Psychiatric home care requirements (4)
Patient must be homebound - "That is, not able to independently leave the home due to the medical or psychiatric
... [Show More] condition"
Psychiatric diagnosis
Requires psychiatric nursing care
Plan of care is developed under orders or physician or APN
Assertive Community Treatment (ACT) is for...
These patients have had...
serious, persistent mental illness
Schizophrenia, Bipolar I, Borderline Personality Disorder
It's for patients that are unable or unwilling to participate in traditional forms of treatment
These patients have had frequent and repeated hospitalization
Observation units are used for how long?
What is addressed there?
Observation units are used for one to three days when exceptions for symptom remission are 72 hours or less
"Often" what is addressed are the psychosocial stressors that led the patient to be admitted
Inpatient care are generally in locked units why?
They have...
What is the major focus?
What must be provided?
Inpatient care are in generally locked units to prevent elopement and provide privacy
They have the same rights as any other hospitalized patient
Patient safety for self and others is the major focus
Written statements of patients rights must be provided -- often with copies of applicable state laws attached
What is therapeutic milieu?
How often are patients tracked?
Are belongings checked?
Therapeutic milieu - an all-inclusive term that recognizes the people (clients and staff, the setting, the structure, and the emotional climate) as important to healing.
Structured aspects of the milieu include activities, rules, reality orientation practices, and the environment
Client whereabouts are tracked at all times
Staff check personal property/clothing for harmful objects and visitors belongs are checked for potentially harmful objects
What is transference?
When is transference intensified?
When a patient unconsciously and inappropriately displaces onto the nurse feelings and behaviors related to significant figures in the patient's past
It's intensified in relationships of authority
It's also intensified if the patient grew up with an overbearing mother and needs authority figures to tell them what to do later in life. The patient might view the nurse as a mother figure.
What is countertransference?
What is a common sign of countertransference?
When the nurse displaces feelings related to people in the nurse's past onto the patient
Common sign of countertransference in the nurse is over-identification with the patient
In Peplau's Model of Nurse-Patient relationship, when do you explore one's own feelings and values?
During the pre-orientation phase
Examples of empathy vs sympathy?
Empathy: "This must be devastating for you"
Sympathy: "I feel so bad for you. I am sorry."
What is positive regard?
Treating everyone like they have inherent self worth regardless of the circumstances that they came to be under your care
___ of communication is nonverbal in nature
93%
What is incongruent messaging?
when the verbal and nonverbal communication are conflicting and don't match up
What are some examples of non-therapeutic communication techniques? (5)
Excessive questioning ("Sometimes students get this one confused with exploring. Exploring is "tell me more" whereas excessive questing demanding information without giving a chance to respond")
Giving approval
Giving disapproval
Giving advice
Asking "why" questions
"I'm only going to go over a few, please see the book for the full list"
Groups can promote feelings of...
cohesiveness -- this is known as altruism
What is the difference between anxiety and fear?
Anxiety effects us at a deeper level
Fear is a reaction to a specific danger whereas anxiety is a vague sense of dread related to an unspecified or unknown danger
In ____ anxiety the sympathetic nervous system symptoms begin
What are they?
moderate anxiety [Show Less]