Psychiatric-Mental Health Nursing

• The American Nurses Association's Psychiatric-Mental Health Nursing: Scope and Standards of Practice defines the role and actions of the nurse practitioner.

Primary Prevention Care

• An example of primary prevention care strategy for community behavioral health includes parenting skills classes for pregnant adolescents because information reduces incidence of disease.

Legal Rulings and Mental Illness

• Trend in legal rulings on cases involving mental illness over the past 25 years seeks to protect the person's freedoms or rights when he or she is committed to a mental hospital, ensuring the protection of individual civil liberties for psychiatric clients.

Psychiatric Clients' Rights

• Psychiatric clients can refuse treatment unless a legal process resulting in involuntary commitment or mandatory court order for treatment has been obtained.

Nurse-Client Relationship

• The primary focus is on the client and the client's needs in the nurse-client relationship. Social relationships are mutual interpersonal relationships where the needs of both parties are addressed.

Community Health

• Modifying the environment and strengthening the capacities of families to prevent new cases of depression and drug use among the teen is an illustration of primary prevention.

Voluntarily Admitted Clients

• Most states allow a brief period of detainment to assess a client for dangerousness to self or others before allowing the client to leave a hospital setting, even if the admission was voluntary.

Therapeutic Relationship

• Authenticity, being genuine, honest, and respectful, are essential in establishing a working relationship with any client.

DSM-5 Principles

• According to the DSM-5, a culturally expected response to a stressor is not a mental disorder. DSM-5 disorders need to consider a person's culture, and a cultural expression of a response to grief, loss, or stress is not considered a DSM-5 diagnosis.

Termination Phase of Therapy

• Clients frequently display resistance and regression at the termination of a therapeutic process, hence the PMHNP is responsible for planning an effective termination and monitoring clients during the termination period.

Developmental Failure

• Low self-esteem, poor self-control, self-doubt, and high level of dependency indicate developmental failure of early childhood.

Psychic Determinism Principle

• The psychic determinism principle states that all behavior has purpose and meaning, often unconscious in nature, and that no behaviors occur randomly or by coincidence.

Mature Defense Mechanism

• Suppression is the only defense mechanism listed in which the client channels conflicting energies into growth-promoting activities.

Immature Defense Mechanism

• Immature regressive defense mechanism is a return to a behavior common to an earlier stage of development.
• Defense mechanisms are a function of the ego used to resolve a conflict.

Affordable Care Act (ACA)

• One of the health care changes is healthcare clinics/systems/doctors/hospitals join together called ACOs (Accountable Care Organizations), assuming the responsibility for quality care to large groups of individuals insured by Medicare. ACO's are groups of doctors or other health care providers who voluntarily come together and assume the care provided to Medicare patients

Healthcare Economics

• Health care efficiency is making risk and benefit decision about how care resources are allocated and equity is ensuring that there is a fair distribution of the resources.

Malpractice Lawsuit

• The four elements that must be satisfied for malpractice to have occurred include: duty of care between clinician and patient, breach of standard of care, an injury to the patient, and the patient's injury must be related to the clinician's breach of care

Just Culture

• Nurses are responsible for developing health care settings that include just culture initiatives understanding that human error can cause error and harm by creating an open and fair environment.

Neurotransmitters

• Neurotransmitters in the central nervous system function as a communication medium.
• Serotonin is produced in the raphe nuclei
• Dopamine is produced in the substantia nigra.
• Appetite, sleep, and libido are regulated by the hypothalamus
• A client with a pacemaker should not receive an MRI of the head
• The primary excitatory neurotransmitter is glutamate

Frontal Lobe

• Problems with working memory, planning and prioritizing, insight into problems, and impulse control indicate a problem in the frontal lobe.

Target Symptom Identification

• Target symptom identification is the identification of specific, precise, and individualized symptoms reasonably expected to improve with a given medication.

Psychiatric Assessment

• The assessment ultimately should identify the needs of the client.

Initial Intake Assessment

• The best location to do the assessment is in a quiet place but public enough to get assistance with client care should it be required during the assessment.

Recognizing Technique

• This exchange about client lateness is an illustration of the technique of recognizing "Sorry I was late. I didn't realize what time it was." PMHNP: "This is the third time now that you have been late for our sessions. I am wondering how committed you are to our working on your problems."

