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Lecture Notes for mental health nursing (psych nursing)

Lecture Notes for mental health nursing (psych nursing)



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Published by run.rebel.run
here are some great notes for psych! also, what nursing schools are you all from??? leave me a comment since I'm curious!

thanks and good luck!
here are some great notes for psych! also, what nursing schools are you all from??? leave me a comment since I'm curious!

thanks and good luck!

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Published by: run.rebel.run on Nov 18, 2008
Copyright:Attribution Non-commercial


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Chapter One
Foundations of Psychiatric Mental Health Nursing
Mental Health
 The WHO defines health as a state of completephysical, mental, and social wellness, not merely theabsence of disease or infirmity.
Mental health is influenced by individual factors,including biologic makeup, autonomy, andindependence, self-esteem, capacity for growth, vitality,ability to find meaning in life, resilience or hardiness,sense of belonging, reality orientation, and coping orstress management abilities; by interpersonal factors,including effective communication, helping others,intimacy, and maintaining a balance of separatenessand connectedness; and by social/cultural factors,including sense of community, access to resources,intolerance of violence, support of diversity amongpeople, mastery of the environment, and a positive yetrealistic view of the world (damn, that was a mouthful!).
Mental Illness
 The APA (2000) defines a
mental disorder
as “aclinically significant behavioral or psychologicalsyndrome or pattern that occurs in an individual andthat is associated with present distress or disability orwith a significantly increased risk of suffering death,pain, disability, or an important loss of freedom”.
Deviant behavior does not necessarily indicate a mentaldisorder.
Diagnostic and statistical manual of mental disorders
is a taxonomy published by the APA. The DSM-IV-TR describes all mental disorders, outliningspecific criteria for each based on clinical experienceand research.
 The DSM-IV-TR has 3 purposes:
 To provide standardized nomenclature andlanguage for all mental health professionals.
 To present defining characteristics or symptomsthat differentiates specific diagnoses.
 To assist in identifying the underlying causes of disorders.
A multiaxial classification system that involvesassessment on several axes, or domains of information,allows the practitioner to identify all the factors thatrelate to a persons condition.
Axis I is for identifying all major psychiatricdisorders except MR and personality disorders.Examples include depression and schizophrenia.
Axis II is for reporting mental retardation andpersonality disorders as well as prominentmaladaptive personality features and defensemechanisms.
Axis III is for reporting current medical conditionsthat are potentially relevant to understanding ormaintaining the person’s mental disorder as wellas medical conditions that might contribute tounderstanding the person.
Axis IV is for reporting psychosocial andenvironmental problems that may affect thediagnosis, treatment, and prognosis of mentaldisorders. Included are problems with the primarysupport group, the social environment, education,occupation, housing, economics, access to healthcare, and the legal system.
Axis V presents a Global Assessment of Functioning which rates the person’s overallpsychological functioning on a scale of 0 to 100. This represents the clinician’s assessment of theperson’s current level of functioning.
All clients admitted to a hospital or psychiatrictreatment will have a multiaxis diagnosis from the DSM-IV-TR.
Period of Enlightenment and Creation of MentalInstitutions
In the 1790’s Phillippe Pinel in France and Willian Tukesof England formulated the concept of 
as a saferefugee or haven offering protection at institutionswhere people had been beaten, whipped, and starvedfor their mental illness.
In the US, Dorothea Dix (1802-1887) began a crusadeto reform the treatment of mental illness after a visit tothe Tukes’ institution in England. She was instrumentalin opening 32 state hospitals that offered asylum to thesuffering.
100 years after establishment of the first asylum, statehospitals were in trouble. Attendants were accused of abusing the residents, the rural locations of thehospitals were viewed as isolating patients from theirfamilies and homes, and the phrase
insane asylum
tookon a negative connotation.
Development of Psychopharmacology
In the 1950’s the development of 
psychotropic drugs
were used to treat mental illness.
Chlorpromazine (Thorzine), an antipsychotic drug, andlithium, an anti-manic agent, were the first drugs to bedeveloped.
10 years later, monoamine oxidase inhibitors,haloperidol (Haldol), an antipsychotic; tricyclicantidepressants; and antianxiety agents(benzodiazepines), were introduced.

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