Any study tips for mental health nursing?

kwagner_51 · Mar 7, 2005

Well, I am just getting ready to start my psych rotation. I am having problems with the therapeutic communications. :uhoh3: :uhoh3:

A friend of mine, who graduated in 2001, told me to pick the answer I think is right and then circle the EXACT opposite.

For example, A lady has a 2 hr. handwashing ritual that is interfering with her nutritional status [breakfast]. What do you as the nurse do?

a.) Get her up earlier, so she can do her ritual and still eat breakfast on time,

B.) Try to help her overcome her compulsion.

I answered b.) and missed it!!!!

The correct answer according to the Hesi test is a.)!!!!

So, my advice is read the questions, answer them they way you normally would, then pick the exact opposite answer.

This is what I plan on doing!!

Hope this helps!!

_______________________________________________

In His Grace,

Karen

Failure is NOT an option!!

Aneroo, LPN · Mar 7, 2005

Need help too. I am hating psych nursing right now. Maybe it's the bad case of senioritis I have. Maybe it's some of the instructors. Either way, I don't like it. I start clinicals next week for psych.... Way nervous, but at least I won't have to wear uniforms. I think our biggie with tests is that they are so wordy. I can handle the words, but I read into questions too much. -a

Altra, BSN, RN · Mar 7, 2005

OK, I'm in the minority here ... but I LOVED psych, and I didn't think I would like it at all. :chuckle

When studying, reading test questions, and interactions, it's helpful to always think about the person's anxiety level/stress response. This is the key. In general, there aren't any "cures" for mental illness, except possibly transient depression r/t an adjustment disorder. Psych/mental health nursing is about helping to MANAGE those illnesses - with meds, with group & individual counseling, with education, and with lifestyle changes & stress management. So in the handwashing ritual question noted above ... a person with OCD doesn't just "overcome" their need to repeatedly & excessively wash their hands - the compulsion is their maladaptive response to stress. Initial inpatient treatment of OCD includes allowing the patient as much time as necessary to complete their rituals (to make them feel safe & decrease anxiety), then gradually decreasing the time allotted for these rituals while hopefully increasing their awareness of the anxiety that leads to the compulsive ritual.

HTH :)

jenrninmi, MSN, RN · Mar 7, 2005

OK, I'm in the minority here ... but I LOVED psych, and I didn't think I would like it at all. :chuckle
When studying, reading test questions, and interactions, it's helpful to always think about the person's anxiety level/stress response. This is the key. In general, there aren't any "cures" for mental illness, except possibly transient depression r/t an adjustment disorder. Psych/mental health nursing is about helping to MANAGE those illnesses - with meds, with group & individual counseling, with education, and with lifestyle changes & stress management. So in the handwashing ritual question noted above ... a person with OCD doesn't just "overcome" their need to repeatedly & excessively wash their hands - the compulsion is their maladaptive response to stress. Initial inpatient treatment of OCD includes allowing the patient as much time as necessary to complete their rituals (to make them feel safe & decrease anxiety), then gradually decreasing the time allotted for these rituals while hopefully increasing their awareness of the anxiety that leads to the compulsive ritual.
HTH :)

Great job explaining it!! I enjoyed psych as well (not the clinical part of it, but the theory).

crb613, BSN, RN · Mar 7, 2005

OK, I'm in the minority here ... but I LOVED psych, and I didn't think I would like it at all. :chuckle
When studying, reading test questions, and interactions, it's helpful to always think about the person's anxiety level/stress response. This is the key. In general, there aren't any "cures" for mental illness, except possibly transient depression r/t an adjustment disorder. Psych/mental health nursing is about helping to MANAGE those illnesses - with meds, with group & individual counseling, with education, and with lifestyle changes & stress management. So in the handwashing ritual question noted above ... a person with OCD doesn't just "overcome" their need to repeatedly & excessively wash their hands - the compulsion is their maladaptive response to stress. Initial inpatient treatment of OCD includes allowing the patient as much time as necessary to complete their rituals (to make them feel safe & decrease anxiety), then gradually decreasing the time allotted for these rituals while hopefully increasing their awareness of the anxiety that leads to the compulsive ritual.
HTH :)

I'm with you I loved Psych & plan on working in this area! your explanation was very good! I would suggest to the poster having a hard time with Psych to learn the diagnostic criteria for the illiness, meds to use, s/e of meds,cognitive/group therapy & therpapeutic communication. Ex. Bipolar merry mood, increased activity (need little sleep, food), bad judgments (say what they think), catastrophic consqnces.

