Keperawatan Jiwa: paket kilat

Lembar rumus, langkah-langkah metode utama untuk setiap topik, dan 6 soal latihan, dengan pembahasan lengkap di bagian belakang.

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1Rumus dan metode

Keperawatan jiwa

Metode

  1. Tentukan apakah ada risiko yang mengancam saat ini: bunuh diri, kekerasan, kegawatan akibat obat, atau penyakit fisik.
  2. Bertindak untuk keselamatan lebih dulu: observasi, singkirkan sarana yang berbahaya, lakukan deeskalasi, hentikan obat yang merugikan, minta bantuan.
  3. Pilih respons terapeutik: akui perasaan, sampaikan kenyataan, hindari penghiburan palsu dan pertanyaan “mengapa”.
  4. Hormati hak pasien: pilihan yang paling tidak membatasi, persetujuan, dan kerahasiaan beserta batasnya.

2Soal latihan

1.Keperawatan jiwaSedang

A patient with narcissistic personality disorder demands that only the senior doctor should speak to him, because the nurses are "beneath him". What is the best approach?

  1. AArrange for only the senior doctor to see him from now on
  2. BRespond respectfully but firmly, and keep the same expectations as for other patients
  3. CAvoid him as much as possible, because he is rude and unpleasant to the nursing staff
  4. DTell him that he is not as important as he thinks he is
2.Keperawatan jiwaSulit

A patient with schizophrenia has marked negative symptoms. He stays in bed most of the day and neglects his hygiene. Which nursing approach is most helpful?

  1. AWait until he asks to join activities before involving him
  2. BLet him stay in bed, because negative symptoms cannot change
  3. CAgree a simple daily routine with small, achievable activities and give positive feedback
  4. DTell him firmly that he will lose his ward privileges unless he gets up and showers at once
3.Psikologi klinisSedang

Studi Rosenhan "On being sane in insane places" menimbulkan keraguan tentang:

  1. AValiditas diagnosis psikiatri
  2. BKeamanan antidepresan
  3. CEtika penelitian hewan
  4. DEfektivitas CBT
4.Psikologi klinisSulit

Bukti mana yang paling mendukung CBT sebagai penanganan gangguan kecemasan, bukan sekadar efek plasebo?

  1. ACBT lebih murah daripada obat
  2. BUji acak menunjukkan CBT mengungguli kondisi kontrol plasebo-perhatian yang kredibel
  3. CKlien mengatakan mereka menyukai terapisnya
  4. DCBT telah digunakan lebih dari lima puluh tahun
5.FarmakologiSedang

During a rapid infusion of vancomycin, a patient develops flushing and a red rash on the face, neck and upper body. What is the most likely cause and action?

  1. AA normal effect; increase the infusion rate to finish sooner
  2. BAcute kidney failure; stop all IV fluids and antibiotics at once
  3. CA sign that the infection is spreading; give a second dose
  4. DAn infusion reaction; stop or slow the infusion and inform the prescriber
6.FarmakologiSulit

A patient taking long-term hydroxychloroquine for lupus is advised to have regular eye examinations. Why?

  1. AThe drug stains the cornea blue
  2. BThe drug causes cataracts within a few weeks of starting
  3. CThe drug can cause retinal toxicity that may be permanent
  4. DThe drug raises pressure inside the eye

3Larutan

1.Keperawatan jiwa

Jawaban: B · Respond respectfully but firmly, and keep the same expectations as for other patients

Mengapa ini jawabannya

People with narcissistic personality disorder have a fragile self-esteem beneath the grandiosity. A consistent, respectful and non-defensive approach avoids power struggles and maintains the usual boundaries.

Jawaban

B · Respond respectfully but firmly, and keep the same expectations as for other patients
2.Keperawatan jiwa

Jawaban: C · Agree a simple daily routine with small, achievable activities and give positive feedback

Mengapa ini jawabannya

Negative symptoms such as avolition and anhedonia improve with structure, step-by-step goals and encouragement. Punishment or waiting for the patient to start on his own usually makes withdrawal worse.

Jawaban

C · Agree a simple daily routine with small, achievable activities and give positive feedback
3.Psikologi klinis

Jawaban: A · Validitas diagnosis psikiatri

Mengapa ini jawabannya

Pseudopasien yang mengaku mendengar satu kata dirawat dan ditahan berminggu-minggu, menunjukkan bahwa diagnosis dipengaruhi konteks. Metode studi ini kemudian dipertanyakan.

Jawaban

A · Validitas diagnosis psikiatri
4.Psikologi klinis

Jawaban: B · Uji acak menunjukkan CBT mengungguli kondisi kontrol plasebo-perhatian yang kredibel

Mengapa ini jawabannya

Menunjukkan keunggulan atas kontrol plasebo yang kredibel menyingkirkan faktor nonspesifik sebagai satu-satunya penjelasan. Banyak uji klinis dan meta-analisis melaporkan hal ini untuk CBT pada gangguan kecemasan.

Jawaban

B · Uji acak menunjukkan CBT mengungguli kondisi kontrol plasebo-perhatian yang kredibel
5.Farmakologi

Jawaban: D · An infusion reaction; stop or slow the infusion and inform the prescriber

Mengapa ini jawabannya

Rapid vancomycin infusion releases histamine, causing flushing and itching of the upper body (formerly called "red man syndrome"). It is managed by stopping or slowing the infusion, and sometimes with an antihistamine.

Jawaban

D · An infusion reaction; stop or slow the infusion and inform the prescriber
6.Farmakologi

Jawaban: C · The drug can cause retinal toxicity that may be permanent

Mengapa ini jawabannya

Hydroxychloroquine can damage the retina, and the risk rises with dose and duration. Regular screening allows the drug to be stopped before vision is seriously affected.

Jawaban

C · The drug can cause retinal toxicity that may be permanent

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