HESI NSG 221: Mental Health
Countertransference - ANSCountertransference occurs when the therapist displaces onto the
client attitudes or feelings from his or her past. For example, a female nurse who has teenage
children and who is experiencing extreme frustration with an adolescent client may respond by
adopting a parental or chastising tone. The nurse is countertransfering her own attitudes and
feelings toward her children onto the client. Nurses can deal with countertransference by
examining their own feelings and responses, using self-awareness, and talking with colleagues.
Tardive Dyskinesia - ANSTardive dyskinesia (TD), a syndrome of permanent involuntary
movements, is most commonly caused by the long-term use of conventional antipsychotic
drugs. Tongue thrusting and protruding, lip smacking, blinking, grimacing, and other excessive
unnecessary facial movements are characteristic. After it has developed, TD is irreversible,
although decreasing or discontinuing antipsychotic medications can arrest its progression
Civial Rights-Psychiatric Clients - ANSClients receiving mental health care retain all civil rights
afforded to all people except the right to leave the hospital in the case of involuntary
commitment. Any restrictions (e.g., mail, visitors, clothing) must be made for a verifiable,
documented reason. These decisions can be made by a court or a designated decision-making
person or persons, for example, a primary nurse or treatment team, depending on local laws or
regulations.
Group Therapy - ANSIn group therapy, clients participate in sessions with a group of people.
The members share a common purpose and are expected to contribute to the group to benefit
others and receive benefit from others in return. Group rules are established, which all members
must observe. These rules vary according to the type of group. Being a member of a group
allows the client to learn new ways of looking at a problem or ways of coping with or solving
problems and also helps him or her learn important interpersonal skills.
Crisis Intervention-Empathy - ANSEmpathy is the ability to place oneself into the experience of
another for a moment in time. Nurses develop empathy by gathering as much information about
an issue as possible directly from the client to avoid interjecting their personal experiences and
interpretations of the situation. The nurse asks as many questions as needed to gain a clear
understanding of the client's perceptions of an event or issue.
Clarification Communication - ANSUnderstanding the context of communication is extremely
important in accurately identifying the meaning of a message. To clarify context, the nurse must
gather information from verbal and nonverbal sources and validate findings with the client.
Depressed Adolescent Rapport (use of self disclosure) - ANSSelf-disclosure means revealing
personal information such as biographical information and personal ideas, thoughts, and
feelings about oneself to clients. Now, however, it is believed that some purposeful,
well-planned self-disclosure can improve rapport between the nurse and the client. The nurse
, can use self-disclosure to convey support, educate clients, and demonstrate that a client's
anxiety is normal and that many people deal with stress and problems in their lives.
Depressed Adolescent Rapport (Establishing Rapport) - ANSWhen assessing a new patient,
establish rapport first. If not much time is available to establish rapport, or if the patient is
guarded or suspicious, you can say, "The questions I am about to ask you I ask all of my
patients," and then proceed. Some other tips include the following:
Establish rapport and connection by showing interest in the patient and by listening.
Codependent Behaviors & Alcohol Abuse - ANSCodependence is a maladaptive coping pattern
on the part of family members or others resulting from a prolonged relationship with the person
who uses substances. Characteristics of codependence are poor relationship skills, excessive
anxiety and worry, compulsive behaviors, and resistance to change. Family members learn
these dysfunctional behavior patterns as they try to adjust to the behavior of the substance user.
One type of codependent behavior is called enabling, which is a behavior that seems helpful on
the surface but actually perpetuates the substance use.
Clonidine (Catapress) - ANSSuppresses opiate withdrawal symptoms
It is given to clients with opiate dependence to suppress some effects of withdrawal or
abstinence. It is most effective against nausea, vomiting, and diarrhea, but produces modest
relief from muscle aches, anxiety, and restlessness
is an alpha-2-adrenergic agonist used to treat hypertension. It is given to clients with opiate
dependence to suppress some effects of withdrawal or abstinence. It is most effective against
nausea, vomiting, and diarrhea, but produces modest relief from muscle aches, anxiety, and
restlessness
Disulfiram (Antabuse) - ANSMaintains abstinence from alcohol
Disulfiram (Antabuse) may be prescribed to help deter clients from drinking. If a client taking
disulfiram drinks alcohol, a severe adverse reaction occurs with flushing, a throbbing headache,
sweating, nausea, and vomiting. In severe cases, severe hypotension, confusion, coma, and
even death may result.
Alcohol Detoxification - ANSAlcohol detoxification through pharmacologic means generally
takes place in a hospital setting but may occur in the home. The home care nurse shares the
responsibility for teaching patients how to use chlordiazepoxide effectively and how to recognize
medication responses that should be reported to the health care provider. The nurse instructs
the patient and/or caregivers to recognize signs and symptoms of alcohol withdrawal and
reviews the pharmacologic treatment regimen with them.
Anxiety Cognitive Behavioral Techniques - ANSCognitive-behavioral therapy (CBT) is used
successfully to treat anxiety disorders.
Positive reframing means turning negative messages into positive messages