup and view all the answers

    Study Notes

    Mental Health Concepts

    • Mental health is dynamic and fluctuates along a continuum, and mentally healthy individuals are able to enjoy life's activities, adapt to changes, set realistic goals, and maintain interpersonal relationships.
    • Factors affecting mental health include inherited characteristics, childhood nurturing, and life's circumstances, which can have positive or negative influences on an individual's response to daily stressors.
    • Mental illness or disorder is a manifestation of dysfunction (behavioral, psychological, and biological), and changes in society and the economy have altered the status and situation of many individuals.

    History of Mental Health Care

    • In ancient times, people believed that mental illness was caused by evil spirits, and shamans or medicine men used magical treatments to remove these spirits.
    • In the Greco-Roman era, the Greeks introduced the idea of explaining mental illness through observation of behavior, and Hippocrates viewed mental illness as an imbalance of humors.
    • During medieval times, the church believed that mental illness was punishment for sins, and treatments included exorcisms, physical punishment, and imprisonment.
    • In the 16th century, the first English institution for the mentally ill was founded, and the term "bedlam" originated from the hospital's nickname.
    • During the Renaissance and the Reformation, little changed in the treatment of mental illness, but in the 17th and 18th centuries, psychiatry became a separate branch of medicine, and Dr. Philippe Pinel and Dr. William Tukes introduced humane care and classification of illnesses.
    • In the United States, Dr. Benjamin Rush established the Pennsylvania Hospital for the treatment of the mentally ill, and Dorothea Dix advocated for the care of the mentally ill and led to the establishment of mental hospitals.

    Development of Mental Health Care

    • In the 20th century, the reform of mental health care began, and the Committee for Mental Hygiene was formed to focus on prevention and removal of the stigma of mental illness.
    • Sigmund Freud introduced his theories and treatment for mental illnesses, and psychotherapeutic drugs were introduced in the 1950s.
    • The government started the movement of deinstitutionalization, and community treatment became a goal, with the aim of returning individuals to their home environment and providing a support system.
    • In the 1970s and 1980s, legislatures brought about further changes in mental health treatment, and the President's Commission on Mental Health was established to assess mental health care needs.
    • Nursing is a person-oriented profession, and every interaction with a patient affords an opportunity for assessment of the patient's emotional state.
    • The nurse has the power and responsibility to create an environment that allows the patient to have a positive experience.
    • Most people have an innate ability to heal themselves, and the nurse can help the patient use this inner healing capacity through nursing interventions.

    Mental Health Continuum

    • Mental health and mental illness are the opposite ends of a mental health continuum, and functioning is normal on the healthy end of the continuum.
    • The midpoint on the continuum represents normal mental health, and the influences of daily stressors, although affecting the mentally healthy individual, do not normally disrupt mental health.
    • Loss of contact with reality can result when an individual is at the illness end of the continuum.

    Personality and Self-Concept

    • Personality refers to the relatively consistent set of attitudes and behaviors particular to an individual, and it consists of unique patterns of mental, emotional, and behavioral traits.
    • Personality development comes under the influence of genetics and interactions with the environment, and it may be viewed as the total of internal and external patterns of adjustment to life.
    • Erik Erikson provided a framework for understanding personality development in terms of task mastery, and Sigmund Freud described personality development as having three parts: id, ego, and superego.### Self-Esteem and Self-Concept
    • Self-esteem is an individual's assessment of their personal worth, comprising thoughts and feelings about themselves.
    • Self-concept is a broader term, encompassing all perceptions, values, behaviors, and interactions, and serving as a frame of reference for all experiences.

    Stress

    • Stress is a nonspecific response to any demand made on the body, which can be pleasant or unpleasant.
    • Stressors can be physical, social, economic, chemical, spiritual, or developmental, and can be combinations of these.
    • An individual's response to stress is often a learned or conditioned behavior.
    • Stress is highly subjective and can have both positive and negative effects.

