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Psych Exam

QuestionAnswer
What is the #1 cause of psychiatric disability in the world and ranked 2nd in the U.S for disability Depression
What are the top ranked psychiatric causes of disability with exception of depression? alcohol use, bipolar d/o, schizophrenia, OCD
What are the 5 models of psychiatric mental healthcare? public health, systems, medical, nursing, person-centered
Through managed care list the criteria necessary for people to recieve services clinically necessary, medically appropriate, w/in benefit parameters, for set amt of time, compliance w/ quality standards, anticipated and measurable outcomes; THINK: necessary, appropriate, parameters, timelimit, standards and outcomes
What are some cost control strategies discount fee-for service, case rate, capitation, medicare/medicaid
Define clinical appropriateness degree to which type, amt, and level of services promote best clinical outcomes; "More is not better"
What are the levels of care and goal in regards to clinical appropriateness Crisis-stabilization, acute-remission, maintenance-recovery, health promotion-optimal level of wellness
Define medical necessity criteria established for admission to various levels of care
What are the levels of care defined in medical necessity inpatient, partial hospitalization, intensive outpatient, outpatient
Define therapeutic impasses. Give examples blocks in progress of nurse-client relationship. resitance, transference, countertransferenceboundary violations
What does the public health model emphasize; what is its focus; interventions? reducing risk of mental ilness for entire population; groups or populations; community needs assesment, id high risk grps, primary, secondary, tertiary prevention
Waht is the emphasis of the Systems model give example of sytems model coordinated system of care to address human needs, physical needs, needs for tx & rehab; case management& community support system
What is case mangemnets major role linking with needed services
What is Biological-medical models emphasis biological & bain research w/ prevention activities focused on individual pt seen u. in inpt setting; includes dx, i.d cause of disease
What does the nursing model emphasize on "The whole person" focuses on risks, proctetive factors, vulnerablity, & human response
What is considered the best practice model. Why person centered model b/c emphasizes consumers & family participation & decision-making
What are the 2 levels of practice for psych nursing RN & advanced practice (APRN-PMH)
What are the 3 domains of psych nursing 1) irect care- incl case manaemnt, cpounseling, psychotherapy 20 Communication- develop tx plans, documentation, peer review 3.) Management
What is the key therapeutic tool the psych nurse must use Use of self
What does the term flight into health mean a & what type of impasse is it? sudden cooperation and acting like they are well; resistance
What is conceptual model of psychoanalytic beliefs & goal beliefs- d/o are related to unresolved anxiety from childhood experiences that are repressed into the unconscious; Goals- to bring repressed experience to conscious and learn healthy ways of coping
What issues is the interpersonal conceptual model effective in dealing with & what is it's goal? effectiveness in grief, role disputes, role transitions,interpersonal deficits; goal- reduce symptoms, improve social functioning, develop coping mechanisms & adaptive ways of relating to others; focuses on the "here & now"
What is the patien and therapist relationship in the interpersonal model partnership
What is hte social conceptual models belief considers the social enviornment as it affects the person and their life experiences; according to these theorists that social conditions are largely responsible for deviant behavior
This model dominates modern psychiatric care its belief consist of that all mental processes derive from operations of the brain and deviant behaior is a symptom of a brain disorder Medical model
What is the relationship of the patient and therapist in the medical model Physician i.d.'s the probelm, formulates tx plan. The pt has little say but hte physician prescribes therapy
What aspects of patient care make up the framework of the Stuart Stress Adapttion Model biological, psychological, sociocultural, enviornmental, & legal-ethical
What are the 5 assumptions of the Stuart Stress Adaptation model 10 social heirarchy- individual is part of family, grp, community, society & lgr biosphere 2.) nursing care is provided w/in biopsychosocial cultural env. & legal-ethical context
Stuart Stree Adaptation Model assumptions cont'd 3) 2 continuums;health/illness&adaptive/maladaptive have a complemtnary nature of the nursing & medical models4) Primary, 2ndary, & tertiary levels of prevention w/ stages of tx inc crisis, acute, maintenance, & health promotion5)based on nursing process
What is the criteria for mental health (+) attitude toward self, growth, devlpmnt, and self actualization;intergration; autonomy; reality perception; env. mastery
The concept of growth, deveolpemnt, and self actualization for mental health means what to an individual seeks new experiences to more fully explore aspects of oneself; this includes in touch w/ self & able to use resources, free access topersonal feelings & intergrate w/ thoughts & behaviors, interact freely w/ env, share w/ others & grow from exp
The concept of intergration in mental health means what fro the individual A balance btwn what is expressed & repressed, btwn inner & outer conflicts; u. measured by one's ability to withstand & cope w/ anxiety
