MPHN

an illness with psychological or behvioral manifestations and/or impairment in functioning due to social, psychologic, genetic, physical or chemical or biologic disturbance

role where she imparts information. important that you will be understood by leveling with the patients capability to understand

role where she encourages the client to participate to establish a meaningful relationship with others. depends on the patient’s capability and behavior if patient is ready

nurse is the one who initiates and seeks out the client even when the patient is not willing to interact with the nurse by staying with the patient even if she has to stay quiet

nurse is available but does not impose herself to the patient to avoid her from being overwhelmed

role of the nurse that can do vital signs taking, assessing, communicating, and administering medications

role where the nurse is caring and nurturing. also sets limits on behaviors

role where the nurse has the responsibility and safeguard the patients rights

role where nurse is actively listening. not really giving advice. it is the ability to observe and be sensitive

nurse does not give advices but rather gives suggestions

role where nurse takes care of the ward, like the facilities, cleanliness, patients assignment, delegation, collaboration, channels of communication

promotive, preventive, curative, rehabilitative

objective understanding of the client. understand what the client feels and understands the meaning of the client’s behavior

what the client feels, you also feel. not therapeutic

appreciate client and respect uniqueness; atmosphere of presence

eye contact, paying attention to both verbal and non-verbal messages of the client, leaning forward to show that you are reaching out and ready to listen

interpersonal skills and communication skills + clinical skills

self awareness is a must prior to meeting the client

Nurse has achieved self awareness in which of the ff statements?

a. Every time people yell around me, I feel upset and withdrawn

b. When the pt yelled at me, I became speechless

c. With the pt’s tone of voice and stare, I got reminded of how my father would be so angry and this made me anxious

d. I thought it was rude for the pt to yell so I kept quiet

When the nurse is asked a personal question, which of these reactions indicate a need to introspect?

a. The client is simply curious

b. The nurse's right to privacy is being intruded

c. The client knows no other way to begin a conversation

d. Some patients are like children in seeking recognition from the nurse

self awareness other term that could be used in the board exam

develop self awareness first and gather initial information about the client to know how to interact/deal with the client for the first time

establish rapport and begin to build trust by introducing self and showing acceptance and being consistent

set a contract with the client like the expectations and parameters

do the initial assessment of the client; the client is the best source of information

formulate nursing diagnosis and priorities

plan related interventions and outcomes; encourages verbalizations of feelings

assist patient to learn more socially acceptable behavior; assist patient to learn more effective coping patterns; assist the client to develop insight

evaluate problems and goals and modify them as necessary

longest phase in the nurse client relationship

encourage verbalization of feelings that go with termination

evaluate the outcomes of the relationship

summarize what client learned in the relationship

Which among the ff indicates the termination phase of the N-C relationship?

a. The nurse and client evaluate outcomes of nursing interventions

b. The nurse and client evaluate outcomes of the relationship

c. The client and nurse share feelings of sadness related to parting

d. The nurse talks about the expectations in the relationship

Which of the following statements is indicated in the orientation phase of the nurse - client relationship?

a. What do you think caused your anxiety?

b. We’ve been talking about ways on how to decrease your anxiety

c. What did you learn in the past 6 weeks of our relationship?

d. I will be sharing to your doctor as well as to the other members of the HCT some of the things that we talked about today

the client avoids anything anxiety provoking about the self and in the relationship;

turns back on the nurse, avoids talking, does not come on time

a problem of the client; client transfers feelings originally attributed to a significant other in the past to the nurse in the present

can be positive or negative reaction

problem of the nurse

the nurse transfers her feeling from an original object of her feeling like a significant other to the client

can be positive or negative

spending time and interacting too much; feeling like the client is a friend

no place for this; bottomline is to accept the client

when you listen not only with the ears but you convey your listening presence

good morning, i’m your nurse, if there’s anything you need i’m just at the nursing station

Good morning julia(patient), you have taken a bath

I have noticed you have been pacing for a few minutes now

what would you like to talk about?

nodding and saying yes

i follow what you said

go on

and then?

making available the facts that the client needs

what do you mean by that?

will you say that again?

tell me more about that

your mother is not here, I am the nurse

that’s hard to believe

you look like you had a very sound sleep. that pill you were given last night is effective, isn’t it?

you claim you don’t drink, but you smell like alcohol

let’s o back to what you are saying about your mother

patient: do you thing I should tell the doctor

nurse: do you think you should?

describe the voice that you claim to hear

tell me if you are ready to move on

everything will be fine

wala yan! kaya mo yan!

