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Mental Health Nursing for RGNM Students
Jeneesh Jabar
CHAPTER 1:
Introduction
MENTAL HEALTH
Components of Mental Health
MENTAL ILLNESS
Characteristics of Mentally Healthy Person
DEFINITION OF TERMS USED IN PSYCHIATRY
Psychopathology of Human Behavior
1. Disturbances of Consciousness
2. Disorders of Motor Activity
3. Disorders of Perception
4. Disorders of Thought
5. Disorders of Affect
6. Disorders of Memory and Intelligence
7. Disorder of Orientation
8. Disorder of Attention
DEFENSE MECHANISM
Uses
Types of Defense Mechanism
I. Successful Defense Mechanism
1. Repression
2. Rationalization
3. Intellectualization
4. Compensation
5. Substitution
6. Sublimation
II. Unsuccessful defense mechanism
1. Suppression
2. Reaction Formation
3. Displacement
4. Denial
5. Projection
6. Regression
7. Conversion
8. Fantasy or Day Dreaming
9. Withdrawal
10. Identification
11. Negativism
12. Sympathism
13. Dissociation
PERSONALITY
Factors Influencing Personality Development
1. Heredity
2. Environment
3. Self
Stages of Development According to Freud
Approaches to Understanding Personality
a. The Trait Approach
b. The Psychoanalytic Approach
i. Levels of Consciousness
ii. Subsystems of Personality
b. Ego
c. Superego
CHAPTER 2:
History of Psychiatry
CONTRIBUTORS IN PSYCHIATRY
HISTORY OF PSYCHIATRIC NURSING IN INDIA
Trends in Mental Health Nursing
1. Educational Program for Psychiatric Nurse
2. Standards of Mental Health Nursing
3. Development of Code of Ethics
4. Legal Aspects in Psychiatric Nursing
5. Promotion of Research in Mental Health Nursing
6. Cost Effective Nursing Care
7. Focus of Care
New Trends in the Role of Psychiatric Nurse
1. Primary Mental Health Nursing
2. Collaborative Nursing Care Practice
3. Clinical Nurse Specialist
4. Neuropsychotherapist
5. Psychiatric Nurse Educator
6. Psycho Social Rehabilitation Nursing
7. Child Psychiatric Nursing
8. Gerentological and Geriatric Nursing
9. Deaddiction Nursing
10. Neuropsychiatric Nursing
11. Community Mental Health Nursing
CHAPTER 3:
Mental Health Assessment
ASSESSMENT
Elements of Mental Health Assessment
Psychiatric History Taking
Diagrammatic Presentation of Family History (Family Tree)
Techniques
Mental Status Examination
PROCESS RECORDING
Outline for Process Recordings
Aims and Objectives of the Interview
Specific Objectives
Summary
PSYCHOLOGICAL TESTS
Intelligence Test
Personality Test
CHAPTER 4:
Community Mental Health
COMMUNITY MENTAL HEALTH NURSING
Attitudes and Misconceptions Towards Mental Illness
Preventive Psychiatry
Nurse's Role in Primary Prevention
Nurse's Role in Secondary Prevention
Nurse's Role in Tertiary Prevention
Community Mental Health Services
1. Day Hospitals or Centers
2. Half Way Houses
3. Group Homes
4. Foster Homes
5. Sheltered Workshop
6. Mental Health Emergency Care
7. Self Help Groups
Role of Nurse in Community Mental Health Services
NATIONAL MENTAL HEALTH PROGRAM
Objectives
Approaches to National Mental Health Program
Fear of Student Nurse
1. Fear of Bodily Harm
2. Fear of Becoming Mentally Ill
3. Fear of Personal Inadequacy
4. Fear of Lose of Emotional Control
5. Fear of Rejection by the Patient
6. Fear of Emotional Involvement of the Patient
CHAPTER 5:
Psychiatric Nursing Management
GENERAL PRINCIPLES OF MENTAL HEALTH NURSING
NURSING PROCESS
Steps of Nursing Process
1. Assessment and Identification
A. Data Collection
B. Data Analysis
C. Nursing Diagnosis
2. Planning
3. Implementation
4. Evaluation
ADVANTAGES OF NURSING PROCESS
ROLE OF NURSE IN PSYCHIATRIC NURSING CARE
1. Patient Care
2. Education and Supervision
3. Ward Management
4. Interpersonal Relationship and Communication
Therapeutic Nurse-Patient Relationship
Factors Determining Effective Nurse-Patient Relationship
Goals of Nurse-Patient Relationship
Phases of Nurse-Patient Relationship
I. Preinteraction Phase
II. Introductory or Orientation Phase
III. Working Phase
IV. Termination Phase
Communication Skill
