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Mental Health
Crisis
| Question | Answer |
|---|---|
| Acute time limited occurrences experienced as overwhelming emotional reactions to stressful situations, a development event, a societal event, a cultural event, or the perception of that event. | Crisis |
| What nurses and other health professionals do to assist those in crisis to cope. | Crisis intervention |
| Factors that may limit a person's ability to problem solve or cope with stressful life events or situations are: | Number of other stressful live events currently coping with,presence of concurrent psychiatric disorders or medical conditions, presence of excessive fatique or pain, quality and auantit of a person's usual coping skills. |
| A natural disaster, a national disaster, or a crime of violence are all examples of | adventitious crisis |
| What are the three basic types of crisis situation? | maturational, situational and adventitious |
| People who have preexisting mental health problems are very vulnerable and are prone to | crisis |
| According to Erikson, each developmental stage can be referred to as a | maturational crisis |
| Marriage, the birth of a child, and retirement are all examples of | maturational crisis |
| This type of crisis arises from an external rather than an internal source and is often unanticipated. | situational crisis |
| Loss of a job, death of a loved one, abortion, change of job, change in financial status, divorce, and severe physical or mental illness are all examples of | situational crisis |
| To a degree, successful resolution of a crisis depends on | Resolution of the grief associated with the loss. |
| A crisis of disaster that is unplanned and accidental. | adventitious crisis |
| It cannot be overstressed how important it is for ___________ and debriefing after any crisis situation for all age groups. | crisis intervention (psychological first aid) |
| It is possible to experience _______types of crisis situations simultaneously. | two |
| What phase of crisis is it when a person responds with increased feelings of anxiety and the increase in anxiety stimulates the use of problem solving and defense mechanisms in an effort to solve the problem and lower the anxiety? | Phase 1 of Crisis |
| What phase is it when the usual defensive response fails, the threat persists, anxiety continues to rise and produce feelings of extreme discomfort? | Phase 2 of Crisis |
| In this phase of crisis, individual functioning becomes disorganized. Trial and error attempts as solving the problem and restoring a normal balance begin. | Phase 2 of Crisis |
| If trial and error attempts fail, anxiety escalates to sever and panic levels and the person mobilizes automatic relief behaviors such as withdrawal and flight. | Phase 3 of Crisis |
| In this phase, some form of resolution such as compromising needs or redefining the situation to reach an acceptable solution may be made. | Phase 3 of Crisis |
| When a problem is not solved and new coping skills are ineffective, anxiety overwhelms the person and leads to serious personality disorganization, depression, confusion, violence against others, or suicidal behavior. | Phase 4 of Crisis |
| A ______is self limiting and is usually resolved within 4 to 6 weeks. | crisis |
| The resolution of a crisis results in achievement of one of three different functional levels, what are they? | The person will emerge at a higher level of functioning, the same level of functioning, or a lower level of functioning. |
| The goal of crisis intervention is | To return the individual to the precrisis level of functioning. |
| The form of resolution of the crisis depends on | The actions of the individual and the intervention of others. |
| During a crisis, people are often more open to_____ ______ than they are at times of stable functioning. | outside intervention |
| With intervention, the person can learn different _____ ______ of problem solving to correct inadequate solutions. | adaptive means |
| The person in a crisis situation is assumed to be mentally healthy and to have functioned well in the past but is presently in a state of | disequilibrium |
| Crisis intervention deals with the person's present problem and resolution of the | immediate crisis only |
| This type of intervention deals with the "here and now". | crisis intervention |
| In crisis intervention the client is encouraged to | set realistic goals and plan an intervention with the nurse that is focused on the current situation. |
| A person'sequilibrium may be adversely affected by one or more of the following: | Unrealistic perception of the precipitating event, inadequate situation supports, and inadequate coping mechanisms. |
| What is the first thing a nurse will assess with a patient in a crisis: | Whether there is a need for external controls because of suicidal or homicidal ideation or gestures. |
| After determining the need for external controls, the nurse then assesses what three things? | The client's perception of the precipitating event, the client's situational supports, and the clients personal coping skills. |
| Why is the client's support system assessed? | To determine the resources available to the person. |
| What are some common coping mechanisms? | Overeating, drinking, smoking, withdrawing, seek out someone to talk to, yelling, fighting, or engaging in other physical activity. |
