ATI Mental Health Chapter 1 Basic Mental Health Nursing Concepts

PSYCHOSOCIAL HISTORY
– CULTURAL BELIEFS AND PRACTICES
– SPIRITUAL AND RELIGIOUS BELIEFS

CULTURAL BELIEFS AND PRACTICES
– to be assessed in order to plan care around the clients beliefs and practices

SPIRITUAL AND RELIGIOUS BELIEFS
SPIRITUALITY
– refers to a client’s internal values, sense of morality, and how he views the purpose of life.
RELIGION
– refers to a client’s beliefs according to an organized set of patterns of worship and rituals

This affects the way in which a client finds meaning, hope, purpose , and a sense of peace.

MENTAL STATUS EXAMINATION (MSE)
– LEVEL OF CONSCIOUSNESS
– PHYSICAL APPEARANCE
– BEHAVIOR
– COGNITIVE AND INTELLECTUAL ABILITIES

LEVEL OF CONSCIOUSNESS
ALERT
– responsive and able to fully respond by opening her eyes and attending to a normal tone of voice and speech.
– answers spontaneously and appropriately
LETHARGIC
– open her eyes and respond BUT drowsy and falls asleep readily
STUPOROUS
– vigorous or painful stimuli to elicit a brief response
ex.) pinching a tendon or rubbing sternum
– might not be able to respond verbally
COMATOSE
– unconscious and does not respond to painful stimuli
DECORTICATE RIGIDITY
– flexion and internal rotation of upper-extremity
joints and legs
DECEREBRATE RIGIDITY
– neck and elbow extension, wrist and finger
flexion

PHYSICAL APPEARANCE
– personal hygiene
– grooming
– clothing choice
EXPECTED FINDINGS:
– well-kempt
– clean
– dressed appropriately for the given environment

BEHAVIOR
assessment of voluntary and involuntary body movements, and eye contact
MOOD:
– information about the emotion that she is feeling
AFFECT:
– objective expression of mood, such as:
– FLAT AFFECT
– LACK OF FACIAL EXPRESSION

COGNITIVE AND INTELLECTUAL ABILITIES
– orientation to time, person, and place.
– memory both recent and remote
IMMEDIATE:
– ask client to repeat
– a series of numbers
– a list of objects
RECENT:
– ask client to recall recent events
– visitors from the current day
– purpose of mental health appointment or
admission
REMOTE:
– ask client to state a VERIFIABLE fact from his past
– DOB
– Mother’s maiden name

CLIENT’S LEVEL OF KNOWLEDGE
– what he knows about his current illness or hospitalization
CLIENT’S ABILITY TO CALCULATE
– if he can count backward from 100 in serials of 7
CLIENTS ABILTY TO THINK ABSTRACTLY
Рif he can interpret a clich̩
– the ability to interpret a higher level of thought process
PERFORM AN OBJECTIVE ASSESSMENT OF THE CLIENT’S PERCEPTION OF HIS ILLNESS

CLIENT’S JUDGEMENT BASED ON HIS ANSWER TO A HYPOTHETICAL QUESTION

CLIENT’S RATE AND VOLUME OF SPEECH, AS WELL AS THE QUALITY OF HIS LANGUAGE

STANDARDIZED SCREENING TOOLS
– MINI-MENTAL STATE EXAMINATION
– GLASGOW COMA SCALE

MINI-MENTAL STATE EXAMINATION (MSE)
ASSESSMENT A CLIENT’S COGNITIVE STATUS
– ORIENTATION to time and place
– ATTENTION SPAN and ability to calculate by counting backward by seven
– REGISTRATION and recalling of objects
– LANGUAGE
– naming of objects
– following of commands
– ability to write

GLASGOW COMA SCALE
– used to obtain baseline assessment
– eye, verbal, and motor response is evaluated and a number value based on the response is assigned
– highest value possible is 15
– indicated that the client is awake and
responding appropriately
– a score of 7 or less
– indicate a client is in a coma

LIFESPAN CONSIDERATIONS
– CHILDREN AND ADOLESCENTS
– OLDER ADULTS

CHILDREN AND ADOLESCENTS

OLDER ADULTS

MENTAL HEALTH DIAGNOSES
SERIOUS MENTAL ILLNESS

ROLE AND LIFE CHANGES

THERAPEUTIC STRATEGIES IN THE MENATL HEALTH SETTING
– COUNSELING
– MILIEU THERAPY
– PROMOTION OF SELF-CARE ACTIVITIES
– PSYCHOBIOLOGICAL INTERVENTION
– COGNITIVE AND BEHAVIORAL THERAPIES
– HEALTH TEACHING
– HEALTH PROMOTION AND HEALTH MAINTENANCE
– CASE MANAGEMENT

COUNSELING
– using therapeutic communication skills
– assisting with problem solving
– crisis intervention
– stress management

MILIEU THERAPY
– orienting the client to the physical setting
– identifying rules and boundaries of the setting
– ensuring a safe environment for the client
– assisting the client to participate in appropriate activities

PROMOTION OF SELF-CARE ACTIVITIES
– offering assistance with self-care tasks
– allowing time for the client to complete self-care tasks
– setting incentive to promote client self-care

PSYCHOBIOLOGICAL INTERVENTIONS
– administering prescribed medication
-providing teaching to the client/family about medications
– monitoring for adverse effects and effectiveness of pharmacological therapy

COGNITIVE AND BEHAVIORAL THERAPIES
– modeling
– operant conditioning
– systematic desensitization

HEALTH TEACHING
– teaching social and coping skills

HEALTH PROMOTION AND HEALTH MAINTENANCE
– assisting the client with cessation of smoking
– monitoring other health condition

CASE MANAGEMENT
– coordinating holistic care to include:
– medical
– mental health
– social services

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