how come that you are separated with your husband when you have so many children

asking further explanations beyond to the client’s readiness in sharing their story

attitude to withdrawn, apathetic, schizophrenia; to the shy, isolated and aloof

tender loving care

attitude to paranoid clients

attitude to the depressed with suicidal tendencies to help turn his hostility outward

make them work on a monotonous, ungratifying, repetitive work so they could have something else to think about

attitude to the manipulative and demanding(the alcoholics, drug addicts, passive individuals); be firm and consistent to them

for them to learn that manipulation is unrewarding and teach them to grow up and take responsibility by explaining rules and regulation

attitude to the assaultive and combative

never approach them alone or they may perceive you challenging them. use large groups to diffuse anger ad tell them you are not going to hurt them

pleasure

reality; balances id and superego

conscience

oral activities (smoking), dependency, aggression

obsessiveness, tidiness, meanness, untidiness, generosity

vanity, self-obsession, sexual anxiety, inadequacy, inferiority, envy

developmental task of young adult - 18 to 40 years old

developmental task of adulthood - 40 to 65 years old

developmental task of 65+ yrs old

sharing of wisdom

by sullivan: people affect other people

interactions with significant others affects self cocept

here and now; regards only at the present and not on the past

alcoholics must face the truth of them being an alcoholic in order to resolve their issue

factors in environmet influences development of personality

like growing up in chaotic environment may lead to development of maladaptive behavior

determining priorities; making assignments/delegation; working with the health care team; coordinating client care from admission to discharge; safety considerations

condition in which the human system responds to input that has disturbed its steady state; a feeling of emotional or physical tension that requires coping and adaptation

caused by unknown or poorly defined threat; only the specific person viewed the threat as threatening; subjective threat

e.g. people who have phobia

relates to a known understood; also associated with feeling of apprehension, dread, or impending doom

trigger is an objective threat

slight muscle tension, slight fidgeting, butterflies in the stomach, energetic, good eye contact

occasional slight irritability and confident (because he feels like thing under his control)

alert, aware of the surrounding, concentrated, accurate perceptions, logical reasoning and good problem solving

he is at his best

difficulty sitting still for a long time, moderate muscle tension, increased bp, pr, rr, dry mouth, HA, startle reflex, slight perspiration, periodic slow pacing, increased rate of speech

decreased confidence, on edge, increased irritability

narrowed perception, problem solving and reasoning can still be done, selective inattention

encourage verbalization and find an outlet, assist in problem solving

preparation for fight or flight response, resistance; extreme muscle tension, increased perspiration, continuous rapid pacing, trembling, loud and rapid speech, poor eye contact, somatic symptoms (N/V/D)

difficulty focusing even with assistance, disorientation, ineffective reasoning and problem solving

provide emotional support to the client, stop any efforts at teaching or problem solving, manage the anxiety first. medication may be needed

actual fight or flight response, immobilization, suicide attempt or violence, eyes fixed, hysterical or mute, incoherent

feeling overwhelmed, disorganized/irrational perception, out of contact with reality, delusion, personality disorgaization

accompany client, place client in a safe, quiet and controlled environment

safety is priority; present reality

girl who was raped was found on a very dark street by a police, the police asked “what happened to you?”, the girl says back “ayaw ko po pagusapan”

a 5 y.o. girl was sexually molested, when she grew up, she ends up hating men but does not understand why

girl who was raped was asked by the police, “ano ba pangalan mo bat ka andito mag isa?”, the girl replied “hindi ko maalala pangalan ko”

son who has a father who had a stroke and is now seriously ill, was the asked by mother, “how is your father?”, without any emotion, the son responds by “the doctor said that daddy is seriously ill because he has a clot in his brain”

child who used to be the youngest now has a baby sister, the child now starts drinking again from a botthle

person carries over the behavior that is expected of an earlier stage of development

a student idolizes a teacher therefore he imitates the way the teacher dresses and style but his traits are still his own

schizophrenic client states, “I am Julius Caesar”, and then acts, dresses and talks like julius ceasar. he wants to be called by the name of the person he/she imitates

also when the client swallows all anger and directs it to self is an act of suicide. instead of directing anger towards others, he holds it to himself and hurts himself

you hate a classmate but you cannot kick the classmate in his face so you kick his chair instead (a less threathening object)

the client believes that someon is plotting to kill him, but in fact, the client is the one who wants to kill the other person

a parent who works all day and deprives children of quality time, when she comes home she gives her children lots of gifts to mitigate the fact she cannot give attention to her children

you have a colleague you are not fond of so whenever you talk about that person, you are all praise but deep down you uncosciously hate that person

a student is not very well in terms of acads but is an excellent athlete

when carie was anxious, she developed physical manifestation such as headache and body pain

a person has strong feelings of inadequacy and powerlessness, but he owns a gun which serves as a like a feeling of power

carie wants to become a billionaire. instead, she worked full time to become a millionaire because it would be more attainable for her

manny has a lot of anger, so he became a boxer so he could release his anger through an acceptable sport

carie was helping with doing the dishes. when her sister asked why isn’t she helping, she replied that she is doing her acads but in reality she was just sleepy

a friend got into an MVA and needed a leg amputation. instead of getting emotional about it, she would tell herself that least she is alive

carie spent 600 pesos on food but was not good. she still said it is worth it and refused to accept that it was not worth it

puberty, goes to school for the first time, going to work for the first time, getting married

unexpected death of a loved one, divorce, seperation

violence, bombing, calamities, disasters

can predict outcome facing a crisis situations

these are individuals perception of the event, situational support, coping mechanisms

“hindi ko na alam anong gagawin ko. Gulong gulo na ako”