hi i'm joanna jackson and we're going to
review mental health concepts
let's start with a quick overview of our
content
we'll talk about the importance of
mental health education
i'll give you a few tips to how to
remember this content
we'll define mental health and defined
mental illness
we'll review common signs and symptoms
of many mental illnesses
we'll talk about nursing practice
concepts
the dsn 5
we'll always review the nursing process
we'll talk about therapeutic
communication and finally
psychopharmacology
so why are mental health concepts so
important for nurses
first it's really important to know that
patients in all areas in all specialties
will be experiencing some amount of
emotional distress and responses to that
stress
it's important for the nurse to
understand the basic concepts of mental
health and mental illness to help you
better care for your patients
at the heart of it all nurses are psych
nurses
here's some quick ways to remember this
content
say the information out loud
practice talking to your friends about
it or practice in the mirror practice as
if you are the nurse explaining to to a
patient or teaching it to a class
another quick way to help you remember
this content is to make up funny or
quirky acronyms about medications
processes or whatever to help you
remember the content
for an example the nursing process which
is assess diagnose plan implement and
evaluate can be remembered as a d pi
if you visualize an apple pie with the
letters a d on it it would be really
hard to forget 80 pi the nursing process
during the lesson when you see these
symbols you'll know which part of the
nursing process we're reviewing
assessment diagnosis and planning
implementation and evaluation
so what is mental health
it's the absence of any mental illness
it's a person exhibiting healthy coping
mechanisms and responses to normal
stress
and the person having the ability to
fulfill responsibilities and
relationships
it also includes adjusting and adapting
to change
now let's define mental illness
mental illness is the maladaption to
stress
exhibiting inappropriate thoughts
feelings and behaviors
the inability to fulfill
responsibilities and relationships
and any disorder that affects the
behavior caused by the brain
some common mental illness signs and
symptoms include hallucinations
delusions
mania
excessive anxiety and extreme mood
changes
some other signs and symptoms of mental
illnesses include inappropriate affect
an example of that is a patient that
receives really devastating or sad news
and responds by laughing that would be
inappropriate affect
rapid or pressured speech patterns
confusion
disorganized thoughts
altered orientation that is not knowing
the person place time or their birth
date
and sleep disturbances
while reviewing common mental health
illnesses and their signs and symptoms
it's very important to be cautious
perceived abnormal behavior does not
indicate the presence of a mental
illness
one's own personal and cultural beliefs
may affect their behaviors and may not
be mental illness mental illness can be
highly subjective so avoid judging and
using labels
now we will review the dsm the dsm
stands for diagnostic and statistical
manual of mental disorders
its first publication was in 1952 and
were currently on the fifth edition
this manual is specifically for mental
health disorders
let's review the rights of patients
all patients have the right to refuse
treatment
all patients have the right to informed
consent which means the patient should
be well aware of whatever procedure or
medication that they are about to
receive
all patients have the right to
confidentiality all patients have the
right to receive visitors and telephone
calls
all patients have the right to be
treated with respect and all patients
have the right to the least restrictive
environment that means abstaining from
seclusion or restraints when it is not
necessary
before you take the nclex be sure to
review theoretical models some of these
include psychoanalytic theory stages of
personality development
theory of object relations and theory of
moral development
some common therapies and treatments
used in mental health include
psychopharmacology that is medications
made specifically to help those
suffering from mental health issues
electroconvulsive therapy also known as
ect
cognitive therapy behavioral therapy
and don't forget complementary therapies
this includes acupuncture meditation and
massage
now let's review common nursing
diagnosis seen in mental health nursing
post trauma responses
anxiety
defensive coping
ineffective coping
fear
grieving
complicated grieving or risk of grieving
ineffective denial
social isolation
risk for loneliness due to withdrawal
risk for suicide
self-mutilation or risk thereof
and risk for self-directed violence
impaired religiosity are risk of
spiritual distress
powerlessness
impaired resilience or impaired mood
regulation
it's the nurse's responsibility to
maintain a safe environment the
environment is frequently referred to as
the million so miliotherapy is also very
important
promote self-care and education
utilize the nursing process
setting appropriate boundaries with your
patients
remaining non-judgmental
and avoid derogatory terms like crazy
insane or any other institutionalized
terms that could be offensive
let's review a sample mental health
nursing care plan this one is risk for
injury
the nursing care plan would read risk
for injury due to maladaptive and
defensive mechanisms and resources
related to substance abuse anxiety
hallucinations delusions or any other
behaviors that the patient may be
exhibiting interventions for risk for
injury could include assessing the
client's level of orientation that is
assessing if the patient is aware of who
they are where they are and what time it
is
assess potential safety risks remove any
and all objects the patient may be able
to use to cause self-injury
obtain drug history and use
and institute safety precautions on the
unit as with all nursing diagnosis you
always want to end with evaluation
for risk for injury be sure to evaluate
that the patient is no longer showing
risk for injury or evidence of injury
you should evaluate this not only by
what the patient verbalizes but their
nonverbal communication as well
a major responsibility for nurses in any
setting is to prioritize nursing
interventions
in mental health nursing safety is
always the utmost importance if given a
question asking what nursing diagnosis
is important while taking the nclex the
most immediate or life-threatening need
should always be addressed first
let's practice a question
a 23 year old female with a history of
depression is admitted into an inpatient
psychiatric facility following a suicide
attempt immediately following a family
member's death
the priority nursing diagnosis for this
patient is
a
impaired mood regulation
b
grieving
c
risk for injury or d
ineffective denial
while all of these nursing diagnoses may
be appropriate for this patient risk for
injury would be the most immediate need
always address safety first
also important for mental health nurses
is therapeutic communication this
includes active listening be attentive
to the patient show that you're
listening by verbal and non-verbal
behavior
be empathetic always accept the other
person's reality
nurses should always encourage hope
communicate to the patient that there's
a possibility for improvement and or
recovery
and don't be uncomfortable or afraid of
silence this allows patients time to
gather their thoughts and reflect on
anything that they might be feeling or
remembering
it's really important for mental health
nurses to know what non-therapeutic
communication is so that we may avoid it
an example of this is giving opinions
be careful not to portray judgment or
take away decision-making from the
patient
asking for explanations is also
non-therapeutic asking a patient to
explain what he or she believes can be
perceived as an accusation or disbelief
and arguing even if you feel the patient
is being dishonest avoid exhibiting
feelings of frustration or anger if you
must remove yourself from the situation
and return when you can contribute in a
therapeutic way
psychopharmacology is a huge part of
mental health nursing there are
anti-anxiety agents mood stabilizers
antipsychotic agents antidepressants
sedatives and hypnotics
review indications
side effects
patient education and normal responses
to these medications before taking the
nclex
tips for success when in doubt always
assess diagnose plan and then implement
when given a question about what the
nurse's priority is always choose to
assess before implement or taking any
action
if two answers feel correct and they
frequently will do your best to pick the
most correct answer
and opposites attract if two responses
are worded fairly similar but have
something that's opposite in them the
correct answer is usually in one of
those two good luck
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