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developmental stages
developmental stage
| Question | Answer |
|---|---|
| name freud stages: | Oral(B-18mo) anal(18-36mo) phallic/oedipal(3-5y) latency(5-11/13y) genital(11-13y) |
| describe (B-18mo) stage | Oral- major site of tension/gratification is mouth, lips, tongue; ie: biting/sucking. Id present @ birth, Ego develops from rudimentary structure present @birth |
| describe (18-36mo) stage | Anal-anus & surrounding area are major source of interest -voluntary sphincter control acquired |
| describe (3-5y) stage | Phallic/oedipal-genitals focus of intrest, stimulation, & excitment -penis is organ of interest for both sexes -penis envy for girls -masturation common -oedipus complex in boys & girls |
| describe (5-11y) stage | Latency- resolution of oedipus complex -sex drive channelled into school activites -formation of superego** -final stage of psychosexual development |
| describe (11-13y) stage | Gential- begins w/puberty & biologic capacity for orgasm; involves capacity for true intimacy |
| name Erikson's stages (psychosocial) first 4: | trust vs. mistrust (infant) autonomy Vs. shame/doubt (toddler) intitiative Vs. guilt (preschool) industry vs. inferiority (schoolage) |
| name Erikson's stages last 4 | identity vs. role confusion (adolescense) intimacy v isolation (young adult) generativity v stagnation (middle adult) ego integrity v despair (maturity) |
| explain Eriksons trust v mistrust | Hope(infant)- viewing world as safe & reliable; relationships nurturing, dependable, & stable |
| explain Eriksons autonomy v shame/doubt | Will(toddler)- acheiving a sense of control & free will |
| explain eriksons initiative v guilt | Purpose(preschool)-beginning of conscience; learning to manage conflict & anxiety |
| explzin eriksons industry v inferiority | competance(schoolage)-emerging confidence in abilities; taking pleasure in accomplishments |
| explain eriksons identity v role confusion | Fidelity(adolescence)-formulating a sense of self & belonging |
| explain eriksons intimacy v isolation | Love(young adult)-forming adult, loving relationships & meaningful attachments to others |
| explain eriksons generativity v stagnation | Care(middle adult)-being creative/productive; establishing next generation |
| explain eriksons ego integrity v despair | Wisdom(maturity)-accepting responsibility for 1 self & life |
| who is Hildeard Peplau? | nursing theorist who developed the concept of the Therapeutic Nurse-Patient Relationship. |
| 4 phases of the nurse-pt relationship | orientation identification exploitation resolution |
| phase 1 orientation | directed by nurse, engages client in tx, giving explainations & info, & answering questions. |
| phase 2 identification | client works independantly w/nurse, expresses feelings & begins to feel stronger |
| phase 3 exploitation | client makes full use of the services offered |
| phase 4 resolution | pt no longer needs pro. services & gives up dependant behavior. relationship ends |
| 6 roles of nurse in the therapeutic relationship | stranger-offering pt same courtesy as stranger resource person-giving specific answers to questions in larger context teacher-helping client learn formally or informally |
| 6 roles of nurse in relationship cont'd | leader-offering direction to pt or group surrogate-being substitute for other like parent/sibling counsler-promoting experiences leading to health for pt like expressing feelings. |
| mild anxiety | sharpened senses inc. motivation alert enlarged percetual feild can solve prob effective learning restless butterflies sleepless irritable hypersensitive to noise |
| moderate anxiety | selectivelt attentive perceptual feild limited to task can be redirected cant connect thoughts muscle tension diaphoresis pounding pulse headache dry mouth higher voice pitch |
| moderate anxiety cont'd | inc rate of speech GI upset frequent urination inc automatisms |
| severe anxiety | perceptual feild on 1 detail or scattered details cant complete tasks cant solve prob or learn behavior of anxiety relief but ineffective feels awe,dread,horror not redirected |
| severe anxiety cont'd | severe headache N/V, diarrhea trembling rigid stance vertigo pale tachycardia chest pain crying ritualistic behavior |
| panic anxiety | perceptual field only on self cant process environmental stimuli distorted perceptions loss of rational thought personality disorganization doent recognize danger possibly suicidal |
| panic anxiety cont'd | delusions or hallucination possible cont communicate verbally either cannot sit or totally mute & immobile mat bolt & run |
| psychoanalysis | takes months or years to complete (rich mans therapy) |
| ID | innate desires pleasure seeking aggression sexual impulse |
| Super ego | moral ethical values parental |
| Ego | mature adaptive the balance between the two behavior |
| deinstitutionalization | Tx for pts in the least restrictive environments possoble. shift from state hospitals to community facilities. Lead to the revolving door effect |
| revolving door effect | shorter hospital stays, but the pts return back to hospitals more frequently. |
| define mental disorder | clinically significant behavioral or psychological syndrome or pattern that pccurs in an individual & is associated w/present distress or disability or w/inc risk of suffering death, pain, disability, or imp loss of freedom |
| mental health | multifaceted & has many infuential factors. catagorized as individual, interpersonal, & social/cultural |
| what is the DSM-IV-TR | outlines specific Dxs. provides standerdized nomenclature & language for all mental health pros. differentiates Dxs & defining charectaristics. assists in IDing underlying c/o disorders |
| Axis I | IDs all major psyc disorders EXCEPT mental retardation & personality disorders ie:depresison, schizo, anxiety,substance-related disorders |
| AxisII | reporting mental retardation & personality disord. & prominant maladap[tive personality features & defense mechanisms |
| AxisIII | current med conditions are potentially relevant to understanding or managing persons mental disor. & med conditions that may contribute to understanding pt |
| AxisIV | psycsocial & environmental problems that amy affect Dx, Tx, & porg. of Dx. ie:problems w/support goups, social environment, occupation, housing, economics, access to HC, & legal system |
| AxisV | Global Assessment of Functioning. scale of 0-100 on CURRENT level of functioning. Dr may give score out of last 6mo or Year. Pt must leave hiigher w/what they came in with |
| managed care | control balance b/t quality & cost of care. ppl recieve care based on need rather than request |
| case management | case-by-case basis to provide necessary services while containing cost. Manager coordinates all needs for pt |
| standard of practice: Assessment | psyc nurse collects comprehensive health data that is pertinant to pts health of situation |
| standard of practice: Dx | psyc nurse analyzes assess data to determine Dx of problems, including level of risk |
| standard of practice: outcome ID | psyc nurse IDs expected outcomes for a plan individualized to pt or situation |
| standard of practice: planning | psyc RN develops plan that prescribes strategies & alternatives to attain expected outcomes |
| standard of practice: implementation | psyc RN impliments the ID plan |
| standard of practice: 5a coordination of care | psyc RN coordintes care delivery. |
| Linda Richards | first psyc nurse (1940) |
| Milieu Therapy | community of therapy where clients interact with one another. Ex: practicing interpersonal skills, giving feedback abt behavior to each other,& working together as a group to solve everyday problems |
| psychosocial interventions | nursing activites that enhance clitent's social & psyc functioning & improve social skills, interpersonal relationships, & communication |
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