Podcast
Questions and Answers
What are neurocognitive disorders characterized by?
What are neurocognitive disorders characterized by?
Significant deficit in cognition or memory.
Which of the following categories does delirium fall under in DSM-5?
Which of the following categories does delirium fall under in DSM-5?
Delirium is characterized by a chronic disturbance in cognition.
Delirium is characterized by a chronic disturbance in cognition.
False
What is a common medical factor that can cause delirium?
What is a common medical factor that can cause delirium?
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Which symptoms are indicative of delirium? (Select all that apply)
Which symptoms are indicative of delirium? (Select all that apply)
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What is the key characteristic of delirium regarding its duration?
What is the key characteristic of delirium regarding its duration?
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Delirium is always irreversible.
Delirium is always irreversible.
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What should be the first step in the treatment of delirium?
What should be the first step in the treatment of delirium?
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Age ______ years and older is considered high risk for developing delirium.
Age ______ years and older is considered high risk for developing delirium.
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What is a common medication used to treat agitation in patients with delirium?
What is a common medication used to treat agitation in patients with delirium?
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What positive effects does being affiliated with a religion have on clients?
What positive effects does being affiliated with a religion have on clients?
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Why is it important to assess a client's involvement in organized religion?
Why is it important to assess a client's involvement in organized religion?
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What should be assessed to understand a client's support systems?
What should be assessed to understand a client's support systems?
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If a client has a spiritual need for love but lacks family support, what should be considered?
If a client has a spiritual need for love but lacks family support, what should be considered?
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What does DSM-5 stand for?
What does DSM-5 stand for?
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What is the primary concern when dealing with mental health clients?
What is the primary concern when dealing with mental health clients?
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Define mental health.
Define mental health.
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What hierarchy does Maslow use to define mental health?
What hierarchy does Maslow use to define mental health?
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Mental illness can interfere with a person's ability to maintain social functions.
Mental illness can interfere with a person's ability to maintain social functions.
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Which level of Maslow's hierarchy concerns the need for physical safety?
Which level of Maslow's hierarchy concerns the need for physical safety?
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What is an example of a maladaptive response to stress?
What is an example of a maladaptive response to stress?
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Maslow's Hierarchy of Needs culminates in the need for ______.
Maslow's Hierarchy of Needs culminates in the need for ______.
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Match the following stages of general adaptation syndrome with their descriptions:
Match the following stages of general adaptation syndrome with their descriptions:
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What are the four levels of anxiety?
What are the four levels of anxiety?
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Anxiety is only experienced in response to stress.
Anxiety is only experienced in response to stress.
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What are the primary moral principles that guide nursing ethics?
What are the primary moral principles that guide nursing ethics?
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What is a common coping mechanism for mild anxiety?
What is a common coping mechanism for mild anxiety?
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What does respect for autonomy mean in nursing?
What does respect for autonomy mean in nursing?
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What is the primary characteristic of panic level anxiety?
What is the primary characteristic of panic level anxiety?
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What is beneficence in the context of nursing?
What is beneficence in the context of nursing?
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What does non-malfeasance mean?
What does non-malfeasance mean?
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Which of the following is a symptom of severe anxiety?
Which of the following is a symptom of severe anxiety?
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What are the five stages of grief?
What are the five stages of grief?
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What is the significance of justice in nursing?
What is the significance of justice in nursing?
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What is required for a patient to have the right to refuse treatment?
What is required for a patient to have the right to refuse treatment?
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In the grief process, the stage where individuals may experience intense sadness is called ______.
In the grief process, the stage where individuals may experience intense sadness is called ______.
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Grief is exclusively associated with the loss of a loved one.
Grief is exclusively associated with the loss of a loved one.
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What is the difference between voluntary and involuntary admissions in mental health?
What is the difference between voluntary and involuntary admissions in mental health?
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What does the right to the least restrictive treatment alternative imply?
What does the right to the least restrictive treatment alternative imply?
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What should nurses monitor for in grieving clients?
What should nurses monitor for in grieving clients?
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Restraints and seclusion should be used as the first option in patient management.
Restraints and seclusion should be used as the first option in patient management.
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Which system is considered your emotional brain?
Which system is considered your emotional brain?
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What is the role of ethical knowledge in nursing practice?
What is the role of ethical knowledge in nursing practice?
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What is the duty to warn in mental health care?
What is the duty to warn in mental health care?
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What must be obtained before any treatment can occur?
What must be obtained before any treatment can occur?
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Cultural concepts can influence the interpretation of behavior in nursing.
Cultural concepts can influence the interpretation of behavior in nursing.
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What are some examples of spiritual needs in patients?
What are some examples of spiritual needs in patients?
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Match the following terms with their definitions:
Match the following terms with their definitions:
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Study Notes
Neurocognitive Disorders Overview
- Neurocognitive disorders involve significant cognitive deficits affecting memory and functioning.
