Was a roman philosopher, statesman, Lawyer, Political Theorist and Roman Constitutionalist Introduced the Romans to the chief

f schools of Greek Philosophy Was the first known person to create a questionnaire for the mentally ill using biographical information

 Persons who displayed abnormal behavior were considered Lunatics, Witches, or demons possessed by evil spirits Superstition, Mysticism, Magic and Witchcraft prevailed as patients were locked in asylums, flogged, starved, tortured or subjected to bloodletting.

 In 13th century Medieval Europe Psychiatric Hospitals were built to house the mentally ill, but there were no nurses to care for them The first mental hospital ,Bethlehem Royal Hospital, opened in England in 1403. Pronounced as Bedlam,the name came to symbolize the , inhumane treatment of persons who were put on public display for twopence a look.

 Individuals with Mental defects that were deemed as dangerous were incarcerated or kept in cages. Wealthier colonists kept their insane relatives in the attics or cellars and hired attendants In other communities the mentally ill was sold as slave labor or forced to leave town

 Also known as trephination, trephining is a surgical intervention in which a hole is drilled or scraped in the human skull Cave painting indicate that the practice would cure epileptic seizures, migraines and mental disorders Evidence also suggest that trepanation was primitive emergency surgery after head wounds to remove shattered bits of bone form a fractured skull

 Humorism is a now discredited theory of the makeup and the workings of he Human Body It was believed that an excess or deficiency of any of the four distinct bodily fluids in a person directly influences temperament and health The four humors of Hippocratic Medicine include Black Bile (melan chole), Yellow Bile (chole), Phlegm (phlegma), and Blood (sanguis) and each corresponds to one of the traditional four temperaments.

Humour

Season

Element

Organ

Qualities

Ancient name

Modern

Ancient characteris tics

Blood

spring

air

liver

warm & moist

sanguine

artisan

courageous , hopeful, amorous

Yellow bile

summer

fire

gall bladder

warm & dry

choleric

idealist

easily angered, bad tempered

Black bile

autumn

earth

spleen

cold & dry

melancholic guardian

despondent , sleepless, irritable

Phlegm

winter

water

brain/lungs

cold & moist

phlegmatic

rational

calm, unemotiona l

 Refers to the definition and dynamics of personality development which underlie and guide psychoanalytic and psychodynamic psychotherapy First laid out by Sigmund Freud, Freud gave up the study of the brain and abandoned his physiological laboratory to focus on the mind and the psychological laboratory of his consulting room

 According to Freud, personality develops through a series of childhood stages during which the pleasure seeking energies of the id become focused on certain erogenous areas This psychosexual energy, or libido was described as the driving force behind behavior. If these psychosexual stages are completed successfully, the result is a healthy personality, If certain issues are not resolved at the appropriate stage, fixation can occur.

 Oral Stage
The infants primary source of interaction occurs through the mouth The primary conflict at this stage is the weaning process the child must become less dependent on the caretakers If fixation occurs at this stage, Freud believed the individual would have issues with dependency or aggression Oral fixation can result in problems with drinking, eating, smoking or nail biting.

 Anal Stage
The primary focus of the libido was on controlling bladder and bowel movements The major conflict at this stage is toilet training developing this control leads to a sense of accomplishment and independence If parents take an approach that is too lenient, an analexpulsive personality could develop in which the individual has a messy, wasteful or destructive personality If the parents are too strict or begin toilet training too early, Freud believed that an Anal-retentive personality develops in which the individual is stringent, orderly, rigid and obsessive

 Phallic Stage
The primary focus of the libido is at the genitals. At this age, children also begin to discover the differences between males and females Oedipus Complex, Electra Complex, Castration Anxiety and Penis Envy Eventually, the child begins to identify with the samesex parent as a means of vicariously possessing the other parent

 Latent Stage
The Libido interests are suppressed. The development of the ego and the superego contribute to this period of calm The latent period is a time for exploration in which the sexual energy is still present, but is directed into areas such as intellectual pursuits and social interactions

 Genital Stage
The individual develops a strong sexual interest in the opposite sex The stage begins during puberty but last throughout the rest of a persons life The goal of this stage is to establish a balance between the various life areas

 The proponent was B.F. Skinner Skinner was influential in defining Radical Behaviorism, codifying the basis of his school of research (named the EAB or the Experimental Analysis of Behavior) EAB or Behaviorism differs from other approaches to behavioral research in accepting feelings, states of mind and introspection as existent and scientifically treatable

 Studies on the behavior of respondents is done by identifying them as something non-dualistic The most widely known experiment by Skinner can best be exemplified by the Dog-Bone-Bell Test.

