"A state of well-being where a person can realize his or her

Mental Health own abilities to cope with the normal _______________ of life
and work ______________________." (WHO)

Mental Hygiene Study of mental health

Criteria for a Positive Mental Health

Self-awareness Integral capacity

Self-actualization

Autonomy

Perceptive ability Mastery of one’s environment

Psychiatric Nursing
An _______________ process

Concerned with the levels of care.

Both a Science and an Art

USE OF APPROPRIATE COMMUNICATION TECHNIQUES

Communication - reciprocal exchange of ideas between or among persons

Modes:
Types of Non-verbal communication:
_______________ - written/spoken
Kinesis
_______________ - posture, tone of
Paralanguage
voice, facial expression
Proxemics
Touch
Cultural artifacts
Meta communication
Therapeutic Communication:
A way of interacting in a purposeful manner to promote the client’s ability to
express his thoughts and feelings openly.

Essentials: Barriers:
G ___________________________ B ___________________________
I ___________________________
R ___________________________
G ___________________________
E ___________________________ S ___________________________
A ___________________________ C ___________________________
A ___________________________
T ___________________________ M___________________________

Tips in answering therapeutic communication:

Eliminante Don’t ask Eliminate Eliminate Eliminate

_________________ __________ “_______________ “focus on the ________________
answer.” ___________ questions.
answer.”

Nurse – Patient Relationship (Hildegard Peplau)

3 WORKING / THERAPEUTIC PHASE

1 PREORIENTATION PHASE Anxiety: _________________

Major task: Identify and resolve problems
begins when the nurse is assigned / chooses by reinforcing coping:
a patient ___________________
Anxiety: ____________________ ___________________
Major task: ________________________________ ___________________
Other tasks: The longest and most productive
data gathering Other tasks: planning and implementation
planning for first interaction Problems encountered:
Transference

2 ORIENTATION PHASE

Major task: establish trust and rapport Management: ________________________

Anxiety: ____________________ Counter transference
Establish contract - __________________
Assure _________________________

Management: _________________________
4 TERMINATION PHASE
Cross-transference
Reinforce, reward and refer
Encourage verbalization
Anxiety: _____________
Summarize the progress
Terminate
Management: _______________________
 STRESS
A nonspecific response of the body to any demand made upon it. (Hans
Selye, 1936)
A state produced by a change in the environment that is perceived as
_______________, _______________ or _____________ to the person’s dynamic
equilibrium. (Smeltzer, 1992)
ADAPTATION
A constant ongoing process that occurs along time continuum, beginning with birth and ending
with death. (Smeltzer, 1992)
GOAL: Restore ___________!
Types:
Physical
General Adaptation Syndrome (GAS)
Involves the whole body in response to stress.
Stages:
A _____________________________
R _____________________________
E _____________________________
Local Adaptation Syndrome (LAS)
Psychological - Defense Mechanisms
Automatic and usually unconscious
Defense mechanisms
Pathologic when overused

Defense mechanism Description

Compensation

Conversion Emotional problems are converted to physical symptoms

Denial Failure to acknowledge

Displacement Redirection to a _____________- threatening object

Fantasy Distortion of unconscious feelings or wishes

Fixation “Arrest of ___________________.”

Identification Integration of someone else's personality

Introjection

Intellectualization

Projection

Rationalization Making _______________ reasons

Reaction-formation Expression of the opposite feeling.

Regression Back to ______________ patterns of behaviors

 Defense mechanism Description

Repression

Suppression

Sublimation Turning unacceptable to _________________________

Substitution Turning unattainable to _________________________

Symbolization

Undoing

Crisis and Crisis Intervention

Ineffective individual coping
A serious interruption of ___________________
Leads to dangerous, self-destructive or socially unacceptable behavior.