CHAPTER 6:
Mental Disorders and Nursing Interventions
CAUSES OF MENTAL ILLNESS
CAUSES OF ABNORMAL BEHAVIOR
Biological Factors
Psychosocial Factors
Sociocultural Factors
Classification of Mental Disorders
A. ICD -10: International Classification of Disease
B. DSM -IV-TR: Diagnostic and Statistical Manual –IV Text Revised
C. Indian Classification
Organic Mental Disorders
Types of Organic Mental Disorders
Delirium
Causes
Signs and Symptoms
Management
Dementia
Causes
Signs and Symptoms
Clinical Types of Dementia
Senile Dementia
Types of Senile Dementia
Management
Nursing Management for Organic Mental Disorders
Schizophrenia
Causes
Signs and Symptoms
Bleuler's Fundamental Symptoms (4As)
Schneider's First Rank Symptoms
Secondary Symptoms
Types of Schizophrenia
Treatment
Psychological Treatment
Drug Therapy
Electroconvulsive Therapy
Nursing Management
Mood (Affective) Disorder
a. Mania
Etiology
Classification
Clinical Features
Diagnosis
Medical Management
Nursing Management
Depression
Causes
Classification of Depression
Triad Symptoms (Main Symptoms)
Other Common Symptoms
Clinical Features
Diagnosis
Treatment
Nursing Management
Bipolar Disorder
Involutional Psychosis
Neurotic Disorders
ANXIETY NEUROSIS
Classification
Levels of Anxiety
Causes of Anxiety
Signs and Symptoms of Anxiety
A. Physical Symptoms
B. Psychological Symptoms
Management
Drug Therapy
Psychological Therapies
Nursing Management
Panic Disorder
Causes
Clinical Features
Treatment
Psychological Therapies
Drug Therapy
Nursing Management
Phobia
Types of Phobia
Clinical Features
Management
Nursing Management
School Phobia
Etiology
Clinical Manifestation
Treatment
Prevention
Psychological Treatment
Drug Therapy
Obsessive Compulsive Disorder
Causes
Classification of OCD According to ICD-10
Clinical Manifestation
Management
Nursing Management
Depressive Neurosis
Causes
Clinical Features
Treatment
Drug Therapy
Nursing Management
Hysteria or Dissociative and Conversion Disorder
Etiology
Diagnostic Evaluation
Types
A. Conversion Disorder
B. Dissociative Disorder
1. Psychogenic Amnesia
2. Dissociative Fuge
3. Multiple Personality
4. Gancer's Syndrome
5. Trance and Possession Disorder
6. Sleep Walking or Somnambulism
Management
Nursing Management
Hypochondriasis
Causes
Clinical Features
Diagnostic Evaluation
Treatment
Basic Principles of Treatment
Psychological Therapy
Drug Therapy
Nursing Management
Psychosomatic Disorder or Psychophysiological Disorder
Etiological Factors
Types and Clinical Features of Psychosomatic Disorder
Treatment
Nursing Management
Substance Abuses or Drug Abuses
Causes of Psychoactive Substance Abuse, Drug Abuse or Alcoholism
Drug Dependence
Alcohol Dependence Syndrome
Classification
Diagnostic Criteria for Psychoactive Substance Dependence
Complications of Psychoactive Substance Abuse or Alcoholism
Management
Treatment
Levels of Care
Nursing Management
Drug Intoxication
Signs and Symptoms
Treatment
Withdrawal State
Classifications
Symptoms
Management
MENTAL RETARDATION
Classification
A. Depends upon IQ level
B. Depends upon the practical application
Causes
I. Genetic
II. Prenatal causes
III. Acquired physical disorders in childhood
IV. Sociocultural causes
V. Psychiatric disorders
Diagnosis
Management
I. Primary prevention
II. Secondary prevention
III. Tertiary prevention
CHAPTER 7:
Biopsychosocial Therapies
PSYCHOPHARMACOLOGY
Psychotropic Drugs
Classifications
Antipsychotics
Mode of Action
Indications
Contraindications
Classifications
Side Effects
1. Central Nervous System
2. Autonomic Nervous System
3. Cardiovascular System
4. Blood and Hematopoietic
5. Endocrine Disruptions
6. Allergic Effects
7. Ocular Effects
8. Hepatic Side Effects—Liver Toxicity
Antidepressants
Indications
Mode of Action
Contraindications
Classifications
Side Effects
Nurse's Role of the Patients Taking Antidepressants
Antimanics
Mode of Action
Contraindications
Classifications
Side Effects
Serum Lithium Levels
Management of Lithium Toxicity
