PYSCH

Regression or reverting to an earlier developmental

stage may be characterized by bed wetting or using
baby talk.

PYSCH
During the orientation or introductory phase,
termination and separation of the relationship are
discussed in anticipation of the time limited nature
of the relationship.

PSYCH
If a client forgets to take the scheduled dose of
Lithium, the client needs to wait for the next
scheduled time to take the dose. REMEMBER: taking
two doses at one time may lead to Lithium Toxicity.

PSYCH
LITHIUM blood level should be drawn in the morning
about 12 hours after last oral dose and before taking
first morning dose.

PSYCH
Taking mood stabilizing drugs should be taken with
meals in order to reduce nausea and vomiting.
Driving should be avoided and not attempted until
dizziness fatigue or blurring vision has subsided.

PSYCH
Flooding is a form of Rapid Desensitization in which a
behavioral therapist confronts the client with the
phobic object until it no longer produces anxiety.

PYSCH
In PTSD, the symptoms occur 3 months or more after
the trauma, which distinguishes PTSD from acute
stress disorder.

PYSCH
The defense mechanism usually used by client with
OCD includes repression, displacement, and
undoing.

PSYCH
In handling patients with OCD, it is important for the
nurse not to interrupt or attempt to stop a ritual
because doing so would escalate the client's anxiety
dramatically.

PSYCH
Countertransference occurs when the therapist
displaces onto the client attitudes or feelings from
his/her past

PYSCH
For a client with suicidal ideation, client safety is the
priority. The nurse protects the client from self
harm, self destruction. Nutrition, sleep, and hygiene
are also important concerns but they are secondary
to safety.

PSYCHIATRIC NURSING
Self awareness- Initial phase of therapeutic
communication

Self evaluation- Assessing oneself's strengths and
weaknesses

Therapeutic use of self - Using oneself as a tool to
provide holistic care for mentally ill patients.

PSYCHIATRIC NURSING
SELFCONCEPT: Johari Window
I (Puclic Self)
-Known to self
-Known to others

II (Blind self)

-Unknown to self
-Known to others
III (Secret self)

-Unknown to others
-Known to self

IV (Unknown self)
-Unknown to self
-Unknown to others

PSYCHIATRIC NURSING
Goal:
-Promote mental health
-Prevent mental illness
-Find meaning to it's experiences


PSYCHIATRIC NURSING
Components of MENTAL HEALTH
Mastery of once environment
Integral capacity (strengths)
Self awareness
Autonomous behavior
Self actualization

PSYCHIATRIC NURSING
SODOMY- Anal intercourse

INCEST- Sexual intercourse with the relatives or
family

FETISHISM- Objects or parts of the body

VOYEURISM- Peeping tom / a person who gets
sexual
pleasure from secretly watching people undressing
or engaging in sexual activity.

TRANSVESTISM- Wearing clothes of an opposite sex.
e.g. Male wearing dress, Female wearing barong

TRANSSEXUALISM- Sex change

PYROMANIA- Sexual intercourse with a presence of
fire

PSYCH
In handling patients with OCD, it is important for the
nurse not to interrupt or attempt to stop a ritual
because doing so would escalate the client's anxiety
dramatically.

Flooding is a form of Rapid Desensitization in which a
behavioral therapist confronts the client with the
phobic object until it no longer produces anxiety.

PSYCH
Taking mood stabilizing drugs should be taken with
meals in order to reduce nausea and vomiting.
Driving should be avoided and not attempted until
dizziness fatigue or blurring vision has subsided.

PSYCH
If a client forgets to take the scheduled dose of
Lithium, the client needs to wait for the next
scheduled time to take the dose. REMEMBER: taking
two doses at one time may lead to Lithium Toxicity.


PSYCH
Countertransference occurs when the therapist
displaces onto the client attitudes or feelings from
his/her past

PSYCH
For clients in CRISIS PHASE (assault cycle), the nurse
must act immediately, using restraints and an
intramuscular tranquilizer to prevent injury to others
or further property damage.
PSYCH
For a patient with Alzheimers disease, the nursing
care plan should focus on safety measures

PSYCH
Disulfiram (Antabuse) is administered orally as an
aversion therapy to treat alcoholism

PSYCH
SCHIZOPHRENIA
- disordered though process
- disrupted interpersonal relationships

PSYCH
BIPOLAR DISORDER
- episodes of MANIA and DEPRESSION with periods
of normal mood and activity in between

DISSOCIATIVE AMNESIA
- inability to recall important personal information as
it provokes anxiety

