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Mental Health

Acute Care and Legal/Ethical Guidelines

Question	Answer
Most third party payers require that at lease one of the following criteria be met to justify admission:	Risk of danger to self or others, failure of community based treatment, medical need.
Gols for acute psychiatric hospitalization tend to include the following:	Prevention of self harm or harm to others, stabilization of crisis with a return to community based services, initiation or modification of psychotropic meds; brief, specific problem solving to enable pt gain/regain of state of compensation, outpatient.
These seek to standardize the daily expected outcomes for patients.	clinical pathways
Any systematic program that coordinates individual patient care throughout the organizationally defined continuum of services and settings.	Psychiatric Case Management
The therapeutic milieu operates on the understanding that	The community can serve as a real-life training ground for learning about self and for practicing communication and coping skills for a return to the community outside the hospital.
Documentation of the patient's progress is the responsibility of	The entire mental health team.
Inpatient psychiatric nursing requires stron skills in	Management, communication and collaboration.
Basic level interventions include:	Counseling, crisis management, milieu therapy, health teaching and psychobiological interventions.
When the mental health team meets initially to plan care (within 72 hours) on an inpatient unit, the outcome should be	An interdisciplinary care plan delineating assessments, interventions, treatents, and outcomes across a time line.
What goal should be evaluated as met prior to a patients discharge fro an inpatient psychiatric unit?	The admission crisis is resolved.
Maintaining an atmosphere in which healing and growth can take place, where nurses strive to keep communications and interpersonal feedback open and constructively honest.	Therapeutic Milieu
This member of the psychiatric inpation unit staff anticipates, prevents, and manages emergencies and crises on the unit	Nurse
The primary advantage of using a case manager is to	Enhance resource management.
A client is admitted to the psychiatric inpatient unit for the first time after a suicide attempt. The nurse can expect that, like most clients, he will experience some	Anxiety
How are clients' rights affected after admission to a behavioral health unit?	Rights as citizens remain intact.
In a behavioral managed care system, if a client who has stopped taking psychotropic medication requires hospitalization for crisis management, what length of stay would be identified in the treatment plan?	Less than 1 week.
An ongoing, critically important responsibility of nurses working on an inpatient psychiatric unit is	milieu management
In most inpatient psychiatric units administration of medications is expected to involve	Clients coming to a central location to receive medication.
Providing for client safety would be a characteristic of	Therapeutic Inpatient Milieu
When a number of staff gather to provide silent support for a staff member who has given a directive to a client in an attempt to deescalate a crisis, the intervention is called	A show of force.
A client with prolonged mental illness was readmitted when symptoms exacerbated after she stopped taking prescribed medication. The client lives alone and has few outside activities. To prepare the client for discharge the nurse will focus on	Psychoeducation to promote medication compliance.
Arranging for rapid assessment of a newly hospitalized client best exemplifies an important focus for a	Case Manager
The patient has the right to _______ or ______ visitors.	Choose or refuse.
The fundamental goal in resolving any legal or ethical issue confronting the nurse in a psychiatric setting is	Striking a balance between the rights of the individual client and the rights of society at large.
This term is used in relation to ethical dilemmas surrounding client care.	Bioethics
What are the five principles of bioethics?	Beneficience, autonomy, justice, fidelity, veracity.
The duty to acto so as to benefit or promote the good of others.	Beneficience
The right to make one's own decisions and respect for the rights of others to make their own decision.	Autonomy
Treating others fairly and equally.	Justice
Maintaining loyalty and commitment to the client and doing no wrong to the client.	Fidelity
This refers to one's duty always to tell the truth.	Veracity
These serve as a field guide for decision making .	Ethical Standards
Ethical guidelines should not override	Laws
What constitutes desirable or acceptable behavior of the individual is decided by	The group that establishes the norms.
Patients cannot be subjected to any procedure or treatment without their consent or ________ will have occured.	Battery
A client can institute a court proceeding to seek a judicial discharge.	Writ of Habeas Corpus
The procedural mechanism used to challenge unlaful detention by the government	Writ of Habeas Corpus
The tow mose important concepts applicable to civic commitment cases.	Writ of Habeas Corpus and Least Restrictive Alternative Doctrine
This mandates that the least drastic means be taken to achieve a specific purpose.	Least Restrictive Alternative Doctrine
________ _________ patients have a the right to demand and obtain relase.	Voluntarily Admission
This is generally necessary when a person is in need of psychiatic treatment, presents a danger to self or others, or is unable to meet his or her own basic needs.	Involuntary Admission
There are 3 types of commitment procedures, what are they?	Judicial determination, administravive determination, and agency determination.
The primary purpos of this type of hospitalization is observation, diagnosis, and treatment for persons who have mental illness or pose a danger to themselves or others.	Observationainl or Temporary Involuntary Hospitalization
Those who undergo extended involuntary hospitalization are comitted solely through	Judicial or administrative action or medical certification.
A preventive measure, allowing a court order before the onset of a psychiatric crisis that would result in an inpatient commitment.	Involuntary Outpatient Commitment
This usually requires outpatient treatment for a specified period to determine the patient's compliance with medication protocols, ability to meet basic needs, and ability to reintegrate into the community.	Conditional Release
What are the criteria that treatment must meet?	The environment must be humane,staff must be qualified and sufficient to provide adequate treatment, and the plan of care must be individual.
The more intrusive or risky the procedure, the higher is the likelihood that what must be obtained?	Informed Consent
A voluntary act performed with the intent to bring about a physical consequence.	Intentional Tort
An act resulting in a person's apprehension of an immediate harmful or offensive touching.	Assault
A harmful or offensive touching of another's person.	Battery
An act with the intent to confine a person to a specific area.	False Imprisonment
The use of seclusion of restraint that is not defensivle as being necessary and in the clients best behavior may result in	False Imprisonment
An act or omission to act that breaches the duty of due care and results in or is responsible foa a persons injuries.	Negligence
The five elements required to prove negligence are:	Duty, breach of duty, cause in fact, proximate cause, and damages.
Conduct that exposes the patient to an unreasonable risk of harm, through either commission or omission of acts by the nurse.	Breach of Duty
The single most important action nurses can take to protect the rights of a psychiatric patient is to:	Be aware of that state's laws regarding care and treatment of the mentally ill.
Involuntarily admitted mental patients have a qualified constitutional right to refuse.	Treatment with antipsychotic drugs.
Observing the patient's right to privacy permits the psychiatric mental health hurse to:	Discuss observations about the client with the treatment team.
Patient abandonment would be a violation of	Fidelity
Which right of the client has been violated if he is medicated over his objection?	Right of Informed Consent
A client who is forced to take medication against his will, in other than an emergency situation in which he presents a danger to self or others, can bring suit against the agency for	Battery
After the death of a client what, if any, rules regarding confidentiality should be followed by nurses who have cared for the client?	Disclose nothing that would have been kept confidential before death.
What ethical principle is supported when a physician obtains informed consent for electroconvulsive therapy from a depressed client?	Autonomy
The use of seclusion or restraint to control the behavior of a client who is at risk of harming self or others gives rise to conflict between the ethical principles of	autonomy and beneficence
A client is released from involuntary commitment by the judge, who orders that a caseworker supervise him for the next 6 months. This is an example of	Conditional Discharge

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