MH- Chapter 7
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Questions and Answers

In the context of a psychiatric nursing assessment, what type of information is primarily gathered through the patient's own statements?

  • Subjective data (correct)
  • Objective data
  • Clinical test results
  • Observable behaviors

Which element is NOT typically included in a patient's History of Present Illness (HPI) during a psychiatric assessment?

  • Details about past psychiatric hospitalizations
  • Details about suicidal thoughts
  • Results of blood tests (correct)
  • Statements regarding their reason for seeking treatment

What does an assessment of 'insight' primarily evaluate when conducting a psychiatric nursing assessment?

  • The patient's past legal history
  • The patient's current social interactions
  • The patient's ability to perform daily tasks
  • The patient's understanding of their own condition (correct)

A patient’s history of self-harm would be categorized under which component of a psychiatric nursing assessment?

<p>Psychiatric History (B)</p> Signup and view all the answers

When assessing a patient's substance use history, which of the following is NOT specifically mentioned as pertinent?

<p>Food allergies (C)</p> Signup and view all the answers

Which characteristic is essential for outcome criteria to ensure they can be evaluated effectively?

<p>Measurable (B)</p> Signup and view all the answers

During a psychiatric nursing assessment, what would be classified under social history?

<p>The patient's developmental information and relationship history (A)</p> Signup and view all the answers

When considering the patient’s reason for seeking treatment, which two factors are most critical for the nurse to assess?

<p>Voluntary or involuntary status and presenting symptoms (A)</p> Signup and view all the answers

What does it mean for an outcome to be considered 'achievable'?

<p>The goal should be realistic based on resources, patient abilities, and support. (A)</p> Signup and view all the answers

In a psychiatric context, what does assessing a patient's 'judgment' primarily involve?

<p>Their capacity to make reasonable decisions (A)</p> Signup and view all the answers

Why is it important for outcome criteria to be time-bound?

<p>To provide a sense of urgency and allow for assessment of progress. (D)</p> Signup and view all the answers

What is the focus of a 'specific' outcome criterion?

<p>To focus on a clearly defined result. (B)</p> Signup and view all the answers

How do patient-driven outcome goals improve patient care?

<p>By aligning interventions with patient motivations and preferences. (A)</p> Signup and view all the answers

What primary purpose is served by outcome criteria written in positive terms?

<p>To provide guidance for progress. (A)</p> Signup and view all the answers

In the context of identifying patient outcomes, what does it mean for goals to be 'flexible'?

<p>They can be changed based on evolving needs and conditions. (A)</p> Signup and view all the answers

What is the primary function of the 'planning' stage in the process?

<p>To select and refine approaches that will help patients achieve their expected outcomes. (C)</p> Signup and view all the answers

Which of the following is considered subjective information?

<p>Current living situation (A)</p> Signup and view all the answers

Which of the following best represents objective data?

<p>Findings from a physical examination (C)</p> Signup and view all the answers

A Mental Status Exam (MSE) primarily assesses what?

<p>Cognitive, emotional, and psychological functioning (D)</p> Signup and view all the answers

Which option correctly lists the components of a diagnostic statement?

<p>Problem, probable cause, supporting data (B)</p> Signup and view all the answers

Which principle emphasizes the importance of using current research and best practices in nursing?

<p>Evidence-based (B)</p> Signup and view all the answers

What is the primary purpose of analyzing assessment data?

<p>To determine diagnosis, problems, level of risk and areas of care (A)</p> Signup and view all the answers

What key aspect is addressed by ensuring nursing interventions are 'holistic'?

<p>Addressing the patient's physical, emotional, psychological, and social aspects (D)</p> Signup and view all the answers

What is the primary focus of patient-centered nursing interventions?

<p>Considering the patient's values and preferences in the care planning process. (B)</p> Signup and view all the answers

Why is it important for nursing interventions to be 'measurable'?

<p>To have defined outcomes that can be evaluated for effectiveness. (A)</p> Signup and view all the answers

What does 'feasibility' refer to within the context of nursing interventions?