The concept of autonomy in mental health means what for the indiv. balance btwn dependence & independence & acceptance of one's own consequences of one's actions; involves self-determination
The concept of reality perception in mental health means what top the individual ability to test assumptions about world by empirical thought; ability to change perceptions w/ new info and a respect for feeling & attitudes of others
The concept of enviormental mastery in mental health menas what for the individual enables person to feel successin approved role in society; ability to take on variety of roles w/ flexibility
What are the biopsychosocial compents of the Stuart Stress Adaption Model 1)Risk factor- biological-genetics, nutrition, sensitivites; psych- intelligence, verbal skills, morale; socio-age, gender education $$ 2) Precipitaing stressors-stimuli that is chalenging/threatening can be internal or external
Biopsychosocial components cont'd 3) Appraisal of event- determines meaning of & understanding impact of stressor
What are the tx stages & their goals in the Stuart Stress Adaptaion Model 1)Crisis-stabilaztio (no harm) 2) Acute- remission(symptom relief)3) Maintenance- complete recovery 40 Health promotion- optimal level of wellness
What action dimensions does a nurse use in a client-nurse relationship 1)Confrontation-expression of perceived discrepancies & invovles timing2)Immediacy-involves focusing on current interactionof client & nurse3)self-disclosure-true personal statments about self used to model/educate
Nusing action dimensions cont'd 4) Catharsis-pt encouraged to talk which brings fears&feelings to open5)role playing
What are the legal roles of the nurse 1)Provider2)Employee3)Citizen
What did the New Freedom Commission on Menatal Health do for mental health? Provided recommendationsto transform MH ; MH is essential to overall health, consumer & family driven, disparities elimin, early screenin, assess & refer, excellent care &research accelerated, technology used to access info & care
What are the other two doccuments that impacted MH Reopt from Surgeon General(USDHHS,1999) & Healthy people 2010
What are the 4 primary prevention strategies with examples 1)Health Education-awareness of issues, increasing understanding of stressors,alternative coping, resources, abilitis of indiv in grp2)Env Change--economic, work, housing, familiy sit 3)Social support-support grps4)Stigma reduction-advocay,education
What were major outcomes of deinstuitionalization 1) community resources not in place20assumption of community reintergration3)assumption of cost effectiveness
What were the major consequences of deinstitutionalization families now primary caretakers, people w/ MI homeless, in nursing homes, care homes, prison
What is the function of ADHS responsible for implementing funded BH svcs; manages delivery sys thru 4 Regional BH Authorities & 3 Tribal Regional BH Authorities
How is Arizona State divided for services? 6 geographic service areas(GSAs) & county lines;
Which RBHA serves Maricopa county ValueOptions (VO)
What are the characteristics of a healthy family Complete life cycle tasks, tolerate conflict& adapt to adverse circumstance, maintains emotional contact, avoids overcloseness, conflicts resolved, differences valued, children have age-appropriate responsibilities & enjoy age-approp privileges, open comm
Name the components of a family assessment culture, family hx, resources, decision-making, nurturing, emotional exp, time, space, & $$
What are maladaptive family characteristics "problem" member, overprotective/distant, overfxn/underfxn, Maintains "peace" at any price, role reversal, poor generational boundaries, substance, physical, sexual, emo abuse, child is scapegoat
What is the competence paradigm focus &goal in regards to family Focus:strengths, resources &competencies Goal: empowerment
What is the pathology paradigms focus &goal in regards to family Focus: deficits & illness Goal: Tx of pathology/dysfunction
What are barriers to family involvemtent for tx of a loved one 1)Profesional bias-suggest families cause illness Family Attitude- (-)past experinces w/ profession 3) Professional fears- alliance w/ family will endanger confidentiality of indiv 4) Adminiatrative Restraints-Managed care
What is the difference in MHRN and and adv practice MHRN MHRN give family ed, support & skill building; adv MHRN family couple therapy
What are known resources fro families who have family member w/ serious MI NAMI, MHA, MIKID
Define a group collection of people who have relationship w/ ea other, are interdependant, and may have common norms
WHat are the characteristics of a therapeutic group focus on grp relations, interactions among members, focus on here & now like behaving and coping
Describe maintenace roles in grp dynamics give examples involves grp processes & functions; Encourager-positive influence, harmonizer-keeps peace, compromiser-minmizes conflict
Describe the use of task roles & give examles Deal's w/ completing grp's task; leader-sets direction, questioner-clarify issues& info, facilitator-keeps grp focused, summarizer-states current position of grp, evaluator- assess performance, initiator-begins grp discussion
Describe what individual roles are and give examples not r/t task or maintenance roles; seen as self-centerd &distracting for grp; victim-deflect responsibilty, monoploizer-actively seek control by talking, seducer-maintains distance to gain attention, mute-seeks control through passive silence
Created by: jrmcderm
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