Characteristics: Types:
___________________ / Developmental
Highly-__________________
Expected, predictable and internal
Self-limiting: __________ weeks ___________________ / Accidental
Unexpected, unpredictable and external
Victim: _______________ and _______________
__________________ / Adventitious
Affects support system Acts of nature

Crisis intervention: Factors to consider:

Also known as _________________________________ ____________________________________
____________________________________
Goal: ___________________________________________
____________________________________
Nursing approaches: __________________________ ____________________________________

Situations Requiring Crisis Intervention

RAPE
Nonconsensual sexual _______________ of an individual, obtained by _______________ or threat, or in
cases in which the victim is not capable of _____________________.
Kinds:
P____________________ , A____________________ , S____________________

Reactions:
____________________ ____________________ syndrome ____________________ ____________________ syndrome
Maladaptive Phases:
Victim is unable to _________________________ ______________ / Impact – shock,
Results to anxiety and phobia numbness, disbelief
______________ / Denial – refusal to
discuss the event
RA 11648 Heightened Anxiety – fear, tension,
Anti-Rape Law of 2022 nightmares
Resolution
BATTERED WIFE SYNDROME
_______________ domestic violence RA 9262
Violence Against Women and
Reasons: their Children

Men: low _____________________

Women: _____________________

CHILD ABUSE An act of omission or commission.

Characteristics of Abusers: Warning Signs:

________________ by their parents Child’s use of ________________ words
From violent families Hair growth in various lengths
Inadequate parenting skills Inconsistent ________________
________________ isolated Low self-esteem
________________ immature Depression
________________ attitude towards the abused
Apathy
Bruised or swollen genitalia
RA 7610 Anti-Child Abuse Law
Unusual _____________ for age and development
Required reporting of suspected
Serious injuries
cases to the nearest authorities
Excessive knowledge about ________________
within _____________ hours

Nursing Interventions:
Primary concerns: Nurse should display: Preserve / protect evidences
Physical injuries ___________________
Psychological trauma Attitude (______________________) Intervention: family as a unit
___________________
___________________ Children: Play and art therapy
Empathy
Dignity

____________________ response to stress

ANXIETY An unpleasant emotional state consisting of ______________________ responses.

Mild Moderate Severe Panic

V___________ Headache
Fatigue
Increase in VS Anorexia Inability to
Pupillary Nausea communicate
Physical Muscular
_____________ Diarrhea / Physical
weakness
Diaphoresis constipation symptoms -
A___________ focus of __________

Perceptive
Increased ability is greatly Personality
Decreased
Cognitive ____________ and decreased disorganization
perceptive ability
_____________ Inability to focus
on major issues

Use of any defense Defense

Minimal use of Defense
Emotional mechanism mechanism
defenses mechanism fail
available operate
 Nursing Management:

Priority:
Encourage ________________
Administer medications, as ordered
Carefully listen
Environmental ________________

ANXIETY DISORDERS

Phobic Disorder
___________________ fear
Most common: ______________________
Treatments:
___________________________________

___________________________________

___________________________________

Examples:
Acrophobia - heights
Separation Anxiety Disorder Agoraphobia - open places and
of being alone in public places
Normal Length Algophobia - pain
Arachnophobia - spider
Below 18 (arachnoids)
Claustrophobia - enclosed
Above 18 place
Monophobia - being alone
Selective Mutism Disorder Pathophobia - disease
Social phobia - criticism,
Mutism on specific topics
humiliation or embarrassment
Duration: 1 month Thanatophobia - death

ANXIETY-RELATED DISORDERS
Obsessive - Compulsive and Related Disorders

Obsession -

Compulsion -

Treatment:
 Trauma and Stressor-Related Disorders

Post-Traumatic Stress Disorder (PTSD) Acute Stress Disorder

AKA: ________________________________________
A.K.A: ____________________________________
Onset: ______________________________________
Onset: ___________________________________ Duration: ___________________________________
Symptoms:
Most common cause: ___________________ ___________________________________
___________________________________
Duration: ________________________________
Numbness
Hallmarks: _______________________________ Flashbacks
Nightmares

Adjusment Disorder Reactive Attachment Disorder

A.K.A: _________________________________________ ______________________________

May be ____________________- or ________________ Reluctance to initiate or accept

More common to ____________________________ comfort and affection.