 Eriksson was a pioneer, defying the theories first established by both Sigmund Freud a d Skinner Erikssons Developmental tasks suggested that the lifetime of an individual can be divided into 7 age-specific groups that have been delegated with tasks that have to be accomplished before the age group ends. Failure to accomplish these tasks lead to specific disorders related to rewards gained.

 Infancy (0 12 months) Major task is development of trust Inability to develop adequate trust leads to severe mistrust or exaggerated trust issues

 Toddlerhood (1-3 years) Major task is establishment of independence Child is mostly negativistic; Learns and takes advantage of the word NO Temper Tantrums are common Should be attended to with a firm manner.

 Pre-School (3-6 years) Child open to new experiences Children should be given time and freedom to explore Safety should always be a priority

 School Age (6-12 years) Unlike during pre-school age, focus shifts from starting activities to finally completing and gaining a sense of achievement Considered as the most productive years in a childs life Competition with other children of the same age is common

 Adolescence (13-18 years) Main focus is the establishment of identity Adolescents are very conscious with their appearance Peer pressure is strong

Early Adulthood (18 - 25 years) Establishment of meaningful relationship Best time to start a family Adults are pressured to do something with their life

 MIddle Adulthood (25 - 35 years)

 Late Adulthood (35 Above)

 The assessment phase of the Nursing Process includes the collection of data about a person, family or group by the methods of observing, examining and interviewing. Two types of data are collected,
Objective Data include information to determine the clients physical alterations, limits and assets. Objective data are tangible and measurable data collected by palpation, percussion, inspection and auscultation. Subjective data are obtained as the client, family members or significant others provide information spontaneously during questioning or during the health history.

 Three kinds of assessment exist, comprehensive, focused and screening assessments. A comprehensive assessment includes data related to the clients biologic, psychological, cultural, spiritual and social needs. This type of assessment is generally completed in collaboration with other health care professionals A focused assessment includes the collection of specific data regarding a particular problem as determined by the client, a family member or a crisis situation. A screening assessment includes the use of assessment or rating scales such as the Brief Psychiatric Rating Scale of Hamilton rating Scale for Depression

 Much data are collected by the psychiatric mental nurse during a comprehensive assessment, which may take place in a variety of settings. Specific questions or guidelines are at times included in the assessment to alert the nurse to information that could be overlooked or misinterpreted

 General appearance includes physical characteristics, apparent age, peculiarity of dress, cleanliness and use of cosmetics A clients general appearance, including facial expressions, is a manner of nonverbal communication in which emotions, feelings and moods are related

 Affect is the outward manifestation of a persons feelings, tone or mood. The relationship between affect or emotional state and thought processes is of particular importance. A clients emotional state, as expressed objectively on his/her face, can be widely divergent from what the client says or does.

 Blunted affect Severe reduction or limitation in the intensity of ones affective response to a situation Flat Affect Absence or near absence of any signs of affective responses, such as an immobile face and monotonous tone of voice when conversing with others Inappropriate Affect Discordance or lack of harmony between ones voice and movements with ones speech or verbalized thoughts Labile Affect Abnormal fluctuation or variability of ones expressions, such as repeated, rapid, or abrupt shifts

 Do they exhibit strange, threatening, suicidal, violent behavior. Aggressive behavior may be displayed verbally or physically against self, objects or other people. Is there any evidence of any unusual mannerisms or motor activity, such as grimacing, tremors, tics, impaired gait, psychomotor retardation or agitation? Do they appear friendly, embarassed, evasive, fearful, resentful, angry, negativistic or impulsive? Is behavior overactive or underactive? Is it purposeful, disorganized, or stereotyped? Are reactions fairly consistent?

 Blocking
Refers to a sudden stoppage in the spontaneous flow or stream of thinking or speaking for no apparent external or environmental reason Blocking is most often found in clients with schizophrenia experiencing auditory hallucinations

 Circumstantiality
the person gives much unnecessary detail that delays meeting a goal or stating a point. This impairment is commonly found in clients with mania and those with some cognitive impairment disorders, such as the early stage of dementia or mild delirium. Individuals who use substances may also exhibit this pattern of speech

 Flight of Ideas
Is characterized by over-productivity of talk and verbal skipping from one idea to another. Although talk is continuous, the ideas are fragmentary. Connections between segments of speech often are determined by chance associations. It is most commonly observed in clients with mania

 Perseveration
The person emits the same verbal response. Perseveration is also defined as repetitive motor responses to various stimuli.
This impairment is found in clients experiencing some cognitive impairment disorders and clients experiencing catatonia.

