1 Introduction To Psych Nursing

Welcome to Mental health and
Psychiatric nursing course
Mohamed Mustafa Abdullah

Introduction to psychiatric nursing
Mental health and psychiatric nursing

Psychiatric nursing
• Psychiatric nursing:
is a discipline of nursing that deal with mental
disorders, through providing care for clients in
hospitals or community, individually or in
groups.
Definition of mental health
• It does not mean the absence of mental
illness, it is the ability to adjust to new
situations and to handle personal problems
without marked distress and still have enough
energy to be a constructive member of
society.
Characteristics of healthy
individual
1- Have an appropriate perception of reality.
2- Have the ability to accept one’s self, others, and
human natural.
3- Have the ability to focus concentration on problem
solving.
4- Have a desire for privacy.
5- Have independence, autonomy, and intensity of
emotional reaction.
6- Have the ability to achieve satisfactory
interpersonal relationships
7- Have creativeness
8-Able to play and laugh.
9-Able to work and be productive
10- Have a capacity to deal with conflicting
emotions.
11-Able to live without fear, guilt, or anxiety.
12-Able to control one’s own behavior.
13-Use good judgment, reach insightful
conclusions.
14-Experience empathy toward others.
Factors affecting an individual’s
mental health
• 1-Biological variable &Hormonal influence.

• 2-Psychological variable (parents and sibling child-
interactions ;intelligence; self-concept; skills,
&emotional development level)
• 3-Sociocultural(family stability, economic level,
housing, supportive system, inadequate health
resources& religious influences & values)
Maslow’s hierarchy of needs
• 1-Physiological needs (food- water- air- sleep-
elimination-sexual)
• 2-Safty & security.
• 3-Love &belonging
• 4-Self esteem &esteem of others.
• 5-Self actualization.
Mental Health
Maslow identified:
• A “hierarchy of needs”
• Self-actualization as fulfillment of
one’s highest potential
12/26/21 10
Maslow’s Hierarchy
12/26/21 11
Mental illness
• We say that person is mentally ill when
behavior deviates sufficiently from the normal
so as to indicate disorganization of the self.
• The mind expressing its discomfort through
thoughts, feelings, and behaviors .
Psychosis and neurosis
• Psychosis is a loss of contact with reality,
usually including false beliefs about what is
taking place or who one is (delusions) and
seeing or hearing things that aren't there
(hallucinations).
• Psychosis is common and treatable. It affects
3 in 100 people, and usually occurs for the
first time between the ages of 15 and 25
• Types of mental illnesses classified under
psychosis include schizophrenia and bipolar
disorder
• Neurosis is a term given to mental illnesses
that causes emotional distress or stress
without affecting a person’s ability to think
clearly
• This classification typically includes anxiety
and fear-based disorders.
General criteria for mental
disorder
• 1-Dissatisfaction with one’s characteristics abilities
and accomplishments.
• 2-Ineffective or unsatisfying interpersonal
relationships.
• 3-Dissatisfaction with one’s place in the world.
• 4-Ineffective coping or adaptation to the events in
one life as a lake of personal growth.
Theories of Mental Illness
• PSYCHOLOGICAL
• PSYCHOBIOLOGICAL
• PSYCHOLOGICAL
• 1-Psycoanalytical theory
• *It believe that disrupted behavior in the adult
return to earlier developmental stages.
• * If the child has been frustrated he become
fixated on particular stage.
2-interpersonal theory
• -If a child is given only disapproving messages

about the self system develops (good me- bad me-
not me) it leading to anxiety because it includes a
threat to rejection by others it Leeds to mental
illness.
3-Social theory
• Social conditions are largely responsible for deviant

behavior ( poverty, family problems, inadequate
education) can predispose person to mental illness.
PSYCHOBIOLOGICAL
Genetic
Other Biological Influences
The Role of the Environment