Dress-often bizarre, alot jewerly, makeup (wear wedding dress & go to ER).Speech loud/rapid.Communication with them- no open ended questions (will go on & on) use short clear sentances & keep them on track. Meds- Lithium used alot watch for toxicity. Sxs nausea/vomiting,polyuria, muscle wkness,ataxia, seizures, stupor.Monitor blood levels of Lithium 0.5-1.5 meg/l is target, also no sodium restricted diet, need alot of water, decreased stimuli non competitive activities, use finger foods because they are always on the move. You get the idea & then when you kinda have a picture of the illness it makes the questions alot eaiser. I hope this helps & Good Luck

twinmommy+2, ADN, BSN, MSN · Mar 7, 2005

Whats helping me so far is putting everything into categories.

Anxiety group (things treated with anti anxiety meds)

Post Traumatic Stess disorder

Generalized anxiety disorder

OCD

so on and so on

Group things up and it might not seem so overwhelming. Group up the anxiety, depression, mood disorders (bi polar), psychosis disorders (schizophrenia, schizoaffective, ect), nutritional disorders (bulemia, anorexia, over eating, ect) which can sometimes be placed in the anxiety or depression group since it seems to be the same biological element in the brain that goes haywire in these people. There are groups of meds for each group like for psychosis patients you got atypicals and typicals, meds for the side effects.

Then think about for each group what special conciderations do you have. Like suicidality, bipolar patients have a higher suicidality than major depressive patients because of their swing back of energy when they move into manic stage.

I'm with you guys on the "nope, not for me" thing. Two more weeks and I'm out and on to another med/surg class.

Tony35NYC · Mar 9, 2005

The big things with our psych instructor were: therapeutic communication, safety, meds, anxiety, mania, and maslow's pyramid. And about 80% of it was communication (i.e. what would be the nurse's best response...) She swears that these are the things that the NCLEX guys mostly test on year after year for integrated psych questions, and I found similar tips in the Kaplan review book.

What really helped me to understand psych is that I borrowed non-academic healthcare books and videos from the library about the various mental health condition. Somehow, it all stuck in my mind when I used these because they make these materials in plain English so that anybody can easily understand whats going on. The problem I had with the psych textbook (and many other textbooks for that matter) is that the author goes out of his/her way to demonstrate why they have a PhD title behind their name, and they use a lot of unnecessary words that are just too much. try watching videos about OCD, mania, schitzophrenia, etc., and see it if that helps you to understand the stuff better.

Wen83 · Mar 9, 2005

Another test coming up next week :uhoh3: Although I have a feeling it'll be better than the last-- I have more of an idea of what's going to be thrown at me haha. Anyways, I really appreciate all the replies!

-Wendy :redpinkhe

Nursetob2005 · Mar 10, 2005

Personally, When I took psyc last semester, I felt that it is a totally different way of thinking. Thinking outside of the box I think is what they kept telling us. Don't think about fixing them like you would with a med surg or surgical patient. it is a little bit more complicated than those patients.

Hope thats a little bit of an insight.

UTRN2005 · Mar 10, 2005

Personally, When I took psyc last semester, I felt that it is a totally different way of thinking. Thinking outside of the box I think is what they kept telling us. Don't think about fixing them like you would with a med surg or surgical patient. it is a little bit more complicated than those patients.
QUOTE]
Agreed. You have to separate psych and med-surg in your head. The main topics like others have mentioned are safety, coping with illness, sign and symptoms, medication management, and communication. Again you cannot "fix" a lot of these disorders, you have to teach coping. For the OCD example if she is having difficulty meeting nutritional needs, helping her to avoid her compulsion will not fix her nutritional needs--it will only make her anxious. But waking her up earlier will allow her to deal with her compulsion and get to breakfast with enough time to eat. Another example we got a lot was if someone is paranoid about the food do you a) tell them no one is trying to hurt them or b) provide them with pre-packaged sealed food. The answer is B. You will not be able to convince a paranoid person that there is no one after them. But you can provide them with selaed food that will meet their nutritional needs and give them the security that their food has not been poisoned.