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Summary NUR2488 / NUR 2488: Mental Health Nursing Exam 2 Study Guide ( 2022/2023) Rasmussen
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NUR2488 / NUR 2488: Mental Health Nursing Exam 2 Study Guide ( 2022/2023) Rasmussen
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Mental Health Exam 2Depression
Define common symptoms
Anergia (loss of energy), hopelessness, difficult making decisions
Beck’s Cognitive Triad (p. 199)
3 automatic negative thoughts - responsible for the development of depression
o 1) negative, self-deprecating view of self:
o 2) pessimistic view of the world:
o 3) Belief that negative reinforcement will continue
(no validation for the self)
Risk for suicide- Questions to ask,
High vs low risk (Ch 23)
o High risk:
Potential lethal suicide attempt or persistent ideation with strong
internet or suicide rehearsal
Interventions: admission generally indicated unless a significant
change reduces risk, suicide precautions
o Low risk:
Risk/Protective factor: modified risk factors, strong protective
factors
Suicidality: thoughts of death, no plan, intent or behavior
Interventions: Outpatient referral, symptoms reduction.
-Give emergency/crisis numbers
o Identify current feeling states
o 2. Ask directly “Are you thinking of, or have you been thinking of, killing
yourself”
If they answer yes then ask about the frequency, duration and
intensity on scale 1-10
o 3. Ask if the person has a plan: “When you think about suicide, do you
have a way you might do it?”
o 4. Determine the lethality of the plan
How lethal is the plan, how detailed is it, does the person have a
gun?
o 5. Gather information about risk factors
Age, sex, medical problems, emotional distress, psychiatric
problems, use of drugs, etc
o 6. If there is a history of suicide attempt assess
Intent, lethality and injury
o 7. Consult with one or more professionals and collaboratively
develop a safety plan with the patient
o 8. If the patient is to be managed as an outpatient, also assess:
, Mental Health Exam 2
Social supports, significant others knowledge of signs of potential
suicidal ideation and provision of safety resources
Nursing Diagnosis (Table 15-2)(pg 206)
o Risk for suicide, self-mutilation
o Decisional conflict/Impaired memory/Acute confusion
o Ineffective coping/interrupted family process/risk for impaired parent
attachment
o Hopelessness/Powerless
o Chronic low self-esteem
o Impaired social interaction
o Imbalanced nutrition: less than body requirements
o Constipation
o Sexual dysfunction
Communication Interventions (Table 15-4)
o Help the patient question underlying assumptions and beliefs and consider
alternative explanations to problems
o Work with the patient to identify cognitive distortions that encourage negative
self-appraisal
· Example: Overgeneralizations, Self-blame, mind reading,
discontinuing of positive attitude
o Discuss physical activities the patient enjoys (e.g., running, weightlifting).
Explain that initially 10 to 15 minutes a day 3 or 4 times a week has short-term
benefits.
o Encourage formation of supportive relationships, such as through support
groups, therapy, and peer support.
o Provide information referrals, when needed, for spiritual/religious information
(e.g., readings, programs, tapes, community resources).
· Physical Interventions (Table 15-5)
o Nutrition—Anorexia
· Offer small, high-calorie, and high-protein snacks frequently
throughout the day and evening.
· Offer high-protein and high-calorie fluids frequently throughout the
day and evening.
· When possible, encourage family or friends to remain with the patient
during meals.
· Ask the patient which foods or drinks he or she likes. Offer choices.
Involve the dietitian.
· Weigh the patient weekly and observe the patient’s eating patterns.
o Sleep-Insomnia
· Provide periods of rest after activities
· Encourage the patient to get up and dress and to stay out of bed
during the day
· Encourage the use of relaxation measures in the evening
· Reduce environmental and physical stimulants in the evening
o Self-Care Deficits
· Encourage the use of toothbrush, washcloth, soap, makeup, shaving
equipment and so forth
· When appropriate, give step by step reminders such as, “wash the
right side of your face, now the left.”
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