- Classification has shifted from DSM-IV, where conditions were grouped as delirium, dementia, and amnesic disorders, to DSM-5 categorizing them into delirium and mild/major neurocognitive disorders.
- Care focuses on promoting dignity, quality of life, and providing support to families and caregivers.
Delirium Characteristics
- Delirium is an acute cognitive disturbance marked by confusion, disorientation, and altered consciousness.
- Symptoms include short-term confusion, excitement, difficulty sustaining attention, disorganized thoughts, and fluctuating consciousness.
- Emotional instability often presents as fear, anger, or anxiety.
Causes and Predisposing Factors
- Common causes include infections (e.g., UTIs), high fever, head injury, low sodium levels, or effects of anesthesia, especially in the elderly.
- Age is a key risk factor, with individuals 65 years and older being particularly vulnerable.
- Substance intoxication or withdrawal can also lead to delirium.
Symptoms of Delirium
- Difficulty maintaining attention; distractibility and disorganized thinking are common.
- Speech may be rambling, irrelevant, or incoherent.
- Disorientation concerning time and place, recent memory impairment, and presence of delusions or hallucinations may occur.
- Levels of consciousness can range from hyper-vigilance to comatose states.
- Physical symptoms might include tachycardia, high blood pressure, flushed face, and dilated pupils.
- Patients can be either hyperactive or apathetic.
Treatment Approaches
- Identify and correct underlying causes (e.g., treat infections, manage electrolyte imbalances).
- Ensure patient safety by providing continuous supervision and reassurance during episodes of hallucination.
- Maintain a calm environment with minimal stimuli.
- Communication should be clear, calm, and supportive to foster a sense of safety and optimism.
Medication Considerations
- Medication usage is reserved for addressing specific symptoms or underlying conditions; caution is exercised to avoid exacerbating delirium.
- Low-dose antipsychotics may be used for agitation and aggression.
- Benzodiazepines are common for treating substance withdrawal-related delirium.
- Haloperidol is often preferred due to its shorter half-life.
Introduction to Mental Health
- Module C introduces foundational concepts of mental health, emphasizing its relevance across all nursing contexts.
- Mental health clients will be encountered in diverse settings, including emergency rooms and outpatient clinics.
- Understanding mental health is crucial for nursing practice, necessitating knowledge of therapeutic communication and safety protocols.
Importance of Safety
- Safety is the paramount concern when dealing with mental health clients; prioritize client safety in all interactions.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
- DSM-5 is the fifth edition of a manual for classifying mental disorders.
- Provides guidelines for diagnosing mental health disorders, including descriptions and symptoms.
- Regularly updated to incorporate new findings in mental health.
Definitions of Mental Health and Mental Illness
- Mental Health: Successful adaptation to stress demonstrated through age-appropriate thoughts, feelings, and behaviors.
- Mental Illness: Maladaptive responses to stress that interfere with social, occupational, and physical functioning.
Maslow's Hierarchy of Needs
- Maslow's model serves as a guideline for assessing mental health.
- The hierarchy includes: physiological needs, safety, love and belonging, esteem, and self-actualization.
- Unmet lower-level needs lead to anxiety and distress, impacting overall mental health.
- Individuals may fluctuate between levels of the hierarchy based on life circumstances.
Stress and Coping
- Assessment of clients should involve evaluating their coping mechanisms and ability to adapt to stressors.
- Adaptive responses indicate mental health, while maladaptive responses suggest potential mental illness.
General Adaptation Syndrome
- Describes the body's physiological response to stress:
- Alarm Stage: Initial shock and burst of energy (fight or flight response).
- Resistance Stage: Body attempts to adapt; use of coping strategies to return to equilibrium.
- Exhaustion Stage: Prolonged stress leads to depletion of energy and can result in health issues (e.g., mental health disorders).
Physical Symptoms of Stress
- Stress activates the sympathetic nervous system, resulting in physical signs such as increased heart rate, dilated pupils, and changes in blood flow.
- Extended exposure to stress can compromise the immune system, leading to various health problems.
Levels of Anxiety
- Anxiety is a common response to stress but becomes problematic when it hinders daily functioning and ability to meet basic needs.
- Different levels of anxiety include:
- Mild: Normal response, manageable.
- Moderate: Increased symptoms, may require intervention.
- Severe: Interferes with functioning, needs significant support.
- Panic: Intense, overwhelming symptoms requiring immediate care.
Implications for Nursing Practice
- Nurses must recognize and respond appropriately to different anxiety levels and mental health conditions.
- Effective coping strategies and interventions are essential for supporting clients with mental health challenges.### Mild and Moderate Anxiety
- Mild anxiety is a normal response to daily stresses, enhancing alertness and readiness for action.
- Heightened senses during mild anxiety help individuals quickly assess and react to potential threats.
