All the highlighted portions are in there
Mental Health Exam 2 Review
How and when can you delegate care?
Therapeutic nurse-client relationship
- Do:
- Allow client to control the discussion
- Give recognition/vali
...
All the highlighted portions are in there
Mental Health Exam 2 Review
How and when can you delegate care?
Therapeutic nurse-client relationship
- Do:
- Allow client to control the discussion
- Give recognition/validation
- Active listening
- Use open-ended question
- Example:
- Is there something you would like to talk about?
- Tell me more about that
- So you are saying you haven’t been sleeping well?
- Tell me about
- Dont:
- ask why
- ask too many questions
- give advice
- give false reassurance
- change the conversation topic
- give approval or disapproval
- use close-ended questions/statements
Examples:
- Don’t worry
- I think you should
- Dont be silly
- Thats great
Referrals to health care professionals - 12 step program, therapy, psychiatrist, case
manager, home health, community mental health services, partial hospitalization
Transference and countertransference
Transference vs. countertransference (always negative no matter what)
- Transference → what happens when a patient feels a certain way
about a nurse. EX: The nurse reminds the pt of someone they don’t
like (the pt may treat the nurse unfairly)
- Countertransference → Feels that the nurse feels some type of way
to the patient? EX: The patient reminds the nurse of someone they
don't like (nurse may treat that pt unfairly)
What can you do when a client refuses tx?
-teach pt what will happen if they do not take med, why this med is being given,
Restraints:
Temporary release is required for basic needs but doesn't discontinue the
restraint
Give them a trail release and discontinue as soon as possible.
-All means have been tried (last resort option)
-redirection, meds, de-escalation, therapeutic communication, family being there (can't
be a trigger), closer to nurse station/ room assignment change,
-reinstate q 4hrs for adult
-reinstate q 2hrs 9-17 years old
-reinstate q1hr 8 & under
Nursing Care- check skin integrity, basic needs, ABC’s, Nutrition, COmfort, toileting,
ROM, assess mood/ behavior change, check bony prominences, check q 15 min
Children- Keep parents notified as to why this happened and current behavior of child
3 kinds of restraints
1. Chemical = benzos [lam/pam] and antipsychotics [haldol, ativan, geodon]
2. Seclusion = restricting their movement
3. Physical = violent patient
Cannot threaten pt with restraints (“If you don't do , we’ll have to put you in
restraints”)
Improving medication compliance
Once daily dosage versus multiple. IM injections at the clinic. Someone handling it
for them
Reflective communication - helps assist the client with identifying emotions and
ideas
[Show More]
.png)
