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

A patient with PTSD begins to dissociate during a conversation. Which grounding technique can the nurse use?

  1. AAsk her to name things she can see, hear and touch in the room right now
  2. BAsk her to close her eyes and think back to the worst moment of the trauma
  3. CAsk her to describe the traumatic event in as much detail as she can
  4. DLeave her alone until the episode has passed on its own
2.Kejururawatan kesihatan mentalSukar

A new nurse delegates several tasks to a healthcare assistant. Which delegation shows a need for further teaching?

  1. AAsking the assistant to take routine vital signs of a stable patient
  2. BAsking the assistant to help a patient with personal hygiene
  3. CAsking the assistant to decide whether a patient needs a second dose of a PRN sedative
  4. DAsking the assistant to sit with a calm patient during a group art activity and report any concerns
3.Psikologi klinikalSederhana

Klozapin lazimnya dikhaskan untuk skizofrenia tahan rawatan kerana:

  1. AIa hanya berkesan pada gejala negatif
  2. BIa tidak boleh diambil sebagai tablet
  3. CIa antipsikotik yang paling kurang berkesan, jadi ia pilihan terakhir
  4. DIa boleh menyebabkan agranulositosis, jadi pemantauan darah berkala diperlukan
4.Psikologi klinikalSukar

Dalam model kognitif kebimbangan sosial Clark dan Wells, faktor manakah yang mengekalkan kebimbangan?

  1. ADorongan seksual tertindas dari zaman kanak-kanak
  2. BPerhatian berfokus pada diri dan tingkah laku keselamatan yang menghalang penyangkalan ketakutan
  3. CParas dopamin yang rendah dalam lobus frontal
  4. DPeneguhan positif daripada dipuji di khalayak ramai, yang memberi ganjaran kepada tingkah laku cemas itu
5.FarmakologiSederhana

How should a patient store sublingual glyceryl trinitrate (nitroglycerin) tablets?

  1. ALoose in a shirt pocket close to the body for quick access
  2. BIn the original dark glass bottle, away from heat, light and moisture
  3. CIn a plastic weekly pill box with other tablets
  4. DIn the fridge in a damp, open container to keep them fresh and cool
6.FarmakologiSukar

A patient who has had several courses of bleomycin develops a dry cough and worsening breathlessness. What should the nurse suspect?

  1. AHeart failure from bleomycin
  2. BAsthma caused by anxiety
  3. CPulmonary fibrosis from bleomycin
  4. DA normal effect that will pass in a day

3Larutan

1.Kejururawatan kesihatan mental

Jawapan: A · Ask her to name things she can see, hear and touch in the room right now

Mengapa ini jawapannya

Grounding techniques use the senses to bring the person back to the here and now. Asking for details of the trauma during dissociation can deepen distress.

Jawapan

A · Ask her to name things she can see, hear and touch in the room right now
2.Kejururawatan kesihatan mental

Jawapan: C · Asking the assistant to decide whether a patient needs a second dose of a PRN sedative

Mengapa ini jawapannya

Evaluating the effect of a medicine and deciding on further doses require clinical assessment and cannot be delegated. The other tasks are routine and suitable for a trained assistant.

Jawapan

C · Asking the assistant to decide whether a patient needs a second dose of a PRN sedative
3.Psikologi klinikal

Jawapan: D · Ia boleh menyebabkan agranulositosis, jadi pemantauan darah berkala diperlukan

Mengapa ini jawapannya

Klozapin berkesan apabila antipsikotik lain gagal, tetapi ia boleh menyebabkan penurunan neutrofil yang berbahaya, jadi pesakit memerlukan ujian darah berkala.

Jawapan

D · Ia boleh menyebabkan agranulositosis, jadi pemantauan darah berkala diperlukan
4.Psikologi klinikal

Jawapan: B · Perhatian berfokus pada diri dan tingkah laku keselamatan yang menghalang penyangkalan ketakutan

Mengapa ini jawapannya

Orang yang bimbang secara sosial menumpukan perhatian pada imej dalaman yang negatif tentang diri sendiri dan menggunakan tingkah laku keselamatan. Tingkah laku ini menjadikan mereka kelihatan ganjil dan menghalang mereka belajar bahawa hasil yang ditakuti jarang berlaku.

Jawapan

B · Perhatian berfokus pada diri dan tingkah laku keselamatan yang menghalang penyangkalan ketakutan
5.Farmakologi

Jawapan: B · In the original dark glass bottle, away from heat, light and moisture

Mengapa ini jawapannya

Nitroglycerin tablets lose potency when exposed to light, heat, air and moisture. They are kept in their original tightly closed dark container, and expired tablets are replaced.

Jawapan

B · In the original dark glass bottle, away from heat, light and moisture
6.Farmakologi

Jawapan: C · Pulmonary fibrosis from bleomycin

Mengapa ini jawapannya

Bleomycin can cause pneumonitis and pulmonary fibrosis, especially at higher cumulative doses. New respiratory symptoms are reported, and lung function may be monitored.

Jawapan

C · Pulmonary fibrosis from bleomycin

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