NRS 202 Exam 1 Study Guide Review PDF

NRS 202 Exam 1 Study Guide Review Mental Health Assessment & Cognitive Function Assessing cognitive function: Focus on memory recall, orientation, attention span, and ability to follow instructions. Mental status assessment: Includes appearance, behavior, cognition, and thought proce...

NRS 202 Exam 1 Study Guide Review Mental Health Assessment & Cognitive Function Assessing cognitive function: Focus on memory recall, orientation, attention span, and ability to follow instructions. Mental status assessment: Includes appearance, behavior, cognition, and thought processes. Affect vs. Mood: Affect is the outward expression (facial expressions, tone), whereas mood is the client’s emotional state. Therapeutic Communication Effective communication techniques: ○ Use open-ended questions (e.g., “Tell me more about what you are feeling.”). ○ Avoid judgmental or directive language (e.g., “You should do this.”). ○ Use reflection, active listening, and summarization. Avoid barriers to communication: Providing false reassurance (“Don’t worry, everything will be fine”), interrupting, or minimizing feelings. Legal & Ethical Considerations Client Rights: ○ Even involuntarily committed patients have the right to refuse treatment (unless court-ordered). ○ Duty to warn: If a client threatens harm to others, confidentiality can be breached. Torts in Mental Health: ○ False imprisonment: Unjustified restraint of a client. ○ Battery: Physically touching a client without consent. ○ Assault: Threatening a client with harm. Documentation: Always use objective language, e.g., “Client hit another patient and shouted ‘I will hurt you’” instead of “Client was aggressive.” Mental Health Disorders & Treatment Approaches Cognitive Behavioral Therapy (CBT): Focuses on identifying and modifying negative thought patterns.  Psychobiological Interventions: Include medication administration and monitoring for side effects. Therapeutic Milieu: A structured environment that promotes healing and social interaction. Crisis Management & Safety Handling aggression: Always ensure safety first, use de-escalation techniques, and avoid confrontation. Seclusion & Restraints: ○ Used only as a last resort. ○ Continuous monitoring is required. ○ Must have a provider’s order. Emergency Admission: Required for imminent danger to self or others. Medication Safety & Pharmacology Antidepressants: ○ SSRIs (e.g., fluoxetine): May take 4-6 weeks for full effect. ○ MAOIs (e.g., phenelzine): Avoid tyramine-rich foods (aged cheese, red wine, salami) to prevent hypertensive crisis. ○ Tricyclic Antidepressants (e.g., amitriptyline): Can cause orthostatic hypotension, dry mouth, and weight gain. Mood Stabilizers: ○ Lithium: Monitor for toxicity (signs: severe diarrhea, blurred vision, muscle weakness). Antipsychotics: ○ Haloperidol: Can cause extrapyramidal symptoms (EPS) such as muscle rigidity, shuffling gait, and tardive dyskinesia. Anxiolytics (e.g., alprazolam): ○ Risk of dependency; do not stop suddenly. ○ Avoid alcohol to prevent CNS depression. Stimulants (e.g., methylphenidate for ADHD): ○ Can cause weight loss, increased BP, and insomnia. Sedative-hypnotics (e.g., zolpidem for insomnia): ○ Take before bed; may cause daytime drowsiness. Maslow’s Hierarchy in Nursing Care  Basic physiological needs first (food, water, warmth, rest). Safety needs next (ensuring a client does not harm self or others). Self-esteem and self-actualization interventions come after physiological and safety needs are met. Dosage Calculation Review Common formulas to remember: ○ Dose calculation: (Ordered dose / Available dose) × Volume = Amount to give ○ IV flow rate: (Total volume in mL / Time in hours) = mL/hr ○ Drop factor calculation: (Volume in mL × Drop factor) / Time in minutes = gtt/min Example calculations: ○ Ordered: 250 mg, Available: 500 mg/5 mL → Give 2.5 mL. ○ Ordered: Haloperidol 1g in 100 mL over 45 min, Drop factor: 10 gtt/mL → 22 gtt/min.