Kejururawatan Kesihatan Mental: pek ulang kaji kilat

Lembaran formula, langkah kaedah utama untuk setiap topik dan 6 soalan latihan, dengan penyelesaian penuh di bahagian belakang.

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1Formula dan kaedah

Kejururawatan kesihatan mental

Kaedah

  1. Tentukan sama ada terdapat risiko segera: bunuh diri, keganasan, kecemasan akibat ubat atau penyakit fizikal.
  2. Bertindak untuk keselamatan dahulu: perhatikan, alihkan alat yang boleh digunakan, redakan ketegangan, hentikan ubat yang berbahaya, dapatkan bantuan.
  3. Pilih respons terapeutik: akui perasaan, kemukakan realiti, elakkan jaminan palsu dan soalan “mengapa”.
  4. Hormati hak: pilihan yang paling kurang menyekat, persetujuan dan kerahsiaan beserta hadnya.

2Soalan latihan

1.Kejururawatan kesihatan mentalSederhana

How should the nurse position herself when talking to an agitated patient?

  1. AAt a safe distance, slightly to the side, with a clear exit available
  2. BDirectly face to face, as close as possible, to show confidence
  3. CBetween the patient and the wall, so the patient can leave easily
  4. DBehind the patient and close to him, so that the patient does not feel threatened by eye contact
2.Kejururawatan kesihatan mentalSukar

A patient with OCD asks the nurse many times an hour, "Are you sure the door is locked?" What is the most helpful approach in his care plan?

  1. ALock and unlock the door in front of him each time he asks
  2. BTell him firmly that if he asks about the door again, he will lose his privileges on the ward for the day
  3. CAnswer once, then follow the agreed plan to limit repeated reassurance
  4. DReassure him every time he asks, as often as he needs
3.Psikologi klinikalSederhana

Temu duga motivasi terutamanya digunakan untuk membantu klien yang:

  1. AMemerlukan diagnosis rasmi untuk insurans
  2. BBerasa ambivalen tentang mengubah tingkah laku seperti minum alkohol
  3. CTakut kepada satu objek tertentu
  4. DMempunyai halusinasi yang memerlukan ubat segera dan rawatan hospital
4.Psikologi klinikalSukar

Seorang lelaki yang mendengar perkataan "thud" dimasukkan ke hospital, kemudian berkelakuan normal. Kakitangan merekodkan catatan notanya sebagai "terlibat dalam tingkah laku menulis". Dalam kajian Rosenhan, apakah yang digambarkan oleh ini?

  1. APseudopesakit mengalami gejala sebenar di hospital
  2. BMembuat nota ialah gejala skizofrenia yang diiktiraf, jadi kakitangan betul merekodkannya sedemikian
  3. CKakitangan memalsukan rekod dengan sengaja
  4. DSebaik sahaja label dikenakan, tingkah laku normal cenderung ditafsirkan sebagai tanda gangguan
5.FarmakologiSederhana

What should the nurse teach a patient starting nitrofurantoin?

  1. ATake it with food, and the urine may turn dark yellow or brown
  2. BExpect blue urine, which shows that the drug is working well
  3. CTake it on an empty stomach with an antacid
  4. DStop it as soon as the burning settles
6.FarmakologiSukar

Why are oral liquid medicines drawn up in dedicated oral or enteral syringes that do not fit IV connectors?

  1. ABecause IV syringes cannot hold liquids
  2. BTo prevent oral liquids being given intravenously by mistake
  3. CTo keep the medicine sterile for injection
  4. DTo make the oral dose more accurate than a dose given through an IV syringe

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: A · At a safe distance, slightly to the side, with a clear exit available

Mengapa ini jawapannya

Standing at an angle and outside arm's reach is less confrontational and safer. The nurse makes sure neither she nor the patient is trapped, so both have an exit.

Jawapan

A · At a safe distance, slightly to the side, with a clear exit available
2.Kejururawatan kesihatan mental

Jawapan: C · Answer once, then follow the agreed plan to limit repeated reassurance

Mengapa ini jawapannya

Seeking reassurance relieves anxiety only briefly and keeps the OCD cycle going. In line with exposure and response prevention, the team agrees to limit reassurance and support the patient to tolerate the anxiety.

Jawapan

C · Answer once, then follow the agreed plan to limit repeated reassurance
3.Psikologi klinikal

Jawapan: B · Berasa ambivalen tentang mengubah tingkah laku seperti minum alkohol

Mengapa ini jawapannya

Temu duga motivasi (Miller dan Rollnick) ialah gaya kolaboratif yang menyelesaikan ambivalens dan mengukuhkan motivasi klien sendiri untuk berubah, digunakan secara meluas dalam ketagihan.

Jawapan

B · Berasa ambivalen tentang mengubah tingkah laku seperti minum alkohol
4.Psikologi klinikal

Jawapan: D · Sebaik sahaja label dikenakan, tingkah laku normal cenderung ditafsirkan sebagai tanda gangguan

Mengapa ini jawapannya

Rosenhan berhujah bahawa label "skizofrenia" menyebabkan kakitangan melihat tingkah laku biasa sebagai patologi. Pengkritik seperti Spitzer berhujah bahawa kajian itu tidak membuktikan diagnosis tidak sah.

Jawapan

D · Sebaik sahaja label dikenakan, tingkah laku normal cenderung ditafsirkan sebagai tanda gangguan
5.Farmakologi

Jawapan: A · Take it with food, and the urine may turn dark yellow or brown

Mengapa ini jawapannya

Nitrofurantoin is taken with food to reduce nausea and can harmlessly darken the urine. The full course is completed, and cough, breathlessness or numbness should be reported.

Jawapan

A · Take it with food, and the urine may turn dark yellow or brown
6.Farmakologi

Jawapan: B · To prevent oral liquids being given intravenously by mistake

Mengapa ini jawapannya

Wrong-route errors, such as giving an oral liquid IV, can be fatal. Syringes with connectors that cannot fit IV lines make this error physically difficult.

Jawapan

B · To prevent oral liquids being given intravenously by mistake

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