| If the patient is suicidal, homicidal, or unable to take care of personal needs, what should be considered? | hospitalization |
| When the nurse is not aware of personal feelings and reactions, she or he may unconsciously | prevent the expression of the painful feelings in the client that are precipitating the nurses own discomfort. |
| Four of the most common problems a new nurse in crisis intervention must deal with are: | The nurse needs to be needed, sets unrealistic goals for clients, has difficulty dealing with the issue of suicide, has difficulty terminating the nurse-client relationship. |
| An important step for staff in coming to terms with overwhelming violent or otherwise disastrous situations once they are over. | Debriefing |
| What are the two basic initial goals of crisis intervention? | Client safety, and anxiety reduction. |
| What are the three levels of nursing care in crisis intervention? | Primary, secondary, and tertiary. (DUH!) |
| This level of care in crisis intervention promotes mental health and reduces mental illness to decrease the incidence of crisis. | Primary care |
| This level of care in crisis intervention establishes intervention during an acute crisis to prevent prolonged anxiety from diminishing personal effectiveness and personality organization. | Secondary care |
| The nurses primary focus in secondary care is to | Ensure the safety of the client. |
| The level of care in crisis intervention provides support for those who have experienced a severe crisis and are now recovering from a disabling mental state. | Tertiary Care |
| Secondary level care occurs in | Hospital units, emergency departments, clinics, or mental health centers, and usually during daytime hours. |
| Example of places that offer tertiary level care intervention are: | Rehabilitation centers, sheltered workshops, day hospitals, and outpatient clinics. |
| What are the primary goals of tertiary care? | To facilitate optimal levels fo functioning and prevent further emotional disruptions. |
| An example of a tertiary intervention directed toward a group that has experienced a crisis. | Critical Incident Stress Debriefing (CISD) |
| Use of short term counseling to help the patient cope with a crisis and resume a state of functioning comparable to or better than the precrisis state. | Crisis Intervention |
| What are the seven phases of CISD? | Introductory phase, fact phase, thought phase, reaction phase, symptom phase, teaching phase, reentry phase. |
| In this phase of CISD the purpose of the meeting is established, confidentiality is assured, guidelines are explained, participants are motivated, questions are answered, and team members are identified. | Introductory Phase |
| In this phase of CISD participants are assisted in discussing facts of the incident, introducing themselves and telling how they were involved in the incident. | Fact Phase |
| In this phase of CISD every participat is asked to discuss his or her first thoughts of the incident. | Thought Phase |
| In this phase of CISD, the participants engage in freewheeling discussion and talk about the worst thing about the incident, what they would like to forget and what was most painful. | Reaction Phase |
| In this phase of CISD the participants describe cognitive, physical, emotional, or behavioral experiences that they had at the scene of the incident and symptoms they felt following the incident. | Symptom Phase |
| In this phase of CISD the normality of the symptoms expressed is acknowledged and affirmed. Stress management techniques are taught. | Teaching Phase |
| In this phase of CISD the participanst review old material discussed, introduce new topics they want to discuss, ask ?'s, and discuss how they would like to bring closure to this debriefing. | Reentry Phase |
| A _____ is an acute, time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable. | crisis |
| A _______ crisis arises from an external rather than an internal source. | advantageous |
| The highest priorty goal of crisis intervention is | client safety |
| Crises that occur as an individual moves from one developmental level to another are called | maturational crises |
| When a person is let go from his job because of corporate cutbacks, he is facing | situational crisis |
| When a tornado ripped though a town in Oklahoma, causing the loss of homes, businesses, and life, the town residents faced | an advantageous crisis |
| A crisis is so acutely uncomfortable to the individual that it is tolerated for | 4 to 6 weeks only |
| The expected outcome of crisis intervention is that at the conclusion of crisis intervention therapy the client will function | At the precrisis level. |
| In the event of an adventitious crisis such as a car driving into a crowd of parade watchers, killing several and injuring many, wwhat age group of spectators would be least in need of crisis intervention? | a distinction cannot be made |
| When a stressful event occurs and the individual is unable to resolve the situation by using his or her usual coping strategies, what happens next? | The individual becomes disorganized and uses trial-and-error problem solving. |
| A person's equilibrium may be adversely affected by one or more of the following: | An unrealistic perception of the precipitating event, inadequate situational supports, and inadequate coping mechanisms. |
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