psych terms from unit 3
Terms
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- congruence
- known as genuineness, conveys trust
- empathy
- ability to view a situation from the perspective of another and communicate the understanding
- positive regard
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ability to show respect,acceptance, and caring for the patient.
demonstrated through attitudes and understanding - clarity
- being clear in communication by selection and use of language most easily understood by the patient
- assertiveness
- ability to express thoughts and feelings honestly, openly, and respectfully of self and others
- trustworthiness
- the act of being responsible & dependable,adhering to commitments, and keeping promises
- restating
- known as paraphrasing, information is restated to the pt., reinforcing the idea that the nurse is actively listening
- Reflection
- pt.'s question is returned by the nurse to encourage patient acceptance of his or her own feelings and ideas
- clarification
- asking the pt to restate or clarify statements, which allows for reconsideration of what was said
- summarizing
- reviews & highlights information discussed
- What are the four phases that are necessary for the success and goal attainment of the task in the therapeutic nurse-pt relationship
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1.The pre-interaction phase
2.The orientation, or introductory phase
3.The working phase
4.The termination phase - which phase emcompassis a variety of emotional reactions,positive & negative
- the orientation or introductory phase
- What is Transference, and what phase is it part of
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orientation/intro.phase
the pt inappropriately & unconsciously displases hehavior or feelings toward the nurse - Countertransference
- the nurse displaces feelings caused by past experiences onto the patient
- Assessment info is gathered to begin formulation of a strong pt database, and Nursing diagnoses are formulated in which phase
- The orientation/introductory phase
- therapeutic tasks of the relationship are accomplished during which phase?
- the working phase
- name atleast 3 steps in the working phase
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1.pt can try new adaptive coping behaviors
2.trust & rapport established
3.evaluation of problems & goals & redefining them as necessary - termination phase
- the end of the nurse-pt relationship; the goals have been met,or the pt may be discharged from the hospital.
- when does the termination phase begin?
- when progress has been made toward goal attainment
- during the termination what goals can be formed?
- future goals can be formulated
- What are some of the goal of a crisis intervention?
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return to a pre-crisis level of function.
provide protection
reduce anxiety - what are the levels of care in crisis intervention?
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primary care
secondary care
tertiary care - primary care
- promote mental health & reduction on mental illness
- secondary care
- intervention during acute crises to pervent prolonged anxiety
- Tertiary care
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provides support to pt who have experienced or are recovering from a disabling mental state
promotes rehabilitation toward maximum level of functioning. - What therapy focuses on social functioning rather than pathophysiology?
- Milieu Therapy
- name some of the characteristics of Milieu therapy
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Emphasis on social & group interaction
rules and expectations are mediated by peer pressure
Empahasis placed on pt rights & responsiblity for involvement in goal setting
Emphasis on interdisciplinary participation - What are the three groups in Milieu therapy?
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Recreation groups
Crative arts groups
Self-care groups - Which group involves activities such as cooking,ADLs, medication administration,& community government?
- self-care group
- These groups focus on teamwork, appropriate use of leisure time, & increasing self-esteem by completion of a project. Also, encompass physical games and exercises to allow release
- Recreation groups
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The goal is for the pt to get in touch w/feelings and emotions though poetry, music, dance, and literature.
help pt who are withdrawn - Creative art groups
- What are the types of psychotherapy
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1.Classical psychoanalysis
2.Psychoanalytical psychotherapy
3.Short-term dynamic psychotherapy
4.Transactional analysis
5.Cognitive psychotherapy
6.Gestalt therapy - What is Individual Psychotherapy?
- tx based on the development of a trusting relationship between the pt and therapist
- Classical psychoanalysis
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based on Freud's personality
therapist- neutral
involves use of free association
Dream analysis is used to uncover unconsciious thoughts & feelings.
transference- the pt transfers feelings onto the therapist. - Psychoanalytical psychoanalysis
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free association,dream analysis, & transference.
Therapist much more involved w/pt.
More intimate relationship - Short-term dynamic psychotherapy
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used for more short-term problems
with a specific symptom or problem
used w/ highly motivated patients who develop a positive relationship w/ the therapist from beginning -
based on theory that people respond to each other from one of the three ego states: child,adult, or parent.
Maladaptive patterns interfere w/ relationships and effective functioning. - Transactional analysis
- cognitive psychotherapy
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assists the pt in developing insight into the way that an individual views himself.
through cognitive therapy attempts to alter dysfunctional beliefs & automatic negative thoughts
improved feelings can emerge when the pt utilizes positive thought - Gestalt therapy
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emphasizes the creative and expressive qualities of the pt. rather than negative ones.
believes only present behavior can be altered or improved
works toward uncovering repressed feelings and needs - What is Behavior Modification Therapy?