SOMATOFORM DISORDERS
- persistent worrying or complains regarding physical
illness WITHOUT physical findings

PSYCH
OBSESSION: preoccupation with persistently
intrusive thoughts and ideas

COMPULSION
- performance of rituals or repititive behaviors to
decrease anxiety

PSYCH
CRISIS: any situation that overwhelms person's
normal coping mechanism

Goal of Crisis Intervention: return the client to PRE-
CRISIS functioning

PSYCH

TOLERANCE: Increased amounts of a substance over
time are needed to achieve the same effect as
obtained previously with smaller doses/ amounts.
-- tinataasan ang iniintake para ma achieve ang same
effect

ADDICTION: The repeated, compulsive use of a
substance that continues in spite of negative
consequences

CLANG ASSOCIATION: Association of words by
SOUND rather than meaning. -- RHYMING WORDS!!
Example: She cried till she died but could not hide
from the ride.

DELUSION OF PERSECUTION - believes that others
are out to harm or persecute in some way. Example:
Client believes their food is being poisoned or they
are being watched.

DELUSION OF GRANDEUR Exaggerated/unrealistic
sense of importance, power, identity; example is
when a client thinks he/she is the President or Jesus
Christ.

PSYCH
The immediate nursing action for a client with
ANXIETY is to decrease stimuli in the environment
and provide a calm and quiet environment.

PSYCH
AVERSION THERAPY
- negative reinforcement = behavior change
- attractive stimulus paired with unpleasant event
- example: si client, alcoholic, ang aversion therapy is
disulfiram, na pag uminom ulit sya ng alcoholic drink
(attractive stimulus), malalagay sya sa life-
threatening situation (tachycardia, nausea and
vomiting, chest pain) (unpleasant event)


PSYCH
DESENSITIZATION
- ineexpose si client sa kinakatakutan nya gradually
paired with increasing level of relaxation, by which,
magiging tolerable yung fear.

PSYCH
Stages of Group Therapy
1. INITIAL STAGE
- mababaw lang yung relationship
- members are aware of similiarities with each other
- members may be unclear of goal of the group
- roles and responsibilities are established

2. WORKING STAGE
- real purpose is done
- members familiar with each other; they address
concerns freely
- members learn to work with each other

2. TERMINATION STAGE
- members' feeling are explored
- provides opportunity to learn to deal more
realistically and comfortanly with normal human
experience

PSYCH -- CBQ!!!
GROUP THERAPY: involves a therapist and, ideally,
FIVE to EIGHT members working on his or her
individual goals within the context of a group, which
presumably increases the opportunity for feedback
and support

PSYCH - DEFENSE MECHANISM

SUPPRESSION: CONSCIOUS exclusion of
unacceptable thoughts and feelings from conscious
awareness
Example: A woman tells a friend she cannot think
about her sons death right now.

REPRESSION: Excluding emotionally painful or
anxiety-provoking thoughts and feelings from
UNCONSCIOUS awareness
Example: Woman has no memory before age 7 when
she was removed from abusive parents.

FIXATION: Immobilization of a portion of the
personality resulting from unsuccessful completion
of tasks in a developmental stage.
EXAMPLE: Lack of a clear sense of identity as an
adult

DISPLACEMENT: Ventilation of intense feelings
toward persons LESS THREATENING than the one
who aroused those feelings
EXAMPLE: Dae Wong is mad at his boss, he yells at
his spouse.

DENIAL: Failure to acknowledge an unbearable
condition; failure to admit the reality of a situation,
or how one enables the problem to continue
EXAMPLE: Waiting 3 days to seek help for severe
abdominal pain.

CONVERSION: Expression of an emotional conflict
through the development of a physical symptom,
usually sensorimotor in nature
EXAMPLE: A teenager forbidden to see X-rated
movies is tempted to do so by friends and develops
blindness, and the teenager is unconcerned about
the loss of sight.

COMPENSATION: overachievement in one area to
offset deficiencies in another area
Example: Nurse Toni has a low self-esteem, she
works double shifts so her supervisor will like her.

SUBSTITUTION: Taking a more attainable goal
because original goal is not attainable

PSYCHIATRIC NURSING

According to psychoanalytic theory, the superego is
the part of the psyche thats composed of morals,
values, and ethics. It continually evaluates thoughts
and actions, rewarding the good and punishing the
bad.(kunsenya)

According to psychoanalytic theory, the id is the part
of the psyche that contains instinctual drives.
(Remember i for instinctual and d for drive.)

According to Psychoanalytic theory, ego is the
organized, realistic part that mediates between the
desires of the id and the super-ego.(balance)