CMN 350 PSYCHIATRIC-MENTAL HEALTH NURSING EXAM #1 COMPLETE SOLUTION RATED A+
Why would someone need to be admitted into a psychiatric hospital? - If they are:
-Dangerous to self or others
-Gravely disabled
-Acutely psychotic
-Suicidal or homicidal
If patient is acutely psychotic - ...
Why would someone need to be admitted into a psychiatric hospital? - If they are:
-Dangerous to self or others
-Gravely disabled
-Acutely psychotic
-Suicidal or homicidal
If patient is acutely psychotic - -They could be placed in a long term care facility (e.g.,
group home)
-they can't take care of themselves
-most likely have schizophrenia
-may be going home with family who can take care of them
The nurse's role in psychopharmacological management - -assess patients' responses
to medication, plan to respond to side effects should they occur, implement those plans,
and evaluate for desired results.
-has a pivotal role, particularly in an inpatient setting, allows intervention before serious
drug-related problems occur. In addition, administers medications and makes decisions
regarding as needed (prn) medications.
-needs a sound foundation in it to teach patients about drugs.
-must have immediate access to information about psychotropic drugs.
The nurse's role in the therapeutic nurse-patient relationship - -is therapeutic not a
therapist
-communication skills
-respect and a desire to help
-understanding
•mental mechanisms
•adaptation styles
•coping strategies
•theraputic intervention skillls
The nurse's role in milieu management - -can change the environment
-The five environmental elements that nurses must consider in creating a therapeutic
atmosphere are the following:
1. Safety: keeping the patient free from danger or harm
2. Structure: the physical environment, regulations, and schedules
,3. Norms: specific expectations of behavior (e.g., acceptance, nonviolence, privacy)
4. Limit setting: clear and enforceable limitations on behaviors
5. Balance: negotiating the line between dependence and independence.
A nurse can disclose patient information when - -the patient is a harm to self or others
-under a subpoena
-court order
you need a court order to - force medication or you could be accused of assault and
battery
assault - making a threat to a client's person, such as approaching the client in a
threatening manner with a syringe in hand, is considered assault
battery - touching a client in a harmful or offensive way. This could occur if the nurse
threatening a client with a syringe actually grabbed the client and gave an injection.
serotonin - ↑______________ syndrome
↓depression
dopamine - ↑Schizophrenia
↓Parkinson's
norepinephrine - ↑hypertensive crisis
↓depression
GABA - ↑seizures
↓anxiety
Glutamate - ↑ Excitotoxicity leading to neuronal death
↓Psychotic thinking
Acetylcholine - ↓Alzheimer disease
Priority when dealing with patients from a different culture - -Communication
1. Do you speak any foreign languages?
2. Is English your first language?
3. Does the patient speak English fluently?
4. Does the patient prefer an interpreter?
5. Does the patient believe that appropriate touching is acceptable?
6. Does the patient use ethnic behaviors?
, 5 areas of the milieu (environment) - 1. Safety: keeping the patient free from danger or
harm
2. Structure: the physical environment, regulations, and schedules
3. Norms: specific expectations of behavior (e.g., acceptance, nonviolence, privacy)
4. Limit setting: clear and enforceable limitations on behaviors
5. Balance: negotiating the line between dependence and independence.
What the nurse must know/ do about restraints and seclusion? - Nurses who are aware
of the potential negative physical, psychological, and legal consequences associated
with restraint and seclusion are more apt to look for alternative strategies. The most
valuable interventions are aimed at preventing a patient's escalation in behavior and
loss of control. Attention to the nurse-patient relationship, therapeutic milieu, and
principles of pharmacologic management can reduce the need for restrictive measures.
Guidelines issued by the CMS for use of restraint and seclusion are substantially
different in medically necessary and behavioral control situations. Although laws differ
from state to state, general guidelines for use in psychiatry include multiple elements
important for the nurse to document.
During vthe vuse vof vrestraints vand vseclusion vthe vnurse vmust vdocument v- v v1. vStaff
vmembers vinvolved v in vdecisions vto vrestrain vor vseclude vand vstaff v who vapply v or v remove
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