Interpreting

• The best response demonstrates concrete thought processes, which are normal in persons younger than age 12 but are abnormal after age 12. To interpret the finding, the PMHNP must know the age of the client.

Working with clients

• An individual therapy model of care requires a therapeutic response to move forward with the client in the first session.
• The most therapeutic response is allowing the client to further clarify and express feelings.

Suicidal Patient TCA

• Do not use TCA's with people who are high risk for suicides.
• The PMHNP needs to assess the client's liver function as an aspect of care planning for her because the client overdosed and then was placed on a medication that affects the liver.

Comprehensive Metabolic Panel

• Client symptoms are consistent with electrolyte imbalance and a physical cause of his symptoms must be ruled out.
• Beta blockers can cause or exacerbate depression.

Sensitivity of elderly

• Older adults usually have decreased protein levels and Most psycho-tropic medications are highly protein protein meds protein bound, thus pre disposing older adults to toxicity.

Psychotropic Medication Teratogenic Effects

• Divalproex can cause spina bifida and lithium can cause Epstein's anomaly.
• Pharmacokinetics is the study of what the body does to drugs
• Tolerance means needing more to achieve the same effect.

Group Therapy

• Group therapy is beneficial because it increases social skills, is cost-effective, and enables participants to acquire the curative factors.

Cognitive Behavioral Therapy

• It helps clients recognize and change their automatic thoughts

Strategic Therapy

• Paradoxical directives are used in this type of therapy
• Homeostasis is balance or stability that the family returns to despite its dysfunction.

Solution-focused

• Miracle questions are used here

Standardized Rating Scale

• Its use will allow the PMHNP to monitor the level of client symptoms and to evaluate the efficacy of the medication for major depressive disorder.

Safety in suicidal clients

• SSRIs are considered among the first-line medications used to treat depression because of it
• Ensuring that her suicide attempt has not led to medical instability is highest priority because of safety in suicidal overdose clients.

Culture

• Ataque de nervios is best treated by brief supportive therapy by a Spanish-speaking Latino therapist in their area.

Freshmen Students

• The student does not meet criteria for alcohol use or other disorder at this point, but if he does not learn alternative coping skills to deal with his shyness, he is at risk of developing an alcohol use disorder if he continues such.

Therapeutic Alliance

• Clarify what is going on for to develop a therapeutic alliance with such.

Hepatic Enzyme

• Diminishes as age

Symptoms

• Look for 'expansive' on page 178

Obstructive sleep apnea (OSA)

• Clients have frequent awakenings and a sense that they are not sleeping deeply ("tossing and turning") that is caused by apnea.

Academic and Accredited

• APRNs degrees must be earned in such places.
• It is not within the scope of practice of a PMHNP to treat hyper-tension and Coordination of care to ensure the client does not run out of medication is the appropriate course of action.

Project

• it asses whether a standard of care was met is a quality improvement project

Legal competence

• Assessment and determination about a person's capacity to make medical decisions

Prevention of illness

• is primary prevention and administration of flu vaccinations in a community is intended to prevent a flu outbreak
• ethical principle use is Autonomy in working.

Child abuse

• PMHNPs are mandated reporters of such.

Role of the psychiatric team

• PMHNP is responsible to identify symptoms and needs of a client to develop an appropriate treatment plan is required for an interview.

Cognitive impairment Levels

• Cut points with certain amount of points on the MMSE

Assessment

• PMHNP and their responsibility is to provide data and then assess understanding and meaning with the client.

Crisis assessment

• Initial is on safety of the client and others

Neurologic Exam

• It assesses for tremors

Symptom

• Is the clients symptom

Family therapy

• Strategic for the family in paradox

Instilled Value

• Hope and similar struggles

Model

• model aspects etc.
• DBT focuses on cognitive and behavioural and many others.

DBT

• Radical acceptance and change.

TA

• Understands the the person is in anego state

Schizophrenia vs other

• They have had social and date

The role and actions of the nurse practitioner is defined by the American Nurses Association. Psychiatric clients' rights include the right to refuse treatment unless involuntary commitment has been obtained. The primary focus is on the client and the client's needs in the nurse-client relationship.