MENTAL HEALTH NURSING

Question no 1 answer

Hallucinogens are the drugs or substances which cause hallucination and alter a person’s awareness of
their surrounding, thoughts and feelings and cause the profound distortion of perception of person’s
reality. examples mushroom, dhatura, marijuana etc

Question no 2 answer

Borderline personality disorder can be defined as illness which is marked by an ongoing pattern of
varying moods, self-image, and behavior often resulting in impulsive actions and problems in
relationships with other people along with the experience of episodes of anger, depression, and anxiety
that may last from a few hours to days.

Question no 3 Answer

Panic attack is the brief period of the extreme anxiety, distress or fear which begins suddenly and is
accompanied by physical and emotional symptoms like pounding horse racing heartbeat, profuse
sweating, fear, trembling and feeling of numbness etc

Question no 4 Answer

Post traumatic stress disorder is an anxiety disorder that may be diagnosed after an occurrence of the
traumatic and stressful events in life to a person himself/ herself or to their loved ones.

Question no 5 Answer

Neurosis is a medical condition which is also called psychoneurosis which is a functional disorder in
which feelings of anxiety, obsessional thoughts, compulsive acts, and physical complaints without
objective evidence of disease, in various degrees and patterns, dominate the personality.

Question no 8 answer

Common clinical features of obsessive compulsive disorder are enlisted below:

Obsessional thoughts: Theses are words, ideas and beliefs that are forcibly intruding into the patient`s
mind. These are usually unpleasant and shocking to the patient. Common types of obsessional thought
content.
Contamination, Repeated doubts, Orderliness, Impulses and sexual imagery.

Obsessional doubts: The obsession often implies some danger such as forgetting to turn off the gas or
locking a door. People of obsessional doubts repeatedly go to check whether the gas is turned off or the
door is locked.

Obsessional impulses: This disorder leads the client to act violently or embarrassing kind, such as
injuring child, shouting in temple, church or any silent places.

Obsessional rituals: Client may perform repeatedly the same activities like washing hands repeatedly
for more than 20 30 times in a day thinking that contamination may spread from one person to another so
they vigorously wash the hands. Also people starts counting repeatedly in a special way or repeating such
words regularly.

Obsessive slowness: Severe obsessive ideas or extensive compulsive rituals characterize obsession
slowness. This leads to slowness in daily activities.
Lack of concentration and task completion and impaired social or work functioning. Common clinical
features are repeatedly hand washing, abnormal doubt, repetitive acts etc.

Obsessional images: Client vividly shows the violent or disgusting sexual practices.

Question no 7 answer

Anxiety is a vague and unpleasant emotion that is experienced in an anticipation or apprehension of fear
uncertainties and misfortunes which may show behavioral, emotional, cognitive and physical symptoms.
There are various symptoms of anxiety that people experience in terms of feelings, behaviors, thoughts,
and physical sensations. Not everyone will experience the same symptoms, nor will each person
experience the same intensity of a symptom. Some examples of the common physical, emotional,
cognitive, and behavioral symptoms of anxiety are as follows:
Psychological: Fearful anticipation, irritability, Sensitivity to noise, restlessness, poor concentration,
Worrying thoughts and apprehension etc
Physical:
 Gastrointestinal: dry mouth, difficulty in swallowing, epigastric discomfort, frequent or loose
motions
 Respiratory: constriction in the chest, difficulty inhaling, over breathing
 Cardiovascular-palpitations, discomfort in chest
 Genitourinary-frequency or urgent micturition, failure of erection, menstrual discomfort,
amenorrhea
 Neuromuscular system-tremor, prickling sensations, tinnitus, dizziness, headache, aching
muscles
 Sleep disturbances-insomnia, night terror
 Other symptoms: depression, obsessions, depersonalization, derealization

Question no 6 answer

A psychiatric nurse is the person who is in the ward with patient most of the time so it is the main and
most important responsibility of the nurse in legal aspects of care and treatment of the mentally ill patient
and their family members. It is very essential to safeguard hers as well as patients and relatives’ right as
there may be various and multiple legal issues in aspects of mental health care of the patient.

Legal and ethical considerations of practice are crucial as in psychiatric nursing. Thus, knowledge of the
law regarding psychiatry in the area where the nurse is practicing helps her to protect herself from
liability and the patient from unnecessary detention and mistreatment. Some of the legal roles of nurses in
are as follows:

