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INTRODUCTION TO PSYCHIATRIC NURSING

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The economic burden of mental illness in the USA, exceeds $ 170 billion. ... OBJECT RELATIONS. AUTONOMOUS FUNCTIONING. STIMULOUS BARRIER. MASTERY COMPETENCE ... – PowerPoint PPT presentation

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Title: INTRODUCTION TO PSYCHIATRIC NURSING


1
INTRODUCTION TO PSYCHIATRIC NURSING
Mercedes A Perez-Millan MSN, ARNP
2
Mental Health
???????
MENTAL ILLNESS
3
Seven Signs of Mental Health
  • Happiness
  • Control over behavior
  • Appraisal of reality
  • Effectiveness in work
  • Healthy self-concept
  • Satisfying relationships
  • (give and receive love)
  • Effective coping strategies

4
Traits of Mental Health
  • Ability to
  • Deal with conflicting emotions
  • Live without undue fear, guilt, or anxiety
  • Take responsibility for one's own actions
  • Think clearly
  • Negotiate each developmental task

5
Prevalence of Psychiatric Disorders
USA
  • The Department of Health and Human Services and
    the National Institute of Mental Health (2004)
    provide the following statistics
  • 57.7 million Americans have a mental illness.
    That is 26.2 per cent of
    Americans 18 or older.
  • Four of the ten leading causes of disability
    include major depression, bipolar disorder,
    schizophrenia and obsessive compulsive
    disorder.
  • The economic burden of mental illness in the
    USA, exceeds 170 billion.

6
National Institute of Mental Health 2002 USA
Statistics
  • Affective Disorders- 9.5 pre-cent. 18.8 million
  • Suicide- 29,350 people committed suicide
  • Schizophrenia- 1.1 percent, 2.2 million
  • Anxiety disorders- 13.3 percent, 19.1 million
  • Eating disorders- 2- 5 percent of population
  • ADHD- 4.1 percent of youth ages 9 to 17
  • Substance abuse- 11.3 percent of the population

7
Theories of Mental Illness
  • PSYCHOBIOLOGICAL
  • PSYCHOLOGICAL

8
PSYCHOBIOLOGICAL
  • Genetic
  • Other Biological Influences
  • The Role of the Environment

9
PSYCHOBIOLOGICAL Overview of the Brain
  • Forebrain
  • Cerebrum
  • Frontal lobe- Voluntary movement, language,
    executive function
  • Parietal lobe- Sensory impulses, tactile
    sensations
  • Temporal lobe- Memory, emotions, taste, smell,
    auditory
  • Occipital lobe- Vision, visual perception
  • Diencephalons
  • Thalamus- Pathway of motor sensory impulses
  • Hypothalamus- Regulates hormonal functioning
  • Limbic system- Modulates emotions

10
PSYCHOBIOLOGICAL Overview of the Brain (cont.)
  • MIDBRAIN
  • Mesencephalon- Processes visual auditory
    information
  • HINDBRAIN
  • Pons- Visceral somatic motor control
  • Medulla- Autonomic functioning of major organs
  • Cerebellum- Modulates movement

11
(No Transcript)
12
PSYCHOBIOLOGICAL NEURON
  • CONDUCTION OF ELECTRICAL IMPULSES
  • NEUROTRANSMITTERS
  • RECEPTORS

13
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

14
PSYCHOBIOLOGICALNeurotransmitter/ Receptor/
Disorder
  • Dopamine DA Schizophrenia, Mania
  • Parkinsons, Depression
  • Norepinephrine NE Mania
  • Depression
  • Serotonin 5-HT Anxiety
  • Depression
  • Gamma-amino- GABA Reduction of
  • buturic acid anxiety
  • Anxiety
  • Acetyl-Choline Ach Depression
  • Alzheimers

15
PSYCHOLOGICAL
  • Freud's Psychoanalytic Theory
  • Conscious, preconscious, unconscious
  • Id, ego, superego
  • Defense mechanisms and Anxiety
  • Theories of personality

16
PSYCHOLOGICALPSYCHOANALYTICAL EGO FUNCTIONS
SELF ESTEEM
EGO
  • REALITY TESTING
  • SENSE OF REALITY
  • JUDGEMENT
  • IMPULSE CONTROL
  • THOUGHT PROCESS
  • ARISE
  • DEFENSIVE FUNCTIONING
  • OBJECT RELATIONS
  • AUTONOMOUS FUNCTIONING
  • STIMULOUS BARRIER
  • MASTERY COMPETENCE
  • SYNTHETIC INTEGRATIVE FUNCTIONING

17
PSYCHOLOGICAL
  • Freud
  • Psychosexual Stages of Development
  • Oral (0-18mos
  • Anal (18mos-3yrs)
  • Phallic (3-6yrs.)
  • Latency (6-12yrs)
  • Genital (13-20yrs)

18
PSYCHOLOGICAL
  • ERIKSON
  • Psychosocial Stages of Development
  • Trust vs Mistrust
  • Autonomy vs Shame and Doubt
  • Initiative vs Guilt

19
PSYCHOLOGICAL
  • ERIKSON (cont)
  • Industry vs Inferiority
  • Identity vs Role Confusion
  • Intimacy vs Isolation

20
PSYCHOLOGICAL
  • ERIKSON (cont)
  • Generativity vs Stagnation
  • Ego Integrity vs
    Despair

21
Maslows Hierarchy of Needs
  • 6. Self-Transcendent Needs
    5. Self- Actualization Needs
  • 4. Esteem Needs
  • 3. Love and Belonging
    Needs 2. Safety Needs
    1. Physiological
    Needs
  • Emphasis on human potential and clients
    strengths
  • Establishes what is most important in sequences
    of nursing actions Sets Priorities
    Varcarolis p. 20-21

22
Psychiatric Mental Health Nursing and the
Nursing Process
  • 1. Assessment 2. Nursing Diagnosis
  • 6. Evaluation 3. Outcome
    Identification
  • 4. Planning
  • 5. Implementation

23
Factors Affecting Mental Health and Nursing
Assessment
  • Support systems
  • Family influences
  • Developmental events
  • Cultural beliefs and values
  • Health practices
  • Negative influences

24
PSYCHIATRIC ASSESSMENT
  • Construct database
  • Mental status examination (MSE)
  • Psychosocial assessment
  • Physical examination
  • History taking
  • Interviews
  • Standardized rating scales
  • Verifying the data

25
DIAGNOSIS OF PSYCHIATRIC ILLNESS
  • Medical- DSM-IV-TV (Diagnostic and
    Statistical Classification of Mental
    Disorders)
  • Nursing- NANDA (North American Nursing
    Diagnosis Association)

26
DSM-IV-TR
  • Mental disorders are considered a manifestation
    of a
  • Behavioral
  • Psychological
  • Biological
  • dysfunction of the individual

27
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)

28
Therapeutic Approaches
  • Psychoanalysis
  • Short term psychotherapy
  • Cognitive Therapy
  • Behavior Therapy
  • Modeling
  • Operant Conditioning
  • Systemic desensitization
  • Aversion Therapy
  • Milieu Therapy
  • Individual, group and family therapy

29
CULTURAL BIASES
  • Consider cultural differences that influence
    health
  • Be accepting of changing families
  • Be open, consider differences in
    order to provide sensitive, competent care

30
GOALS and Interventions ofPsychiatric Care
Directed to
  • Anxiety
  • Reality testing
  • Self esteem
  • Level of functioning and manage disease process
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