PSYCHOBIOLOGICAL
NEURON
 CONDUCTION OF ELECTRICAL IMPULSES

 NEUROTRANSMITTERS
 RECEPTORS
PSYCHOBIOLOGICAL
NEUROTRANSMITTER
 CHEMICAL MESSANGERS
 RELEASED AT PRESYNAPTIC NEURON
 DIFFUSES ACROSS SYNAPSE TO POST SYNAPSE
 ATTACHES TO SPECIALIZED RECEPTORS
 INHIBITS OR STIMULATES
 RELEASED AND THEN DESTROYED OR TAKEN BACK
FOR RECYCLING
PSYCHOBIOLOGICAL
Neurotransmitter / Receptor / Disorder
 Dopamine DA Schizophrenia, Mania
Parkinson’s, Depression
 Norepinephrine NE Mania
Depression
 Serotonin 5-HT Anxiety

Depression
 Gamma-amino- GABA Reduction of

buturic acid anxiety
Anxiety
 Acetyl-Choline Ach Depression

Alzheimer’s
break
By the end of this lecture you will
able to:
• Diagnosis of psychiatric • Patients Rights.
illness.
• Roles of Psychiatric
• Limit setting
Nurse.
• Nurse’s Role in
prevention of Mental
Illness.
DIAGNOSIS OF PSYCHIATRIC ILLNESS
 Medical- DSM-IV-TV/ V (Diagnostic and

Statistical Classification of Mental
Disorders)
 Nursing- NANDA (North American Nursing

Diagnosis Association)
DSM-IV-TR
Mental disorders are considered a manifestation
of a:
Behavioral
Psychological
Biological
dysfunction of the individual.
DSM- IV- TR
MULTI-AXIAL CLASSIFICATION
 Axis I- All major psychiatric disorders
 Axis II- Personality disorders; Mental
retardation
 Axis III- Current medical conditions that are
relevant to the mental disorder
 Axis IV- Psychosocial and environmental
problems
 Axis V- Global Assessment of Function
(GAF)
 Roles of Psychiatric Nurse
• Socializing Agent, Teacher, Model, Advocate,
Counselor, Role Player and Milieu Manager
 Nursing Interventions
• Active Listening
• Anger Control
• Behavior Management
• Body Image enhancement
• Caregiver Support
• Spiritual support
• Suicide prevention
• Teaching
• Communication enhancement
• Milieu therapy
 Nurse’s Role in prevention of Mental Illness
 Primary Prevention
• Education, guidance and support
• Promotion of optimal well-being
• Promotion of self-care
• Promotion of healthy relationships
• Symptom management
 Secondary Prevention
• Goals
• Decrease incidence
• Decrease duration of illness
• Targets high-risk individuals
• Nursing interventions
 Tertiary Prevention
• Goal
• Decrease morbidity associated with chronic
illness
• Nursing interventions
- Education
- Promotion of self-care
- Case management
Limit setting
Limit setting is a process through which
someone in authority determines temporary
and artificial ego boundaries for another person.
Purpose of limit setting
• -provides protection for the patient and
others.
• -provides security.
• -provides a reality contact between the
person and his environment.
• -Decreases the patient anxiety.
• -Learn new behaviors.
• -make patient able to make good
relationships.
Types of behavior needing limits
• 1-Acting out behavior;

• -Is behavior in which the patient is responding
to a present situation as if it were a past
situation seeking gratification of unconscious
impulses or desires.
• 2-Manipulative behavior
• -Is process by which one person influences
another to function according to his needs
without regard for the other persona's needs.
it include gift giving,flattery,asking for special
favors]
Types of limit
• 1-verbal comments and nonverbal.
• 2-physical
• 3-pharmacological [neurozine,largactil]
• 4-Isolation
Any question�
Thank you

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Welcome to Mental health and

Psychiatric nursing course

Mohamed Mustafa Abdullah

Mental health and psychiatric nursing

• 1-Biological variable &Hormonal influence.

• -If a child is given only disapproving messages

• Social conditions are largely responsible for deviant

Other Biological Influences

The Role of the Environment

 CONDUCTION OF ELECTRICAL IMPULSES

 Serotonin 5-HT Anxiety

 Gamma-amino- GABA Reduction of

 Acetyl-Choline Ach Depression

 Medical- DSM-IV-TV/ V (Diagnostic and

 Nursing- NANDA (North American Nursing

• 1-Acting out behavior;

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