- Coping mechanisms for mild anxiety include exercising, studying, crying, and giving pep talks.
- Moderate anxiety leads to reduced environmental awareness, selective attention, and the need for assistance in coping.
- Defense mechanisms (denial, isolation, rationalization) are often used in moderate anxiety but may be less effective than direct coping strategies.
- Active listening and supportive interventions can help clients cope with moderate anxiety, particularly in high-stress situations.
Severe Anxiety and Panic
- Severe anxiety impairs basic functioning, with cognitive disorganization and inability to solve problems.
- Symptoms include neurosis, dissociative disorders, phobias, and panic disorders as maladaptive responses.
- Panic-level anxiety causes a complete disconnection from reality, with hallucinations and an inability to focus.
- Interventions for clients in severe and panic levels of anxiety include clear communication, maintaining safety, and potential medication administration.
- The higher the anxiety level, the lower the functional capacity of affected individuals.
Grief Response
- Grief is a subjective experience and can arise from any form of loss, not just death (e.g., loss of a job or body part).
- The process of grief involves stages, often not experienced in a linear fashion; common stages include denial, anger, bargaining, depression, and acceptance.
- The acute phase of grief typically lasts 6 to 8 weeks but may vary with age and individual circumstances.
- Prolonged or maladaptive grief can lead to significant functional impairments and requires careful assessment and intervention.
Interventions for Grieving Clients
- Providing a safe space and therapeutic silence can be vital during the acute phase of grief.
- Therapists should monitor for safety concerns, especially regarding suicidal ideation in depressed clients.
- Supportive behaviors include acknowledging grief, promoting adaptive coping, and facilitating expression of feelings.
Biological and Behavioral Factors in Mental Health
- The limbic system, hormonal imbalances, and genetic predispositions can significantly influence mental health disorders.
- Family history plays a crucial role in understanding the risk for certain mental health conditions.
- Diagnostic tools such as MRI, CT scans, PET scans, and EEGs are used to assess mental health disorders.
Ethical and Legal Considerations
- An understanding of ethical principles and legal guidelines is pivotal in nursing practice.
- Key ethical principles include autonomy (patient's right to make decisions), beneficence (promoting good), and non-malfeasance (avoiding harm).
- Nurses must provide equitable care and maintain patient confidentiality while advocating for patients’ rights.
- Client rights include access to treatment and the right to refuse treatment, applicable in both voluntary and involuntary admissions.
- Involuntary admissions occur when a patient poses a danger to self or others, but they still retain their rights to treatment.### Patient Rights and Treatment Refusal
- Patients have the legal right to refuse treatment unless immediate intervention is required to prevent death or serious harm.
- In emergencies, medication may be administered without consent to protect patients or others from harm.
- Patients, if of sound mind, can refuse medications after being informed about risks and benefits.
Least Restrictive Treatment Alternatives
- Clients should be treated in the least restrictive environment appropriate for their care needs.
- Outpatient settings are preferred for clients who do not require 24/7 hospital care.
- Restraints and seclusion should only be used as last resorts and for the shortest duration necessary.
Confidentiality and Duty to Warn
- Confidentiality is paramount in mental health treatment, but there is a duty to warn if a patient poses a risk to themselves or others.
- Legal precedents reinforce the obligation to report threats of harm, exemplified by a case involving failure to inform a victim of a potential threat.
Reporting Abuse
- Nurses are legally obligated to report suspected child and elder abuse without being judgmental.
- Reporting must be done based on observation and evidence, rather than assumptions about the family dynamics.
Informed Consent
- Patients must provide informed consent before treatment; exceptions include emergencies where informed consent cannot be obtained.
- Nurses serve as advocates, ensuring patients have adequate information before they sign consent forms.
Liabilities in Nursing
- Nurses can face liability for intentional torts (e.g., assault, false imprisonment) and unintentional torts (e.g., negligence, malpractice).
- Accurate documentation is critical to avoid legal repercussions; it should be factual and objective.
Cultural Concepts in Care
- Understanding cultural differences in communication and behavior is essential in nursing practice.
- Cultural influences extend to personal space and interpretation of actions, impacting patient interactions.
Spiritual Needs Assessment
- Spirituality is universal and provides meaning and purpose; assessing spiritual needs can inform care approaches.
- Factors like faith, hope, and love can significantly influence patient adaptation and coping strategies.
Support Systems and Community Resources
- Patients should have access to support systems, which can impact their mental health and overall coping.
- Identifying community resources is crucial for patients lacking familial support, enhancing their ability to adapt to challenges.
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Description
This quiz video discusses neurocognitive disorders, with a focus on delirium. It highlights the significant cognitive or memory deficits that distinguish these disorders from prior levels of functioning. Learn about the changes from DSM-IV to DSM-V regarding the classification of delirium.
