RANDOM NOTES FOR PSYCH: 1. Linda Richards- 1st American psych nurse; better nursing care 2.

Hildegard Peplau- Mother of psych nursing; published interpersonal relations in nursing 3. Community Mental Health Centers Act of 1963 4. Authenticity- being open to self exploration of thoughts, needs, emotions, values, and defenses, actions, communication, problems and goals 5. Johari window; increase self awareness 6. Pre-interaction- before interaction, self exploration, gather data 7. Orientation- meet pt., must find out why pt. seek help, establish trust 8. Working phase- therapeutic; explore stressor, behavioral change 9. Termination phase- most difficult phase; reality of separation 10. Transactional analysis- study of communication or transactions that take place between people 11. Action dimension: confrontation, immediacy, self disclosure, emotional catharsis, role playing 12. Therapeutic impasses: blocks progress of nurse-pt. relationship a. Resistance, transference, countertransference, 13. Mood disorders a. Major depressive episode- at least 5 or more symptoms for most of the days in 2 weeks; must have: depressed mood, loss of interest of pleasure b. Major depressive- at least 1 depressive episode; severe form of depression c. Dysthymic- milder form of depression lasting 2 or more years d. Bipolar disorder- person experience one or more manic episodes w/ or w/o a major depressive episode; experiencing both mania and depression i. Bipolar 1- current or past experience of manic episode; last at least 1 week ii. Bipolar 2- presence or history of one or more major depressive episodes and at least one hypomanic episode iii. Cyclothymic- hx 2 years of hypomania in which person experience numerous periods with abnormally elevated, expansive, irritable, moods; moods did not meet criteria for manic episode and many depressed mood did not meet criteria of major depressive disorder 14. Mood is subjective, affect is objective 15. Grief- subjective state following loss; normal griefuncomplicated grief; delayed grief- prolonged suppression that will ultimately interfere with effective functioning 16. Melancholic- loss of pleasure; worse in the morning 17. Atypical- weight gain, hypersomnia, increase appetite

18. Highest priority should be potential for suicide (bipolar) 19. Levels of lithium above 1.5 are dangerous 20. Schizophrenia a. Positive symptoms- exaggerated normal behaviors (delusion, hallucination, disorganized speech and behavior, bizarre behaviors (movement disorder) b. Negative symptoms- diminished normal behaviors (flat affected, blunted, anhedonia, asociality, alogia (one word answer), avolition (incapable of initiating any activity), apathy (no interest in anything(, Attentional impairment) 21. Terms a. Anosognosia- when a person with a disability seems unaware of her disability b. Delusion- personal belief based on incorrect inference c. Alexithymia- difficulty naming and describing emotion d. Astereognosis- inability to recognize objects by sense of touch e. Agraphethesia- inability to recognize numbers or letters traced on skin f. Dysdiadochokinesia- impairment of the ability to perform smooth, alternating movements g. Catatonia- stupor state in which pt may require physical nursing care similar to that of a comatose h. Echopraxia- purposeless imitation of movement by other people 22. 4 phases of post psychotic adjustment: cognitive dissonance, attainments of insight, stability in all aspects of life, moving toward achievement of work or educational goals 23. Types of schizophrenia a. Paranoid- systemized delusions, hallucinations, ideas of reference, b. Disorganized- incoherence, flat, disorganized, unusual mannerism, socially withdrawn c. Catatonic- stupor, rigidity, posturing, negativism, excitement d. Undifferentiated- failure to meet any criteria of the other types; prominent delusions and hallucinations e. Residual- socially withdrawn, inappropriate affect, eccentric, no psychotic behavior 24. Stages of relapse and management of relapse a. Overextension- intensified feelings b. Restricted consciousness- anxiety and depression c. Disinhibition- psychotic features (hallucinations) d. Psychotic disorganization- overtly psychotic symptoms (intensified hallucinations and delusions) e. Psychotics resolution- occurs in hospital; robotic manner 25. Management techniques

a. Distraction, fighting back, isolation, attempts to feel better, help-seeking 26. Axis: a. Axis 1- clinical syndromes, why theyre there b. Axis II- personality disorder c. Axis II- general medical condition d. Axis IV- psychosocial and environmental problems e. Axis V- Global assessment of functioning 27. Ss 28. D 29. D 30. D 31. D 32. D 33. D 34. d