    Anxiety

    • Anxiety is a vague feeling of apprehension that results from a perceived threat to the self.
    • Anxiety is a universal emotion and a response to stressful events.
    • Anxiety can be described in terms of levels, with higher levels immobilizing coping skills and resulting in emotional chaos.
    • Signs of higher levels of anxiety include vocal changes, rapid speech, increased pulse, respirations, and blood pressure, tremors, restlessness, and others.

    Motivation

    • Motivation is the inner drive to complete a task or reach a goal, generated by anticipation of reward or punishment.
    • Motivation is an important aspect in treating emotional problems, and can help patients through the stages of recovery.

    Frustration

    • Frustration is the emotional response to anything that interferes with goal-directed activity.
    • Frustration can lead to anxiety when adaptive behavior fails.

    Conflict

    • Conflict is a struggle, usually mental, resulting from the simultaneous presence of opposing or incompatible thoughts, ideas, goals, or emotional forces.
    • Conflict can lead to anxiety and can be resolved easily or lead to serious levels of anxiety.

    Adaptation and Coping

    • Adaptation refers to the ability to adjust to changing life situations using various strategies.
    • Coping responses are used to reduce anxiety brought on by stress, and can include conscious and unconscious behaviors.
    • Defense mechanisms are unconscious, intrapsychic reactions that offer protection to the self from stressful situations.

    Illness and Mental Health

    • Illness can affect mental health by reducing control and creating instability, leading to anxiety.
    • Hospitalization can exchange familiarity with unfamiliarity, leading to anxiety and emotional upheaval.
    • Nurses play a crucial role in addressing the mental health needs of patients, including providing effective patient education and support.

    Crisis

    • A crisis is an unstable period in a person's life, characterized by an inability to adapt to change from a precipitating event.

    • Successful management of a crisis period is needed to prevent disorganization within the individual or family unit.

    • Cultural and ethnic backgrounds affect the patient's and family's behavior during illness.### Crisis and Illness

    • Family members may withdraw from an ill person or the ill person may isolate themselves from the family, presenting an opportunity for personal growth and strength.

    • Phases of crisis are similar to stages in grief and dying, including:

      • Initial phase: confusion, disbelief, and high anxiety
      • Denial phase: grasping of the conviction that everything will be all right
      • Reality phase: expression of anger and remorse
      • Sadness and crying phase: acknowledgment and expression of loss
      • Reconciliation phase: acceptance of the new reality and adaptation

    Nursing Intervention in Crisis

    • Help individuals or families get through a crisis by providing accurate information and empathic gestures.
    • Identify family supports and adequate coping mechanisms to recognize family communication patterns.
    • Active listening, restating facts, and using therapeutic communication techniques can help address problems constructively.
    • Offer flexibility in visiting hours to reduce frustration of separation.
    • Crisis often resolves over a 4-6 week period, resulting in the development of coping mechanisms and redefinition of goals and roles in life.

    Crisis Intervention

    • Goals:
      • Decrease emotional stress and protect the victim
      • Assist the victim in organizing and mobilizing resources
      • Return to pre-crisis status or a higher functional level
    • Steps:
      1. Assess the situation and individual involved in the crisis
      2. Determine possible interventions with input from relevant parties
      3. Implement the intervention plan

    Assessment of Emotional Status

    • General appearance: dress, makeup, and hygiene
    • General behavior: activity level, posture, gait, and response to examination
    • Speech pattern: rate, tone, loudness, and quantity content
    • Content of thought: reality-oriented, delusional, hallucinations, or non-reality-based thinking
    • Mood and affect: overall feeling state and affect
    • Sensorial function: orientation, memory, attention, and abstract thinking ability
    • Insight and judgment: understanding of the situation and willingness to take action
    • Potential for danger: potential for violence or self-harm, degree of impulse control, and history of violence or aggression

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    Explore the basics of mental health nursing principles applied in various healthcare settings, including understanding patient behavior and responses to disease and dysfunction.

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