<p>The availability of resources, time, and support for interventions. (B)</p> Signup and view all the answers

Which of the following is an example of a quantitative measure used in evaluating patient outcomes?

<p>Changes in lab values. (A)</p> Signup and view all the answers

A patient outcome of 'patient will independently manage medication' is being questioned during an evaluation for not being specific enough. What is the most likely reason?

<p>The outcome does not specify how or when independence in medication management is achieved. (D)</p> Signup and view all the answers

What is a primary consideration when evaluating the achievability of a patient's goals?

<p>The patient's current condition, lifestyle, and access to resources. (A)</p> Signup and view all the answers

An evaluation reveals that the patient's goal to reduce anxiety is not aligned with their current post-surgical recovery needs. This outcome can be described as lacking what?

<p>Relevance. (B)</p> Signup and view all the answers

Which aspect of evaluation focuses on whether the goals were evaluated at the appropriate times?

<p>Timeliness. (D)</p> Signup and view all the answers

A goal is set for a patient to 'increase mobility by the end of the week'. What additional element should be included to increase its specificity?

<p>The method and amount of mobility increase. (C)</p> Signup and view all the answers

What is the primary purpose of using qualitative observations in outcome evaluation?

<p>To gather subjective information such as patient's self-reports. (C)</p> Signup and view all the answers

Which of the following is an example of an intervention intended to meet the goal of a patient utilizing 3 coping mechanisms to help with mood regulation?

<p>Providing the patient with education about coping mechanisms. (A)</p> Signup and view all the answers

Flashcards

Subjective Information

Information directly from the patient, such as their complaints, feelings, and interpretations of events.

History of Present Illness (HPI)

A detailed account of the patient's current mental health concerns, including their own description of the problem and its onset.

Voluntary vs. Involuntary Treatment

The patient's willingness or lack thereof to seek treatment.

Suicide Risk Assessment

An assessment to determine the patient's risk of harming themself.

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Homicidal Risk Assessment

An assessment to determine the patient's risk of harming others.

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Hallucinations

False sensory perceptions that occur without any external stimulus.

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Delusions

False beliefs that are firmly held despite evidence to the contrary.

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Insight

A patient's understanding of their own condition and the impact it has on their life.

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Review of Systems

Information related to disease or illness in any of the body systems, gathered from the patient's subjective reports.

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Mental Status Exam (MSE)

A structured assessment evaluating cognitive, emotional, and psychological functioning, used to assess a patient's mental state.

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Diagnostic Statement

A statement summarizing a patient's health problem, probable cause, and supporting data.

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Diagnosis

The process of analyzing assessment data to identify patient problems and areas of care and treatment focus, including risk levels.

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Evidence-based Interventions

Interventions should be supported by current research and best practices in nursing.

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Individualized Care

Care plans should be tailored to the individual patient's needs, preferences, and circumstances.

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Safe Interventions

Interventions should prioritize patient safety and minimize risks.

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Holistic Interventions

Interventions should address the whole person, including physical, emotional, psychological, and social needs.

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Patient-Centered Care

Engage the patient in the care planning process to ensure their values and preferences are considered.

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Outcome identification

Identifying desired health changes that are measurable and attainable for the patient.

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Outcome criteria

Specific criteria outlining the desired outcome for a patient's health.

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SMART-F Goals

The criteria for a well-defined outcome should be Specific, Measurable, Achievable, Relevant, Time-bound, Patient-driven, Flexible.

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Maximal level of patient health

These outcomes should reflect the highest level of health attainable for the patient considering their condition and resources.

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Positive terms in outcomes identification

Goals should be written in a positive and proactive manner, focusing on what the patient will achieve.

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Measurable outcomes

Outcomes should be measurable to track progress and assess effectiveness of interventions.

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Patient-driven goals

The patient's needs and preferences should actively shape the goals set for their care.

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Flexible planning

The plan should be flexible and adaptable to adjust for changes in the patient's condition or new information.