Manifestations: Disinhibited Social ____________________

Depressive symptoms Indiscriminate and excessive

Anxiety symptoms attempts to receive comfort and

Traumatic stress symptoms affection.

Somatic Symptom and Related Disorders

Somatic Symptom Disorder Characterized by physical symptoms but no identifiable

______________ cause

Unrealistic or ___________________ physical complaints

Illness Anxiety Disorder
In spite of ________________ reassurance

Conversion Disorder Anxiety converted unconsciously into functional symptoms.

(Functional Neurological
Symptom Disorder) Hallmark:

Chronic pain
Pain Disorder
Alters ADL

Cause: previous ________________

 Dissociative Disorders

Inability to recall extensive information

Dissociative Amnesia
(Psychogenic Amnesia) Cause:

Recovery may occur

Periods of detachment from self

Depersonalization Disorder _________________ is intact

Escape to “a dream” or “fantasy land”

Two or more personalities

Dissociative Identity Disorder
Each can control

DISORDERS COMMONLY DIAGNOSED TO CHILDREN

NEURODEVELOPMENTAL DISORDERS
Intellectual Developmental Disorder (Intellectual Disability / __________________________________________)

Onset: 18

IQ below 70

Sub-average intellectual functioning

Predisposing factors:
_________________________________________________

_________________________________________________

Specific Learning Disorders

Reading Disorder
Mathematics Disorder
Disorder of Written Expression
Learning Disorder NOS

COMMUNICATIONS DISORDERS

Difficulty

Language Disorder

Speech Sound Disorder

Childhood-Onset Fluence Disorder

Social Communication Disorder

 AUTISM SPECTRUM DISORDERS

Asperger’s Syndrome Childhood Disintegrative Disorder

Age: 5 (____________________________)
Predisposing factor: Physical stress
Age: 2-10 years
Hallmark: _________________________
Hallmark: _______________________________
Motor development may be delayed
Loss of function (2 or more)
Expressive language
Autism
Receptive language
Age: _______ Social and self-care
Gender: Males Control over elimination
Hallmark: _____________________ behavior Play
Diagnostic: _____________________ Motor
Diet: ________________________ Drug of choice: ___________________________
Signs and symptoms:
Odd play (spinning, blocking, staring)
Wants inanimate objects
Not cuddly Pervasive Developmental Disorder
Pain ________________ Not Otherwise Specified
Likes patterned activities
AKA Atypical Personality Development,
Acts like deaf
Atypical PDD and Atypical Autism
Crying tantrums OWN PLACE
Echolalia

ATTENTION DEFICIT HYPERACTIVITY DISORDER

Gender: males Management:
Age: 7
Triad: Priority: ____________________________
___________________________ Diet: ____________________________
___________________________
___________________________ DOC: ____________________________

MOTOR DISORDERS

Manifestation

Developmental Coordination
Disorder

Stereotypic Movement
Disorder

Tourette Syndrome

DISRUPTIVE, IMPULSE-CONTROL AND CONDUCT DISORDERS

Oppositional Defiant Disorder Manifestations: (at least 4)

Doesn’t comply with majority Blames others
Pattern of angry / irritable mood, Frequently loses temper
Deliberately annoy others
argumentative / defiant behavior, Seeks revenge
Resentful
or vindictiveness Sensitive
Argues often
Conduct Disorder Impulse Control Disorders
Not Otherwise Specified
Juvenile delinquents

Precursor to ________________ personality Kleptomania

Pyromania
disorder Intermittent Explosive Disorder

DISORDERS COMMONLY DIAGNOSED TO ADOLESCENT AND

ADULTS
EATING DISORDERS

Restrictive Food Intake Disorder

Anorexia Nervosa
Main sign: Morbid fear of gaining weight
Binge Eating Disorder (Eating DNOS)
Other signs:
Sensitivity to _____________ Binge-eating without
A_____________________ compensation
Deliberate self-starvation Done privately and accompanied
Denial of _________________ by negative feelings
Obviously thin but feels fat
L______________ all over the body
Loss of scalp hair Nursing Interventions:

