Quiz #3 Mental Health Review PDF

Michael Elkin Quiz #3 Review Legal/Ethical Least restrictive environment Taraso= Act – Duty to warn and protect Must warn victims about pt. made threats Judgment that the patient has harmed someone or is about to injure someone...

Michael Elkin Quiz #3 Review Legal/Ethical Least restrictive environment Taraso= Act – Duty to warn and protect Must warn victims about pt. made threats Judgment that the patient has harmed someone or is about to injure someone Lack of competence – usually have a legal guardian to run everything by Domestic Violence Interventions- ask for consent IPV risk factors – Pregnancy, children under 3, suspected of wanting to leave When to contact CPS – when abuse is suspected, or knowledge of neglect or abuse is known Definition of abuse – any unwanted emotional or physical contact Sexual assault victims Give them phone numbers, 24-hour hotline, referrals, follow up appt. RN Documentation – Can be used as a legal document in court need to consent in order to examine pt. for evidence RN therapeutic communication – Sperate vulnerability from guilt Management of Aggression Procedure for application/order for restraints – no restraints should be used unless all else fails, you must get a order within the hour Least restrictive environment Procedure for responding to a psychiatric emergency – tell sta= to stay close with you, remove pt. from room with others, walk with them in the hall, talk with them Personality disorders Borderline personality Splitting Manipulative Suicidal,  Always in a crisis Always dissatisfied Best treatment – Dialectical behavior therapy (DBT) – practice lessons with di=erent outcomes approaches Splitting – black and white , no gray its either left or right Antisocial personality disorder Lack empathy, pervasive pattern, arrogant, self-centered, feel privileged, Bully, exploit others Usually diagnosed at 18 with one or more misconduct disorder characteristics before the age of 15 Interventions Correct tendency to expect others to fulfill needs Focus on self-esteem and coping patterns Encourage acting autonomously Eating Disorders Anorexia Nervosa Dehydration Osteoporosis Fatigue/Weakness Eroded tooth enamel Organ breakdown Treatment Restore healthy weight is the number one priority Nutrition rehab- have pt. slowly increase feeding to gain 1 to 2 lbs. per week Promote body image confidence Promote sleep No tube feedings Give SSRI such as Fluvoxamine Bulimia Nervosa Purging – vomiting or use of laxatives, diuretics, or emetics  Nonpurging - vomiting or use of laxatives, diuretics, enemas or overexercising Hypokalemia Tooth enamel erosion – from vomit Dietary restraints disturbed sleep patterns Risks Linked to sexual abuse Obstetric complications May overlap with anorexia nervosa Female gender Treatment Identify Triggers is the number one priority No overeaters anonymous Relapse prevention Cognitive therapy SSRIs Childhood problems Death and grieving – These are the children often express greif through somatic complaints such as that going to the nurses o=ice often and say there stomach hurts and want to go home Typically react more to others response than death itself Can become hostile Separation and divorcee Similar response to as death Sibling relationships Positive relationships are protective ones Negative ones lead to behavioral problems such as rivalry and conflict Bullying Physical illness Regression Sleep and feeding di=iculties  Behavior problems Autism Physical Safety is the #1 priority Treatments should be individualized Severe and sustained impairment in social interaction Repetitive patterns of behavior Stereotypic behaviors – hand flapping and tippy toe walking ADHD Psychostimulants is the drug of choice for patients with ADHD Adderall, Ritalin Help children concentrate but have potential for abuse Not stimulant Meds – Strattera, Circulant Conduct Disorder Serious violations of social norms under the age of 18 Destruction of property Cruelty to animals Theft and Deceitfulness Usually have outbursts such as saying “No” to setting the table Once over 18, antisocial personality disorder is the diagnosis