Psych Midterm Notes PDF

Psych \| Midterm 45 Questions --- 68 Points **Stages of Anxiety** **Therapeutic Response** --- Goal is to set up client relationship Touch --- comforting + supportive when welcomed Active listening --- concentrating exclusively on what the patient is saying Active observation --- watchin...

Psych \| Midterm 45 Questions --- 68 Points **Stages of Anxiety** **Therapeutic Response** --- Goal is to set up client relationship Touch --- comforting + supportive when welcomed Active listening --- concentrating exclusively on what the patient is saying Active observation --- watching non-verbal actions as speaker communicates **Mental Health VS Mental Illness** Mental Health -- difficult to define, no universal definition \| influencing factors: individual (personal), interpersonal (relationship), social/cultural (environmental) Mental Illness -- disorders that affect mood, behavior, thinking that cause distress + impair functioning. Factors contributing: individual (biological makeup, intolerable worries), interpersonal (ineffective communication), social/cultural (unwarranted negative view of world)  **Health History** **Cultural Competence** In psych nursing: actively listening to a patient's concerns while considering their cultural perspective on mental health, asking about their beliefs regarding illness + treatment, using cultural appropriate language, respecting personal space norms Examples: Asians with eye contact, Hispanics with their "nervous", Muslim medication regulations during Ramadan **Examples of Holistic Practices** Acupuncture Breathwork Massage Stress management Meditation Humanistic Theory - Abraham Maslow - Hierarchy of needs \| basic physiological, safety, security, love and belonging, esteem, self actualization - Carl Rogers - Client centered therapy (focus on clients role) - Unconditional positive regard, genuineness, empathetic understanding **Freud --- Psychoanalytic** - All human behavior is caused + explainable \| repressed sexual impulses, desires as motivation for behavior - Personality components --- id, ego, superego - Id: the primitive + instinctive component of personality. The id is a part of the unconscious that contains all urges and impulses; including the libido - Ego: "that part of the id which is modified by the direct influence of the external world." The YOU that you are trying to project to the external world. - Superego: moral component of the psyche, representing internalized societal values + standards Behavior motivated by subconscious thoughts, feelings \| conscious, preconscious, unconscious, Freudian slip --- dream analysis + ego defense mechanism Common defense mechanisms --- displacement, repression, sublimation, regression - Psycho-sexual stages of development - Oral - Anal - Phallic/oedipal - Latency - Genital - Transference and counter transference **Promoting Mental Health** - Creating a safe + supportive environment - Active listening - Encouraging self care - Educating about mental illness - Utilizing therapeutic communication techniques to empower patients **Stages of Grief (Kubler-Ross)** 1\. Denial 2\. Anger 3\. Bargaining 4\. Depression 5\. Acceptance **Signs of Suicide** **Ethical Principles** Autonomy --- right to self determination, independence Beneficence --- duty to benefit others or promote good Nonmaleficence --- requirement to do no harm Justice --- fairness Veracity --- honesty, truthfulness Fidelity --- obligation to honor commitments + contracts **Reactive Attachment Disorder (RAD)** --- Occurs before the age of 5 \| usually when the child is neglected in some way - Condition where a child doesn't form a healthy emotional bonds with their caretakers, usually due to physical or emotional neglect - Causes: children who have --- 1. Abuse or neglect --- child feels abandoned or alone 2. Food insecurity --- basic needs not met 3. Safety --- they feel in danger 4. Lack of hygiene --- the child sits in soiled diapers for hours 5. Multiple caretakers --- doesn't know who to trust 6. Inconsistent caretakers --- child's needs are met only for a certain period of time - Symptoms: unique but not limited to--- - Not showing positive emotion when interacting with others - Avoiding eye contact + physical touch - Expressing fear or anger by throwing tantrums or showing unhappiness and sadness - Trying to find things in their environment that they can control but makes them break the rules - Avoiding caretakers - Withdraws from social situation - Resistant to signs of comfort like hugs - Complications --- - Delays in developmental milestones - Depression, PTSD, anger management - Eating disorders - Substance abuse - Trouble in school - Problems in relationship - Treatment --- - Psychotherapy - Family therapy - Social skills - Special ed - Parenting classes **Disinhibit Social Engagement (DSED)** --- no allows, they want to be loved by anyone \| promiscuous (lots of STI) - Behavioral disorder that affects young children and is characterized by a lack of inhibition around strangers - Causes --- - Physical emotional, sexual abuse - Danger at home - Food insecurity - Trauma or violence - Symptoms --- - Be overly friendly with strangers - Go to strangers without checking with their parents - Act younger than their age - Seek out affective from others in unsafe way - Be willing to go off with any stranger without any hesitation - Treatment --- - Psychotherapy - Parenteral training **SATA: Treatment for PTSD** - Counseling + therapy (individual or group) - Medications: - SSRI's --- sertraline (Zoloft), paroxetine (Paxil), Fluoxetine (Prozac) - SNRI's --- Venlafaxine (Effexor) - **Cognitive behavioral therapy (CBT)** - **Exposure Therapy** - **Relaxation Techniques** - Cognitive processing therapy - Community based care - Mental health promotion **SATA: Factors contributing to Mental Illness** - Biological factors -- chemical imbalances Life experiences -- abuse, trauma, death Family history -- history of mental illness Substance abuse Medical conditions Environment Childhood experiences Social isolation  **First Gen --- Antipyschotic Drugs** Tx: treat symptoms of psychosis \| MOA: blocks dopamine receptors Drugs: - Chlopromazine - Fluphenazine - Thioridazine - Haloperidol - Loxapine Side effects (general): EPS (acute dystonia, pseudoparkinosism, akathisia), NMS, tardive dyskinesia, anticholinergic side effects --- dry mouth, constipation, urinary hesitancy or retention Client teaching --- adherence to regimen, management of side effects (dry mouth: sugar free candy, constipation: dietary fiber/exercise, sleepiness: safety measures) - Actions for missed dose --- dose if within four hours of usual time **Acute Dystonia -- Tx** - Torricellis, opisthotonus, oculogyric crisis - Tx: anticholinergic drugs or diphenhydramine - Anticholinergic: Benztropine or diphenhydramine - Benzodiazepine: diazepam or lorazepam - Dopamine antagonist: haloperidol or risperidone   **Dissociative Disorders** --- subconscious defense mechanism used to prevent recognition of a horrific or traumatic event \| essential feature: disruption in usually integrated functions of consciousness, memory, identity, environmental perception Types--- - Dissociative amnesia - Dissociative identity disorder - Depersonalization/derealization disorder Tx--- - Individual therapy - Group therapy that focuses on reassociation - Meds: for anxiety or depression or both **Agoraphobia**--- intense fear of being in a place where you might not have any help to get out \| ex. Escape Rooms **Anxiety Disorders**---- vague feeling or dread or apprehension Conditions in children: separation anxiety, selective mutism (unable to speak in certain situations), social anxiety (can persist into adulthood) Late life anxiety disorders: phobias (agoraphobia, GAD most common), panic attacks, ruminative thoughts (repetitive negative thoughts sort of like dwelling) Tx: SSRI **Panic Disorders** --- Tx. Deep breathing, relaxation, benzodiazepines, SSRIs, tricyclic antidepressants, antihypertensives (clonidine, propranolol) **Phobias Tx** --- **Restraints Criteria** **Inpatient hospitalization**--- **Stages of Crisis**