Reinforce dietary prescriptions

Bulimia Nervosa
Establish rapport
Extreme measures to lose weight
Monitor weight and vital signs
uses diet pills, diuretics or laxatives

____________ after eating Encourage ventilation

Russel's signs Decrease emphasis on foods, eating,

chipmunk face weight

clear / eroded teeth
Involve in decision making
extreme exercise
Employ limit setting
Depression
Stay after meal
Anhedonia

SUBSTANCE RELATED DISORDER

Alcoholism and Related Disorders

Progression:
Alcoholism:
_______________________
____________________ -
starts with social drinking
_______________ cardinal symptom
tolerance develop
develop
Excessive (_____________) _______________________
Chronic - intoxicated all
alcohol becomes a need
day
Altered _____________ blackouts occur
denial starts
Behavioral problems: Alcohol Withdrawal Delirium (Delirium Tremens)
Within 48 - 72 hours after the last intake.
____________________ Increase in VS
____________________
5Ds
__________________
____________________ Agitation
____________________ __________________ alterations
____________________ ___________________
___________________
Alcohol withdrawal
Cause: ____________________________________
Chronic probles:
Occurs when an individual abruptly stops
_________________ Psychosis
drinking
A form of amnesia
Symptoms develop within few hours
Vitamins B1 and B12 deficiency
Increase in VS
_________________ Encephalopathy
__________________
Cerebral bleeding / inflammation
Agitation
Vitamin B1 deficiency
__________________ alterations
Tremors

Alcohol Detoxification Program:

Overcome _______________________
Support groups
Drug of Choice: Disulfiram (Antabuse)
Follow - up

Drug-related Disorders

Cocaine-Related Disorders (Stimulants) Cannabis-Related Disorders (Cannabinoids)

Cocaine is a white powdered substance Marijuana

Uses: sniffed, snorted, smoked, IV or SC Stimulant or depressant
Poor man’s cocaine: _________________
Mild hallucinogen
Signs of use
Psychological dependence
Cocaine _______________
Plant : ________________________
Obvious ________________ of the pupils
Cardiac problems Active component is ________________________
Agitation Routes of use:
Insomnia Oral
No appetite Smoked
Excessive sweating Onset: _______________ minutes
Severe to panic anxiety Duration: _______________ hours
Classic sign: ___________________________________ Classic sign: bloodshot eyes

SEXUAL DISORDERS

Sexuality is the result of biologic, psychological, social and experimental factors that mold an
individual's sexual development, ____________________, body image and behavior.

Phases of the Sexual Response Cycle

Desire
Excitement / Arousal
Plateau - “intense moments”
Orgasm (Climax)
Resolution
Sexual Dysfunction Disorders
Sexual Desire Disorders
Sexual Arousal Disorder Gender Dysphoria
Orgasm Disorders AKA ____________________
Sexual Pain Disorders
Persistent discomfort on the assigned sex.

Paraphilia (Sexual Deviation)

Abnormal sexual behaviors Necrophilia - involves the use of corpses
___________ months + distress or _______________ Partialism - inserting penis into the other parts
to functioning. of the body
Examples: Pedophilia
Anilingus - tongue brushing the anus use of prepubertal children (13 years of age
____________ or Zoophilia - contact with or younger)
animals _____________ sexual act or a fantasy
Coprophilia - smearing feces on the partner Sadism – __________________ pain
Cunnillingus - tongue brushing the vulva Telephone Scatalogia (sex on phone)
Exhibitionism - exposing one’s sexual parts Transvestism – wearing the clothing of a
to unsuspecting strangers woman
Fellatio - inserting the penis into the mouth Urophilia - urinating on the partner
Fetishism - inanimate / non-living objects or Voyeurism
articles "Peeping toms"
Frotteurism - touching or rubbing against Includes cyber-voyeurism
the unsuspecting people.
Masochism - sexual gratification from
________________ pain

