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§ Remain competent
§ Maintain a current knowledge base
§ Practice at a level appropriate for their Education
§ Practice unimpaired by drugs, disability, or illness.
§ There has to be a formal petition filled out.
§ Physician assessment, at least one but maybe two.§ A determination is made during a court hearing.
1. If the Public becomes endangered.
2. If the client is transferred to another facility.
3. If the clients attorney, law enforcement, or court request information.
occurs when a client’s space, body, or belongings are violated.
1. The care provider owed a duty to a client.
2. The care provider did not carry out the duty (breach).
3. There must be a proximate cause (injury as a result of the action or inaction).
4. Actual loss or damage resulted from the actions.
1. Do no harm.
2. Accept each client as a whole person.
3. Develop mutual trust.
4. Explore behaviors and emotions.
5. Encourage responsibility.
6. Encourage effective adaptation.
7. Provide consistency.
receiving what is being offered. Accepting the person, not the behavior.
you have to care for yourself first before you will be able to care for the clients.
speaks constantly, shifting between loosely related topics.
can be answered in a few short words. Better at increasing patient participation and interaction. Ex. “How?” “Why? – be careful using this it could put them on the defensive side.” (If it begins with why it’s probably not the right choice.) “Tell me more about…” (The best answer.)
II. Offer at least two possible interpretations of the behavior.
when the nurse gives simple or meaningless responses to patients. Ex. “How are you feeling about leaving the hospital today?”
o Essential Elements or Dynamics:
- This phase stops when the testing stops, reliability is established and trust is gained.
§ The client actively working on issues to solve problems and manage daily affairs.
§ They are trying to reach the goals of their contract.
§ Want to identify past behaviors and patterns that have been effective for coping and help them establish positive coping behaviors.
§ They will be practicing and trying out new behaviors.
§ May see that the client appears shameful or very vulnerable during this phase. Mentally they will be very, very weak.
§ Will see a lot of growth and resistance. They will try to test us during this phase. Use limit setting when in this phase and stick to the contract.§ Remind them of the Termination Date.
§ Assist client to review and summarize their work, what was learned and to transfer thus learning to interactions with others.
§ Concluding or ending the relationship.
§ Will occur when the goals are met.
§ Most clients respond in a negative way. Want them to express this feeling and to talk about it.
§ May respond with regression (returning to their old behaviors), Could have withdrawal (may start missing appointments at the end or deny that they need help anymore), and continuation (where they keep bringing up new problems).
§ Help them express and cope with their sense of loss. May be hard and take some time. Remind them of their progress. Encourage them and talk to them about ways to be healthy and to continue on with their lives.
§ Milieu should be purposeful and planned to provide safety from physical danger and emotional trauma.
§ Should facilitate a homelike atmosphere with privacy.
§ Still provide physical needs.
§ Milieu should promote opportunities for interaction and communication.
§ Milieu should also provide a testing ground for new behaviors while the client takes responsibility for their actions.
§ Have to be consistent when setting limits.
§ Need to be encouraged to participate in activities.
§ Provide respect and dignity.
§ Anyone working in the Milieu should convey an attitude of acceptance and optimism.
§ It depends on the person’s perception of the event.
§ A crisis occurs when usual coping mechanisms fail.
§ Self-Limiting or only last a short time. Typically 24-36 hours but it could last up to 4-6 weeks.
§ Usually affects more than one person.
o Advantages: they don’t feel isolated, they can gain from others, usually groups are cheaper, learning multiple ways of solving problems, and you gain a reference group.
o Disadvantages: feel like your privacy is being violated, and it might turn into a private session when the therapist focuses on only one person.
· Encourages the patient to face a fear without engaging in the accompanied behavior.
· based on principle that muscle tension is related to anxiety and if tense muscle can be made to relax then anxiety will decrease.
teaches the patient how to control their autonomic functions.