• Informed Consent
• Explanation of client rights and unit policies to client/guardian
• Signed statement of understanding/refusal to receive treatment
• Explanation of insurance benefits or payment options/third-party reimbursement
• Protect patient’s rights; the nurse should be aware of these rights of patient in the first place.
Some of the rights of psychiatric patient are as follows:
 o The right to have reasonable access to all communication media likes telephone, letter
writing and mailing.
o The right to see visitors every day.
o The right to treatment in the least restricted setting. • The right to hold civil service status.
o The right to refuse electroconvulsive therapy.
o The right to manage and dispose of property and execute wills.
o The right to wear their own clothes.
o The right to have individual storage space for their private use.
o The right to keep and use their own personal possessions.
o The right to spend a sum of their money for their own expenses
• She should ensure that ward procedures and policies should not violate patient's rights.
• Psychiatric patients are often the least capable of protecting their own rights. It is therefore one of
the responsibilities of the nurse to guide the patients and relatives in matters related to their rights
and protect the patient from any mistreatment.
• Discussing these rights with the mental health team and including these rights in the nursing care
plan is all part of her responsibility in protecting the patient's rights.
• During the nurse-patient relationship a lot of information is gathered through direct and indirect
sources, which is both verbal and written. Keeping in view the ethics of the nursing practice, such
information gathered should be kept confidential and best used for providing enhanced care rather
than for other purposes such as gossip or personal gain.
• Record Keeping: Nursing notes and progress records constitute legal documents and hence
should be maintained carefully. They should be non-judgmental and the statements made should
be objective in nature.
• The patient and his relatives are likely to have all sorts of anxieties about various procedures and
investigations. The nurse needs to be sensitive to these feelings, and give enough time and
attention and allow them to express their feelings about the patient's condition, treatment and
outcome. All information should be provided as appropriate.
• Any paper work, signing of documents should be completed. The hospital file along with all
charts and notes should be sent to the medical records section.

Question no 10 answer
According to ICD 9 Personality disorder is defined as, “Deeply ingrained maladaptive patterns of
behaviors recognizable by the time of adolescence or earlier and continuing through most of adult life.
Because of this, there is an adverse effect on individuals and society."
Paranoid Personality disorder:
Paranoid Personality disorder is marked by a distrust of other people and a constant unwarranted
suspicion. Client usually searches for hidden meanings and hostile intentions in everything others say and
they do for them. The signs and symptoms are of paranoid personality are:
Suspicious
Sensitive
Stubborn
Self important
Jealous and irritable
Hypersensitive
Mistrustful

Question no 11 Answer

Conversion disorder is characterized by the presence of one or more symptoms suggesting the presence of
neurological disorder that cannot be explained by any known neurological or medical disorder.
Nursing Management
Nursing assessment
• Psychological test are used to further evaluate the authenticity of the symptoms.
• Along with physical assessment a baseline psychological assessment is done to rule the change in
behavior, thoughts and level of functioning.
• Collect information related to childhood or adult trauma.

Nursing Diagnosis
• Altered thought process related to trauma or memory loss.
• Anxiety related to the event of loss of identity.
• Ineffective individual coping related to altered neurological functioning.

Nursing Interventions
• Nurses are those who provide care to the patient throughout the hospitalization. Therefore the
nurse must first establish the supportive therapeutic relationship with the patient.
• Monitor the physician’s ongoing assessments, laboratory reports and other data to rule the
pathological causes.
• Identify the primary and secondary gain.
• Identify specific conflicts that remain unresolved and assist patient to identify possible solution.
• Assist the patient to set the realistic goals of the patient.
• Encourage the patient to keep a diary of though and emotions he/she felt during the each day.
• Promote a safe environment to the patient and keep the patient far away from the harmful
stimulants like sharp objects, bright light etc.
• Positive reinforcement for identification of alternative dissociative disorder.
• Don’t allow the patient to use the disability in
• Identify the environmental stressor that triggers the symptoms of conversion disorder.
• Assist the patient to identify alternatives to self injury
• Withdraw attention if patient continuously to focus on physical limitations.
• Encourage the patient to verbalize the fear and anxiety of the patient.

Question no 9 answer

The gender identity disorders (GID) are defined as disorders in which an individual exhibits marked and
persistent identification with the opposite sex and persistent discomfort (dysphoria) with his or her own
sex or sense of inappropriateness in the gender role of that sex. The onset of this disorder may be as early
as 4 years of age, but the diagnosis cannot be made until adolescence or adulthood.

Paraphilias: Paraphilia is defined as abnormal sexual desires. Paraphilic patient usually fanatsize and
enjoy in sexual gratification. They usually show abnornal sexual desires and interest. Most paraphilia is
common in men than in women.
Paraphilai includes sexual behaviours society may view as unusual or abnormal.
Usually paraphilic seem different or extreme, they start talking differently arousing for some people, and
they start to show the sexual interest and desirse.
Paraphilic patient usually shows the symptoms of anxiety that are palpitaions, restlessness, sweating,
stressing events etc
Causes
The causes of paraphilia is not exactly known
Psychoanalysts theorize that an individual with a paraphilia is repeating or reverting to a sexual habit that
arose early in life. Behaviorists suggest that paraphilias begin through a process of conditioning:
Nonsexual objects can become sexually arousing if they are repeatedly associated with pleasurable sexual
activity. Or particular sexual acts (such as peeping, exhibiting, and bestiality) that provide especially
intense erotic pleasure can lead the person to prefer that behavior.
Treatment approaches for paraphilias have included traditional psychoanalysis, hypnosis, and behavior
therapy techniques.
antiandrogens can be used as it drastically lower testosterone levels temporarily have been used in
conjunction with these forms of treatment. The drug lowers sex drive in males and can reduce the
frequency of mental imagery of sexually arousing scenes. This allows for concentration on counseling
without a strong distraction from the paraphiliac urges. Increasingly, the evidence suggests that
combining drug therapy with cognitive behavior therapy can be effective.