Psych Exam Slam PDF

\]\] Psych Exam Slam - What can "KILL" your patient and recognizing the cues to intervene - "If the patient can have a bad side effect, end up dead, or suffer a consequence in some way -- we WILL lets you on it" - Not about stable patients - Risk Management and keeping patients...

\]\] Psych Exam Slam - What can "KILL" your patient and recognizing the cues to intervene - "If the patient can have a bad side effect, end up dead, or suffer a consequence in some way -- we WILL lets you on it" - Not about stable patients - Risk Management and keeping patients safe - Person-driven recovery - Individuals have control over their recovery journey - Importance of an individual's role in choosing their own recovery path - HCWs act in collaboration with patient/SO/family to attain optimal QOL - Multiple Pathways - This model recognizes that there is no "one-size-fits-all" approach to recovery. - Recovery can involve various interventions, including but not limited to clinical treatment, peer support, and community engagement - Because each Recovery Model - Check table 20-1 page 344&345. Patient collaboration in the mental health recovery process - Not being tested on specific models Therapeutic communication - Chapter 7 tables 7-2 & 7-3 - This is like the entire course - In non-therapeutic techniques table, the examples have better alternative statements the nurse might use - Read the non-t table and then the alternative statement to start to show your brain how this type of communication works - Think about the concepts of active listening, voicing doubt, validation, humor, or stigmatizing language - What do those look like/sound like - How might you clarify or refocus clients - Focus on LEAPs from Dr. Touw - Effective therapeutic communication is essential - Verbal as well as nonverbal - As an assessment as well as an intervention - Promoting positive patient outcomes - The importance of building therapeutic relationships - What are two key elements of therapeutic communication? - Active Listening - Involves focusing on the patient and acknowledging their concerns - What does it look like? - Empathy - Requires understanding and acknowledging the patients' feelings without judgment or getting lost in the emotions - SOLER Techniques Legal & Ethical (Chapter 5) - Will not be asked about ethical theories - Like utilitarianism, or ethical egoism - Need to know ethical principles and - ALL THE TERMS - And - HOW TO APPLY THEM - EX: - Patient Rights: Assault & Battery, false imprisonment, etc. - Ethical Principles: autonomy, beneficence, non-maleficence, veracity - Duty to warn: How to assess the situation for risk and what you do with that information - Civil Rights: voluntary or involuntary commitment - Patients right to make decisions about their care - Importance of holistic care, including psychosocial factors - Emphasis on individualized care and strengths-based approach - Can you explain why a client with a detailed plan to harm themselves would be a candidate for involuntary commitment, even without an immediate plan - A client with a detailed plan to harm themselves demonstrates a significant risk of self-harm, regardless of whether there is an immediate plan to act on it. This risk overrides their autonomy, so involuntary commitment might be necessary to ensure their safety by providing further evaluation and Stress & Coping (Chapter 1 -- The WHOLE THING) - Stress responses and effects - The body's reaction to stress can be described in stages - Alarm reaction, resistance, and exhaustion - Know the stages of stress, stress management, and coping strategies - Practice TIPL stress is everywhere -- the challenge here is to see it BEYOND someone's medical condition - Stress is emotional, physical, environmental and or a combination - While you are in clinical this week -- look for the reasons for stress in your patients and key in on how you can support that person. Use active listening - Morgan Chapter 12 Page 228 - Something on page 2 as well Suicide (Chapter 16) - Know risk factors for suicide - Review intro and table 16-1 (facts and myths) - Not testing on sociological theory - Like Durkheim's Joiner's, Klonsky and May - Review the application of the nursing process, fig 16-1, table 16-2 table 16-3 (Care plan) and continue to the end - This is ALL important - How do you assess for SI? - How do YOU as the nurse manage suicidal thoughts? - Managing suicidal thoughts - What resources would you engage to support someone in a crisis? - Additional Things - 1\. Risk Factors - Current suicidal ideation: frequency, intensity, and duration of thoughts - Suicide plan: specificity, lethality, and access to means - Previous suicide attempts: timing, method, and intent - Mental health history psychiatric diagnoses, substance