 Verbigeration
Describes the meaningless repetition of specific words or phrases. It is observed in clients with certain psychotic reactions or clients with cognitive impairment disorders.

 Neologism
Describes the use of a new word or combination of several words coined or self-invented by a person and not readily understood by others This impairment is found in clients with certain schizophrenic disorders

 Mutism
Refers to the refusal to speak even though the person may give indications of being aware of the environment Mutism may occur due to the conscious and unconscious reasons and is observed in patients with catatonic schizophrenic disorders, profound depressive disorders, and stupors of organic and psychogenic origin.

- refers to the giving and receiving of information involving three elements: the sender, the message and the receiver - Communication is incomplete when feedback, or a reply is absent

Verbal Communication

Primarily referring to spoken verbal communication, typically relies on both words, visual aids and nonverbal elements to support the conveyance of meaning Includes discussion , speeches, presentations, interpersonal communication and many other varieties

Non-Verbal Communication

Is said to reflect a more accurate description of ones true feelings Peoples have less control over non-verbal reactions

Vocal Cues Gestures Physical Appearance Distance or Spatial Territory Position or posture Touch Facial Expression

Lacking Clarity Using Stereotypes and Generalizations Jumping to Conclusions Dysfunctional Responses Lack of Confidence Physical Barriers Physiological Barriers

Intimate Zone

Body Contact such as touching, hugging, wrestling

1 to 4 feet; some body contact such as holding hands; therapeutic communication occurs in this zone 1 to 12 feet; formal business; social discourse 12 to 25 feet; no physical contact; minimal eye contact; people remain strangers

Personal Zone

Social Zone

Public Zone

Is a planned and goal-directed communication process between a nurse an a client. The sole purpose is providing care to the client and the clients family and significant others.

Empathy

Empathy is the nurses ability to zero in on the feelings of another person Is different from sympathy

Respect

The nurse considers the client to be deserving of high regard

Genuineness

The nurse is sincere, honest, and authentic when interacting with the client

Self-Disclosure

The nurse shares the appropriate attitudes, feelings, and beliefs as a role model to the client

Concreteness and Specificity

The nurse identifies the clients feelings by skillful listening and maintains a realistic, not theoretical, response to clinical symptoms

Confrontation

The nurse uses an accepting, gentle manner after having established a good rapport with the client

Immediacy of relationship

The nurse shares spontaneous feelings when he or she believes the client benefit from such a discussion

Client self-exploration

The nurse encourages the client to learn positive adaptive coping skills

Pre-Orientation Phase

Phase of the relationship with no client contact The nurse utilizes this time to engage in reading the health history of the client Used as time to plan a means of action

Orientation Phase

The nurse sets the stage for a one-to-one relationship by becoming acquainted with the client The nurse also begins the assessment process Establishing rapport and the feeling of acceptance is most important in this phase

Orientation Phase

Establish a therapeutic environment, include privacy Establish a mode of communication acceptable with both client and nurse Initiate a therapeutic contract by establishing a time, place, and duration for each meeting, as well as the length of time the relationship will be in effect Assess the clients strengths and weakness

Working Phase

The client begins to relax, trust the nurse, and is able to discuss mutually agreed on goals with the nurse and is able to discuss mutually agreed-on goals The nurse continues the process of assessment as a plan of care develops Alternate behaviors and techniques are explored tok replace those that are maladaptive

Working Phase

Explore clients perception of reality Identify available support systems Encourage verbalization of feelings Implement a plan of action Evaluate the results of the plan of action Promote client independence

Termination Phase

The nurse terminates the relationship when mutually agreed on goals are reached, the client is transferred or discharged, or the nurse has finished the clinical rotation The clients commonly exhibit regressive behavior, demonstrate hostility or experience sadness The client may attempt to prolong the relationship

Termination Phase At this stage the client should be able to:

Provide self-care and maintain his or her environment Demonstrate independence and work interdependently with other Recognize signs of increased anxiety Cope positively when experiencing feelings of anxiety, anger or hostility Demonstrate emotional stability