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Goal Setting

A clear, measurable, achievable, relevant, and time-bound statement of what the patient should achieve by the end of care.

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Interventions

Actions or strategies used to help the patient reach their goals.

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Evaluation

A method to ensure the patient is making progress towards their goals and to assess the effectiveness of the interventions.

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Specificity

The goal should clearly state what the patient is expected to achieve.

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Measurability

The goal should include ways to measure the patient's progress toward it.

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Achievability

The goal should be realistic for the patient's current health condition, resources, and time frame.

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Relevance

The goal should be relevant to the patient's overall treatment plan.

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Timeliness

The goal should have a specific time frame for achieving it.

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Study Notes

Psychiatric Nursing Care - Assessment

  • Subjective Information: What the patient states.
  • History of Present Illness (HPI): Includes reason for seeking treatment, whether voluntary or involuntary, thought content and perceptions. Includes suicidal and homicidal ideations, hallucinations, delusions, illusions, obsessions, and ruminations. Includes insight and judgment.
  • Psychiatric History: Age of onset of symptoms, age when diagnosis was received, prior psychiatric hospitalizations and suicide attempts/self-harm history, homicidal ideation history, legal history, trauma history.
  • Substance Use History: Details caffeine, nicotine, controlled substances, and illicit substances use.
  • Social History: Developmental information, relationship history (childhood and adult), educational background, current occupation, living situation, and support systems.
  • Medical History: Details of past surgical procedures, current medications, allergies, and a review of systems.
  • Objective Information: What the nurse observes or assesses (vital signs, physical assessment, lab results, scans). Information provided that is observable.

Psychiatric Nursing Care - Diagnosis

  • Diagnosis: Analyzing assessment data, determining diagnoses, care and treatment focus, level of risk, and patient problems/potential problems.
  • Components of Diagnosis Statement: Include problem/potential problem (unmet need), probable cause, relevant supporting data (signs and symptoms).
  • Outcome Identification: Setting outcome criteria that outline patient-centered outcomes that reflect the patient's maximal potential health state attainable through interventions.
  • Principles for outcome identification: Specific, Measurable, Achievable, Relevant, and Time-bound. (SMART goals).
  • Examples of outcome criteria: Use specific, measurable, actionable descriptions to accurately represent patient and nursing goals (e.g. Patient will ambulate 50 feet using a walker).

Psychiatric Nursing Care - Planning

  • Planning Principles: Strategies to help the patient obtain expected outcomes, including the consideration of safety, compatible and appropriate interventions, realistic interventions, interventions aligned with evidence-based practice, individualized interventions, considerations for safety and feasibility, and an understanding of holistic patient needs.
  • Interventions should be: Supported by evidence-based best practices; individualized to meet the specific needs and preferences of the patient; safe; feasible, and holistic.
  • Collaborative consideration: Needs to consider the collaborative interactions with other health care professionals to provide comprehensive and interdisciplinary care plans.

Psychiatric Nursing Care - Evaluation

  • Evaluation Criteria: For each goal, ensure specificity and clarity on patient outcomes and expectations. Measures should be measurable to determine success/progress. Quantitative (lab values, vital signs), Qualitative (patient self-report), Achievability (realistic for the patient's ability and circumstances), Timeliness (consider appropriate time frames for evaluation).
  • Patient engagement: Incorporate feedback and understanding from the patient on the perceived effectiveness of interventions and progress towards goals.
  • Comparison against Standards: Compare patient outcomes against established standards to determine effectiveness in relation to best practices.
  • Analysis of factors: Analyze external factors affecting outcome, such as support systems, psychosocial factors, and adherence to the treatment plan.

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Chapter 7: Nursing Process & Standards of Care Outline PDF

Description

Test your knowledge on psychiatric nursing assessments, focusing on the key components and considerations that inform patient evaluations. This quiz covers topics such as history of present illness, insight evaluation, and substance use assessments. Perfect for nursing students and professionals looking to reinforce their understanding of psychiatric practices.

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