PMHNP Boards - Purple book

PMHNP Boards - Purple book 1. Asterixis: involuntary flapping movements of the hands 2. Akinesia: inability to initiate movement 3. Why are older adults more sensitive to psych meds?: They have lower muscle mass and higher body fat concentration, also decreased intracellular water, decreased protein binding, and decreased metabolism 4. Etiology of ODD: Temperament Parents who model extreme ways of expressing emotions Trauma Unresolved conflict 5. Erikson's Psychosocial Stages: 1. Trust vs. Mistrust (birth-1 year) - if needs are met, infants develop basic trust 2. Autonomy vs. Shame and Doubt (2-3 years) - toddlers learn to exercise will and do things for themselves, or doubt their abilities 3. Initiative vs. Guilt (3-6 years) - preschoolers learn to initiate tasks and carry out plans, or feel guilty about efforts to be independent 4. Industry vs. Inferiority (6-11 years) - children learn the pleasure of applying themselves to tasks, or feel inferior 5. Identity vs. Identity Diffusion (12-18 years) - teens work at redefining sense of self by testing roles and integrating them to form a single identity, or become confused about who they are 6. Intimacy vs. Isolation (early adulthood: 19-mid 20s) - young adults struggle to form close relationships and gain capacity for intimate love, or feel socially isolated 7. Generativity vs. Stagnation/Self-Absorbtion (middle age: late 20s-50s) middle aged discover a sense of contributing to the world, usually through family and work, or they may feel lack of purpose 8. Integrity vs. Dispair (old age: 60s and beyond) - when reflecting on his or her life, the older adult may feel a sense of satisfaction or failure 6. Phases of a therapeutic relationship: Introduction, Working - clarify expectations, identify mutual goals; implement tx plan; monitor pt health; preventative healthcare; measure/evaluate outcomes Termination 7. Freud's Psychosexual Stages: 1. Oral Stage - (birth to 1 year) pleasure centers around mouth (sucking, biting, swallowing) 2. Anal Stage - (1-3 years) withholding elimination/ultimate release = pleasure, toilet training 3. Phallic Stage - (4-6 years) pleasure around genitals, identifies with same-sex parent, attraction toward opposite sex parent PMHNP Boards - Purple book 4. Latency Stage - (6-puberty) pleasure around social-interactions with others, represses all interest in sexuality 5. Genital Stage - (puberty to death) sexual reawakening, pleasure outside of family 8. Gray matter: composed largely of nerve cell bodies and unmyelinated interneurons and dendrites; working area of the brain and contains the synapses, the area of neuronal connection 9. White matter: myelinated axons of neurons 10. Anticholinergic intoxication: psychosis, dry mouth, hyperpyrexia, mydriasis, restlessness, tachycardia 11. Nurse practitioner core competencies: scientific foundation leadership quality practice inquiry technology and information literacy policy health delivery system ethics independent practice 12. Confidentiality: -clients right to assume that info given to provider will not be disclosed -protected through Medical Record Confidentiality Act of 1995 -requires signed medical authorization and consent to release medical info 13. HIPAA: guarantees clients 4 fundamental rights: 1. to be educated about HIPAA rights 2. to have access to their own medical records 3. to request amendment of their health info to which they object 4. to require their permission for disclosure of their personal info 14. Health Information Technology for Economic and Clinical Health Act (HITECH): -incentive payments for sharing specific EMR data -meaningful use incentives -EHR's can improve both individual and population based health outcomes -EHR's can improve quality, safety, efficiency, effectiveness, and outcomes 15. Ethical principles: Justice: doing what is fair Beneficence: promoting well being and doing good Nonmaleficence: doing no harm Fidelity: Being true and loyal PMHNP Boards - Purple book Autonomy: doing for self Veracity: Telling the truth Respect: treating everyone with equal respect 16. Mental illness in homeless population: -50% homeless people have co-occurring substance and mental illness -Schizophrenia 15-45% of US homeless -greater risk risk for violence and noncompliance 17. Migrant worker: persons who leave their permanent residences to take agricultural jobs in different locations 18. seasonal worker: worker who travels from their permanent residences seasonally for agricultural employment 19. sexual identity: How people identify psychologically on a continuum between female and male and to whom they are sexually and/or affectionately attracted. 20. gender identity: a person's identity along a continuum between normative constructs of masculinity and femininity -biological factors may include pre/postnatal hormone levels and gene expression -social factors may include gender messages from family, mass media, and cultural attitudes 21. gender dysphoria: the formal diagnosis to describe a marked incongruence between one's experienced and expressed gender and the gender assigned at birth 22. sexual orientation: direction of sexual attraction -asexual -bisexual -heterosexual -homosexual -transgender -transsexual -LGBTQ 23. sexual behavior: The manner in which humans experience and express their sexuality, including attracting partners, sexual interactions and social interactions between individuals 24. forensic: the application of scientific knowledge to legal problems 25. forensic science: application of a broad range of sciences to answer questions of interest to the legal system PMHNP Boards - Purple book 26. forensic nursing: Practice of nursing when health and legal systems intersect; the forensic nurse provides direct services to individual clients; consultation services to nursing, medical, and legal agencies; and expert court testimony in areas dealing with trauma and/or investigations of questioned deaths, adequacy of services delivery, and specialized diagnoses of specific conditions as related to nursing. 27. forensic risk assessment: Protects the public from individuals with known mental disorders having dangerous, violent and criminal histories 28. risk assessment: psychiatric evaluation performed in ED after arrest and before person is confined to a correctional facility 29. transference: displacement of feelings for significant people in the client's past on the PMHNP in the present relationship 30. countertransference: the nurse's emotional reaction to the client based on her or his past experiences 31. Signs of countertransference: -intense emotional reactions (positive or negative) on first contact -recurrent anxiety or uneasiness while dealing with the client -uncharacteristic carelessness in interaction and follow up -difficulty empathizing -resistance to others treating/interacting with client -preoccupation with or dreaming about the client -frequently running overtime or cutting time short -depression or other strong emotions during or after interaction with the client -feedback from others over involvement with the client 32. Psychodynamic (psychoanalytic) theory: -focus on concepts of intrapsychic conflict among structure of the mind -designed to explain neurosis and high anxiety such as phobias and hysteria -later expanded to include normal and abnormal development and personality development -assumes all behavior is purposeful and meaningful -most mental activity is unconscious- urges, feelings, adn fantasies that would be unacceptable to the person's values if consciously experienced -conscious behavior and choices are affected by unconscious mental content -childhood experiences shape adult personality -instincts, urges, or fantasies function as drives that motivate thoughts, feelings and behaviors