NR 326 Week 2 Insights and Assessments

NR 326 Week 2 Insights and Assessments

Student Name

Chamberlain University

NR-326: Mental Health Nursing

Prof. Name:

Date

Clinical Manifestations of Mental Health Alterations

Mental health alterations often manifest through a range of observable psychological and behavioral symptoms rather than physical indicators. Disorganized appearance, exaggerated self-importance, rapid or pressured speech, and avoidance of direct eye contact may signal deteriorating mental well-being. While an irregular heartbeat is a significant physical finding, it typically does not indicate changes in mental status. Individuals with major depressive disorder frequently exhibit diminished self-care, feelings of hopelessness, and low self-worth. However, perceptual disturbances (hallucinations, delusions) and poor impulse control are more indicative of bipolar disorder.

Mental Health Nursing Assessment

Nursing assessments in psychiatric settings emphasize psychosocial, cognitive, and emotional indicators. Nurses evaluate behaviors and emotional responses using validated tools rather than relying solely on physical instruments like stethoscopes or reflex hammers. Common assessment observations include hallucinations, inappropriate behaviors, hygiene neglect, withdrawal, substance abuse, suicidal ideation, and encounters with law enforcement.

Table: Common Assessment Findings in Mental Health Settings

Baseline evaluations are crucial in identifying symptom trends. Consistent documentation using these tools helps track changes in emotional states and informs care planning.

Goals of Mental Health Nursing

Mental health nurses aim to support patients in managing environmental stressors by encouraging adaptive thought patterns, emotional responses, and behaviors. Effective interventions include building therapeutic relationships, promoting client autonomy, using crisis management techniques, and supporting recovery. Establishing rapport early helps create a safe space for healing. Ultimately, the nurse’s goal is to promote and sustain both client and personal mental wellness.

Professional Identity in Mental Health Nursing

Professional identity in psychiatric nursing stems from the nurse’s awareness and application of their own emotions, beliefs, and behaviors during client care. This concept, referred to as “use of self,” is best developed through tools such as personality inventories rather than lifestyle modifications like healthy eating or exercising.

Nursing Diagnoses in Mental Health

Accurate nursing diagnoses are foundational in determining effective interventions and maintaining professional boundaries. These diagnoses allow nurses to create individualized care plans based on symptoms and client needs.

Table: Common Mental Health Nursing Diagnoses

Environmental factors such as family dysfunction or strained relationships often influence these diagnoses. Additionally, underlying causes like trauma, relocation, or abuse contribute to these behavioral expressions.

Use of Survey Tools in Mental Health

Survey instruments provide standardized, validated methods to quantify mental health symptoms. They assist in diagnosis, treatment planning, and progress evaluation. Nurses use these tools to gather client-reported data and monitor changes over time.

Table: Examples of Validated Mental Health Tools

These tools ensure reliable symptom tracking and help justify clinical decisions, such as administering PRN medications. For instance, in opioid withdrawal, a nurse might document: “COWS score: 28; alprazolam administered as ordered.”

Common Nursing Interventions in Mental Health

Effective nursing actions in psychiatric care include:

• Crisis intervention
• Medication management
• Therapeutic communication (e.g., reframing, reassurance)
• Environmental adjustments (e.g., reducing stimuli, isolation if necessary)
• Team collaboration
• Activity engagement for distraction
• Removal from potentially harmful environments

These strategies reduce the risk of escalation and support emotional stabilization. Target outcomes may include appropriate behavior, factual understanding, emotional regulation, and independent self-care.

Role of the Case Manager

Case managers coordinate interdisciplinary meetings and develop discharge plans. Their focus is on continuity of care rather than routine clinical tasks like administering medication or monitoring vitals, which are typically performed by bedside nurses.

Crisis and Its Impact on Mental Health

A crisis is a sudden disruption that overwhelms a person’s coping mechanisms. Although often brief, a crisis can lead to significant psychological distress. Vulnerable individuals, especially those with pre-existing mental health conditions, are more prone to negative outcomes.

Characteristics of a Crisis

• Sudden onset
• Temporary disruption of equilibrium
• Ineffective coping mechanisms
• Potential for personal growth or psychological injury

Perception, support availability, and coping ability determine a crisis’s intensity. While some may view a situation as manageable, others may perceive the same event as catastrophic.

Phases of Crisis

Variables Influencing Crisis Severity

Three core factors shape how a crisis is experienced:

1. Perception of the Event: A person’s view of the event determines its impact.
2. Available Support: Those with strong support systems (family, financial stability) tend to fare better.
3. Coping Mechanisms: Past experience and learned coping strategies help mitigate crisis effects.

Demographics like age or education may influence vulnerability, but they are not primary predictors of crisis severity.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

Halter, M. J. (2022). Varcarolis’ foundations of psychiatric-mental health nursing: A clinical approach (9th ed.). Elsevier.

Townsend, M. C. (2023). Psychiatric mental health nursing: Concepts of care in evidence-based practice (10th ed.). F.A. Davis.

NR 326 Week 2 Insights and Assessments

Videbeck, S. L. (2022). Psychiatric-mental health nursing (9th ed.). Wolters Kluwer.