abuse - Recent stressors: loss, trauma, or significant life changes - Life stressors - 2\. Protective Factors (Strengths) - Social support systems - Reasons for living - Cultural or religious beliefs that discourage suicide - 3\. Suicide Inquiry - Ideation: ask directly about suicidal thoughts - Plan: investigate specific details of any suicide plan - Behaviors: assess for any preparatory actions or rehearsals - Intent: determine the likelihood of acting on suicidal thoughts - Communicating with a suicidal client - Broaching the subject - Do not be afraid to say the word suicide - How long have you been feeling this way - Have you ever felt this way before? - Gives some context to the client's mood - May lead to a discussion about what triggered the suicidal thoughts, and - What has led him/her to this point - AKA identifying the stressors - NOT an interrogation - Takes time and patience - Many feel vulnerable and inadequate Anxiety Disorders - Focus on Dr. Touw's slides and page 571 - Panic - GAD - Agoraphobia - Social Anxiety - We will NOT test you on how to diagnose someone as in box 27 1&2 - Then skip over to 577 - Focus on anxiety 2/2 medical conditions and - Anxiety 2/2 substance/medication induced disorder - Move all the way through obsessions/compulsions including hoarding (not asking to diagnose as in box 27 3&4 - Review outcome criteria )p 581 - Care plans - Really look at Table 27-3 (outcome interventions & rationales) GAD (Generalized anxiety disorder) - What are the common symptoms of GAG? - What are the nursing interventions for someone in a state of anxiety? - What medications would you use\>? - Buspirone, SSRIs, Benzodiazepines, Beta-Blockers, Antihistamines - Vistaril (hydroxyzine) is classified as an antihistamine - Primarily used to treat anxiety, nausea, allergies, and as a sedative - Although is an antihistamine, it is commonly used for its sedative and anxiolytic properties in managing short-term anxiety and tension Medication Management -- Anxiolytics - See Dr. Touw's slides along with p593 (Table 24-7) - Chapter 4 -- p61-63 (Table 4-3\_ A black and white medical list Description automatically generated with medium confidence Schizophrenia (Chapter 24) - Make sure you understand the phases & symptoms associated with each phase of the disease - What is the significance of each phase? - Make sure you know the key Terms (p461) - Box (24-2) - Differentiate positive symptoms/negative symptoms - We are not focusing on psychobiology -- except for the dopamine hypothesis in the way that it causes symptoms in the patients - Review pg. 474-485 starting with disturbed thought processes - Focus on the terms, care plans, and the nursing interventions - P 485 -- look at the concept map - Check the interventions and outcomes - Review Psychological treatment: individual therapy, (types of) group therapy, ie, CBT, social skills, pet, art, family therapy, etc (p 486-488) Medication Management -- ANTIPSYCHOTICS (490 ch 4&24) - Page 490 - Check the sections on indications, actions - Side effects area a huge deal, what is the significance? - Make sure you can teach about the medications - Teaching is an intervention - Starting on p 73 review the content and pay attention to safety issues and nursing interventions for antipsychotics - We will no test you in the AIMSA test though you should know what it is because of the ATI - Review the antipsychotic medications - These medications primarily work by blocking dopamine receptors (particularly D2 receptors) reducing dopamine activity - This blockage can alleviate symptoms such as hallucinations, delusions, and disorganized thinking Teaching Patients/SO/Family about medication management - What is/are the indications for use? - When will I feel "better"? AKA when will the medication become effective? - When should I contact my PCP? - How do I manage the side effects? - When should I go to the ER? - When and how do I refill the prescription? - Dystonia, akathisia, medication induced parkinsonism, and tardive dyskinesia - AND how to manage each A close-up of a medical chart Description automatically generated Both generic and brand name given Involuntary and voluntary patient differences - Voluntary patients can request to leave - Involuntary is present against their will - Court ordered Practice Questions/Exams - ATI recommended for "literally everything - "I am in LOVE with ATI & Dr. Touw is in LOVE with ATI" - Weird love triangle - Dynamic quizzing - "Most successful students do ATI" Schizophrenia Patients - Can they be held if they are not harmful to themselves or others - Broaden your expectations - Can they properly take care of themselves? - Connected to resources to get a holistic understanding of the full picture - Can they organize themselves enough to function within society