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NURS 661 Exam 1 Study Guide - Maryville University
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NURS 661 Exam 1 Study Guide - Maryville University
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NURS661 Study Guide for Exam 1 Final Copy•Know what Socratic Dialogue is and why it is used
Non-directive: therapists’ interpretations are thought to lead the patient into insight, integration, and change. Therapist guides pt. through a series of questions and answers to elicit automatic thoughts and assumption and examines the logic and evidence that relates to them. The therapist asks specific questions derived primarily from restatement of the individuals’ own words as the major technique where the individual can self-discover insight which leads to subsequent changes. Use of guided discovery using SD appears relaxed and nonconfrontational, with the therapist genuinely listening and reflecting what the patient is saying. The SD process includes seven types of questions: memory, translation, interpretation, application, analysis, synthesis, and evaluation. This type of therapy helps the patient find the answer for him or herself. This is a hallmark of CBT.
Cornerstone of CBT, therapist guides the pt through a series of questions and clarification to a point of self-discovery. Therapist doesn’t come out and say what they want to they want
pts to come to their realization •Know what the Diathesis-Stress model is what it is used for
Recognizes that genetics, nature, and the environment, stress contribute to psych disorders. Person may have genetic vulnerability & Significant stress in early life can lead to mental health disorders= change in DNA with the process of methylazation. the theory that mental and physical
disorders develop from a genetic or biological predisposition for that illness (diathesis) combined
with stressful conditions that play a precipitating or facilitating role. is a psychological theory that attempts to explain behavior as a predisposition vulnerability together with stress from life experiences. diathesis. vulnerability to mental illness. stress. a state of mental or emotional strain
or tension resulting from adverse or very demanding circumstances.
Person who has genetic vulnerability +life stressors or childhood trauma etc.= psych disorder is
TRIGGERED. (Like a predisposition) this is countered by having parental nurturing. However,
in the absence of parental nurturing regulatory and attention problems result. (Page 23, 24 Chapter 1) Think bipolar and schizophrenia as examples
Genetics, Environment and stress come together to play a part in mental health (Nature Vs Nurture)
•Know what the HPA axis and why is it important
The HPA axis regulates cortisol, a potent hormone that inhibits growth, immune responses, and
inflammatory responses.
Plays a role in ACTH, it is important because the pathway of the HPA axis results in production
of cortisol. ACTH comes from the anterior pituitary (above the brainstem). HPA plays a role in fight or flight, stress hormone. Chronic stress leads to activation of the HPA axis. Examples of chronic stress include constant work troubles, debt, and other situations that arise in everyday life.
Adrenaline (Epinephrine) is a stimulant that causes the body to prepare to fight. You want more blood in the muscles and a higher blood pressure to allow your body to resist a hit. To get
the additional blood in your muscles, your body takes it from the frontal lobe.
Many people make the mistake of substituting 'hippocampus' for 'hypothalamus.' The hypothalamus is the control center of the brain and autonomic body systems, and it is a component of the HPA axis. The three components of the HPA axis is : hypothalamus, pituitary, and adrenals.
The various chemicals released by the adrenal glands damages the body. The system functions best in short bursts, providing energy and strength at the expense of some damage. Chronis activation of the HPA axis can damage the body and lead to memory impairment, heart problems
and wearing down of the heart and muscles.
Hypothalamic pituitary and adrenal glands. Plays a role in the body’s response to stress. The pathway of the axis results to the reduction of cortisol. •Know what cortisol is and how PTSD affects cortisol production
A person with PTSD has chronically lower levels of cortisol and, when and if traumatized again, a blunted cortisol response occurs with a quicker return to baseline. Cortisol is a stress
hormone.
•Know the risk factors for eating disorders
Body image Dissatisfaction with oneself Perfectionism with their behaviors- Self orientated perfectionism “setting unrealistic high expectation of yourself” Body image distortion History of anxiety Female
Age, Lates teens (early 20s) Close relative with an eating disorder or mental condition (anxiety depression addiction) Type 1 insulin dependent
Hx of anorexia Weight stigma Teasing bullying Internalization of appearance Historical trauma
Limited social network anorexia •Know Erikson’s stages of development
Infancy (birth to 18
months)Trust Vs Mistrust •
Early childhood (18
months to 3 yrs)Autonomy Vs Self Doubt•
Late childhood (3 to 6 yrs)Initiative vs guilt •
School Age (6 to 12 yrs)Industry Vs Inferiority •
Adolescence (12 to 20 yrs)Identity Vs Role
Confusion•
Young Adulthood (20-30
yrs)Intimacy Vs Isolation •
Adulthood (30-65 yrs)Generativity Vs
Stagnation•
Old Age (65 yrs to death)Ego integrity vs despair•
(Know ages and stages of development those are associated with)
1.The conflict between trust and mistrust defines the oral-sensory stage
2.According to Erik Erikson, psychosocial identities involve the interplay between our emotional lives and our social circumstances.
3.An elderly adult who feels content about her life is experiencing ego integrity.
4.The struggle between intimacy and isolation is most common during the late adulthood stage.
5.An identity crisis is most likely to take place during the adolescent stage.
•Know Freud’s psychosexual stages
StageAgeFocus of LibidoDevelopment Adult Fixation
Oral0-1 yrmouth Feeding; could develop issues with dependency if
disruptedSmoking, biting
nails. Overeat
Anal1-3 yrsanus Toilet training; learning a sense of control, accomplishment, and
independenceOrderliness and
messiness
Phallic3-6 yrsgenital Oedipus/electra complexes. Boys and girls
will look up to their
parentsSexual dysfunction
Latent6-12 yrsNone Socialism and
development of newNo
development
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