Mental Health Flashcards
Levels of Consciousness
Alert
Patient is Responsive, Opens Eyes Spontaneously, and Answers
Questions Appropriately
Lethargic
Patient Can Open Eyes & Respond to Questions, But Falls Asleep
Quickly
Obtunded
Patient Responds to Light Shaking, But is Confused & Slow to
Respond
Stuporous
Patient Barely Responds to Painful Stimuli (Like Sternal Rub)
Comatose
Patient is Unresponsive & Abnormal Posturing May Be Present
Decorticate
Arms Flexed & Inwardly Rotated, Legs Extended & Inwardly
Rotated
Decerebrate
Head Arched Back, Arms & Legs Extended
Nursing Ethical Principles
Autonomy
Patient has the right to make his/her own decisions, even if not in
their best interest
Beneficence
Do what is Best for the Patient (Do Good)
Fidelity
Keep Your Promises
Justice
Provide Fairness in Care & Allocation of Resources
Nonmaleficence
Do No Harm
Veracity
Tell the Truth
Patient Rights
Refusal of Treatment
Even Pts Who Are Involuntarily Admitted Have the Right to Refuse
Treatment
Confidentiality
HIPPA States Health Info Cannot be Released W/O the Pt’s
Permission
, If Someone Calls to Get an Update, Suggest They Reach Out to
the Pt’s Family Regarding the Pt’s Condition
If You Overhear a Convo in the Elevator, Take Immediate Action to
Stop the Violation
Mandatory Reporting
Nurses are Required to Report Suspicion of Abuse, and to
Warn/Protect 3rd Parties Who are at Risk for Harm
Informed Consent
Provider Responsibilities
Communicate Purpose of Procedure, & Complete Description of
Procedure in Pt’s Primary Language (Use Interpreter)
Explain Risk v. Benefits
Describe Other Options
RN Responsibilities
Make sure Provider Gave the Pt the Above Information
Ensure Pt is Competent to Give Consent (Adult or Emancipated
Minor, Not Impaired)
Have Pt Sign Consent
Notify Provider if Pt Has More Questions or Doesn’t Understand
Any of the Info
Restraints
Types
Physical (Vest, Belt, Mittens)
Chemical (Sedative or Antipsychotic)
Alternatives
Reorientation
Supervision
Diversions
Prescriptions
Prescriptions Must be in Writing
If Need For Constraints Continues, Provider Must Rewrite Rx Every
24 Hours
In an Emergency Situation, a Nurse can Use Restraints, But Must
Obtain a Written Rx Per Facility Policy (Usually Within 15-30 Mins)
Time Limits
Adults (18 & Up): 4 Hours
, Ages 9-17: 2 Hours
Ages 8 & Under: 1 Hour
Documentation
Complete Every 15-30 Minutes
Include: Precipitating Event, Alternative Interventions Attempted,
Time Treatment Began, Medication Administration, Patient
Assessment (Current Behavior, VS, Pain), Pt Care Provided (Food,
Toileting)
Discontinuation
Restraints Can be Discontinued When Pt Can Follow the Nurse’s
Directions
Torts
Unintentional
Negligence (Forgetting to Set Bed Alarm for Pt At Risk For Falls)
Malpractice (Medication Error That Harms Pt)
Intentional
Assault (Nurse Threatens Pt)
Battery (Nurse Hits Pt, or Administers Medication Against Their Will)
False Imprisonment (Nurse Inappropriately Restrains a Patient or
Administers a Chemical Restraint Such as a Sedative
Communication
Intrapersonal
Self-Talk, Thinking Thoughts, But Not Verbalizing Them
Interpersonal
One-on-one Communication w/ Another Person
Open-Ended
Promotes Interactive Discussions Ex. Tell me more….
Closed-Ended
Used to Obtain Specific Data, Use Sparingly as it Can Block
Further Communication
Restating
Repeat the Pt’s Exact Words
Reflecting
Return Focus Back to Pt
Paraphrasing
Restate Pt’s Feelings to Confirm Understanding of What Pt is
Saying
Exploring
Gathering More Info About Something Pt Has Mentioned
General Leads
Allows Pt to Guide Discussion
Presenting Reality
Communicate What is Actually Happening, Dispel Hallucinations,
Delusions, False Beliefs
Offering Self
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