Nurse's Role of the Patients Taking Antimanics
Antianxiety Drugs
Indications
Mode of Action
Contraindications
Classifications
Side Effects
Nurse's Role of the Patients Taking Antianxiety Drugs
Psychosocial Therapies
Goals of Psychosocial Therapies
Types/Techniques of Psychosocial Therapies
1. Individual Psychotherapy
Types of Individual Psychotherapy
a. Psychoanalysis
b. Hypnosis or Hypnotherapy
c. Abreaction
d. Reality Therapy
e. Supportive Psychotherapy
1. Ventilation
2. Environmental Modification or Manipulation
3. Persuasions
4. Reeducation
5. Reassurance
6. Explanation
7. Suggestion
8. Relaxation
9. Reinforcement
10. Recreation
2. Group Therapy
Purposes
Types of Group Therapy
Stages of Group Therapy
i. Initial Stage
ii. Working Phase
iii. Termination Stage
Techniques Used in Group Therapy
Advantages of Group Therapy
Disadvantages
Nurses Role in Group Therapy
1. Group Task Role
2. Group Building and Maintenance Roles
3. Individual Role
4. Some Basic Role
3. Behavioral Therapy
1. Behavior Modification
2. Systemic Desensitization
3. Aversion Therapy
4. Assertive Training
5. Cognitive Behavior Therapy
6. Flooding
7. Positive Reinforcement
4. Interpersonal Psychotherapy
a. Marital Therapy
b. Family Therapy
c. Transactional Analysis
5. Other Therapies
a. Therapeutic Community or Milieu Therapy
Purposes
Principle of Therapeutic Community or Milieu Therapy
Elements of Therapeutic Community or Milieu Therapy
Components of Therapeutic Community or Milieu Therapy
Advantages
b. Attitude Therapy
Criteria of Planning of Attitude Therapy
Advantages
Attitudes
c. Occupational Therapy
Principles
Process
Goals
Advantages
Treatment Activities
Somatic Therapy
Electroconvulsive Therapy (ECT)
Indications
Contraindications
ECT not Effective in
Techniques
Placement of Electrodes
Mechanism of Action
Complication
ECT Device
Nursing Management
Before Giving ECT
During ECT
After ECT
Insulin Shock Therapy
Psychosurgery
CHAPTER 8:
Forensic Psychiatry/Legal Aspects
LEGAL RESPONSIBILITIES IN CARE OF MENTALLY SICK PATIENTS
Civil Responsibility
Criminal Responsibility (McNaughton's rule)
Admission of Mentally Ill Patient
1. Admission on Voluntary Basis
2. Admission Under Special Circumstances
3. Admission on Reception Order
4. Admission in Emergencies
5. Admission of Mentally Ill Prisoners
Discharge Procedure
Leave of Absence
Indian Lunacy Act
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Indian Mental Health Act
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
The Narcotic Drugs and Psychotropic Substance Act (NDPSA)
Role of Nurse in Legal Psychiatry
CHAPTER 9:
Psychiatric Emergencies and Crisis Intervention
OVERACTIVE PATIENT
Conditions in Which Over Activity Present
Conditions of Over Active Patient
Nursing Management
Destructive Patient
Phases
Treatment
Nursing Management of Aggressive Patient
Suicide
Causes
Methods of Suicide
Prevention and Management
CRISIS INTERVENTION
Techniques of Crisis Intervention
Process of Crisis Intervention
Assessment
Nursing Problems or Diagnosis
Planning
Intervention
Types of Crisis Intervention Programs
Appendices
A. DIFFERENTIATION AND COMPARISONS
I. Psychosis and Neurosis
II. Delirium and Dementia
III. Organic Psychosis and Functional Psychosis
IV. Fear and Phobia
V. Indian Mental Health Act and Indian Lunacy Act
VI. Epileptic Fits and Hysterical Fits
VII. Hallucination and Illusion
VIII. Difference between Endogenous Depression and Exogenous Depression
IX. Difference between Behavior and Personality
B. NURSING DIAGNOSIS
I. Nursing Diagnosis of Patient with Organic Brain Disorders
II. Nursing Diagnosis of Patient with Schizophrenia
III. Nursing Diagnosis of Patient with Depression
IV. Nursing Diagnosis of Patient with Mania
V. Nursing Diagnosis of Patient with Anxiety
VI. Nursing Diagnosis of Patient with Substance Abuse Disorder
C. MULTIPLE CHOICE QUESTIONS
D. MATCH THE FOLLOWING
E. STATE TRUE OR FALSE
ANSWERS
INDEX
TOC
Index
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