4.stress and coping

Stress and Coping

List six characteristics of being mentally healthy:

1. FLEXIBLE: Ability to be 2. SUCCESSFUL: Ability to be3. FORM CLOSE RELATIONSHIPS:

Ability to4. ABILITY TO MAKE APPROPRIATE

JUDGEMENTS5. ABILITY TO SOLVE PROBLEMS6. ABILITY TO COPE WITH DAILY

STRESS

List characteristics of mental illness:

Impairment of ability to think Impairment of ability to feel Impairment of ability to make sound

judgments Difficulty or inability to cope with

reality Difficulty or inability to form strong

personal relationships

REMEMBER:

Society can be stressful. Our lives are fast paced, economics, etc. Sometimes even those who typically deal with stress or day to day can and may develop physical or emotional illnesses.

What are the eight areas that are assessed during a mental status exam and list an example of each:

Area assessed during a mental status exam:

Appearance / behavior Level of awareness / orientation Thinking / content of thought Memory Speech Mood / affect Judgment Perception

What is the Diagnostic and Statistical 1 Manual of Mental Disorders?

Why is it used?

DSM- IV -TR

Diagnostic and Statistical Manual of Mental Disorders Most commonly used by psychiatrists and

psychologists Standard classifications and diagnostic criteria Classifying criteria from all standpoints and

ranking by severity. Including cultural, ethnic and religious considerations. Attempts to get reliable, accurate and objective diagnosis.

What sort of diagnostic tests are performed to confirm or rule out mental health disorders?

Blood-work: To rule out electrolyte, imbalance, dehydration, drug tox, infections, thyroids

CT / MRI: To rule out tumors, lesions, etc. PET (Positron Emission Tomography):

Identifies how parts of the brain are functioning by showing chemical activity or metabolism.

DEFINE THE FOLLOWING TERMS:

Coping Successfully adapting psychologically,

physically and behaviorally to problems / stressors. “deal with problems / stress”

DEFINE THE FOLLOWING TERMS:

Stressor Something, condition that produces

stress in an individual (divorce, death, money, etc.)

DEFINE THE FOLLOWING TERMS:

Adaptation Act of coping with or handling stressors

DEFINE THE FOLLOWING TERMS:

Anxiety Reaction to stress ranging from a

feeling of uneasiness to panic, uneasiness or apprehension

DEFINE THE FOLLOWING TERMS:

Ego defense mechanisms Unconscious techniques, habits that

reduce or eliminate anxiety. If over used are unhealthy and ineffective.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Denial Person unconsciously rejects the truth

and reality. Not lying because they believe in it.

Diagnosis of CA – denial

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Repression Unconsciously keeps unpleasant

experiences from awareness. “forget”

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Rationalization Denies his or her real thoughts by

excusing behavior because more socially acceptable reasons.

Sounds like logical excuse

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Compensation Person develops an alternate ability in

order to overcome a real or imagined defect

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Reaction formation Overcompensation – person usually

develops exact opposite trait, tries to rid world of what they feel they are inadequate at.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Regression Return to earlier mental or behavioral

level. Individualized, not all go back to same age.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Projection Individual places blame for short

comings on someone else mental or verbal finger pointing.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Displacement Taking our hostility on someone other

than person for whom it is intended, usually one because less power than you

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Conversion reaction Changing emotional problem into

physical symptoms

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENSE MECHANISMS:

Avoidance Unconsciously staying away from event

or situation that may open feelings of aggression or anxiety.

REVIEW THERAPEUTIC COMMUNICATION TECHNIQUES:

Review Therapeutic Communication Techniques: purposeful “Active” or “Purposeful” listening For various reasons patient may not be

comfortable sharing his or her needs and concerns. As a nurse it is up to you to try and uncover the problem.

GIVE EXAMPLE OF THERAPEUTIC COMMUNICATION TECHNIQUES:

Reflecting, repeating, parroting Clarifying terms Open ended questions Asking for what you need or want Identifying thoughts and feelings Empathy Silence

Give examples of Communication Blockers

False reassurance Minimizing or belittling Questioning ‘Why’ Advising Agreeing or disagreeing Closed end questions Providing answers Changing the subject Approving or disapproving

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING:

Cognitive Thought process / ability to think

judgment, reasoning, understanding

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Milieu Environment for treating patients

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Psychopharmacology Medications as they are used and

prescribed for mental illness

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Psychotherapy Treatment of mental and emotional

disorders

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Psychoanalysis Method of psychotherapy based on

Freud. Uses free association and dream

interpretation as part of the treatment.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Behavior management Modification – change in behavior by

eliminating a reinforcer for undesirable behavior or increasing the reinforcer for desirable behavior.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Cognitive Behavior Therapy Stresses ways of rethinking situations. Therapist confronts patient with

problem and helps them work out ways of thinking differently.

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Humanistic Therapy Form of therapy that concentrates on

the whole person

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Counseling Focuses on emotional, social,

vocational, educational, health related, developmental and organizational concerns

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Group Therapy 6 to 10 individuals meet face to face

with a trained therapist. Members decide the topic to be

discussed Members encouraged to give each

other feedback

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Relaxation Therapy Aim is to quiet the mind allowing

thoughts to flow in a smooth rhythmic way

Allows for rest and rejuvenation

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING DEFENCE MECHANISMS:

Imagery Formation of mental pictures Involves using one or more of the 5

senses Hearing,taste, touch, sight, smell

DEFINE AND GIVE EXAMPLE OF THE FOLLOWING

Electro Convulsive Therapy Method of treatment in which electrical

impulses are used to produce seizures in mentally ill when that person does not respond to drugs or other therapy.

Very controversial, generally used with depression schizophrenia.

List three side effects of electro- convulsive therapy:

Usually given 3-4 day intervals for first few treatments, then decrease to a week

Memory loss, confused and forgetful If strong seizure – muscle soreness

List eight nursing interventions for the client undergoing ECT:

NPO 4º before VS Document – subjective and objective response Asked to void Pre ECT meds as ordered by anesthesiologist or

psychiatrist Drugs dry secretions, decrease pneumonia Drugs relax muscles to relieve anxiety

Dentures, contacts, metallic objects removed O₂ before and after treatment Keep safe after treatment