1 .what are some psychiatric histori- cal events that have occurred in the early psychiatric era?18 th century- state asylums creat- ed, 600,000 residents were in them, 1st school or psychiatric nursing was created in 1882, deinstitutionalization, shift in role of the nurse from custodial care to professional care.2 .explain what early use of phenoth- iazine was for in early psych nurs-ing.it was discovered to help control psy- chotic behaviors and improve/ clear thinking.3 .what were the two nursing inter- ventions associated with somatic therapy in early psych nursing?insulin therapy ECT therapy 4 .explain significance of insulin ther- apy in the early psych era.insulin was administered until the client was comatose, this could kill the patient because the blood sugar could drop below normal levels, but it helped relive psych symptoms.5 .explain significance of early ECT therapy.an electrical stimulus was given to the brain with the result of a grand-map seizure. now we can control the shock given and give medications to sedate the client and stimulate the seizure and for proper monitoring throughout the procedure.6 .explain what deinstitutionalization is.there was a massive discharge of psy- chiatric patients from mental hospitals back to their original communities.7 .what is significant about the impact of deinstitutionalization?many of the psych patients who need- ed services were forced onto the streets, potentially leading them to more harm and crime.8 .3 main reasons deinstitutionaliza- tion was initiated.the belief that treatment in the hospi- tals was inhumane1 / 36 1 / 4
hope that medications would offer a curelack of funding at the state and federal level 9 .what is the order of maslows hier- archy of needs bottom to top?physiological needs-safety need- love and belong needs- self esteem- self actualization 10 .what is important to know about maslows hierarchy of needs?motivation is continuous quest for self actualization, can reverse levels based on life circumstances, lower level needs must be met first before advancement to higher level psycho-logical needs.11 .examples of psychotherapy behavioral therapy, cognitive therapy, didactical behavior therapy based on a verbal therapist to client interaction 12 .examples of open environment therapies family, group and milieu therapy 13 .examples of Brian stimulation tech- niques ECT, trans-cranial magnetic stimula- tion, vagus nerve stimulation 14 .explain what behavioral therapy is.aims to modify maladaptive behavior patterns.based that a behavior is learned and has consequences and abnormal be-havior results from an attempt to avoid painful feelings and reduce anxiety.15 .what is the nurses role with behav- ioral therapy?
Role of the nurse: to use the nurs-
ing process to assist the client with behavior modification. This can be through 1 on 1 groups, different ways like classical and operant conditioning
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16 .explain what cognitive therapy is.focuses on individual client thoughts and behaviors to solve current prob-lems.Based on changing the way one thinks.17 .what is the role of the nurse with cognitive therapy?the nurse will plan psychoeducation, use of the therapeutic relationship and counseling interventions. They also reevaluate to determine if intervention was successful with the therapy.18 .explain what cognitive behavioral therapy is (CBT) uses both cognitive and behavioral approaches to assist a client with anx-iety management.19 .explain what family therapy istherapy based on family dynamics and improving family functioning by learning the ways for dealing with mental illness in the family, improving understanding among family mem-bers, maximizing positive interaction with family members.20 .explain what milieu therapy iscreates an environment that is sup- portive and therapeutic and safe to benefit clients and promote coping within a safe place.21 .explain what group therapy istherapy focused on helping individuals develop more functional and satisfy-ing reactions within a group setting with common feelings, experiences and thoughts that lead to positive be-havior changes from interaction and feedback.22 .explain what ECT is used todaythe induction of a grand-mal seizure through the application of electrical currents to the brain during anesthe-
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sia.Electrodes are placed bilaterally and an appropriate dose of electrical cur-rent is sent through the brain to en-hance the effects of certain neuro-transmitters.23 .what types of disorders can ECT help with?Used as a last resort in depression, mania, schizophrenia, and psychosis when medication and treatment has failed.24 .side effects from ECT confusion and memory loss, headache 25 .what is the role of the nurse during ECT?often during the pre-op and post-op phases. Complete assess-ment should be completed before the client goes back to the procedure, in-cluding medication reconciliation and a signed consent form. places the IV, gives pre procedure medications, takes vitals before and after proce-dure. after procedure : placing the pa-tient on the side, orient the client, de-scribe what happened, allow the pa-tient to have therapeutic communica-tion based on their feelings, assisting them as needed until fully awake.26 .what will actually happen during the ECT procedure?When in the treatment room, the nurse will help position the patient while the CRNA gives the patient a short acting anesthetic and medica-tion to induce the seizure.a bp cuff, pulse ox and oxygen may be given as needed and a bite block and elec-trodes to monitor EKG.once asleep, the provider will decide how much electricity the client will get and will 4 / 36
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