Nursing Interventions:
Attitude:
_____________________________
Non-judgmental
Accept his feelings related to sexuality
Have a private area for discussion
Employ ______________
Intervene to discuss self-esteem issues, anxiety, guilt, and empathy for victims.
Refer to the correct clinic.
NEUROCOGNITIVE DISORDERS

Personality Disorders Diagnostic Criteria:

Deviating from __________________
Pervasive and inflexible patterns of functioning Alters __________________
Duration:__________________ Onset: Adolescence to __________________
Incidence: Not associated with other mental illness
____________________ Not associated with other physical illness
All socio-economic classes

Type B (_________________) Type C (_________________)

Type A (_________________)
Avoidant: _________________
Paranoid: _________________ Antisocial: _________________
Dependent

Schizoid: _________________ Borderline: _________________ Obsessive-compusive:

Histrionic: _________________ _________________

Schizotypal: _________________
Passive-aggresive:
Narcissistic: _________________
_________________
 Schizophrenia and Schizophrenia Spectrum Disorders

Schizophrenia Diagnostic criteria: 2 or more for 6 months +

Not a single disease entity
____________________
"split mind"
Characterized by: Delusions
impaired communication Hallucinations
altered reality
Disorganized ________________
deterioration from OLOF
Theories Disorganized ________________
Biological Negative symptoms
Neuroanatomical and
neurodevelepmental
Immunovirological Defense mechanism: ________________-

Schizophrenia Spectrum

Disorder Criteria

Shizophreniform Disorder Less than _______ months; ADL not impaired

Brief Psychotic Disorder Sudden onset; 1 day to 1 month

_______________________ Disorder Psychosis + mood disorders

Delusional Disorder 1 or more bizarre delusions; ADL not impaired

Shared Psychotic Disorder (_______________) 2 or more people share a similar delusion

Mood Disorders

Mania Depressiion

Biological

Neurochemical

Psychoanalytical

Common Types of Mood Disorders

Major Depressive Disorder Clinical Symptoms: Management:

Duration: ______________________ Flat affect

Group therapies
Impairs ADL Anorexia
Insomnia Antidepressants
Hallmark: ______________________
Loss of memory Electroconvulsive
Defense mechanism: ______________________ Sad feelings therapy
Mania Bipolar Disorder
elation of more than 7 days Mood cycles between mania and depression +
altered _________________
alters ADL
Bipolar I Disorder
Hallmark:________________________ Bipolar II Disorder
Defense mechanism: ________________________ Dysthymic Disorder
2 weeks or more
Does not alter ADL
Clinical Symptoms:
Flight of ideas Cyclothymic Disorder
I_____________________
DNOS (Depression Not Otherwise Specified) -
Distracted
lasts for 2 days-2 weeks
Grandiosity Types:
Energetic ________________________________
________________________________
Talkative

BASIC CONCEPTS ON PSYCHOPHARMACOLOGY

DISORDER CHEMICAL IMBALANCE

Alzheimer’s Disease

Schizophrenia

Anxiety

Depression

Mania

Major Tanquilizers

Indication: Schizophrenia and other psychosis

Desired effect: ___________ of symptoms
Best taken after meals
Mechanism of action: ________________________
Adverse effect: report promptly
Tardive dyskinesia - lip smacking
Agranulocytosis
Assess for:
Fever
Sore throat
_____________
Lab data: WBC count
· Hepatotoxicity
Assess for ______ & ______
 ELECTROCONVULSIVE THERAPY (ECT)

Exact mechanism is _______________ Contraindications:

Requires a consent Fever
Voltage: ______________ volts Increased ICP
Length: ____________ seconds _______________ conditions
Frequency: ___________ treatments TB with history of ___________
Interval: ______________ hours Unhealed fracture
Indicator: ______________ seizure Retinal ____________
Indications of use: ____________
_________________ Osteoporosis
Mania

Before the procedure:

Take VS
Diagnostic procedures
____________
ECG
EEG During the procedure:
Implement safety protocols
Observe for tonic-clonic seizure
Administer medications as ordered given
Priorities:

After the procedure:

Position: ____________

Check vital signs

Reorient the client