Can cause fatigue, sedation, dizziness, orthostatic hypotension.Very likely to cause physical and psychological dependence
BuSpar(buspirone):not considered a benzo
Tricyclic (TCA): are not the first choice
never given to a suicidal client
Work on levels of norepinephrine and serotonin.Can cause dry mouth, constipation, sedation, drowsiness, dizziness, orthostatic hypotension, weight gain, and tachycardia
aged cheeses, avocados, bananas, beer, broad beans, dried sausage, fish, liver, meats prepared with tenderizing, poultry, raisins, red wine, sour cream, yogurt, yeast extract, chocolate.
SSNRIs: Selective Serotonin/ Norepinephrine Inhibitors
Can cause nausea, dry mouth, dizziness, sedation, sweating, anorexia, monitor blood pressures
Weight loss greater than 15 % of the minimum normal weight for age and height.
· compulsive rapid ingestions of large quantity of food over a short period of time. (Nagging) followed by inappropriate behaviors to rid the body of excess calories, such as: self- induced vomiting, miss use of diuretic or enemas.
o Binge but don’t purge
o Associated with obesity
o >20% of their body weight
Sleep walking and sleep eating
Persistent eating of non-food itemsDefinition
Congenital Disorder usually present from birthCauses a relenting feeling of hunger, they are never full.
Have low muscle tone, and short stature.
The involuntary exclusion of a painful or threatening though or feeling.
Condition where a person experiences excessive and unrealistic worry and anxiety about two or more life circumstances for at least six months.
Extreme fear that you can’t control.
Diagnosed when the client has recurrent unexpected panic attacks, followed by at least one month of persistent concern or worry about future attack
people avoid social situations as a result of fear of humiliation.
Rapidly and repeatedly exposed to the fear until anxiety decreases.
o Obsession: repetitive thought, urge or emotion.
o Compulsion: repetitive act or behavior that may appear purposeful.
-Have to be done to reduce anxiety.
o Flashbacks: vivid recollection of the event that can last second, to a half hour or longer where the person may relieve and act out the traumatic event. Can be life threatening.
o Night mares.
o Emotional numbness.Sleep disorders
o Body complaints.
o Anxiety and irritability.
o Outburst of anger.
o Feelings of intense guilt.
o Anniversaries trigger events.
o Individually psychotherapy, group therapy, systematic, teaches relaxation exercises, bio feedback.
o May use medication: Bezos’s
o Watch for dependency with Benzo’s
psychological disorders in which a patient experiences physical symptoms despite underlying medical condition that can explain them.
Chronic syndrome that is characterized by multiple symptoms affects multiple organ symptoms that can’t be explained medically.Common complaints: GI, Pain, Neurological issues.
when person has a persistent fear or belief that they have a serious disease even when all diagnostic tests have been negative & reassurances have been given by physicians. Similar to somatization. Tend to “doctor shop” because they do not feel the
when a person has a persistent fear or belief that they have a serious disease, even when all test have been negative and reassurances have been given.
the disruption of integrated function of consiousness, memory, identity, or perceptions of the environment. very rare
body dysmorphic disorder
client is preoccupied with imagined defect in appearance when there is no abnormality.
where the person experiences pain without a physical basis for the pain.
separation of one's emotions from a situation. soldier casually describes the battle which he lost a leg.
where patient has sense of detachment from their self. Feels like they are outside of their body or mind.
can cause hypertensive crisis
why is it important to not give stimulants with MAOIs
person's ability to recall important personal information b/c it is anxiety provoking and cannot be explained as ordinary forgetfulness
dissociative amnesia where pt. blocks memory of specific time period
dissociative Identification disorder
2 or more fully developed distinct and unique personalities within the same person
dissociative fugue disorder
assumption of new ID in a new environment.
hard to diagnose and treat
people who avoid all situations that require interpersonal contact
person is very arrogant. need for consistent admiration and attention
inability to function independently
emotional, attention seeking behaviors
instability of affect, I'D and relationships. Cyclical personality
very aggressive personality, manipulative.
emotional unattachment and detachment from social relationships. unable to form relationships.
mistrust or suspicion of others
abnormal or highly unusal thoughts, perceptions, speech, and behavior patterns.
characterized by depressed mood, or cycles of depressed and elated mood and feelings of hopelessness
moderate depression. occurs for 2 years before diagnosis. has depressed mood combined with normal mood
recall memory about some but not all of a specific time period
loss of all memory about a past life
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