- based on the assumption that behaviors are learned and that maladaptive behavior can be unlearned. Specific observable dysfunctional patterns of behavior can be altered by means of stimulus and response conditioning.
- name the five examples of behavior therapy techniques.
- modeling,conditioning,self-control therapy, systematic desensitization, and aversion therapy.
- Modeling
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therapist provides a role model for specific identified behaviors, the pt learns through imitation.
freq. used in combination w/other therapies. - Conditioning
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based on the works of Pavlov and Skinner.
a person can learn specific behaviors if they are conditioned to do so.
use positive reinforcement -reward for good behavior, or to avoid negative responses or negative feedback - Systemic desensitization
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technique that asst. persons in overcoming the fear of a phobic stimulus.
pt slowly approaches a feared object while in a relaxed state or controlled environment` - Flooding
- similar to systemic desensitization but, the pt. is saturated with continuous images of the feared situation/object until it no longer causes anxiety.
- Aversion therapy
- used to change behavior by introduction of a negative reinforcer or unpleasant experience. Ex -mild electrical shock
- Contracting
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contract is drawn up among all parties involved.
include negative consequences d/t not meeting desired behaviors - Token economy
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provides "tokens" as rewards
used to increase,decrease,or maintain a behavior - what are meds given for Alcohol detoxification?
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Valium
Chlordiazepoxide (Librium)
disulfiram (Antabuse) - meds given for chemical substance addiction detox.
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methadone
clonidine
Valium
Haldol - Antipsychotic Drugs are useful in the tx of which disorders?
- schizophrenia,panic phase of bipolar, organic brain syndromes
- Examples of antipsychotic meds
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Phenothiazines(Thorazine, Mellaril, Prolixin)
Thioxanthenes: Navane
Butyrophenones: Haldol
Dibenzodiazepine:clozapine
Benzisoxazole: Risperdal - examples of antiparkinsonian drugs
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Benztropine mesylate (Cogentin)
Trihexyphenidyl (Artane) - What is NMS?
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Neuroleptic Malignant Syndrome
potentially fatal synd. may occur post admin of drugs that alter dopamine levels in the brain,
antipsychotic agents
withdrawl of meds that inc. CNS levels of dopamine - Common s/sx of NMS
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hyperthermia
catatonic rigidity
MSC
profuse sweating - Tx for NMS
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Antipyretics
Curare based paralytic drugs
Bromocriptine
Dantrolene - Antianxiety Drugs
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Benzodiazepines -most common
Valium
Ativan
Xanax
Non-benzodiazepine :
BuSpar
Atarax, Vistaril - How do antidepressants work?
- increases the concentration of norepinephrine, serotonin, and dopamine in the body by blocking the reuptake of those monoamines at the nerve synapse
- What are the three major categories of antidepressants?
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Tricyclic
MAO
SSRI - examples of tricyclic antidepressants
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Trazodone
Amitriptyline
Imipramine - examples of SSRIs
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Prozac
Zoloft
Paxil
Wellbutrin - What enzyme is found in food that may cause severe reactions such as hypertensive crisis and hyperthermia
- tyramine
- most common MAOIs
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Isocarboxazid (Marplan)
Phenelzine (Nardil)
Tranylcypromine (Parnate) - What are examples of foods that contain tyramine
- cheese,preserved meats, or alcohol
- Lithium is believed to act by altering______ in the nerve cell.
- alters sodium transport
- side effects of Lithium
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tremors, thirst, nausea, increased uop, & diarrhea
*toxicity may occur if renal function is impaired - What are sedative-hypnotics used for?
- short-term management of anxiety & insomnia
- caution should be used when admin. sedatives to which pts.?
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elderly- dose may need to be reduced
pts. w/hepatic or severe renal disease
*SHOULD NOT BE USED W/MAOIs - sedative-hypnotics should not be used at the same time with what?
- alcohol,antihistamines,antidepressants,phenothiazines, or any other CNS depressants.
- A pt that is acutely suicidal, refuses to eat, fails to respond to antidepressant meds, or unable to tolerate meds may receive what type of therapy?
- Electroconvulsive Therapy
- What is required for the procedure?
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Signed Informed consent
NPO several hours prior to procedure
heart rate and rhythm are mtr'd during & after the procedure.
supplemental O2
Support & maintain airway - post procedure the patient will experience what?
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short-term memory loss
disorientation - how long is ECT treatments usually gived?
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series of 2-3 per week for several weeks
*not a permanent cure