Introduction to Psychiatric Nursing

Psychiatric History? -Deinstitutionalization -Homelessness -History of Psychiatric Nursing Education

-What are the Benchmark periods in

-How Common is Mental Illness?

Psychotherapeutic Management Model

Clarifies and distinguishes the role of the
psychiatric nurse Three dimensions:
The therapeutic nurse-pt relationship (use of self) Psychopharmacology (use of drugs) Milieu management (use of environment)

please open the Keltner book on pg 15, 16

Determining Placement on the Continuum (pl open Keltner book

on pg 17)

-Initial contact Assess and refer to services that are:

Least restrictive Most effective Most cost-conscious Risk Assessment Phase: Occurs at Discharge: -Provide ongoing guidance to an appropriate level of care

Continuum of Care
Structured to provide services based on
the changing needs of the individual Services include:
Prevention Treatment Rehabilitation

Nursing Role:
Therapeutic Communication (being
Psychopharmacology (Assess, plan,
therapeutic)

implement, evaluate, administer, decide on prn medication, reevaluate) Milieu Management (safety, structure, norms, limit-setting, balance, environmental modification)

Models for Working with Psychiatric Patients (Keltner, pg 22-25 Tables

3-1, 3-2)

Psychoanalytic Model Developmental Model Interpersonal Model Cognitive Behavioral Model Reality Therapy Stress Adaptation Model
Defense Mechanisms

Legal Issues: The role of the RN

Key Terms:

- Patients Rights

Assault Battery False Imprisonment Informed Consent Voluntary Patients Involuntary Commitment Seclusion, Restraints Power of Attorney Negligence Duty to Care, Duty to Warn Others

Psychobiologic Bases of Behaviors

Importance of Brain Biology Significance and Role of 5 specific

Neurotransmitters in normal brain function as well in schizophrenia, depression, anxiety, and dementia Key Psychobiologic Assessment Issues for the Psychiatric Nurse

Neuroanatomy of the Brain

Function and Issues associated with
Frontal Lobes Temporal Lobes

The Role of Neurotransmitters in Mental Illness Schizophrenia Increase in dopamine Depression Decrease in serotonin Decrease in norepinephrine Anxiety Decrease in GABA Alzheimers Disease Decrease in acetylcholine

Continuum of Care (Decision Tree Keltner

pg 76 Figure 6-1)

Preventative Services (The role of Managed Care) Hospital-Based Care

Types of hospital-based care Discharge planning Psychotherapeutic management Programs Available Case Management Nursing Process Holistic Care (culture, spirituality)

Community-Based Care